Saturday, October 12, 2013

A Late Night, an Early Morning and Traffic



Last night we had a farewell party for Dr. Reed and Dr. Rich, two visiting doctors from DC. Most of the (off-duty) clinicians were there, and we drank the last of the beer that Reed and Rich had bought for their stay. Sometime during the shindig, someone received a call saying that a couple of critical patients were one their way. This is rare at FAME because usually critical patients simply arrive unannounced. (Yesterday we had a dead patient brought into the outpatient clinic for treatment; I don’t know how they got the body into the doctor’s office without the clinic staff noticing he was deceased.) Anyway, nobody gave it much thought because often, “critical patients” decide they might not come right after they call but instead wait for morning. 

After the official party, we headed into town to find a bar and send the doctors off in proper fashion, but on the road to Karatu a white Land Rover flew by in the opposite direction with flashing lights. Ambulances are very rare in Northern Tanzania and typically mean something serious, so we turned around and brought the doctors back to work.

It turned out that two American tourists on safari had been in a car crash in transit from the Serengeti to Ngorongoro Crater. Dr. Reed pronounced one in the ambulance and the other will need to be evacuated by air this morning. Luckily the driver (who was wearing his seat belt) was unhurt. We can’t afford to evacuate Tanzanians, not even to Dar Es Salaam. There are lots of phone calls to be made when an American needs to be flown out (and when one dies in Tanzania too) so it’s been a busy morning for everyone. I’ll go with the patient to the airport, so that I can learn about the handoff procedure in case I ever need to organize a medevac.

The lab at dawn:



Last night at the party, I told one of the local doctors that the big thing I was afraid of in Tanzania was riding in a car. Karatu, a town of 20,000 has only one paved road. All the other roads in the area are dirt tracks, steep, frequently lopsided, washed out, filled with cattle, and impassible in the rainy season. Tanzanians don’t really go in for speed limits (difficult to enforce when most of the traffic police lack weapons or vehicles), so instead they use speed bumps… everywhere. If you have kids, you build speed bumps in front of your house and their school because otherwise people will drive as fast as they can. The government also builds them. Most of the speed bumps are made out of the same red dirt as the road, so you can’t see them until you are almost on top of them.

There are also lots of pedestrians crossing the road, some of them very young, some inebriated, some herding cattle, some all of the above. The highway is full of heavy trucks moving at slow speeds and Land Rovers swerving around them at high speed. In short, not a safe place.

To cap it all, people get around on motorcycle taxis (called piki pikis) where you cling precariously to the driver’s back as you bounce over the speed bumps. He has a helmet; you don’t. A friend of mine was very distraught because she saw a man killed in front of her after he bounced off a piki piki on the highway. Later in the week, one of our volunteer doctors found the “dead” man very much alive in the government hospital. He shook not-so-deceased’s hand and they took a picture together to show the friend who saw the accident.

UPDATE: In my previous post, I asked for help with our EKG machine, and I’ve gotten a lot of great advice and connections, including someone who knew someone who knew someone who knew someone who works at GE Healthcare. I’ve submitted a full report on the issue directly to that person, so hopefully we will see some progress there soon. It couldn’t come at a better time because Dr. Reed left this morning, and we will now have to rely on long-distance cardiology consults. Many thanks to everyone who helped out.

Bonus picture: Popi, the hospital's mascot. She's a Standard Tanzanian Dog. All dogs look about the same here, I suppose because there aren't any fences.


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