Hello from Arusha! I have finished my first 10 days into my second attempt here and so far I am anatomically intact. Mentally, however, it has been a whirlwind. My days begin with a beautiful 3.5 mile walk from my village of Il Boru to Selian Hospital. The walk itself summarizes life at the hospital such that I am able to see the wide economic divide first hand. From the playful smiles of poor young kids in tattered uniforms walking to school yelling muzungu (foreigner) and asking for fist bumps to the Land Rovers that careen by spraying dust over us, it is quite the experience. 

The days at Selian are generally similar to the structure of US internal medicine wards. We conduct rounds with two medical interns, one registrar (someone who has finished intern year and is working as a staff), and the nursing staff. The key difference lies at the end of every patient interaction when the medical team's plan to order tests and medications needs to be conveyed to the patient and their family. The difference in that conversation between the US and Selian lays plain the inability of the family to afford basic diagnostics that are taken for granted in the US (such as a urinalysis or a chest xray). This is somewhat complicated by an intermittent lack of resources at Selian to perform these diagnostics. 

Such difficulties make the practice of medicine very challenging and sometimes frustrating and this is evident among the interns and the rest of the medical team. However, the reliance on history, exam, and most importantly local epidemiological data make the practice both exciting and educational.
Selian Hospital is a major safety net for the Masai population and the poor around Arusha and the medical team truly cares about the patients and I am lucky to be here working with and learning from them!

A hungry baby goat on the walk to the hospital

Selian hospital