Ahsante (Thank you)

Well, my trip has come to a close and I am back in Chapel Hill! I left on July 12th and reached Charlotte on July 13th (took me a bit to get back and have time to settle down to write). In summary, it was an incredible clinical and personal experience. Travelling by myself was a really unique and special opportunity that I am already grateful for. Of course, just because I traveled by myself does not mean I did this trip on my own – there are many, many people who made this trip possible. So, ahsante (thank you) to these people for this incredible experience!

  • My parents: my dad for supporting me the whole time and helping me get my visa/airline tickets figured out & my mom for not believing that I was actually going to Tanzania on my own until the last month of planning, but still swallowing her apprehension and supporting me anyway. Also, they both helped me through the tough times and were always reliably just a phone call away regardless of the time difference or cost of calling internationally.
  • My friends: I was very, very close to calling off the whole trip before I left purely because of my nervousness, but my friends took the time out of their days to talk me off the metaphorical ledge and coax me into remembering all my reasons for planning the trip in the first place. The last few days before I left, I was certifiably crazy and I really would not have gotten on that plane without them. A special shout out to those who kept in touch while I was abroad – I missed everyone and it was so great to have contact with good friends while I was on my own!
  • Dr. Justin Myers, Kari Corker, and Shay Slifko – These 3 people put in a lot of work to arrange my trip, working with the University of Arusha and ADRA to make sure I had a place to stay and a place to work during my time there. Again, in the last few weeks before I left, they made sure I felt as comfortable as possible by putting me in contact with various people who had travelled extensively before.
  • Dr. Akech, Dr. Koshuma, and the nursing staff – Dr. Akech was the adminstrator who allowed me to come to work at the university and Dr. Koshuma and his entire nursing staff really made me feel at home and gave me the privilege of seeing the real Tanzania by inviting me into their homes. They helped me through every step of the clinic experience, explaining things and allowing me to practice my handiwork at procedures even though I know they could have done everything twice as fast. I learned a great deal because of their patience and because they made me feel okay if I made a mistake (which I did plenty of).
  • ADRA, Leah, and Aziza – ADRA’s guesthouse was a great place to stay for my trip. Leah was always ready to help me with anything, from finding an ATM to arranging airport transportation when I left. Aziza, the cook, made excellent meals every day and I never had to worry about where my next meal would come from because of her. She watched over me like I was her own and I will be forever grateful for it!
  • My drivers – Even though I was nervous on my first day, I fully appreciate the people who drove me back and forth from clinic and around town. I was completely at their mercy, but they taught me to trust and that a little conversation in someone’s native language goes a long way! They were reliable and my trip would not have been possible without them.
  • Saumu – my first friend in Arusha, she showed me around town the first weekend I was there and introduced me to her family. Her quickness to take me under her wing was so sweet and I appreciate it so much!
  • It Started in Africa – I had an excellent safari with them and I know I will treasure that experience for the rest of my life!
  • My Kindle – although it stopped working the day I left for safari (sad face), it was my best friend on this trip. I got to read all the books I had been wanting to read and it was a great reminder (and encouragement) of how much I love reading.
  • Dry shampoo, Simple face wipes, and pocket hand sanitizers – for keeping me remotely clean as I went without power/hot water for days at a time
  • You – for keeping me accountable and following along as I blogged my trip because I know I will look back at this a few years from now and treasure the memories it brings!

So it has come to an end, but my life in medicine is just beginning! Ahsante!

 

Safari: Day 4

This was the short day of the safari, where we drove into the crater and then left around lunchtime to drive back to Arusha. I think we had bad luck for the first time on our trip because we didn’t see too many animals. However, the views and the landscapes of the crater were beautiful!

At the edge of the crater in the morning – we descended right down into it for our game drive!

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Wildebeest everywhere!

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Majestic lion – you can really appreciate its camouflage as well!

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The views!

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Hyenas – they were hanging around by the lions to look for food!

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So many flamingo

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Skulls of buffalo laying around

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Zebra hanging out at our campsite

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We drove back to Arusha and then I got a ride back to ADRA, where I relished in wifi and hot water! The safari experience was well worth it – I can see why its on so many bucket lists. These posts/pictures don’t fully describe the feeling of anxiety you get when you see an elephant walking towards your car and you’re fully aware you are completely at the mercy of the giant animal. They also don’t describe the beauty of the sunrises and sunsets over the immensity of the parks or how beautiful it is to visit animals in their natural habitats and see their interactions with each other in its raw state.

I hope every one of you gets to experience a safari for yourself because it’s the only way to really get the full experience!

Safari: Day 3

Day 3 started with a sunrise game drive, which meant we got ready and had breakfast before the sun rose. Without electricity, this also meant getting ready in the pitch black darkness which is SO hard to do! It was totally worth it though because today was the best safari experience ever!

Stunning sunrise over the Serengeti.

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I wish you could really tell how tall giraffes are through a picture, but this will have to do.

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Elephants again!!!

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We watched this herd of elephants (20ish) for about an hour because it was so amazing. I can’t post any more videos on here (damn free subscription) but check out this link for my favorite video of the whole trip: https://www.facebook.com/ammu.vijay23/videos/10157292185740724/. It shows the mom and baby elephant crossing the road in front of our car to join the dad elephant, seen below:

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Reunited family!

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The baby elephant walked under the mom for most of the time, leading us to believe this was a newborn!

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You can see how smooth the baby’s skin is compared to the mom!

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Giraffe carrying birds! (or birds hitching a ride)

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A lion’s kill – it’s a buffalo, we think. You can see the skull and the blood.

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The lion was sitting a bit away, obviously full and done with his share of the food. So a golden jackal came up and starting sneaking some food. It was cool to watch because the jackal kept stealing glances at the lion to see if it was okay. It’s hard to see the jackal, but he’s eating to the left of the skull and he has a black stripe running down his body.

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The lion laying a bit away, not caring that the jackal is eating its food. It was cool because we drove past this area again at the end of our day and we saw vultures eating the same carcass. Circle of life!

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Male lion standing a bit far away near the tree.

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Female lion – we saw her hunt a group of gazelle! Right now, she’s just relaxing.

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You can see the lion scoping out a group of gazelle.

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Another female lion hanging out closeby.

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This lion was obviously full because it completely ignored the herd of zebras.

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Hippos lounging. In this lake, we also saw a crocodile kill something, but it was too fast and hard to see so I couldn’t take a picture or video to show you.

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We left the Serengeti and drove back to the Ngorongoro Crater to camp overnight there. This is the Simba campsite – it’s right on the rim of the crater, so it was a beautiful view! We saw an elephant and a herd of zebras just hanging out on the edge of the campsite. The campsite amenities were severely lacking, however. There was electricity, but the bathrooms and kitchen area were pretty gross. Oh well, it’s all part of the experience!

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The eating area.

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Safari: Day 2

Day 2 started at the Panorama camp with an early breakfast, sunrise watch, and then we were off on our way! We were driving to the Serengeti National Park, which was about a 3-4 hour journey. On our way, we actually drove past the Ngorongoro Crater, so we stopped to look at it from above.

This picture doesn’t quite capture the Ngorongoro Crater’s beauty. It is massive and it just feels like you’re standing on the edge of the world.

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We made a quick stop at the Simba campsite, where we would be camping the next day to grab our camping equipment! The last camp provided us with equipment, but for the next 2 days we would need to take our own. It ended up as a blue bundle on the roof!

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We had the option to stop near the Ngorongoro Crater to see a Maasai village. We chose to do it and had a really beautiful, educational experience!

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The villagers performing a welcome dance – you can see the men wear shades of red and women wear shades of blue. The huts on the edge of the picture are made from cow dung and sticks – we got to go inside one of them, but I couldn’t take pictures because it was too dark and small inside!

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Maasai baby!

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After a lot of waiting (each park has a long process to enter), we finally made it inside the Serengeti! However, it was just around sunset when we got there so we didn’t see many animals – just drove our way through to the campsite. I still got some gorgeous pictures as we were driving!

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This campsite was less nice, but still clean. No electricity (thank you for iPhone flashlights), but sleeping under the Serengeti stars was an extra special experience. We were warned that hyenas would visit the camp at night, so we were not to leave our tents after we went in them. The campsites at any of these parks are not fenced in or anything, so animals visit frequently. I did in fact hear the hyenas that night and it was especially terrifying, but I made it out alive!

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My tent!

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Our car in the sunset!

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Safari: Day 1

After all the safari drama (and no, I’m not exaggerating), I finally decided on taking 4 days off from the clinic to go on a safari to Lake Manyara, Serengeti National Park, and Ngorongoro Crater. I wanted to join a group since I had been travelling alone all summer, so I contacted a bunch of companies and ended up going with “It Started in Africa” for my safari.

Someone picked me up from ADRA to take me to their office (an hour drive), then I hopped in the safari jeep and drove across town to pick up the rest of my group. I was really nervous about this whole group joining business – I didn’t want to be in a group with honeymooners or a large family (talk about feeling left out), but I was really happy to join a group of 3 30-somethings from London! They were so friendly and really made me feel like  a part of their group.

Lake Manyara was our first stop and it is about an hour and a half outside of Arusha. We saw lots of herds of zebras, buffaloes, wildebeests, etc. in addition to the animals I have pictures of here. I will say I was a bit disappointed with the feel of this safari – we drove on really nice carved paths through the park, so it wasn’t the bumpy crazy ride I was expecting. But, it was a really beautiful park and I had a great time!

Driving through the countryside!

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Pop up roof on the jeep!

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Little monkey family

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Just chillin’.

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A huge group of monkeys hanging out on the path – they didn’t move for a good 5 minutes (I guess it’s okay; after all, we were intruding in THEIR home). See the two babies in the middle?

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We stopped for a picnic lunch in the park, where they had a designated spot with a bunch of picnic tables and toilets. After lunch, we got back on the road and saw this amazing elephant (!!!!!) right next to the path.

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It was destined to be the day of the elephant, I think, because we saw herds and herds of elephants , which all walked right by the car.This is one of my favorite pictures!

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Beautiful sunset!

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This elephant walked right next to our car!!!

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Panoramic view of the lake and the surroundings!

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We left the park and wound our way up this large mountain to drive to our campsite. On our way up, we stopped at an overlook and took a few pictures! Those trees behind us were where we were driving through and you can see Lake Manyara in the background.

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Enjoying a candlelit dinner at our campsite. This place luckily had electricity though!

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To our pleasant surprise, we had live entertainment during our dinner! Acrobatics, dancing, and live music!

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Our campsite the next morning. This was definitely my favorite camp (Panorama Camp) – they had clean facilities, electricity, and a beautiful view to watch the sunrise in the morning.

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Dining area the next morning!

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Havilah Orphanage

Three places I wanted to go in Tanzania: a hospital, a school, and an orphanage. I knocked out two in one at the Havilah Orphanage! I’ll let you look at their website, which does a good job describing what they do.

I went Friday morning, when only the smaller kids were there  (everyone else was in school at TAPS or TASS). We had a lot of fun playing outside, making bracelets (they made me one that I know I’ll treasure), and learning English in their school. I took some snacks for them, which they went crazy over! Here are a few pictures:

Yum, they love Go go squeezes as much as I do!

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We brought the snacks in during one of their breaks, but the teacher said they had to finish the lesson before they could eat. So, they painstaking used pencil on the plastic (it didn’t work as well as they thought it would) to label their individual snacks and then set them on the desk until later. I joined them in the classroom as they learned English! P.S. those desks are way smaller than you probably remember them being from elementary school.

Lunchtime!

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This little lady

The clinic sees a lot of kids from TAPS and TASS (Tanzania Adventist Primary/Secondary School). A teacher usually comes with a group of them (5-6 kids) each day and predictably, they mostly present with a runny nose, cough, etc.

I got back early from my lunch break on Friday and there was a girl from TAPS waiting outside for the receptionists to get back and find her file (or chart, as we call it back home). The doctor also wasn’t back, so I sat next to her and the teacher for a bit. It was the first time I had seen a patient from TAPS alone without other classmates, so I got to talking with her. She was really shy, which made me smile, and she mostly answered my questions with one word (although I got a sweet ‘good afternoon, madam’ from her when I walked up to her).

After sitting for a bit, I asked her if she knew what she wanted to be when she grew up. She said yes and I waited for her answer. Nobody said anything for a bit and I realized I only asked her if she knew, not what she wanted to be. So I followed up and asked her what she wanted to be. She said and I quote, “I want to be like you” and it made my heart warm (she stared stubbornly at the ground the whole time she talked, like looking at me would be too embarrassing).

So I took her to the doctor’s office, gave her my white coat to wear, and showed her how to use the stethoscope to listen to her heart and mine. On our way out of the doctor’s office, she reached for my hand and held it while we walked outside to show her teacher what she had learned! She went around and listened to everyone’s heart (once, listening on the wrong side) as I introduced her to the nursing staff as our new doctor in training.

She’s rocking the white coat! (You can see the TAPS school uniform she’s wearing, too).

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A lot of people have a lot of goals in their lives, both personal and professional. Even within the medical professional realm, some people want to be CEO of a hospital, do groundbreaking research to solve a question, or be world renowned for their clinical finesse. There are so many different paths doctors can take in their careers. I’ve tried these various goals on for size, but they never speak to me the way the speak to other people.

My professional goal is to inspire the next generation. It’s less lofty and less impressive than the other goals above, but I wanted to be a teacher longer than I wanted to be a doctor and what better way is there to combine the two professions? Medical education is at the heart of what I want to do when I grow up and seeing this little girl amazed at the heartbeat she was producing with the stethoscope in her hand, walking around the clinic in a too-big-for-her white coat reminded me why academic medicine, and therefore inspiring the next generation, is my professional goal.

 

Last Thursday!

Thursdays, as you may remember, are my favorite days at the clinic because it’s vaccination day! Today was my last Thursday (there’s only one more left in my trip and I’ll be on safari during it) and it was just as fun as the other times!

One interesting thing I’ve noticed is when a newborn baby comes for the BCG vaccine (subdermal) and the first dose of the polio vaccine (oral), the mom cringes and looks away when I pull out the needle. Now that I’ve done these for a few weeks, I know the oral vaccine doesn’t hurt since it’s just two drops of liquid and the baby usually sleeps through it. The BCG vaccine is a small needle with 0.05 mL of the vaccine and it goes in the arm, right under the skin. Because it’s not an intramuscular injection like the other ones, it doesn’t hurt. The baby usually squirms a bit when it first goes in, but keeps sleeping throughout. But by the looks on the moms’ faces, you’d think I was about to cut the kid’s arm off! They’re usually way more nervous and conditioned to see a needle and think pain than the newborn is. I’m sure this is a universal reaction when babies first get vaccinated 🙂

Here’s where I hang out on Thursdays! The chair is where mom and baby sit, the big blue freezer box has the vaccines, and the exam table is my area to prepare the vaccines. If the power goes out (as it does routinely), I pull the chair close the window to get some light and the generator kicks on for the blue freezer box.

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This is probably one of the coolest things I’ve seen since being here – moms use a piece of cloth and wrap it around themselves to hold the child on their back. The kids (as young as 2 months or so) know to stay still and hang on the mom’s back while she gets the cloth ready to wrap around.

Close up look at my prep station: from left to right – the clear bucket is the trash box, the red box holds cotton for bleeding and water/sodium chloride for mixing up powdered vaccines (ex. BCG), the different sized syringes are next, and the gray box is an icebox that keeps a few vaccines cold as we use them repeatedly through the day (so we don’t keep opening up the giant freezer box).

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Slow days

The past week in clinic has been really slow – the students of University of Arusha are taking their final exams, so they’re not coming into the clinic. Since the clinic’s patient population is about half students/workers from the university (the other half is from the surrounding village), it’s been noticeably quieter.

Few pictures documenting daily life: first one is lunch at the university cafeteria. The food is fresh, but it’s the same menu every day so after 5 weeks, I’m ready for some variety in what I eat! It’s really good food though (and cheap – 2000 shillings, or just under $1). The next pictures are my view of Mt. Kilimanjaro from my post lunch relaxation spot. The university sits between Mt. Meru and Mt. Kilimanjaro, making for some beautiful scenery!

Dala Dala-ing

Alright, sneaked a few pictures of a dala dala when I was on my way to the district hospital. For those of you who are curious about how the dala dala system works, it’s the method of public transportation around here. But it seems to be highly unregulated. There aren’t timely stops, ticket prices posted, a ticketing system at all, or a limit on the number of people a dala dala can hold. It’s notorious for pick pocketing and people bring all kinds of things with them on the dala dala – there was once a body sized bag which smelled like it was full of fish.

You stand at the side of the road and flag down a dala dala (or sometimes, they slow down in front you yelling “Twende, twende”, which means let’s go – I guess if you wanted to hitch a ride, you’d just run and hop on?). The door slides open and you squeeze your way on. If you’re lucky, you get a seat. Then, you sit and wait as the bus picks up more and more people. At some point in the journey (it’s not at a predictable time), the guy who stands at the door will shake his hand full of change, which is the signal to pull out your money and give it to him. They hate making change, so I always try and have bills of less than 10,000 ($5) shillings to give. Depending on where you go, the fee is between 300 and 600 shillings. I never know the fee when I get on – I just hand them a small bill and hope they’re honest enough to give me the correct change. The fee doesn’t seem to be determined by distance though because a trip from ADRA to the city center of Arusha is 600 shillings and takes an hour, but a trip from the main Usa River area to ADRA is 300 shillings and takes about 5 minutes.

When you’re ready to hop off, you say the name of the stop (for ADRA, you say Danish) and the bus driver taps the side of the bus to signal the driver to stop. Most people are really elegant and fast when they get off, but I haven’t quite figured that out yet. You usually have to climb over people while ducking your head down and it’s usually a mess when I try and get off. I usually really like taking public transportation when I travel (especially in Europe), but taking a dala dala is honestly not my favorite way of traveling. It’s still one of those things a tourist “must do” when visiting Tanzania though!

Dala dalas are usually white, with various bright stickers on them. Each one will have two horizontal stripes (these are blue and green on this one) signaling the direction of travel.

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This guy leans out of the door for most of the ride, calling out the potential riders on the street. He’s the same person who signals to the driver when a passenger needs to get on/off and he’s the person who collects the money from you.

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