This is Africa

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So........finally arrived in Africa. Thought I’d write a bit about it as I’ve been here in Tanzania for about 10 days now. To be honest, I didn’t have much time to think about the trip before I left, I was kind of distracted with my mum’s 50th birthday celebration and also, was getting no answers from the hospital or anyone, so I just kind of thought it’d sort itself out when I got there. When I saw an Africa elephant poster at the airport that was the first twinge of excitement - and reminded me of how much I love this whole thing, just going somewhere completely new, where anything could happen!
I arrived last week, acutely aware that they were not exactly aware of my arrival. Adey had said it’d be ok, we’d sort it out when I got here, so I was prepared to feel a bit generally miffed from when the plane landed onwards. Especially at the Visa stand! I just joined the queue of white people and paid what I was told (which I hear all the guidebooks recommend to do in developing countries.....) He was there waiting anyway, slap bang in the centre, one white fella in a sea of back faces. During the 45 minute drive back to the compound I quizzed him profusely, on accommodation, the hospital, money, food....pretty much everything id been wondering for the last month or so. And the answers came thick and fast, in typical Adey style, which is at 300 miles an hour. To be honest, I knew I’d find out soon enough, but it just felt so good to actually have answers to everything I could ever think of!
And so we finally got to the compound. It’s a compound of maybe 40 or 50 houses, pretty much next to the hospital. It’s completely African terrain, like just what you’d imagine - really dusty reddish roads, but pretty green and lush too. The little houses are ever so cute, usually there’s about 6 or 7 people to a house. I’m not sure who lives in the rest of the houses, but at the moment there’s about 30 elective students and a few medical volunteers staying in them. Mainly from Europe or Australia.... So it’s really social. Kind of like a cross between backpacking (with the whole where do you come from- where have you been - how long you been here conversation being repeated continuously) and the first year of uni.
I was knackered after the journey and savage early morning so we just went to Adey’s mate Will’s house for a drink and to chill out. Will is Malaysian, and he’s a surgeon who’s being working in London and volunteering here at the moment. And God, he knows everything and anything about medicine, honestly. That first night was nice, I was just pretty overwhelmed to be honest, Adey had gone from everything from Swahili to daytrips to wages and my head was swimming. On the whole it just felt great to finally be here really, after the mammoth faff leading up to it. Anyway, the next couple of days were trying to get myself sorted really, and I definitely became a bit more familiar with the whole This-is-Africa attitude. Nothing gets done! You have to laugh, the first day we waited for like 7 hours for the guy, only to find he said come back tomorrow. We went back and forth and just hung around a lot to be honest, but it was a nice slow introduction really!
The hospital itself is something else. Kilamanjaro Christian Medical Centre, KCMC. The first time I was shown around, I’d prepared myself to be shocked and it wasn’t for nothing. Patient’s families are responsible for caring for their relatives while in hospital, that includes cleaning sheets and feeding them. The wards are so full, there are beds lining the corridors and in the centre of the wards. You’re generally squeezing through the corridors on the wards. The sheets are generally always filthy which just makes everything look so much worse. And of course, maintenance is not a priority with the lack of funds, so everything needs to be fixed and is dirty. Its a million miles away from the super-clinical, super-sterile hospitals at home. One of the most frustrating things I find is the lack of simple things like pillows. If you need to prop a patient into a position, you just can’t, there’s no towels or pillows and while I suppose it is frustrating, it makes you bloody resourceful! This is the best hospital in the whole of the north of this huge country, so people travel for days to come here, which makes you really have to consider how you are going to treat them.
The patients we are seeing we would never see anything like at home, because things are structured so differently. For example, there’s no post operative care, so generally speaking people come into outpatients with horrendous contractures and so there’s only so much you can do. And you think, if only they’d been told to move it every day and stretch, they wouldn’t be stuck with a bent knee and unable to walk. Which, don’t get me wrong is frustrating. But it’s made me think a lot really. It’s so easy for us to come in and brandish it all as dreadful and disorganised and exasperating. And then lavish energy into making everything as we know it. Essentially make it all like English healthcare. And the thing is, this is Tanzania. Things work at a different pace, not necessarily wrong. You find that to make a decision, people always need to always ask the next one above you in the ladder and therefore everything takes forever. Which again, is a cultural thing. And organisation isn’t a priority, and although you can argue it’s to the patient’s detriment, you have to appreciate that to a certain extent, that’s just the way it is here at the moment. At first I wanted to change it all and make everything run like clockwork, like it does at home. But I don’t know, it makes me thing, who do I think I am? Coming in and thinking I know best. It’s difficult really though, when everything in you, tells you that you do!
The whole being- a-real-physio thing was the only thing I was apprehensive about to be honest. Like, this is my first job really. I tried to reason with myself and think how much scarier it’d be in the NHS as pretty much anything goes here (which is probably bad to think, but did the job in settling my nerves!) It’s just, you know, going into a room and assessing a patient, and being the decision maker, without anyone watching you, is a scary concept!! I can safely say, 10 days in though, that its worked out fine! I have done a week in the outpatients department and to be honest, while I don’t have anyone telling me if I’m wrong or not, it seems to be going ok. 90% of the patients seems to be women who are hyper-lordotic (and have a black woman’s posture, booty out!) and have been carrying things on their heads for years........so they come in with back pain. Other than the surgical wards are generally motorbike accidents (not remotely surprising here, there’s no test you have to pass, and no one wears helmets!) and people falling from banana and avocado trees. I did have on hilarious patient the other day though, a guy with back pain for months, who didn’t think anything in particular had brought it on. Then it occurred to him as I examined him that his wife injured him, when she grabbed him, when he....ej-ul-aaaate. I was hoping it was a miscomprehension thing, but it was ok, he simulated the whole thing, to make sure I understood fully.
We are really at the foothills of Kili here, you can go a few miles in each direction and you get to the ‘gates’, which are the gates of the national park and where people start the climb. The first day I walked out of the doctors compound and the view of Kili was UNBELIEVABLE. Slap bang in front of us, clear as day and so beautiful - Africa’s highest mountain. Climate wise, it was surprisingly not too hot when I arrived, maybe because we are at 800 metres altitude. I say that though and it’s got boiling within the last few days, as it starts to get hotter now until the wet season in November. A lot of the time it’s a bit muggy (although defiantly tan-worthy).
The primary language here is Kiswahili. I’m desperately trying to learn some, even just basic physio instructions (up, down, right left, does it hurt?) and having a lesson tomorrow in fact! I love it though, they say hello like ten different ways and it lasts a good while. It makes your subjective assessment of patients pretty limited and you start to learn to ask just what you need.
So since I’ve been here it’s been brilliant. Mainly I’m hanging round with Adey and his four Swedish housemates and Will really. But you get to know everyone on the compound, more or less. And people seem to be chopping and changing every couple of weeks or so, there’s hardly anyone staying for 6 months so it’s always new faces. Ha, listen to me, I sound like I’ve been here so long already....! It just feels like it.
There’s lovely things you see, that remind you that you are in Africa. I don’t think the women carrying things on their heads will ever lose its novelty. When we go to work in the morning, we pass them with huge trays of bananas (and I mean huge) on their heads, just walking along. And the kids here....aaaah the kids! They are little dreams! They make such a fuss of you and shout ‘Mambo, mambo!!!’ (hello) as you go past. I’m trying to jog along the main road here and the other day they were all flooding out of school as I jogged past. They all held their hands out for high fives, and I felt like Rocky, finishing a marathon! They are so adorable. Another thing that’s hilarious is there is no limit on how many people you can have in a taxi, so regardless of how many people are going out, we’ll only ever order one. Then its just every man for themselves.
You know what else I love? That often you see people holding hands. Like men and men or whoever. It’s again a cultural thing. Homosexuality is strictly illegal here (Close by in Uganda its punishable by the death penalty....on grounds of, wait for it, HIV). But it’s not that, they’ll just hold your hand as an affection thing.
So, so far, we’ve been on a few nights out. There’s a club called La liga, which seems quite cool. And we went to The Watering Hole the other night, where they pick you up and it’s an outdoor bar with a deckchair cinema. In fairness I lasted half the film (I struggle with the 2 hour sedentary thing) which was good for me really! But, there’s some nice places. And we’ve been for tea quite a bit.
I don’t know, this is gonna come as a bit of a revelation to everyone who may be reading this and know me, but the nights out and parties are just not on my priority list! There so much I want to do here, like climb Kili, climb this other one Mount Meru, go on safari, loads of bike expeditions....that I’m much more keen to spend money on that. Jeez Louise, is this what growing up is??? Ha. In honesty though, much as I LOVE a glass of wine, I just enjoy that stuff so much more at the moment and there’s a million and one exciting stuff for the weekends, that hangovers can’t be on the cards too regularly!
This Saturday we went to visit a waterfall, in a place called Kidir. We, perhaps naively, thought it’d be a little walk and then a big relaxing day swimming and sunbathing. Hmmm. We met a local guide when we were there and he said he’d take us. What he didn’t mention was the hour and a half trek, through literally jungle, basically down a mountain side. In flip flops. It was BRILLIANT and made better by the fact it was a surprise little hike. Although I do wish I’d thought about footwear a bit more! We had to cross four rivers, by jumping over on stones before we finally got there. And it was completely beautiful. We had spent the last hour talking and fantasising about our pre-prepared lunch and was pleased to find at this point, that we had forgotten it. So back up the mountain! Honestly, if you looked up it you would think it was no way possible to get up there - which made it all the more satisfying. Saw mini water snake things too in one of the rivers.
Then by the time we got home we were all dead on our feet and got takeaway Zanzibar pizzas - the most calorie laden, exquisite delicacies made from fried veg, in egg, wrapped in like a chapatti, then fried. A-maaaz-iiing.
Then on Sunday Adey and I went out on his motorbike on a photo taking mission. Being on the motorbike is cool enough in itself (don’t worry mum!!!) but we just went from place to place, taking photos and just taking it all in. Through all the huge coffee plantations and banana farms, passing little shacks and shops and fruit stalls. Definitely the weirdest thing was how people stared though. It’s literally like they can’t believe it...they stop on the street and should Jambo (yet another way to say hello)...and the kids go crazy to see some Nzungus (white people) on a motorbike. We were on our way back in the afternoon when we came across this little spot, kind of beneath the road. It was the most beautiful little river and natural waterfall in the rocks. We climbed down and there was a mum at the top of the waterfall, washing clothes in the water. And further down were her kids slithering around on the rocks and swimming. We went down and played with them for a bit, ended up having a bit of a swim (fairly clothed though!!) and it just made my day.

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