Day 18 - Back to work

It was back to work today after having the long weekend off.  I spent the first part of the morning working in the lab where all the tests are conducted and then went to a ceremony that was being held at the clinic.

The way it works here is that the patient visits the doctor and the doctor writes any tests that need to be done in the patient's notebook (patient records are very different here to at home!). The patient then takes their notebook to the lab where the lab technician reads the notes and carries out the testing and then writes in the results.

Today I was testing patients for malaria. I had to prick the patients finger with the lancet (the same horrible one they use for testing HIV). As the lancet is so big it hurts the patients a lot and they would jump and then I would jump. At first I was trying to be gentle by not inserting the lancet to far but I quickly learned that it is best to just do it because if you are to careful it doesn't go in far enough and you have to do it again. I figure it is better to do it once properly than have to do it twice. I would then scoop up their blood and put it on the test strip and add some liquid. The blood would then seep down the strip and show either one line for negative or two lines for positive.

Next, I went to the ceremony. The ceremony was held because Pasua was opening a new building and there is also two new vaccines being rolled out in Tanzania. One protects against pneumococcal which causes pneumonia and the other protects against rotavirus which causes diarrhoea. It is a pretty big deal because those two issues are the cause of many death of Tanzanian children. Our night guard here at TV house, Babu, buried his two week old grandson on the 1st of January as he had died from pneumonia. The Tanzanian health ministers came and gave speeches (not that we could understand them!) and there were TV cameras and photographers there. At the end of the ceremony Leonie presented Tabatha with some medical equipment and we met the government officials. I am pretty sure we were on the news tonight!

After lunch I attempted washing my laundry by hand for the second time. I definitely did a better job this time!

Tonight I went out to the Green Bamboo BBQ restaurant for dinner with Aynsley, Sarita, Ally, Jenny, Leonie and Leonie's friend Karen. The restaurant was pretty awesome. It has an open air setting and when you walk in there is a big round bbq with all different types of meat cooking in a circle. It looked amazing. The food was really good too. I ordered a 1/4kg mixed grill with a side of fries and a side of salad as well as a soda (they don't know what you are talking about if you say soft drink here!) and a milkshake and it cost 13 000 shillings ($7.80AUD). So cheap!

Tomorrow, I will be working in inpatients. I haven't worked there yet so it should be interesting.

I am off to bed now. Good night. I love you <3

Day 17 - Ngorogoro Crater and back to Moshi

Today was the forth and final day of safari.

We drove down into and around the crater. Again, we saw many of the same animals as seen previously. Just before we headed to lunch a lone black rhino was spotted! It was quite a distance away but we could see it well with binoculars.  We have now seen the big 5!

We stopped by a lake for lunch. We had to eat our lunch in the truck as the birds will steal your food. There was one couple there who had obviously not been told this by their guide as they set up a picnic blanket in a nice open grassy area but it wasn't long before they were being swooped by a heap of large birds! Also, as we ate our lunch a hippo popped up in the water in front of us. Adam assured us it was a well trained hippo and it wouldn't come out of the water to eat us.

As we left the crater to head back home we spotted a pride of lions walking along a hill in the distance. It was a nice way to finish our safari!

On the way home we stopped at a Maasai village. First they danced for us and then we danced with them. After that they showed us inside one of their huts. Unfortunately it was so dark inside the hut that we could not see a thing. The huts are very small and only have two rooms; one side for the boys to sleep and one side for the girls to sleep. Maasai men marry multiple women and one village is made up of one family. You can tell how many wives a Maasai man has by counting the huts in the village because a hut is built for each wife. An interesting fact we learned was that the Maasai only eat meat, milk and blood (apart from when we give young boys food!). They make their money through cattle/goats and jewellery so the family had jewellery on display for sale. I got each of you boys a necklace from their store. Zane, yours has a turtle on it!

We got home to Moshi at 7:30pm and had dinner. I am going to bed now as I have work in the morning and it is getting late.

Love you all <3

Day 16 - From Serengeti back to Ngorogoro Crater

Day three of safari!

Last night we could hear the hippos in the lake behind the lodge grunting as we went to sleep. They sound like pigs!

This morning as I walked to the restaurant for breakfast there were these giant mouse like creatures laying on the rocks. They were so cute!

Today was day two in the Serengeti. We saw lions, buffalo, a sivel cat and crocodiles along with many of the previous mentioned animals that we have seen over the last couple of days.

There is a list of five animals here known as 'the big 5'. They are elephant, buffalo, lion, leopard and rhino. If you see the big 5 it is considered that you have had a very successful safari. So far we have seen elephants, lions, leopards and buffalo so we are hoping to see rhinos tomorrow.

As we drove back to Ngorogoro Crater we stopped at 5pm to celebrate the Australian New Year with a count down and champagne. We danced and celebrated on the Serengeti with wildebeast and zebras in the background much to the amusement of safari trucks passing by who stopped to make sure we were not broken down.

By the time we reached Ngorogoro Crater it was raining heavily. I was very relieved to be lodging rather than camping as the tents had to be set up in the rain as it was getting dark quickly. The girls backpacks, sleeping mats and sleeping bags all got wet.

Adam then drove Leonie, Tania, Sandy, Emma and I along the crater to the Ngorogoro Wildlife Lodge. Emma is joining us for the night as she is really unwell at the moment and not up to sleeping out in the cold wet weather. The drive was pretty scary as it was very dark, the windscreen was fogged up, the road was narrow and extremely muddy/slippery and the bottom of the crater was a very long way down!

We didn't arrive at the Lodge until 8:30pm so we had dinner and are now going to bed. I am glad we celebrated the Australian New Years as there is no way I would be able to stay awake tonight.

Tomorrow we are heading down into the crater and then we will head home. If we have time we will be stopping at a Maasai village on the way home.

I am missing you guys heaps! Love you <3

Day 15 - Ngorogoro Crater and the Serengeti

Day 2 of safari and we saw the Ngorogoro Crater and visited the Serengeti. We saw a leopard, baboons, giraffes, zebras, wildebeast, hippos, hyenas, giselles, voltures, impalas (that is the one I couldn't remember the name of yesterday) and secretary birds.

During breakfast this morning we were able to watch the baboons playing outside. We left the Lake Manyara Wildlife Lodge at 8:30.

We drove up a long narrow windy road while playing chicken with the oncoming traffic and competeing with the other trucks in our group to see who could get to the check point first!

Along the way we stopped at the Ngorogoro Crater and had a quick look before it started raining heavily so we jumped back in the truck and headed for the Serengeti. It was a long drive but we saw lots of animals along the way. I am also travelling in what is known as the 'party bus' so the young girls keep me very entertained with music, singing, dancing and jokes!

Not long after we entered the Serengeti we stopped to have lunch under a tree. While there we were slowly and cautiously approached by a group of about 15 young Masai boys. These boys are currently going through a traditional initiation into manhood. This is an event that occurs every 7 years. During this initiation boys aged between 7 and 14 are circumsised and dressed in black with painted white faces. They are then sent out on their own to fend for themselves. I have no idea how long this goes on for and I am sure there is more to this initiation process then just that. So, these boys approached us wanting to sell jewellry and asking for money for photos that were taken of them. We were eating from very overstocked lunch boxes so we gathered all our excess food together and gave it to them. They collected the food and went away to eat it before returning the rubbish to us. I had heard of this initiation process before and found it quite frightening that boys that young are sent out to fend for themselves but it was interesting to see these boys today and see how they were looking after each other and they were happy. They actually seemed to be really enjoying themselves and you could sense their comradery.

After lunch we headed off for more animal spotting. The animals are usually not to concerned about all the safari trucks and just live their lives around them. At times they come really close to the trucks.

The leopard we saw crossed the road right in front of us. I tried to take photos of it but it was going dark and I don't think they will turn out.

At one stage we were checking out the baboons when they suddenly decided to attack. They were jumping up at the windows and trying to grab at us. One of the larger baboons tried to attack Adam (our driver) and the attack was so sudden that he screamed and almost jumped out of his seat. That was amusing and the young girls are not going to let him forget about it in a hurry!

Tonight Lionie, Tania, Sandy and I are staying at the Serengeti Wildlife Lodge. This place is not as nice as the one yesterday but it is still a whole lot better than camping. It is cold and rainy out here and the camping matresses the other girls are sleeping on are very thin!

I miss you guys heaps and wish you could be here with me. I hope you have a good night on New Years Eve and don't go to bed to early! Love you <3

Day 14 - Lake Manyara National Park and Lake Manyara Wildlife Lodge

Happy birthday Mum and Sachin!

Day one of safari...OMG, what an awesome day!

Adam, Louis (a different one to the one I usually mention) and Doc arrived at the house to pick us up in the safari trucks. The trucks have six seats in the back (three rows) and a front passanger seat so everyone gets a window seat. The roof also pops up so you can stand on the seat and look out through the top! I travelled in a car with Aynsley, Sarita, Daisy, Debra, Tash and Taz. I got the front passenger seat and Adam was our driver and guide.

We headed off and our first stop was a supermarket in Arusha. We needed to stop for snacks and alcohol! We will be away for New Years Eve so a few of the girls are planning to have a couple of drinks.

We then headed for Lake Manyara National Park. I think the trip may have taken about 3 1/2 hours excluding the snack stop but I don't know because I wasn't paying any attention to the time. I slept for some of the trip but for the rest of it I just looked out the window and tried to take it all in. I enjoyed the drive. The scenery was similar to Australia...at times it reminded me of the drive to Dalby but it was also very different. There were Masai all along the way with their cattle and goats. The Masai are a Tanzanian tribe who are quite distinct therefore easy to recognise. They wear colourful 'robes' and lots of beaded jewellery and they often carry a stick. They graze their animals along the side of the road. Their homes are also easy to spot. The live in cute little round straw huts!

When we arrived at Lake Manyara we stopped for a packed lunch before heading off further into the park.

The first animal we saw were monkeys...lots of monkeys! As we drove around we also saw elephants, giraffes, wilderbeasts, flamingos, one zebra, baboons and little deer like things but I can't remember their name.

The experience was amazing. At times the animals were only metres away from the truck!

After we left the park we went to a souvenier shop. Mum, I was able to get you an African doll like you had asked for. I was pretty impressed with my bartering skills too! I asked how much and was told $20USD (the shops are more expensive here because it is a touristy area and for some reason they like to work in US dollars!) but in the end I worked them down to $9.50USD. $9.50USD is equal to 15 000 shillings. I could have got a similar doll cheaper in Moshi but the ones in Moshi are a bit smaller and not as well made so I figured it was worth paying a bit extra.

I went to the campsite with the girls to drop them off and then Adam drove me to the 'lodging accomodation'. Well, the lodging turned out to be a beautiful hotel! There are four of us, Leonie, Sandy, Tania and myself, who chose the lodging accomodation while the rest opted to camp. We were giddy with excitment when we saw where we were staying and that continued for the whole night! We wandered the grounds and took some photos and then went to the pool bar for a drink. The view is absolutely amazing. We are on top of a cliff overlooking the national park we just drove through. We then went to the restraunt where a buffet dinner was served. Dinner was great and it was nice to have something different for a change as we have been eating pretty much the same thing everyday for the past two weeks. After (way too much) dinner we returned to our rooms (I am sharing with Leonie) and I had the best shower I have had since leaving Australia!

I am now tucked up into bed and am about to go to sleep. I have no idea where we are going tomorrow but I am looking forward to it!

Love you all <3

Day 13 - Morning Tea and a Birthday Dinner

Hi,

We went by taxi to placement this morning. We were supposed to go by daladala but some of the girls complained and said they would rather wait until next week. I think they are being wusses! Although I will probably do it once and never want to do it again ;o).

I spent my morning in the antenatal clinic with Sister Karen and three of the student nurses. Nazmin kept me up to date with what was being said and I got to listen to fetal heartbeats, palpate the Mamas bellies to feel the position of the baby and measure fundal heights. I wasn't very good at feeling the position of the baby as I was to gentle and you need to push deeply to be able to feel anything. I am gentle because I remember how much it hurt when the midwives at home did it to me but if I am ever going to feel anything I will need to get over that.

Today was the local student nurses last day of placement at Pasua so Bellinda, Chioma, Sandy and I had taken biscuits and cake to share for a late morning tea before we left. The student nurses were very excited and really enjoyed the food.

I don't know why but I was feeling particularly tired today so after placement I went home and layed on the lounge and read my book.

At 6:30pm we went out to a restaurant down the road called 10 2 10 for Jenny's 50th birthday. The service was very slow and we did not start getting our meals until 8:30pm. There were a few different types of cuisine offered and I ordered from the Indian menu. I can't remember the name of the dish but it was potato stuffed with cheese and cashews. I also ordered steamed rice, naan bread and yogurt to go with it. The meal was delicious however the yoghurt didn't even arrive until I had finished eating! I was lucky though because I did receive all the dishes I had ordered...a lot of people didn't. When it came time for us to leave the bill added up to 80 000 shillings ($48.90 AUD) more than we had ordered and received! Louis spent 1 1/2 hours arguing over the bill without success so in the end we all had to put in extra money to cover it. It was a bit disappointing as all the meals were very good and we would have liked to return to the restaurant but it is not nice to feel you have been taken advantage of. Louis will return to the restaurant tomorrow to discuss the matter further with them.

Tomorrow I am going on safari for three nights. We leave here at 8am and I have not yet packed my bag so I will be up early in the morning to do that.

Good night, love you <3

Day 12 - A Baby Girl and More Shopping

Habari,

Bellinda, Chioma and I headed off to Pasua this morning in the taxi - still no daladala experience however I have heard rumours that that may happen tomorrow. Sandy stayed home today as she was not feeling well.

I was really looking forward to placement as today was my turn in Labour and Delivery. When we arrived we went to the morning hand over meeting. There had been two births during the night but one inparticular had the Sisters' attention. An 18 year old girl had attended the clinic in labour claiming to be about 5 months pregnant however she had given birth to a full term baby. The Sisters were amused as the girl had only been married for about 5 months so they believed she was fibbing about the babies due date. They were all chuckling about it!

After hand over I went to the delivery room with Melanie (one of the midwives) and was very excited to see a Mama on one of the two delivery room beds. She was in labour and was waiting for a pelvic examination to assess the progress of her labour. This helps the midwife to know how far into the labour the Mama is and how much further she needs to go. Melanie examined the Mama and found that her cervix was 7cm dilated. This was good news to me as I knew she only had another 3cm to go which meant I would probably be able to be there for the birth!

I helped Melanie clean the labour and delivery and postnatal rooms with a cold water and bleach solution and a rag and then I spent time with the Mama.

It is different here than at home. The Mamas birth alone with no family members at all...not even the baby's father. Even the midwives ignore them! This Mama's name was Happiness (that is not unusual here!) and she was in a lot of pain but she kept as quiet as possible. She was definitely a lot quieter than I was (for those who don't know, I was very loud through each of my deliveries!). She was trying to rub her own back unsuccessfully and the midwife continued to ignore her so I rubbed and massaged her back for her. I couldn't understand her and she couldn't understand me but she appeared to appreciate it. There is no pain relief offered to labouring women so natural methods are the only option. Also, unlike home, the Mama brings all the equipment needed with them to the clinic when they come in. This includes kitenge (similar to a sarong and is used as the bed sheet), sterile gloves, cord clamp, a large roll of cotton swab, oxytocin, syringe and needle. When Happiness was standing I tried to encourage her to lean on the bed and sway her hips but she either didn't understand or wasn't interested!

Happiness's contractions had started at 5am this morning and she was 7cm dilated at 8:30am. This was the first stage of labour. At about 11am to 11:30am she had reached 10cm dilated and was entering the second stage of labour. During the second stage the contractions slowed down a bit and this stage was delayed. Second stage would usually last about 30 minutes but it took longer. Happiness gave birth to a baby girl at 12:25pm. I was luck enough to help Melanie guide the baby out and hand her to her Mama!

The third stage is to deliver the placenta. Unfortunately, that was done very differently here than at home. The baby was wrapped and taken away to be weighed and then placed on the next bed alone. Happiness was given the injection of oxytocin and the midwife then started to pull on the umbilical cord straight away. The placenta wasn't ready to come out so I collected the baby and tried to encourage the Mama to breastfeed her as this releases natural hormones in the body which causes contractions and helps the placenta to come away from the wall of the uterus more easily however I was told she was not to breastfeed the baby until the placenta had been birthed. As the pulling of the umbilical cord was not sucessful the midwife proceeded to push her whole hand in and dig the placenta out. I was horrified! Again, I offered to let the Mama breastfeed but again I was told no. Not only was this method the last thing she needs after giving birth but it is dangerous for the Mama. It introduces bacteria which cause infection and increases the risk of bleeding and pieces of the placenta being left behind which also causes infection. The infection caused by doing what this midwife did is very serious and has the potential to kill the Mama if not picked up and treated early enough, which is very possible in a third world country like Tanzania. The birthing of the placenta should be relatively simple and easy. It does not usually require the intervention that was used today!

I am still trying to work out how to deal with this situation however I am considering printing out some journal articles regarding best practice for placenta delivery and talking about it with Tabatha (the director of nursing).

So, while the delivery of the baby was amazing, the delivery of the placenta was horrifying! However, I now know with 100% confidence that I want to be a midwife and next year I will enroll in the Master of Midwifery starting part-time in 2014 (sorry Steve!).

After work Bellinda and I went into town for lunch and to do some shopping. We tried a different restaurant called Deli Chez or Chez Deli that some of the girls had recommended but the meals took about an hour to come out and they were not very good! Grandad, while shopping I got you a green 'hippy shirt' (you know the style!) with a picture of Africa on it.

Anyway, it is time for bed now. Tomorrow I will be working in Family Planning and Antenatal which I am also looking forward to because they are my other favourite areas to work in. I will give you boys a call some time tomorrow as I am going on safari on Saturday and I probably won't have access to an internet connection again until Wednesday so I won't be able to contact you.

I love you and I hope you are enjoying your holidays <3