Health Care

Jambo!

It is difficult to know where to begin in order to give you an idea of the way health care is in this part of Tanzania.

There are dispensaries located in many of the small districts. These facilities are equipped to care for basic medical needs, and deliver babies (but not if this is the woman's first baby or if it is her fifth or greater). They are often ill-equipped and understaffed. The government continues to build them.

There are "duka la dowas" (no idea how this is spelled!) - the main pharmacies in many towns and villages. Here you can purchase just about anything over the counter and without a prescription. Patients will arrive at the duka and describe their symptoms, and the duka will provide just the right medication without ever laying a hand on the patient. If you only have half of the money for the antibiotic, let's say, the duka will give you half the number of pills. This is one area in which Minnesota International Health Volunteers has made some progress. They have trained the dukas not to sell half doses, and then sent secret shoppers out in the villages to see if the dukas learned anything. And - they did! Most in this area will no longer sell half of the needed dose for malaria treatment, or other such remedies. That doesn't stop them from offering their own prescription though.

There are hospitals, too. There is a main teaching hospital in Dar es Salaam and one at the foothills of Kilimanjaro - called Kilimanjaro Christian Medical Center - KCMC -(which was primarily started by the father of the man who helped write Three Cups of Tea and is building schools in Pakistan). These teaching hospitals sound like good places, but I've heard some horrific stories. For example, there was a woman who delivered at KCMC and couldn't pay her bill, so they took her baby away from her!

There is a very small hospital in Karatu - where I am - about 2 hours northeast of Arusha. The hospital was built in 1999, but looks like something out of the 1950s. I went there for a tour the other morning, and spent the day there today helping with consults and examining patients. I also rounded on the c-section patients with one of the other physicians. I was prepared before going - by hearing a number of horrifying stories about what has happened there. So I was not completely mortified by the terrible things that I saw - but I do need some time to process everything before I can write about it competently. I was quite pleased to see that all of the mammas that delivered had their babies swaddled and with them - but, after all, who else is going to look after them? There are 12 beds pushed so close together, you could literally roll over onto your neighbors baby if you weren't watching carefully. This is where the women labor and recover. They have a separate room, very similar, with the same number of beds where the c-section patients recover for 10 days before going home. Imagine rounding! But some of these women live more than 20 miles away (with no car or money for a bus) and walked in for their deliveries. The hospital does a good job to ensure that their stitches are removed and there is no sign of infection before making them walk home 10 days later.

I am so fortunate - and take so much for granted...