Wednesday, December 17, 2014

IM Resident Daniel Townsend's Week 4 Update from Arusha, Tanzania

"Remember, Reuse and Return"

I have completed my 4th and final week. 

Remember: Tanzanian Independence Day was this week on the 9th. People got off work, they celebrated with their friends and families. No large fireworks displays that I could see, but it was a celebration nonetheless. I finished my last day of work this week and it was bittersweet. I am anxious to see my family again and take a break from bartering, but it has been a great experience.  Although it's hard to put into words right now, as one missionary couple put it, "This place just pulls you in and doesn't let go". I suspect I will see the people who live in the shadow of Mt. Meru again. The registrar who I worked with the most this month, Christopher, was sad to see me go. He is a talented physician and a compassionate man. His advocacy for patient education and communication were inspiring. I had lunch with him on my last day, and I asked him what goals he had for his medical career.  He looked me in the eye and said "Not internal medicine.” I laughed out loud. I was surprised because he was skilled at it.  He thought he like obgyn the best, and if, Lord willing he was able, he would try for this residency. It's not easy as they have to find a way to pay for their residencies, unlike us. I was again reminded of how thankful I am for the education I have received. Regardless of his ultimate career path, he was skilled with cardiac ultrasound by the time I left and this alone was an accomplishment. He gave me a gift on my last day, he said "It's very small, not much, but I wanted to show our appreciation". He gave me a traditional masaai shuka, which is a common piece of clothing they wear. He made me put it on in the hospital and the nurses laughed. I felt honored. He told me, "Go home to your family, but remember us. Don't forget us, and come back soon.” 

Reuse: Tanzanians are a resourceful people. After leaving Arusha, I flew to Zanzibar to meet up with an old friend who is doing Peace Corps in Botswana. It had been a long time since I had last seen him and his wife, so it was a good reunion. When we were there, we decided it would be fun to try and fish. We asked some local guys on the coast if they could take us out. They agreed after we hashed out a price. They met us down by the water and took us out in their dhow. It was made of hand carved wood and was absolutely a blast. The sail was hand sown.  I was curious though because I didn't see any fishing poles. We got out past the reef, and they dropped the sail and anchored. They  then produced from their bag a few "fishing poles.”  One was a plastic bottle with string wrapped around it. One was an aluminum can with the bottom taken out and wire attached to it. The weights?  Spark plugs. I was stunned. They cut up some small fish, put it on the hook, and we dropped our lines down. We caught a total of 6 fish before the sweltering sun and constant rocking of the boat made us feel it was time to head in. I was struck by how everything seems to be reused. In the local market in Arusha, their brooms are handmade, and their cooking spoons are made from other pieces of recycled metal. In Zanzibar I found a rope that had washed ashore during the night. Immediately a local gentleman approached me and asked kindly if I was willing to part with it.  I said I was, and he said thank you and left with his newly acquired commodity. We were eating dinner one evening, and I ordered something that came with french fries. The waiter took our order, then immediately left the restaurant, went next door to another restaurant, and disappeared for a few minutes. I was perplexed, but I had become accustomed to being perplexed by this point so I didn't think much of it. She re-appeared a few minutes later carrying a fryer. She was borrowing the neighbors’ fryer to make my french fries. Even street food seems to be a communal affair as different venders borrow from one another when they would run out of ingredients. I tried to think of a similar scenario in the States, and all I could come up with was when I borrowed a stud finder from my neighbor when putting up pictures in my house. Lame comparison. I then thought  if my neighbor has a leaf rake, why would I need one, and if my neighbor needs a snow blower, he doesn't need to buy one but could use mine.  Communal living is the way to go. I'll get back to you on whether or not my wife is ok with it. :-)

Return: There are a lot of things that are hard about engaging a new culture, especially in only 1 month. It's not enough time to really engage, but more of an exercise in experiencing. I'm working on what to say when the inevitable question gets asked back home... "How was Africa!!!?" Well. I can't generalize the whole continent, but Tanzania was.... challenging? rewarding? frustrating? thought-provoking? I haven't come up with a good 1 word answer to summarize the whole, but it represented a lot of things for me. For the moment though, I'm thrilled to be returning to my son who turned 2 while I was gone, sleep without a mosquito net, and have a beer other than a lager. I will integrate back into my home culture but maybe now with a few twists. A little more sensitive to culture, a little more conscious of waste, a little more thankful for healthcare resources, and a little more thankful for air conditioning. As I prepare to finish my residency and enter a palliative care fellowship, I am keenly aware that although this world is filled with beautiful diversity, there are moments when barriers are broken down and you see that there are Paulina's everywhere--  people engaging their culture and working for its improvement, one person at a time. For the time being I will throw myself back into engaging my culture and being a part of meaningful, positive change. This is going to be painful for me to say since I grew up in Kansas, but there really is no place like home…even if that home is covered in snow. 

~Daniel Townsend

Tuesday, December 16, 2014

December 17, 2014 Tropical and Travel Medicine Seminar


Please Join Us

Tropical and Travel Medicine Seminar
December 17, 2014 - 6pm-8pm

Global Health Update

Brian Hilliard, MD
Resident - Medicine-Pediatrics, University of Minnesota

"Race, Racism, and Medicine" - Hosted by SocMed

Michael Westerhaus, MD, MA
Director, HealthPartners Center for International Health
Assistant Professor, Department of Medicine,
University of Minnesota
Co-Director, SocMed

Amy Finnegan, PhD
Chair, Department of Justice and Peace Studies,
University of St. Thomas
Assistant Professor, University of St. Thomas
Co-Director, SocMed

Stephen C. Nelson, MD
Director, Hemoglobinopathy Program
Co-Director, Vascular Anomalies Clinic
Adjunct Assistant Professor, Department of Pediatrics,
University of Minnesota
Children's Hospitals and Clinics of Minnesota

Global Health Pathway Faculty and Resident Meeting

Shriners Hospitals for Children
2025 East River Parkway
Minneapolis, MN 55414
(612) 596-6106