Blog Post written by Emily Hall, DO, 3rd Year Pediatric Resident
Jambo from East Africa!
I have spent the first few weeks in Arusha, Tanzania settling in and acquainting myself with the resources, medical facilities, and the community. As true with all my adventures abroad--this has not been what I expected, but equally holds exciting potential and opportunity. In future posts I hope to tell more tales of adventures. However, before things get too exciting...let me explain my perspective of life here in Arusha so if you are considering this as an International Elective you will know a bit of what to expect.
Danielle (another U of MN Pediatric Resident who most of you know) and I initially started our work at Arusha Lutheran Medical Centre, which is located in downtown Arusha and offers more specialty hospital and outpatient clinic care. They have a small NICU which was impressive to tour and have a total of 2 pediatricians on staff in addition to a pediatric registrar. In contrast, we observed and in the past few weeks have found our place at the Council Designated Hospital also known as Selian Lutheran Hospital (subtle name difference to the former mentioned). This hospital is in a semi-rural location in a village just outside Arusha serving both Maasai, Waarusha tribes, as well as people of Arusha. We walk to the hospital with beautiful views of Mt. Meru along the path. (see photo below) The resources here are limited in comparison to the Arusha Lutheran Medical Centre.
We have been working with two Tanzanian trainees in pediatrics; one of which received his medical training in China the other from Dar es Salaam, Tanzania. Our primary physician contact here is from Australia; she has been a truly wonderful mentor. We round with two nurses and the four of us trainees. Together we have been discussing and collaborating on patient management decisions with particular consideration of differing International Guidelines of management and factors relating to a resource limited setting. This type of work and learning environment has taken a few weeks to develop, but has recently started to come together in an exciting and highly educational format. Later in the week the physician from Australia has been joining us--by this time we have had some autonomy to make decisions and can discuss in more details questions or concerns regarding patient care that have been debated in her absence. Additional training opportunities have included pediatric HIV clinic, pediatric general clinic, and serving at rural outreach clinics.
There have been several very interesting patients and cases, some of which are still a bit of a mystery. Perhaps in the coming weeks Danielle or I can write about one or two interesting patients to give you a taste of the variety of medicine and the diagnostic approach here at Selian.
Arusha provides quite the balance of work and fun. There are limitless things to do in the city and in the country. It is my hope in the coming weeks we can provide a bit of insight on both the medical and culture opportunities we have explored.
Until then, wishing you all well in Minnesota or wherever this missive finds you.
Emily Hall, DO, PL-3
U of MN Pediatric Resident
Posted on behalf of Eric Bomberg, MP3 resident.
This last week has been busy as usual. I helped deliver a baby for the first time since medical school, and then being the pediatrician that I am, was first in line for newborn assessment and resuscitation. I have really enjoyed working at the Shawano Medical Center, and have had the opportunity to care for many adults and children here.
We had one patient come in during my last call with a history of anoxic brain injury who was having fevers and possible seizure activity. As we do not have many specialists around, we had to transfer to another hospital. These experiences really show me how much of a luxury it is to be at a large academic center with specialists that can come 24 hours a day. And they have taught me a great deal about the challenges of working in a hospital where the resources are limited in this respect. There are specialists that we are able to call for consults but most of them are only around on a very limited basis.
Photo of the clinic
View on the Menominee Tribal Reservation
Driving on the reservation
I finally got my car back from the shop. I hit a deer on the freeway about 2 and a half weeks ago and it took this long to repair. This is extremely common in Shawano County and most people have experienced this at least once. Happy that is finally taken care of. Green Bay is the closest major city to us, which is about 45 minutes away.
This last weekend I spent one day kayaking on the Wolf River which I have never done before and then spent spent some time looking exploring Green Bay. I visited Lambeau Field and got to explore the shoreline of Lake Michigan a bit.
Lake Michigan shoreline
I have really enjoyed being able to explore the reservation and have now been around most of the area by this point. The land is beautiful, full of forests and lakes. Much of the housing looks similar as most of it was built through HUD housing projects in the 1970s.
Heading back to the Twin Cities in the next couple of days. This whole experience has been unreal.
Posted on behalf of Eric Bomberg, 3rd year MedPeds Resident
Yesterday, I had a tour of the Menominee Reservation. The reservation is beautiful and is covered with trees. There is a powwow site and twice a year they have 3 day powwow events where the Menominee come from all over the country to attend. The Menominee people used to own over 9,000,000 acres covering much of the state of Wisconsin, from up here all the way down to Milwaukee. Due to repeated treaties, the land size has been cut down to around 265,000 acres. Each time a treaty was signed, they were given a smaller area of land in exchange for such supplies as food and money. However, with each newly-signed treaty, what was promised from the previous treaty was made null and void, and as such the Menominee people each time did not get what they were promised from the government. This has lead to a land size much smaller than they originally owned, as well as a general mistrust of the government. On one such occasion, the government passed a treaty in which only 5% of the Menominee people agreed to, many of whom did not understand the English language. This has all leads to a concept called "historical trauma," which I will talk about more in a later post and which underlies a lot of the challenges faced within the community. Overall, Menominee County is the 13th poorest county in the nation. The main industries on the reservation are the logging company, which employs about 200 people (most of whom are native), and the casino, which also employs a large amount of workers as well.
I had the day off on Sunday and went up to Door County, which was
incredible. It is located right on the peninsula in Wisconsin. Up
there, they have multiple state parks, wineries, restaurants, and shopping. I
went for a 7 mile hike right on the shores of Lake Michigan!