Thursday, 23 February 2012

On challenging patients and weekend exploits

As we enter our 4th month in Tanzania I seem to be becoming busier and busier.  So I think I am going to go for the little and often approach as otherwise these blogs are going to become few and far between.
These blogs will be less about my medical experiences as I am now writing a blog for the BMJ and the first one can be found at

ITU in the corridor whilst cleaning went on

Since the strike and Kelvin taking over the ward we have had a huge number of challenging adult and paediatric patients.  We had a man admitted with toxic epidermal necrolysis, which is when all your skin peels off due to a drug reaction, and this is a dermatological emergency (yes we do have emergencies in dermatology!)  We do not have up to date treatments here so treated him with IV hydrocortisone and he was nursed on ITU.  Fortunately the inflammatory process switched off and he has made a good recovery as mortality is usually up to 50%.  We have had up to 18 inpatients and many of these have had other difficult blistering conditions and I think Kelvin, the ward resident is jinxed as the ward is the busiest it has ever been!  The ADDV students are in the midst of exams so Kelvin and the medical students have been very active.  I was in charge of the ward whilst other senior consultant staff were at an albino outreach clinic in Tanga.  Surprisingly I actually really enjoyed the diagnostic and clinical challenges of managing all these complex, sick patients.  We forget how fortunate we are in the west where investigations such as biopsies and blood tests are available and are free as many patients cannot afford the limited investigations and medication available here in Tanzania.  You can read more about the ward on my next BMJ blog.

So what have we been up to?  We spent a fantastic weekend back at Marungu Hotel camping with a group of friends.  Sadly it was Sebastian and Julianne’s last weekend and also joining us was Tobias, a Danish physio and his 2 children Alex and Edvin and Camilla and Jeremy, both homeopaths, and their children Ike, Amy and Noga.  The weather was glorious and we splashed about in the hotel pool on the Saturday and then did the beautiful waterfall walk on the Sunday.  

Nguduru falls at Marangu

This time however the sun was shining and the Ndura falls were spectacular and we all dived in and swam (well not Aaron as he is such a wuss in cold water!) and Zac and I swam right under the waterfall.

Amy and Noga wrapping up at dinner whilst camping
Juliane and Sebastian

The boys have started a weekly horse-riding lesson which they love and on Friday they will start tennis lessons as last week it was rained off.  Yes we are getting some rain now, which is a blessed relief as it has been SO hot.


Last weekend we drove out to the hot springs which are literally an oasis in the middle of nowhere reminding me of passages from the bible!  You drive and drive and turn off the road and down dusty, forking tracks which wind through villages where we had to keep stopping to ask directions.  Eventually a 4WD truck beeped us and we followed him in a cloud of dust until we arrived at a tree fringed beautiful pool full of green, glassy water. 
where are we going????

Vicky Yates, my work colleague and Aaron getting his feet nibbled!
going, going...

In the water are tiny fish that nibble the hard skin off your feet, a sensation the boys and Aaron loved but I hated!  There was a rope swing which we swung on to jump into the water and I managed to stop the boys from climbing an enormous tree to jump in even higher!
We returned dirty, tired and happy and slept very well.  

On Sunday was the hash and this time it was held in the hilly region of Machame.  The walk was stunning and we tramped up and down into gorges and over rivers and through banana and avocado fields.  I think we are all getting fitter and the boys seem to be used to 2-3 hour walks now.  I hope this will continue when we get back home!

This weekend we are off to Arusha national park on Saturday and Sunday is the Kilimanjaro marathon.  Aaron is running the half-marathon due to his knee and the boys and I will be running, or more likely walking, the 5km fun run along with the whole of Moshi I think!
Simon Matui the current record holder for running up and down Kilimanjaro unassisted in 8 hours!!!! 

making chocolate brownies for Friday night dinner!

And now some other animals that i couldn't upload to the last blog.  And yes I do like elephants!


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