After the presentation we headed back to the homeland- the Cancer Care Clinic. This week there is a pharmacist from Germany, Peter, who is here doing a workshop on safe handling and preparation of cytotoxic medications. He has been around the last few days, observing and taking notes on what could be done to improve the workflow here. Since there are a few differences between here, Germany, and America, we have a lot of things to discuss!! We sat in for the first few minutes of the workshop (there were a few pharmacists, other doctors from other wards, and a few other people I didn't quite know) and were introduced, but gracefully made our exit when the presentations started. We will actually be presenting tomorrow during the workshop on the nursing side of chemotherapy administration. After discussing the agenda with Peter, we all agreed that it would have been interesting to sit in on the workshop, but we simply do not have time! Another day..
We headed over to the infusion center (which was empty) and began working on two things: protocols and the power point presentation for tomorrow. Brittany and I chugged away on protocols, and Nat and Cari started to make the presentation. We worked for a few hours, and then decided to head home for lunch, we were starving! We made the familiar 15 min trek and arrived "home" to some seriously wonderful smells. Fatuma had started to prepare lunch. While she finished cooking, we debriefed on how the rest of the afternoon would go. We had a delicious lunch of rice and lentils (seriously, I don't know how that woman can make something that seems so boring SO DELICIOUS!).
Walking back to the CCC, we encountered a Norwegian man who is here as a physical therapy student. We have been running into more and more muzungus, I'm not sure if they were here all along and we have been in our own bubble, or if they all just arrived, but there are so many here now! He invited us to a BBQ tomorrow evening at a neighboring house, one of the girls they traveled here with is having a little birthday party with all new friends she has made here. We appreciated the invitation but we actually have other plans. Furaha invited us all to have dinner at his house with his wife and child, and we are really looking forward to it!
In the clinic, we continued to chug away at the protocols. Currently, the oncologists see a cancer diagnosis, and look up in their books etc on what the protocol should be for the treatment. This can be a really time consuming task, they then have to hand write out the whole protocol in the "orders," and then again in the MAR. We are attempting to create documents that can be their "protocol sheets"- where they can turn to the file cabinet and pull out the protocol for neoadjuvant Breast Cancer- for example- and the chemos and dosages will be typed and printed in the treatment box. Hopefully this will save them a lot of time and headache. We currently have made almost 40 sheets with different types of cancers, etc. We plan to have a big meeting tomorrow with the oncologists and the pharmacist, to review them and hopefully finalize them so they can start to be used! It's a time consuming process but the protocols look really nice and they should be really helpful. Here's a pic of just some notes (aka chicken scratch) that I took while confirming with Furaha which protocols and cancers they want, as you can see, its pretty detailed!
One of our favorite times of the day is at the end of the infusion day- when we are all working on our presentations/protocols etc. This is the time where Furaha comes over and checks in with us to see what questions we have. Since he is busy all day with patients, we usually just make a list of questions and things to clarify with him (sometimes there are multiple protocols and different lines of chemotherapy- and not all of the chemos are available here- so we don't want to write up a whole protocol if it isn't even relevant). After we get the questions answered, we usually just start chatting with Furaha about anything and everything. Upon chatting with Furaha, we realized that our taxi driver, Festo, had taught us a HORRIBLY OFFENSIVE phrase but told us it meant something else ("I'm hopeless"- we were using the phrase a lot when it came to swahili, because usually one or most of us is confused about what is going on). When I mentioned it to him yesterday, Furaha almost fell over laughing. Literally had tears in his eyes. It was so embarrassing but also so funny at the same time. I don't know why this stuff keeps happening to me- first I spray him in the face with saline and now this. Anyway, at least he is a good sport about it. After laughing and laughing, he asked us if we wanted to know what it meant, and when we said yes, he started laughing again and it took him a while to get it out. Needless to say I will not be repeating it here on this blog! Thanks a lot, Festo.
We were able to finally pay Oliver (the other oncologist) for the disposable bone marrow biopsy needles that we purchased with the Fairview Medical Mission grant money. We might have mentioned this before, but the most direct and easiest way was to have Oliver purchase them from a supplier he has found in Belgium ($9 per kit)- and have us pay him back in Tanzanian Shillings. It took almost a week of pulling out the maximum limit at the ATM to reach the $950 we needed. It was the equivalent to over 2 million shillings!!!! We counted and re counted and basically felt like ballers when we handed it all over today. It was quite a bit of cash to hand over, especially since 950 US dollars can go a very long way here. These bone marrow biopsy needles will last them a year.
Here's a pic of a patient that was in the clinic today. Through Nat, and broken swahili, we were able to communicate a little bit with him. We gave him some Play-Doh (Thanks, Liz!) and he was so happy! It was so fun, he was such a cute and polite kid.
Until Kesho (tomorrow!)
-Kari
PS: The title of the blog post is something that WE CANNOT STOP SAYING. I don't know why it happened or how it happened, but now, almost every other sentence ends with, "you know what I mean?" I think we are spending too much time together and I regret to admit that I am the largest perpetrator of this annoying habit. We are all calling each other out on it and it's pretty much dominating our conversations. Hopefully by Zanzibar this weekend this phase will have passed! If not, it may be a fun drinking game ;)
PSS- haven't mentioned the McKroket today. Well here we go.. next week we will all be reunited with this delicious dutch "hamburger" from the McDonalds in the Netherlands. YES!
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