MOSHI TOWN September 2009

Our 3^rd day in Moshi began with a clinical conference entitled Ethical Considerations. Despite that the presenter had not used powerpoint in the past, (the words ran into the layout, the fonts changed so drastically that they ran off the page, and none of the speakers had given presentations before and therefore practically whispered in the microphone) the discussion was actually quite lively and spurred several MD’s to recommend that one of the next presentations had to be for a discussion of proper end of life decision making.

I was quite sure that it was going to be an awful presentation, and if it had not been for the material…wow.
Anyone who has been to Tanzania understands the difficult issues that people are faced with. The first case was regarding a woman who had undergone a c-section and had low blood pressure but was getting post-op meds when another patient next to her had a spontaneous delivery. The nurse gave the meds to a student to give the c-section to help emergently with the birth. (of course it was at night and she and the student were alone.) When she returned to the c-section patient, she had stopped breathing because the injection of pain medicine had gone in too fast.

Fortunately, she was able to revive her and all was well. The second was more difficult with a 13 year old arriving from Tanga with her mother. She had been unconscious for some time with eyes open but not seeing (not fixed and dialated). She was breathing but stopped, and was sent to ICU placed on respirator where she remained unchanged for a week. One night the MD came in and said, she is brain dead, take her off vent. The nurse was very uncomfortable but did as requested. So, it was a very lively conversation about how to determine brain death. Way Crazy!

So, for the first 3 nights we have had no internet and it has been quite frustrating, but now at last we are here with it again like a miracle. I moved around the house to take a few pictures.

We also hashed 12 hours after arriving. Somehow we had enough energy for that and really looked forward to seeing all our friends. The hash was at Sara and Simon’s land in Mweka (near the Kilimanjaro National Park) and beautiful. We had a crowd of mostly young Scandanavians (beautiful girls) and a few of the regulars.

What a great time. The weather is quite cool in the evenings and mornings, but it has been very dry. No long or short rains for the last year and everyone is suffering.

The next day wasn’t so easy. Little sleep, and tossing and turning. Our house is now in the hands of a lovely medical student from Stanford. Very smart! And she is enjoying her stay so far. She is a very positive person which counts for a lot.

Downtown Moshi looks the same, with some building and some tearing down. I already had all my hair cut off because it only costs $5. Pretty good I would say.

Well that is about all from me for now. This will be a quick trip and we are already figuring that it will be over before we know it!