Mambo vipi!

Mambo from Tanzania!
I'm so sorry to leave all of you hanging for so many days, but it has been a very busy week! I arrived in Moshi over 24 hours after I left home and was utterly exhausted and overwhelmed. I won't lie that my first night was a bit rough, but twelve hours later I had met all of my contacts at KCMC and my lifesaver Dana which made all the difference.

Allow me to recap the last week here and throw in a few of the highlights:
This week is the national elections for president which has been quite interesting. There has been lots of shouting and music in the street, lots of music, and lots of paraphernalia supporting one candidate or another. Today is election day and the town seems very calm.

I am working in all of the different pediatric clinics at KCMC. Since KCMC is a referral hospital, it gets very sick children whose parents have waiting to bring them because the expense of health care is often more than the family budget can afford. I have seen many clinical cases that I would never see in the US including rabies, congenital hypothyroidism, and lots of rheumatic heart disease. The mentality in treating these children is very different because of their co-morbid conditions (HIV/AIDS, tuberculosis, malnutrition, unvaccinated) which changes the entire approach to their care. Sadly, it sometimes becomes more palliative care because there is nothing more to do for their situation. The medical language is English but the patients and their families all speak Swahili so I am trying to learn key phrases. It is a difficult language to learn, but I am slowly gettin' there. The Duke collaboration with KCMC is quite large and there are a lot of really great physicians here. The idea of a nurse practitioner does not really exist in Tanzania so I had a difficult time in my first couple of days explaining that I needed to follow the doctors and not the nurses.

I live with 2 British 3rd year medical students interested in internal medicine, a Danish 1st year medical student studying lipodystrophy associated with antiretroviral therapy in HIV pediatric patients, and an American PA student doing OB/GYN. Our house has the essentials and that's about it! We lose power almost every day which I fully expected.

Yesterday I went on a trek with my roommates and my friend Dana up to a village named Materuni to see their waterfall (pictures coming later!). The hike to the falls took us through banana and coffee plantations and on the paths of the small village. Children love to see mzungu (white people) so we had quite an entourage throughout our hike. The falls are about 80 meters high and beautiful! We continued hiking to the border of the Kilimanjaro National Forest and took a sharp turn up the mountain where we ended up at our guide's homestead for lunch. As part of our dessert he brought us some dried coffee beans which we shelled, sorted, roasted, ground, boiled, and pressed into the most delicious (and time intensive) cup of coffee I have ever had in my entire life! You know how much I love coffee so that is a hefty compliment, but there's really no comparison when you're sitting on top of a mountain in Africa sipping kahawa (coffee) with beautiful Swahili watoto (children) in a house with dirt floors. We also tried maize beer (gross) and banana beer (equally as gross). I can't wait to show you the pictures!

I plan on hanging out and resting for the rest of today and while the rest of the Americans celebrate Halloween I will be resting for a bright and early day in the HIV family clinic.

Thank you to everyone who has made comments and emailed me! They are nice gifts to get during the week! Keep them coming, although I will respond to everyone here since internet is so scarce. Love you all!