January 9th

January 9th

Brittany went on hospice visit and did not know what to expect. Learned the importance of spiritual care. “One of greatest things I have seen in Tanzania” She learned more about the way of life of the people. Their houses are dark and small, had to lean over to get in.

Amanda was in Ortho room. Learned a great deal. Pleased that she correlated her anatomy knowledge with what she saw in OR. She stayed for a very long day and even got to suture. Dan said she has good surgical hands.

Mike said scopes are a work in progress. Scopes were the same but attitudes a little better. Surgeons teaching surgeons is not always the best way, Progress being made and the resident getting better. After doing 12-14 scopes, 2 tumors identified which is a very high rate and since less than ideal scope and visualization, they could have missed some abnormalities. Still very limited ability without better equipment.

Kim did not have previous experience with hospice and did not know what to expect. Noted that when the team entered the homes the people were not happy but when the team was leaving they were happy and smiling. Really felt they had made a difference.

Pat appreciated the CME talk on arthritis given by Dan. Saw a wide variety of surgical cases. Will be working on a presentation that she can give on the wards. Had very good in depth conversation with Limbe. He appreciated the team and felt this team did good teaching and was nice to work with. 


Shannon went on hospice visits. Beautiful day. Went to 2 villages. Lots of social issues. Saw an end of life patient that has not long to live. HIV patients taking meds are doing great. Living 25years. Not one man seen. Stigma to HIV. Men more non compliant and die earlier than women. Woman with 2 year old works all day. Minimal child care. Bus driver in charge of giving meds. Unfortunately funding lost.HIV rate has dropped. What will happen now without funding?

Jenny went on hospice. First hospice experience in Tanzania. Impressed with the care. Stigma still great. Sometimes teams need to drop off meds so patients do not have to go to clinic. Good evidence that treatment works with good results. Impressed with the team skills and ability. Very capable staff and village volunteers.

Dan had another very busy day in Ortho surgery. Operated on a tough forearm fracture which was about 5 months old. Fracture angulated and not healed. Tough fracture because pieces do not fit back together when old fracture. Fortunately this one did come together well. Dan thinks patient will do well. Lady with osteogenesis imperfects with femur fracture in exfix old fracture but not healing after 3 months. Decided to do bone graft from iliac crest. Had previous bilateral bone graft harvest. Had lots of bleeding.

John said day filled with successes and not. Dr. Roberts cleared out his desk with lots of equipment and tried to get many things fixed. Kept him very busy. Worked on trying to improve scope cleaning procedure. Visited many hardware stores. Each individual store like an aisle in the US. Spread out all over town. Very different culture. John working on computer and has written at least  6 pages with suggestions for improvement. More pages to come. 

(this is one of the donated trays of instruments that was used to help many patients..thanks to the donors for making this happen.  God is good!)

Mary’s mastectomy patient did not show today. Hopefully will show later. Had teaching experience with Limbe. Discussed breast cancer management and use of NCCN guidelines. Limbe very excited. We googled NCCN and we were able to pull up breast guidelines and discuss use.