A Very Productive Day!

Last night, Cari and I joked about our colorful underwear and sock bushes in the yard with our lovely Scottish/Ethiopian roommate, Ryan, who then decided to scare the crap out of us.  He informed us of the East Africa Mango Fly that will lay its eggs in your clothes, burrow under you skin, and then incubate until it forms pupae!  I thought he was just trying to prank us, but upon investigating via the very reputable Wikipedia, I found that he was correct.  As he went off to bed, he uttered in his Scottish accent, "Don't want you all to turn into a box of worms!"  Needless to say, all of us feel like our skin is crawling today and we have been thoroughly checking our delicates for signs of bugs.  Yuck!  Another running joke in the house has been about Ryan leaving the sign with his name on his bedroom door.  When we asked why he kept it up he stated (insert Scottish accent) - "well if I come in drunk some night, I need to know where to go.  I don't want to be accused of anything".  Hopefully tonight it is clear which room is his...

This morning, we had the delight of sleeping in for an hour because of the clinical training conference that Peter, the German pharmacist, was conducting.  When we arrived at the conference, we all took turns presenting "The Nurse's Role in Safe Chemo Handling and Administration".  We really tried to stress that the nurse is the "last line of defense" for the patient prior to administering the chemotherapy.  Britty really got into the presentation when she demonstrated the use of a chemo spill kit with me as her helper.

Peter, Britty, and Cari at the presentation

Me presenting our objectives and pre-administration

Cari presenting on Chemo Administration

Kari presenting on Safe Handling of chemotherapy

Chemo Spill Demonstration with Britty and Me

After the presentation, we finished up our parts of the new chemotherapy protocols and sent them to the oncologists, so they could verify them and add the parts that we are missing.  We also finished our Table for Extravasation Management and Hypersensitivity Flowsheet.  Needless to say, after all that work, we were pretty hungry, so we went to the burger stand again to eat.  Kari of course was elated!  As we sat and waited for our food, we noticed that our table was right next to a giant tree covered in ants and bugs.  After our mango fly scare and the massive cockroach that hangs out in our cupboards, we were feeling pretty "bugged-out", so we decided to move our table a bit.   All of a sudden, a giant fly (apparently Britt thinks it was just the size of a house fly) hit my head, so I jumped and whined a little.  This apparently caused me to kick some pebbles on Cari's feet, which she thought was more bugs, so she let out this guttural scream and jumped out of her seat.  It literally sounded like she was being murdered, so every single person in a 1 mile radius stopped and stared at the crazy table of wazungu trying to keep their shit together!  Cari was a little jumpy after that and when a little ant tried to crawl up her clothes, she whipped it off so hard, she ripped her shirt.   The lady making our lunch thought it was hilarious and kept imitating her.

 After our rejuvenating lunch, we returned to the clinic and had a very productive meeting with Peter (The German pharmacist), Oliver (one of the oncologists), Jane (one of the nurses), and Rahim (the KCMC pharmacist).  We talked about issues we have observed with their workflow that can be improved and brainstormed ways to fix them.  The meeting was really successful and we were even able to decide what other ways we can use the rest of our grant money to assist the clinic.  Hopefully, over the years that we maintain this relationship with the CCC, we can help them to implement these things!

After the meeting, we walked back to the infusion clinic, where we saw both an extravasation of a IV and a chemo spill.  Interestingly enough, we had just taught the nurses about both of these today.  Upon helping the nurses through the process of maintaining both, we realized how difficult it is here because they don't have all the supplies available to them as we do--down to applying a cold compress to the extavasated IV (we had nothing cold to put on the IV site) and not having pants for the patient to change into.


Unfortunately, Furaha's daughter was sick today, so we took a raincheck on our dinner with him tonight.  We had all anticipated on going straight from the clinic to his house, so we tried to look presentable in the morning, which included me applying my roll-on deodorant to Britty's feet to prevent "Stink Foot".  Luckily, it sounds like we might go to the local Biker Bar (a.k.a. bicycle bar) tomorrow with the doctors.

Me putting deodorant on Britty's feet

Being that we postponed our dinner plans, we decided to venture to a local shop near our house, that a lot of people were saying was nice (we were hoping to scope out some decent beer).  While I went to ask for directions at the hospital gate, the other girls went to the ATM, so Cari could make her daily withdrawal from our fund to pay the clinic.  She put her card in, but suddenly the phrase "This machine is closed" flashed across the ATM screen seconds before the screen shut off!  There she stood, shocked as her card remained inside the machine.  After her stressful day with the bugs, she had had enough.  She shouted at the machine, "Just give me my card!"   Quite unexpectedly, a man's voice came out of nowhere: "Okay, just be patient!" Meanwhile, Kari was watching this outside of the ATM room, and thought, "Yeah right, scream at the machine...that's gonna do a lot." Kari's jaw dropped as Cari talked back into the machine: "O-o-okay!"  We really thought she had lost her marbles for good, but apparently there was a maintenance man behind the kiosk that was fixing the machine.  After several minutes of arguing back and forth with the man about whether or not the machine had said "Closed" before Cari put her card in, the man finally gave her back her card, and we were on our way to find the Woodland Market.

We met our housekeeper, Fatuma, to help us get there, and I asked her in Swahili whether or not it was far.  She said that it wasn't too far, so we believed her.  Well, it ended up being much longer on a very windy and rocky path, and of course, most of us didn't wear good shoes.  We estimated that the whole walk was about 4 miles!  We passed a lot of huge, extravagant houses along the way, which Fatuma thought that were owned by other wazungus.  It was interesting to see the contrast between the giant mzungu houses and the small, simple houses of the native Tanzanians.

Fatuma and I walking to the Market

Enjoying a beautiful Tanzanian day walking to the Market

We finally arrived at the shop and thankfully they had a nice selection of wine and beer, along with other groceries.  The trip was worth it!  The cashier looked at us like crazy people, as we unloaded our grocery carts with a variety of wine, beer, yogurt, and chili sauce.  As we collected our goods in our bags, we walked the rest of the way home.  We were all so grateful for Fatuma escorting us the whole way home!

Tomorrow is our last full day at the clinic.  Hopefully, it will be just as productive as today.

Siku njema (Have a good day),
Nat