Greetings from Zanzibar!
This past Tuesday was our honorary ‘farewell dinner’ with the residents – we went out for local African cuisine and were joined by so many of the spectacular residents (all of whom are not only tremendously skilled medicine residents, but had all performed C-sections, exploratory laparotomies, and countless other procedures as part of their residency training), including Kilonzo, Gunda, Matungmbwate, Alex, Mopondo, and of course our all-time favorite, Meda. We are so proud to call them our friends and colleagues and are even more thrilled that, as part of the ongoing Cornell-Bugando exchange, we will be seeing many of them for a month at a time at Cornell this summer and fall! (I fully expect Annie to talk about her experience with the Assistant Medical Officers-in training in her post, because I contributed nothing to that amazing relationship.)
[Annie writing now, taking over mid-Santosh-blog-post]
The AMO’s are the Assistant Medical Officers. They are non-MD medical care providers, much like Physicians’ Assistants in the US; but unlike in the US where Pas are specialized in a given field, the AMOs are responsible for EVERYTHING, from pediatrics to adult medicine to ob-gyn to basic general surgery. This is because Tanzania has such a shortage of physicians that non-physicians are needed to serve the people who live in smaller communities, where resources are even sparser than what we’ve seen in Mwanza (the second largest city in the country). Whereas your average Tanzanian medical student or intern is in his or her early 20s, the AMOs are usually in their 30s-40s and have worked in the past often as pharmacists. And, unlike many of the medical student who unfortunately go into training to become a doctor because they are looking or a stable salary, I got the impression that the AMOs have decided to go into their training not because they need the salary – as they already had jobs before this training – but because they felt a calling to serve their country. In any event, every week I taught a group of about 12 AMOs; lectures ranged from rheumatic heart disease to portal hypertension to stroke, and we focused on the practical ‘how-do-I-diagnose-this/how-do-I-treat-this’ knowledge base that they so desperately wanted to establish before going out into the community. While I’ll be the first to admit that my teaching experience thus far has been limited, this has by far been the most gratifying part of the Tanzania trip for me. I felt truly honored to be working with such devoted men and women, and their genuine concern for others and enthusiasm about learning was inspirational. I’m convinced that they are the first step in filling the great shortage of medical care providers in this country. And, as though the teaching itself weren’t wonderful enough, on the last day of class they bought me a present – a traditional cloth that women wear. (And of course, they put me in it – can’t wait to share the picture with everyone.) Okay, back to Santosh.
Wednesday night was Annie and my last night in Mwanza, and to be sure, the evening was a bittersweet one. We’ve written about the many amazing things we’ve learned at Bugando hospital, but equal in importance has been the relationships we’ve formed here. This is really the first vacation we have ever taken where we have made true friends with the locals (and other visitors). We went out for dinner at our favorite local spot, Bugando Hill, and were joined by all of our co-visiting residents/students from Cornell as well as other visiting students from Ireland and England and Germany, but best of all, by the three people who made Mwanza home for us – Mussa (who teaches yoga, makes clothes, plays a mean Frisbee and an even meaner soccer), and the unmatchable duo that are Hezron and Emmanuel (our ‘taxi drivers’ who became so much more – local guides, protectors in sketchy areas, and most of all, friends). Nothing really makes an experience like being welcomed by the local residents, and with Hezron and Emmanuel around, we always felt that we belonged.
It was with a heavy heart that we set out on our final day of rounds on Thursday (featuring an exciting yet incredibly confusing respiratory arrest accompanied by complete loss of muscle tone and bilateral areflexia in a guy whom we had just pronounced stable for transfer to the floor). That afternoon, after showing the new medicine resident Amy the wonders of the local Mwanza market (which sells souvenirs and fabric as well as vegetables, live chicken, and other assorted goodies) as well as the wonders of the local ice cream shop (Mr. Cool Ice Cream Mwanza), we went to the apartment of our incredible attending physician, Dr. Peck, and enjoyed an afternoon soiree with him, his wife, and his four incredibly cute kids. (I’m proud to say that I built Lego castles, did ballet dances, played “airplane,” and gave piggyback rides while being bonked on the head with a toy soccer ball with all of them. Oh, and played hide-and-seek, a game at which I was surprised to discover, I stink.) As evening approached, we were taken to the airport by Hezron – this was the toughest goodbye of all, especially when he gave us a parting gift (a super cool traditional warrior fabric worn by the indigenous locals, the Ma’sai).
After a typical delay on Precision Air (their tagline should be “but not accurate, ha!”), we arrived at Dar Es Salaam, the nation’s capital, for a four hour siesta before heading out to Zanzibar. Let me summarize Dar: overpriced cab ride to decent hotel above an incredibly sketchy bar frequented by, um, people of questionable moral fiber, to another overpriced cab ride to waiting for our flight where we ate granola bars because the canteen had run out of veggie samosas and had no plans to make more. Yeah. Four hours in Dar is four too many.
Nevertheless, we arrived in Zanzibar yesterday morning and were met at the airport by Taxi Tembo, a lovable old Tanzanian man who is a tour guide/taxi driver (although now he, oddly, sits passenger while someone else drives), and he sports an incredible shirt designed like an American flag. He deposited us at Pongwe Beach resort.
So Pongwe is insanely awesome. First, it’s right on the beach, and it looks like what you picture when you think of the perfect tropical beach. Second of all, the staff is unbelievably nice (like everyone here). Third, the food is amazing, they have a pre-dinner cocktail hour where you can play Scrabble, and while you do so, they supply you with AWESOME snacks (hello, spicy popcorn, spicy roasted peanuts, and olives!). So what else have we been doing in Pongwe?
*Drum roll please*
Annie has been helping me with my (lack of) swimming technique! It helps that the pool water here is seawater, in which even a total idiot like me can float, but with some helpful tips on (and feel free to laugh here) floating, breathing properly, and kicking technique, I have actually been able to swim! Multiple different strokes! AND, we took snorkeling gear out into THE OCEAN, and snorkeled a bit! Someone needs to tell my mom.
Also, we kayaked. We set a course for a peninsula that seemed very attainable, but after an hour, it was clearly not. On the way back, I inexplicably began to struggle as my kayak would continuously drift to the left. By the time I exhaustedly got back to Pongwe, I had concluded that (as usual) water causes me to be a complete tool. But I was vindicated: it turns out that the kayak had a giant leak on the left side that had caused THE ENTIRE KAYAK TO FILL WITH WATER. As I said to Annie, “I just kayaked a friggin’ anchor back home.”
What else have we been doing here? What we always do: lounging around on either beach chairs or hammocks and reading. Annie and I are absolutely transfixed by our current books: she by Philip Roth’s American Pastoral, myself by Dostoyefsky’s Crime and Punishment (thankfully on the Kindle). Oh, and we’ve been drinking lots of Fanta – oh man, how have I not mentioned this? There are CRAZY FANTA FLAVORS HERE, and they are all way better than orange – passion fruit, pineapple, and black currant are all ridiculously good. Oh yeah, and because Pongwe is on Zanzibar’s east coast, we got up at 6am and watched a glorious sunrise on the beach.
Tomorrow we leave Pongwe and head for Stonetown (the historical center of Zanzibar), where we hope to a) learn some Zanzibarian history, b) do some shopping, and c) watch a nice sunset (Stonetown is on Zanzibar’s west coast). Then it’s off the next morning to the airport for 36 hours of flights back home! Hoorah!
Well, this may have been my most long-winded post, and I’m not sure there will be another one. Our friend Nick coined a phrase, “TIA” while we were at Bugando. It stands for “This Is Africa,” and it was what we said to each other in the hospital whenever a lab test wasn’t available or a medication didn’t get given, to not only be able to overcome our frustration, but to remind ourselves to withhold our judgment. Well, these last six weeks were our Africa, and we loved every second. To everyone who made our experience unforgettable, asante sana!
This morning we left Pongwe for Stone Town, the historical center of Zanzibar. En route, we stopped for a traditional 'spice tour,' in which a local guide takes you through a farm in which they grow fruits, vegetables, and yes, spices. Nothing like smelling fresh cinnamon bark or having your guide dig out turmeric root, but for nerds like Annie and me, two highlights were the iodine tree as well as the quinine tree, for obvious reasons.
By the end, we were stuffed to the teeth, and proud of our efforts.
