Eleven Healthcare Workers on a Medical Mission

January 17, 2005

We have an awesome bunch with us--teaching ultrasound, seeing patients, teaching diabetes techniques, brainstorming etc. The container [medical supplies shipped via Global Health Ministries] has not arrived yet but hopefully will while we are here--this has not stopped us from getting a lot done.I continue to be so impressed with Dr. Saga and the staff at Ilula. I had stumbled on a quote from the British Medical journal that some of you will have seen in our devotions--for me, it depicts the situation correctly--we indeed have found a dedicated staff of hardworking people--we really are not the teachers we thought we were--rather we are students of those here in
Tanzania that work in conditions that may have led us to give up long ago.

Several touching moments where we think we are making an impact then realize we have just touched the tip of the iceberg--we purchased about 250 bednets in Dar for malaria protection--we are giving them to mothers at the health center with new babies, and handed them out at the Sunday church service at the Ilula church to mothers with children under five--we then announced we would also hand them out at the children's Sunday school lesson at 2pm Sunday (we anticipated the 40 sunday school kids) but when we got to the church at 2 pm we saw a whole sea of children--literally 400 kids engulfing us--how do you decide to ration the limited resources--we ended up not giving any nets out there since we did not have enough for everyone.

We are treating a 7 year old boy who received 18% body surface area burns to his right arm from a scalding injury--they only have tylenol for him for pain and no burn ointment--this little guy was so stoic, trying not to cry--it is painful just to think of him. We have come to Iringa today (1 hour by bus) to get him burn cream--if he survives the burn, that arm will probably be crippled from contractures, etc. We rounded on 26 inpatients this morning--many we suspect have complications of HIV, but of course there is no way to tell--a mother with what appears to be advanced stages of HIV, nursing a very sickly looking infant--they lie in bed, both hanging on for dear life.

The simply amazing thing, is, in a country where if I were living here I might ask "why have I been forsaken" we see basically happy thankful, faithful people that raise their joyous voices in song all of the time. What a world--sometimes you don't know whether to sing, dance, or cry.

Anyway, the surgery suite looks awesome. We now have a clear idea of what to do next--our priorities are to get the OR up and running--it is getting close; finish the "unfinished building"--it is nearly complete and could be turned into useable space quickly; we should then do some upgrades on the existing 48 bed inpatient ward; we then need to concentrate on training--we should maximize what they already have to make sure they are getting the most out of what they have-- the knowledge to put all of these offerings to use...and with God's blessing, they will suceed!

That's all for now--
Randy


January 17, 2005

This afternoon we are in Iringa.....able to use an internet cafe. We are sending you some info. about our trip so far. Please post this to the www.sotv.org Ilula site......so others can find out how things are going for us.....Thank you!  We arrived safely....on-time.....with no difficulties. We have spent the last 4 days in Ilula.....at the Ilula Hospital. We have been able to join Dr. Saga for his morning rounds, which has been truly heart wrenching. Seeing so many sick people, who are receiving such limited care for Malaria, HIV, Typhoid,
Malnutrition, and other diseases, is very difficult to witness.

There are so many things that the Health Care Center needs such as: proper medications, necessary medical equipment, more staff, essential education, bed nets, food, clean water.....etc. But we feel blessed that we are here and that we are doing what we can to help these wonderfully grateful people!  The good news is that the 40 foot container that we shipped over here will be
arriving soon! This container is filled with much needed medical equipment and medications....etc. Once it arrives, our Doctors and Nurses will be able to provide instruction and education to the staff at the Ilula Health Care Center.  The construction on the Surgical Center is on-time, and should be completed within the next 2 months! This is great news because having a Surgical Center here at the Ilula Health Care Center will give it "Hospital" status, which means that a great deal more funding will be given to the Health Care Center from the
Tanzanian Government.

On Sunday, we attended the Ilula Village Church Service. Even though we could not understand the Sermon, we could see the love that these people have for Jesus. These people have almost nothing, yet they are so grateful for the little that they do have. We handed out hundreds of bed-nets to the pregnant women and children at the service. Bed-nets are essential here for the prevention and spread of Malaria. (Pregnant women and children are at the highest risk for contracting Malaria.)

We visitited a primary school in Ilula this morning! Here there are 1,300 students and only 36 teachers. Wow!! The children were so happy to see us and we had a wonderful time interacting with them. They loved it when we took polaroid pictures of them, and gave the pictures to them. Most have never seen what they look like, so giving them a photo of themselves was like handing them a million dollars!

We walked into the village of Ilula 2 days ago, and saw how the local people try to make some kind of a living by selling things they have either grown or made by hand. The average family in Ilula lives on $200.00 U.S. dollars per year. Hard to believe.....right?

Well....that's all for now. We will send another message when we are near another internet cafe. We hope everyone is doing well back home, and we greatly appreciate all of your prayers while we are here in Tanzania on this important Medical Missions Trip.

Sincerely,
LeeAnn Carlsted



January 19, 2005

Our trip is coming to a close later this week. We spent time at Ilula working with the staff at the Health Center to help understand their needs. We have spent 3 days in Tungamalenga, Shepherd of the Valley’s sister congregation/village that also has a Lutheran dispensary. Provision of health care here is even more impoverished. The dispensary is without electricity. Their only laboratory instrument, a microscope, is broken and thus they have absolutely no diagnostic capabilities. The staff includes clinical officer Barnabas Kwahage,
Diana Saga-nurse midwife who's schooling was funded by SOTV donors, Geoffrey the lab tech (now working as nurse assistant), and Asnot (a nurse assistant). They all work 24/7. People basically cannot afford care here so much of it is charity care. Money for salaries often goes to buy medicine and at the end of the month the workers occasionally go unpaid. They are looked after by the church to make sure they have food and a place to sleep (Diana sleeps in a room in the church office building).

Barnabas runs an AIDS home-care program for people in the village dying of AIDs. Of course, there is no treatment available, so all of the care is supportive. Barnabas makes home visits on foot traveling from mud hut to mud hut. We have accompanied him on these rounds, delivering hospice kits [donated by SOTV and Global Health Ministries (GHM)]. These kits contain comfort items such as soap, towels, Tylenol to relieve pain and fever, multivitamins, etc. One home we visited was a grandmother caring for 4 children--the parents had died of AIDS over a year ago. Two of the 4 children have definite HIV/AIDs and are dying. Has the world forgotten about these children? My wife Kari, referring to malaria and HIV here in Africa, asks, "Is this the silent Tsunami?"  However, we continue to meet amazing/inspiring people--one example: Laura Ward is a middle-twenty-something women from Ottawa Canada who is working in a remote village (25km from Ilula) doing primary health education (HIV, malaria, etc). If you ask her what brought her out here to the middle of no-where, she replies, “it was my heart." She has elected to delay entrance to medical school to continue to work here.

Give my love to everyone, there will be lots to talk about (and lots to do) upon
our return

Randy


January 28
 

Things are going well! Dr. Saga and Dora have been exceedingly kind to us and we are eating like kings!

Last week went really well! We did organizational things-e.g. stocked and arranged the pharmacy and stock/supply room so things were grouped by categories, and a med list written out describing the drugs we brought, indications, and dosages. Rounds, seeing outpatients, crazy ER along the roadside medicine, met with the SPW HIV HQ office, both gave talks that went really well.

Plans for next week: primary school and distributing Albendazole to 1500 students and treating staff at Ilula health center, continue to pursue the SPW contact, educational talks for the staff, in-service for staff on orientation to stock room and the supplies and their uses, and demonstrations on how to use things such as IV needleless catheters, pulse ox, glucometer etc. We'll also visit the hospital in Iringa to figure out their lab for Hgb and Cappilus testing.

Also we met with Dr. Saga and in terms of needs, there are a few things we have identified which could potentially be brought over next week (the other ones are longer term-e.g. portable x-ray machine, washing machine, training OR nurses).

1. Adapters-for pulse ox
2. Mattress pads/water resistant covers for hospital beds
3. Stanford anti-microbial pocket guides
4. pocket pharmacopias
5. Clipboards
6. Gail's glucometer stuff-hi/low solution

In closing, we will email next week with more updates from the week. Thanks again for an amazing trip and putting all of this together! We are thankful to be here!

Peace and lots of love and hugs!
Amy and Rob