Day 13: Lupus, Leprosy and Kaposi’s Sarcoma [NSFW]

Dr. Joshua tests a patient's lesions for sensation

Dermatology in Africa differs from the US or Canada in one big way – there isn’t much skin cancer. Darker people with more melanin in their skin aren’t as susceptible to it. But they do have more infectious diseases with some interesting presentations. For the second day in a row, I saw patients with Dr. Joshua in … [Read more…]

Day 12: Things You See in Dermatology

Dermatology Clinic, Amana Regional Hospital

After some difficult days in the medicine ward and delivery room, I took shelter today in the dermatology clinic at Amana Hospital in Dar Es Salaam. Today being Tuesday, Dr. Joshua, Amana’s only dermatologist, was doing a pediatric clinic. Wednesdays are the adult clinic, and Thursdays are reserved for minor dermatologic procedures. I didn’t know what … [Read more…]

Day 11: Should I try and save this woman?

Bing in the Medicine Ward

A recurring theme at Amana Hospital in Dar Es Salaam, Tanzania is the chronic lack of resources. There isn’t much healing and recovery going on in the medicine ward because there isn’t a lot of real medicine being practiced. Patients wallow away for days on end hoping to get better but they don’t because they … [Read more…]

Day 10: Vaginal Tears

Preparing to suture the vaginal tear

Today, Dane, Lidia and I did morning rounds in the medicine ward with Dr. Stanley, the head doctor of the hospital. Dr. Stanley was sharp, and if he didn’t always know his stuff, he sure seemed like he did. One intern doctor presented a patient whom he’d diagnosed with anemia secondary to peptic ulcer disease. … [Read more…]

Day 9: Diabetes and Necrotizing Fasciitis

Today began as a relatively uneventful but educational day in the diabetes/hypertension clinic. We were assigned to work with Dr. David, an intern (first year resident) who was on his first day of his rotation in the diabetes clinic. The senior doctor, Dr. Chris, who would ordinarily be holding the fort, was needed on a “special assignment” … [Read more…]

Day 8: Psychiatry, COPD, and how I paid an Uber driver’s fine

Asthma/COPD Clinic, Amana Hospital

Asthma and COPD at the Amana Regional Hospital Dane and I started the day at the diabetes/hypertension clinic. The doctor on duty told us that Wednesdays were reserved for asthma/COPD patients – there was only one patient today, though we were welcome to see her. Our patient today was an elderly woman with COPD and possibly … [Read more…]

Day 7: Life in the Orthopedic Department

Dislocated Shoulder, Anterior View

Yesterday I wrote about Martha, an HIV-positive woman with advanced stage PCP pneumonia. This morning I returned to the medicine ward to try and find her. I found Martha’s bed empty, two large oxygen tanks still sitting where they were yesterday. My heart sank. “What happened to Martha, the woman with PCP?” I asked an … [Read more…]

Day 6: You can save this woman’s life for $500

Amana Regional Hospital

It’s rare we’re confronted with life or death decisions that come down to money, but these sorts of heartbreaking choices happen everyday at the Amana Regional Hospital in Dar Es Salaam. Martha (probably not her real name) is a 43-year-old HIV-positive woman who was admitted to Amana Hospital this morning with severe shortness of breath. … [Read more…]

Day 5: Tanzania’s Free HIV Program

Buguruni Child and Maternal Health Center

Today I witnessed something that borders on amazing – an HIV treatment and prevention program at work in Tanzania. HIV programs have a special place in my heart – I volunteered as an HIV test counselor for the San Francisco AIDS Foundation for two years before medical school, albeit with a very different demographic than … [Read more…]

Day 4: The Hospital is Out of Supplies

Mnazi Moja Hospital Supplies

When you go the hospital, you expect them to have basic supplies like gauze, surgical masks and antibiotics. Supplies like these are cheap and readily available in Western countries, but in government hospitals in Tanzania, they’re coveted treasure. We noticed the last few days that the minor procedures theater was running low on basic supplies … [Read more…]