Week 11- Before leaving

It’s Hanna again.

The 11th week was just as challenging as the previous one, since I was losing the battle with time. There were still very many details which needed to be taken care of.

On Monday we would go to the dispensary to make some final observations and to check-up on some previous HBC patients. During the evening I needed to start writing reports.

Tuesday was another important day – we (Gasto and I) met Raizon and his aunt in KCMC in order to do the blood tests needed and to see the neurologist recommended by the Gabriella Center. We were very lucky to have gotten everything free in the KCMC. The Social Welfare Unit offers free medical check-up to orphans. Unfortunately the blood count machine was broken during that particular day, so we had to pay another fine trip to KCMC on Thursday.

Wednesday was my last day in Msitu Wa Tembo. In the morning Gasto and I went to the dispensary and we tried to implement the blood pressure (BP) measuring system once again. We gave an automatic BP machine and a colored table of  BP for diagnosing hypertension  to the dispensary as a gift. We had discussion with Dr Risiki about the treatment of hypertension in the dispensary.

Giving the BP machine and the chart to the dispensary.

Thursday was occupied by the revisit to KCMC. In the evening attempted to reorganize all the drugs left from the caravan and to make my best to finish the reports.  I also passed some important work to Paula which she kindly accepted.

Although the end was hectic and difficult, I would not exchange this experience for anything. None of the decisions during the last weeks were easy, but there is absolutely no charm in taking the easier option. 

Semana 11- Antes de marchar

Aquí Hanna de nuevo.

La semana 11 supuso un reto, al igual que la anterior, ya que veía que estaba perdiendo la batalla contra el crono. Todavía quedaban muchos detalles que tenían que ser cuidados.

El lunes, iríamos al dispensario a hacer algunas observaciones finales y el seguimiento de algunos pacientes previos de la atención domiciliaria. Por la tarde, me tocaba empezar a escribir informes.

El martes fue otro día importante – Gasto y yo nos encontramos con Raizon y su tía en ell hospital KCMC para hacer los análisis de sangre previos a ver a la neuróloga (recomendación del centro de rehabilitación Gabriella’s). Tuvimos la suerte de conseguir gratis todos estos servicios en KCMC ya que la unidad de bienestar social ofrece revisiones medicas gratuitas a los huérfanos. Por otra parte, debido a una avería en ese día en particular, tuvimos qu volver el jueves.

El miércoles fue mi último día en Msitu Wa Tembo. Por la mañana, Gasto y yo fuimos al dispensario e intentamos implementar la medición de presión arterial, una vez más. Como regalo, les dimos un medidor automático y una tabla de colores para diagnóstico de hipertensión. Pudimos compartir puntos de vista con la doctora Risiki sobre el tratamiento de la hipertensión en el dispensario.

En el dispensario, con el medidor automático y la tabla de hipertensión.

El jueves tras la repetición de la visita a KCMC, intenté reorganizar todas las medicinas que habían ido sobrando en caravanas y atención domiciliaria, para que puedan usarse más adelante, e hice lo posible por finalizar los informes. También pasé algo del trabajo a Paula, que acetó amablemente.

Aunque el final fuera frenético y difícil, no cambiaría esta experiencia por nada. Ninguna de las decisiones durante las últimas semanas fue fácil, pero no tiene ningún encanto tomar el camino fácil.

Week 10 – Home Based Care

The 10th week was a challenging one for me (Hanna). On Tuesday I would find myself saying goodbye to Julia and trying my best to complete the rest of the work which had been started. Luckily I had the support of my local team and of the previous medical students who were already back home. When facing difficult decisions, I could always rely on their feedback.

On Monday Gasto and I would take Raizon (the boy with cerebral palsy from Msitu Wa Tembo) to the Gabriella Children Rehabiliation Center (GCRC) for an evaluation. The center provided 5 days of free stay to Raizon and his grandmother. The evaluation was done by a pediatrician, physiotherapist and an occupational therapist. 

On Friday we would pick him up and take him back to Msitu Wa Tembo. We arranged another free evaluation week for Raizon, but in the meantime, the center emphasized the need of having a check-up in the Kilimanjaro Christian Medical Centre (KCMC) in order to rule out some diseases. On Friday we were accompanied by Paula, another volunteer who would continue the case after I had left. She was the best help.

 Raizon enjoying the walking device given by the Gabriella Rehabilitation Centre. On the picture you can also recognize the bibi (grandma) and Gasto.

Meanwhile, in addition to the rehabilitation centre, the main energy was also focused for the preparations of the third home-based care caravan which would happen on Saturday. Gasto, Veronica and I revisited all of the patients previously examined by Miranda. We tried to learn from our previous mistakes and to improve our work. Walking around the sun and trying to identify the patients was physically very exhausting, but regular lunch breaks in Veronica’s house saved us.

On Thursday we would meet with Dr Jackson and present the patients we had interviewed. Together we tried to predict the drugs needed for the caravan day and discussed the follow-up possibilities for some previous HBC patients.

On Saturday was the big day – the third HBC caravan. Everything was nearly perfect and by far my favorite day in Tanzania. Our calculations and efforts had been worth it. We managed to cover 15 patients in from 9.30 to 16.30. We worked efficiently and quickly on the field. It was perfect team work. I loved organizing every step of the caravan, however, there are still several issues to be addressed with this kind of intervention.  

HBC III. In the front (from the left) Dr Jackson, Godfrey, Hanna. In the back (from the left): Veronica and Rose. 

Semana 10- La atención domiciliaria

La semana 10 fue un reto para mí (Hanna). El martes, diría adiós a Julia y me encontraría haciendo lo posible por terminar el trabajo que habíamos empezado. Por suerte, contaba con el apoyo de mi equipo local y de los estudiantes de medicina que ya se habían ido a casa. Cuando me encontraba ante dificultades, siempre podía contar con su opinión.

El lunes, Gasto y yo llevaríamos a Raizon (niño de Msitu Wa Tembo con parálisis cerebral) al Centro de Rehabilitación Gabriella’s (GCRC), para una evaluación. El centro proporcionó 5 días de estancia gratuita para Raizon y su abuela. Pediatra, fisioterapeuta y terapeuta ocupacional se encargaban de la evaluación.

El viernes iríamos a buscarle y llevarle de vuelta a Msitu Wa Tembo. Acordamos otra semana de evaluación para Raizon, pero, antes de esta segunda, el centro insistió en tener una revisión en el hospital KCMC, para descartar algunas enfermedades. El viernes, nos acompañó Paula, otra voluntaria de TATU Project, que continuaría con el caso cuando yo me fuera. Ella fue la mejor ayuda.

 Raizon disfrutando el andador que recibió de GCRC. En la foto, puedes ver también a la bibi (abuela) y Gasto.

Mientras tanto, además de GCRC, la mayor energía se enfocó a las preparaciones de la tercera caravana de asistencia domiciliaria, que sería el sábado. Gasto, Veronica y yo visitamos a los pacientes que había sido previamente examinados por el equipo de Miranda. Intentamos aprender de los errores previos y mejorar nuestro trabajo. Andar bajo el sol y tratar de identificar a los pacientes fue una actividad agotadora, pero los almuerzos en casa de Veronica nos salvaron.

El jueves, nos encontraríamos con Dr. Jackson y presentaríamos los pacientes que habíamos entrevistado. Juntos, intentamos predecir los medicamentos que íbamos a necesitar el día de la caravana, y discutimos las posibilidades para seguimiento de pacientes previos.

El sábado fue el gran día – la tercera caravana de atención domiciliaria (HBC por el inglés Home Based Care). Todo fue prácticamente perfecto y de lejos mi día favorito en Tanzania. Nuestros cálculos y esfuerzos merecieron la pena. Conseguimos cubrir 15 pacientes desde las 9:30 a las 16:30. Trabajamos de manera eficiente y rápida sobre el terreno. Perfecto trabajo de equipo. Me encantó organizar cada paso de la caravana; sin embargo, hay todavía algunos aspectos ue replantear en este tipo de intervención.

Caravana de atención domiciliaria (HBC) III. Delante (desde la izquierda), Dr Jackson, Godfrey, Hanna. Detrás: Veronica y Rose.

Week 9- just two of us here in the field

 This week is the last one for some of us, and now, I am (Julia) the one in charge of tell you about new things!

Last week Luis, Jaime, Angela, Miranda and Parra finished their work in Msitu wa tembo. After many weeks of hard work, they went to Pangani, a coast village in northeast Tanzania for a well-deserved holiday. Asante team!

Hanna and I took turns working in the dispensary. We continued collecting data and learning more about their work there. The doctor, the nurses and the laboratory workers are a big help and they solve all our doubts.

I started the week working on this week´s seminar about hygiene. This subject may be simpler than the ones taught by my partners but it is important that the mamas understand that hygiene can be critical in their health. For this seminar some problems came about. This month is critical for the work in shambas (fields) so only 2 mamas were free for the seminar and just on Friday. Also that Saturday the big group of mamas had arranged a free day from the meeting to work in the shambas so they will perform the seminar another week. One more time our work teaches us to accept the problems and keep searching for new solutions.

Meanwhile Hanna took over the monitoring of the child with cerebral palsy and his reception in the Gabriella rehabilitation center that should happen on Monday the 25th. She visited the center and the director was so helpful and involved. We found out that they also help young people and that was good news for us since we know about some cases at Msitu wa tembo that would fit in this center. We will continue with the investigation!

In addition in our free times we visited other projects such as the English classes for the mamas and the Maasai jewelry group which TATU coordinates with the Maasai women in the community. And on the weekend we visited some incredible places that this country showed us such as Lake Chala and Majimoto oasis.

Sometimes this country surprises us with such a different way to have things happen, another part of the culture that we have to get used to and fit in to in order to end our projects on a good note. As Angela told us last week, sometimes it is difficult and usually we should change and readjust times, plans and thoughts, but pole pole (slowly) we are accomplishing our projects that will help this community. And you know what they say; the hardest work brings the greatest success!

Semana 9 - Ya quedamos menos sobre el terreno

¡Comienza la última semana para algunos de nosotros! Y ahora soy yo, Julia, la encargada de poneros al día.

La última semana Luis, Jaime, Ángela, Miranda y Parra terminaron su trabajo en Msitu wa tembo. Así que tras el duro trabajo, fueron a Pangani, un pueblo costero al noreste de Tanzania. Unas muy merecidas vacaciones. ¡Asante equipo!

Hanna y yo nos turnamos esta semana para trabajar en el dispensario. Seguimos tomando datos y descubriendo como funciona. La verdad es que la doctora, las enfermeras y las trabajadoras del laboratorio son de mucha ayuda y están abiertas a todas las preguntas que queramos hacer.

Yo empecé trabajando en mi seminario para las mamas. Esta semana tratamos el tema de higiene y aunque más simple que el resto de seminarios que han ido enseñando mis compañeros, es muy necesario que las mamas recuerden principios básicos de higiene en sus hogares ya que su salud dependerá en gran medida de esto. Para este seminario surgieron unos cuantos contratiempos. Este mes las mamas están muy ocupadas trabajando en las shambas (tierras de cultivo) y solo pudieron acudir el viernes al seminario, además su exposición al grupo será otra semana. Una vez más el trabajo nos enseña a encajar los contratiempos y a seguir buscando soluciones. 

Por su parte Hanna se hizo cargo del seguimiento del niño con parálisis cerebral y su acogida en el centro de rehabilitación Gabriella que tendría lugar el lunes siguiente. Visitó el centro Gabriella y descubrimos que también ayudan a jóvenes. Esto es una gran noticia para nosotros puesto que conocemos varios casos en Msitu que requerirían esta ayuda. ¡Seguiremos investigando!

 Además en ratos libres visitamos otros proyectos como la clase de inglés a las mamas de Msitu y el grupo de joyería Maasai que TATU lleva a cabo con las mujeres Maasai de su comunidad. Y el fin de semana aprovechamos para visitar algunos lugares increíbles que este país nos enseña como el Lago Chala y el oasis de Majimoto.

A veces este país nos sorprende con la forma tan diferente de hacer las cosas, otra parte de la cultura a la que tenemos que acostumbrarnos y amoldarnos para llevar a buen puerto los proyectos. Como Ángela nos comentaba la semana anterior, a veces es difícil y normalmente hay que cambiar y reajustar horarios, planes y pensamientos pero pole pole (despacio) vamos consiguiendo sacar a delante proyectos que ayudaran a esta comunidad. Y ya sabéis lo que dicen, cuanto más duro es el trabajo, mayor el éxito alcanzado!

week 8. last days of work

This week was the last one for a big part of the Health Project team. Lots of things to be done.

Parra was finishing the reports about HIV and medical caravans, and Luis the one of the medical examination done to Msitu children. Later, they show them to the doctor of Msitu and to PamojaTunaweza. Plenty of data was analized and really good information was got to plan new projects.

Jaime gave a big impulse to the program formation for the mamas, that later whe revise and finished all together. He was also helping with the tourism project, translating the information into Spanish.

Hanna was in charge of this week seminar. This one was difficult, as we wanted to talk to the mamas about drugs side-effects, in order to advise them of the dangers of giving drugs without medical supervision. The seminars went great, the mamas said it was because Hanna is a really good teacher, but Hanna insists that they are perfect students.

Julia was helping another NGO, Cre-Aid. They are building two houses in Msitu and they wanted us to talk to the families about personal and house hygiene. Julia worked this week with one of the families, and although it was difficult because of the conditions, with the help of Zara and with drawings that were put in the walls of their new house, everything went well.

In the dispensary, I was learning how is the pregnancy women and children-under-five care, as well as the family planning program. These issues are given a big importance during the last years, and in the dispensary, they seem to work quite well. Luis was with Junior and the doctor, measuring blood pressure. Our goal was that someone in the dispensary did that work when we leave. But they didn’t like the idea, as they said they have already a lot of work. We will try again.

Miranda has been preparing a new medical caravanfor the Home Based Care (HBC,) that will take place on Saturday with a doctor from PamojaTunaweza, thanks to the extra-money we got with the donations. The HBC is a program from the government that tries to give follow up to patients that require special cares and have difficulties to go to the dispensary. Veronica is the one in charge, and they are also other three workers and three more volunteers. They have more than 140 cases, so this week the team formed by Veronika, Gasto, Miranda and Hanna visit some of them in order to decide which ones will take more advantage from the caravan. This was hard work. Every day more cases about people with serious medical problems and  difficult family situations reach our ears. TATU can not take over these cases, as we don’t have the necessary resources, but there are some local NGO that can, as CCBRT, Plaster House or Gabriellla Rehabilitation Cente. This one is a NGO that works with disable children and has offered to evaluate the incorporation of a boy from Msitu with cerebral palsy to one of their programs. For future cases, we have gave the contacts of these NGOs to the doctor and Veronika.

Luis, Parra, Miranda, Jaime and I have said goodbye to Msitu this week. Luckily, Julia and Hanna are staying to give the final push to the project.