This is a team member testing some of the cranial nerves using a tuning fork.
Yesterday I spent in the clinic with our supervising Tanzanian physician. He essentially had me do all of the physical exams. Listened to heart sounds. Listened to lung fields. Felt lymph nodes for inflammation and foreheads for fevers. Rotated osteoarthritic shoulders. Interpreted ECGs. Took blood pressures, heart rates, resp rates, temperatures. Watched a lot of swahili conversations. Wished I spoke it. Felt dumb sometimes. Felt smart other times. Mostly the former.
I was happy to see that in terms of management of some common ailments, like type II diabetes and hypertension and congestive heart failure, patients in this clinic are treated very similarly to Canadian treatment. The same drugs, same dose. Similar follow-up. Similar lifestyle advice… modified for different lifestyles I suppose! One patient (a sheep farmer) with diabetes was advised to skim the cream off his dairy using a different mechanism. And to eat less animal fat. I was told afterwards that he had agreed to skim more of the cream off.
To be effective as a physician here, it’s clear to me you need to know the language. What a large barrier. I can feel arthritic changes in a shoulder, but I know nothing about how the patient wants to be treated, what brought on his current pain, how he is using his shoulder, what he has tried to make it better, if its impacting his work, you know… nothing really about his experience.
For those of you that have heard my rat saga… we have killed six so far. Three with mouse traps, and three with poison. I think we’re making progress; we haven’t seen any more around. Fingers crossed! (But mom, in terms of your hygiene concerns, there aren’t any in our room, our poisonous bananas have gone untouched for two days). (And the other girls with the rats are sleeping in different rooms, mostly).
Doing fine and having the experience. Miss you! xox Kelly