30jan2018tuesday ilula, tz blog/michael madalon reporter today (he doesn't have a google account and likes small case letters....deep apologies)
education is a progressive discovery of our ignorance---- will durant (this is a quotation on the cover of a child's writing pamphlet....the pamphlets are used as the medical record for inpatients on the hospital general ward)
the rosy fingered dawn is about the same as last year....the avian morning alarm clocks (read roosters) start crowing about 04-something....often the first bell chimes at 0545 and the second longer bell chimes at 0600, but some days the clangs are also earlier....cole had already started his lengthy run by then, but margaret, lisa, and michael start theirs at the usual 0615, all to return to the guesthouses about 0715 to prepare for the day
anna's 0730 breakfast today includes warm hard boiled eggs, fried donuts, a local cooked sweet potato, and of course, coffee or tea....bananas/peanut butter are always available as well
the half hour weekday worship service at 0800 in the hexagon room has about 30 hospital staff attendees, but our crew tends to be a tad late....this could be because it is in the swahili language....the service is followed by the morning report for the medical/nursing staff (a case today discussed a 17-25 week pg abdominal bleed patient who was hypotensive even after 5 liters of nss....transferred to iringa)....our group has had some discussions about the format and use of the morning report (the quality seems variable and purpose unclear)
the morning report room has 2 wall boards with hospital information (lab test availability and hospital event tracking for the previous day).....presently creatinine, sickle cell, iron, gram stain, and cryptococcus testing are unavailable....the hospital had 157 opd visits, 58 ipd visits, 13 admits, 20 discharges, zero deaths, 5 vaginal births (no c-sect), zero neonatal deaths/sepsis, 3 injuries, and 8 dental visits on 29jan2018
after the report ken directed a tour to the underground mortuary (although it was locked) followed by a brief tour of the laboratory guided by one of the technicians there....the lab was fairly neat and looked organized
elizabeth and bree then attended the ctc clinician/patient visit for follow up and drug refills (adult hiv clinic) while the remaining members (cole, addrienne, lisa, margaret, aneudy, michael )of our group made up 2 teams (with medical staff members benjamin and kiwono) for general ward rounds until completion about 1230....cole also performed a chest/cardiac ultrasound for one of his team's heart failure patients (wider use of ultrasound skills would be very useful here)....rounds would not be nearly as colorful were it not for the dresses, wraps, and linens that the ladies wear and bring to the hospital....the top ten admission categories (as listed on a ward room poster) are, in declining frequency, malaria, accidents, diarrhea, pulmonary tb, pneumonia, asthma, hiv/aids, anemia, congestive cardiac failure, and stroke
anna's lunch included spaghetti and white rice, mushroom sauce, potatoes + sauce, beans, and avocado
the quarterly hospital staff conference in the hexagon room was to start at 1400, but was a bit late....many of our group attended....it was mostly in the swahili language and lasted until 1645....it was difficult to endure
before today's evening meal most of the group took our customary late afternoon hike to some part of ilula or surrounding land....these walks have little purpose short of an excuse to explore together so we do for an hour or two....thus far we have not been inclined to stop at an amber fluid parlor (safari, kilimanjaro, tusker, etc.)....so it goes....there are a few healthy and similarly appearing dogs around and even fewer scrawny cats....some of the trees around ilula look like they have been through a lot, could be described as gnarly, and likely have stories to tell
ken provided an exciting and early evening film to watch ("taken 2") and this kept our attention until anna and the kitchen crew served us her special potato-egg pancake, spaghetti, a bowl of roasted meat nuggets, and avocado and mango chunklets
it seems to rain nearly every day, enough to give the soil a good soak
the purpose of education is to replace an empty mind with an open one----malcolm forbes (another writing pamphlet quotation)
signing off, michael
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