The Days As They Unfold – Latest Updates!

Day 82, Tuesday October 22nd, Arusha, Tanzania

First stop of the day was Mount Meru Hospital to visit the District Medical Officer and plan my visit to Arusha.

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Dr Maliki was one busy lady! All of her staff gathered around at 8am each day before dispersing to their various areas.

I was taken under the wing of the Medical Director of the hospital Dr Mlay, with whom I visited the Obstetric department – a new wing to the North side of the hospital:

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The department sees 30-40 deliveries per month; in September there were a total of 819 babies born and of those 164 caesarean sections (20%) with no instrumental deliveries (vacuum or forceps). There was a vacuum machine (metal cup) but it wasn’t functioning.

I had a quick tour of the labour ward:

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and the antenatal and postnatal wards of which this was one:

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The matron uploaded the ‘Safe Motherhood’ section from the Global Library of Women’s Medicine (http://www.glowm.com/) onto her computer from the memory stick I had been carrying. I’ve been giving the data to as many institutions as possible and especially in areas where the internet is not readily available, courtesy of Mr David Bloomer.

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And then there were my donations:

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I’ve really been very happy with the choice of blood pressure monitors as donations; they have for the most part been in very short supply wherever I have been travelling!

The senior staff from Mount Meru were going to be in a meeting for the rest of the day, and so, with the agreement of returning the following day to deliver a lecture, I jumped in a taxi to visit Mr Andrew Browning MRCOG
at the Selian Lutheran Mission Hospital. I had met Andrew in Liverpool last summer at an RCOG conference and promised to visit!

I found him in the operating theatre and so got changed:

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He has almost finished his list when called to the labour ward – a Masai patient with eclampsia (fitting with very high blood pressure and protein in the urine) had come from home after apparently fitting 4 times. She was semi-conscious and her baby had died as a consequence. Her blood pressure was difficult to control and her kidneys were failing. She was in labour but would she deliver naturally, and quickly?

Andrew finished his list and then delivered the eclamptic patient by caesarean section as labour was not progressing well and delivery was not imminent. The blood pressure monitor in theatre wasn’t functioning so well and so I handed over my donation a little early:

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She went to high care post operatively and luckily, given timely intervention, her outcome was good and her kidneys recovered (I checked the next day).

We had a look around the other parts of the hospital, in particular the fistula ward. And I spoke about Early Warning Charts (‘usual’ for me, by now!)

The working day was drawing to a close, and I headed back to the Flying Medical Service Mission where dinner had been prepared! How lovely – so nice to have home cooked food when you have been travelling for so long!

I wandered around the Mission:

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and appreciated the garden, together with the wonderful view of Mount Meru from the back:

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Pat was off on an emergency evacuation flight; vaccines were being prepared for use at rural, fly-in clinics the following day. It was all go at the Mission!