9th June--OPD

     Spent the day in OPD, out patients department.  Happened to be put in a consulting room with one of the head doctors and he was excellent! Such a good teacher, that I actually felt like I learned a lot from him as he took the time to explain things as we went.  Whenever I had questions he even took time away from the patient after speaking a slew of swahili to make sure that I understood in english, didn't mean for him to but it was the idea that he wanted me to be included as he proceeds that was really nice.  [Dr. Mburi]
    Saw two older women come in with a prolapsed uterus, of which I hadn't really heard much less seen before now.  He told me that it happens a lot in older women as the muscles lose elasticity as we age that they no longer hold the uterus in place, therefore it just comes out of the vagina.  Another reason that could cause this to happen is if a women has had many births in her lifetime that as she ages, the muscles are just so weak.  The first women had had 7 children and the second had 9 in her life.  Temporary solution to the problem: shove it back until a more permanent solution can take place-->that being surgery to either 1) remove the uterus entirely or 2) cut part of the muscle that holds it in place so that it is shorter when it heals.

     One thing that the doctor pointed out to me was that not all patients say what their immediate symptoms or issues are out of embarrassment and not all doctors will find out the problem if they don't do a thorough analysis and exam.  The second women for instance, went on and on about pain that she has and how all the medication that other doctors have prescribed to her hadn't worked, she was talking so much, to me, telling the doctor her whole life story (it was in swahili) and finally Dr. Mburi did an exam on her and immediately found her problem, that she neglected to mention.  That's why he stressed that as a doctor you must always do an exam during each consult if the problem isn't obvious.

    One of the other patients that stood out to me was a young guy with a hugely swollen right leg with no open wound.  The doctor pressed on his leg and it left an indentation, which I had never seen before and he told me that it means that fluid is outside cells, pitting edema.  Dr. Mburi had me feel the leg to see if it was warm or cold, warm usually meaning that there is an infection within. Because there was no history of organ problems within his family and he was a relatively healthy guy, the doctor determined that it had to be a bacterial infection {from only one leg being swollen and it being warm to the touch} and prescribed him wide-range antibiotics. 

    It was a really good morning, was in there in OPD from 8ish to 3 then took the dallah-dallah home.  Had a bucket shower, power was out which I haven't really described yet.  Well, power goes out everyday at any time of the day and for a who knows amount of time.  The power company decided to ration the electricity around the country in February and they just didn't stop I guess after having a nationwide deficit on the grid.  You get used to it, using gas for cooking and many candles, lanterns and torches.  Anyways, went to the market with mama Beatrice to buy vegetables for dinner, so many sellers in the Usa Market of the same things though: oranges, tomatoes, potatoes, sweet potatoes, carrots, greens, avocados, and eggplant (aubergine), bananas, passion fruit, beans and spices.  That's about it for fruit and veg, then you have all the clothes and shoes and bags like in the Arusha market.  Ridiculously cheap though! Beatrice filled two plastic bags with 10 oranges 10-12 whole carrots, a bunch of greens, 6 ginormous sweet potatoes, and about 10+ tomatoes for only 12000Tsh....about £5 or $7...if only :( 

      Ella and I decided to surprise the family and make banana fritters for desert.  We had so many bananas just sitting in the kitchen getting mushy and black that we could stand for them to be chucked out! It was my first time making/eating them and it was so simple!  Bananas, flour and spices!! Put a little bit of oil in the pan, shove a banana slice on one side and fry away until firm and that's it! They tasted sooo good too :)  Had to cook by head torch light and lantern, but was fun that way.  One thing that was interesting though was how often Line and Lily, the daughters, kept asking if we wanted to put more oil in the pan, which we didn't need to.  They, being most Tanzanians that I have met, don't seem to realise that you DON'T need to add a cup of oil to EVERYTHING that they cook.  Don't get me wrong, all their food is great and I look forward to it all but also it can be very oily. 

Banana Fritters!