Morphine delivery - Africa style!

The morphine delivery service continues to function – not always quite as smoothly as we’d hope. The rural service on Thursday arrived spectacularly to the patient’s home; 3 on a motorcycle and straight into a bush! Tears of laughter all round and certainly one way to make an entrance! Cosmos the pharmacist our driver is not always so handy behind the wheel and his gear changes often leave a lot to be desired. Achieving air between you and the seat not always ideal either over the bumpy roads – but all in a days work! The urban delivery service on Friday used public transport to get morphine from Kolandoto to the patient’s home in Shinyanga. So a rather tense journey on the packed dala dala bus (hiace) with a bottle of morphine stashed in my bag but it made it safely you’ll be pleased to know! Both patients are doing well in terms of their pain and have really benefitted from using morphine which we are chuffed about. A few issues with constipation to resolve but we’re working on it. Rather bizarrely whilst buying Ducolax (a laxative) in the local pharmacy we managed to catch a quick glimpse of the royal wedding party which was playing on the BBC world news service. Didn’t get a proper look so will have to catch up on some trashy ‘Hello’ or ‘OK’ snaps or something when I get home!

Interesting ward round at the regional hospital on Wednesday – full of young people with hideous pathology of uncertain origin. The lack of access to basic investigations and basic treatments means people are really poorly managed and there is an awful attitude here by staff that ‘we can’t do anything.’ Grace and I are trying to gently challenge this (particularly when it comes to basic care and analgesia) but we can see also how hard and demoralising it must be, to be a doctor in this country at times, when resources are so limited and people are so poor and cannot afford even the test and treatments that do exist. Do you know, families even take home moribund, imminently dying relatives as it costs 3 times as much to transport a dead person back to the village than a living (albeit only just living) person? To think that in your last hours you could be on the back of a bicycle or in the back of a taxi travelling over bumpy roads is horrifying but a reality here. I have never taken the NHS for granted but for sure will appreciate it a whole lot more when back home. That and running water you can drink from a tap, electricity at the touch of a switch, the privilege of having had a good education and many more things besides….

I will also appreciate

No longer having to stick ‘Mr Men Bite and Sting plasters’ all over my mosquito bitten legs to try and stop the itching. They have been a godsend (thanks mum!) but I do look a bit of a berk wearing Mr Tickle and Mr Bump on my ankles at the age of…

No longer having to light candles at night when the power has gone off using ‘Lucky Matches’ – aptly names because you’re ‘lucky’ not to take your eyebrows off when you strike them!

No longer washing my hands before I eat at the Millennium Social Club (our local in Shinyanga!) where they work on the principle that the water has to be scolding enough to take off several layers of skin in order for your hands to be properly clean…

No longer sitting down after a hard days work with the intention of relaxing or enjoying some quiet time to be greeted by ‘odi’ at the door (the traditional greeting as you enter someone’s home) followed by multiple visitations. You cannot turn people away here! We had 8 visitors the other night – the last one arrived at 9.50pm!! I felt like getting into my pyjamas but I think the subtlety would have been lost…..

Or perhaps I will miss these things? Time will tell.

We have just 3 weeks of work left here in Shinyanga. This week is an important week as we have Karilyn and Richard coming from the UK to meet us. They are key people in the running of this palliative care project and have overseen multiple projects in the roll out of palliative care over Tanzania. So we are on our best behaviour this week!  (It is possible for me to behave sometimes!) The prize at the end of 3 weeks is a long awaited trip to the Serengeti…. I just can’t wait!!

For now sending lots of love as usual. Hope you’re enjoying the bank holiday break.

C x