Hello from sunny, hot, beachside Dar es Salaam!! Sounds nice, huh?! Well, it is!! Dar has been treating me very well these past few months!! I’m now in the final homestretch with 3 weeks to go..
It’s hard to completely put into words what my experience has been like here. Most times it feels like I’m here for work, but other times, it just feels like I’m on a vacation, haha.. is this what it feels like for those who live by the beach all the time!? Life is constantly a vacation?! And maybe it’s not just the beach, but it’s also this wonderful place I’m staying (I mean, look at this view…) and the little side trips I’ve been able to take on the weekends… sailing, Zanzibar, beaches, etc! It’s so different from Moshi, that it doesn’t quite feel like I’m “working” here. It’s been a nice balance of work and play, that’s for sure, so… I’m not complaining! 🙂
As most of you know, my main reason for being here in Dar is to help run a 10-week pediatric oncology certification course for 7 of the oncology nurses at Muhmbili Hospital. It is something that has been in the works for a while, and when it finally came together a few months ago, I was asked if I could come for the entire course, and help with a lot of the coordination and run the course. So, together with the amazing Dr. Trish (she’s an Irish doctor who has been here in TZ for over 10 years, completely changing the care for peds cancer kids…basically, she’s amazing, and I’m so lucky to work with her!), and about 15 other nurses, doctors, and pharmacists from Ireland and the United States, we are here doing lectures and working with the nurses at the bedside teaching them everything they need to know about pediatric oncology.. haha… or trying at least!!
In a nutshell, the course (so far) has completely exceeded my expectations. I came on board unsure of how the nurses would respond to the demands of the course, how they would respond to the preceptors, how the teachers would adapt to the setting, how I would handle running the course and working through all of the challenges that come up… I just wasn’t sure how it would all go.
I guess this is the way most things have gone here so far.. I tend to either not have many expectations at all, or maybe set them low.. and then.. am just blown away by what actually happens. The nurses have been complete rockstars! The way the course is structured is that we do a short lecture in the morning from 8-9am, then work with the nurses at the bedside from 9-3pm, then have another short lecture or review time in the afternoon for an hour. So….this means everyone who is participating in the course works Monday-Friday 7am-6pm, and then one other weekend day. Yes. 6, 12-hr days, for the whole 10-week course. I know… it’s a lot. Not to mention there are only 7 of them working, caring for upwards of 90 patients. (Really puts things into perspective… all the days as charge nurse on CCBD, when we were “short” staffed!! Haha). These nurses continue to show up, motivated, eager to learn.. day after day! It’s amazing! And.. not to mention we have also completely changed the way they do nursing here. We have switched them from task-based nursing to patient centered care, and added many, many things that go along with that.. so, yeah. They’re rock stars!
The other nurses and doctors who have come to help teach have been wonderful! Most have been to TZ before, or at least to another third world country to do nursing, so they knew a little bit about what to expect….which is SO helpful!! The teaching styles have all been very different and all have been so engaging with the nurses! It’s been fun for me, to meet new people every week, and continue to learn so much from them (both from their lectures and their experience). They have all been so encouraging to me, and so supportive in what we are doing here!!
Running this course has been a huge learning experience for me! It has challenged me in so many ways, has forced me to work outside of my comfort zone and be creative when faced with issues that arise. I’ve learned to trust myself more, and to give myself some credit for what has already been accomplished on this course. I’m proud of what we have done so far, and I’m so proud of all the nurses… it has been so awesome seeing how much they have grown in just 6 short weeks!
One thing I didn’t quite expect was how much of an emotional reaction I would have being on the ward. I guess since I’ve done pediatric oncology nursing for many years, and I’ve been to this hospital and ward before, I didn’t think I would have such a strong reaction to it all. But I did, and it was hard. It was hard seeing these tiny little bodies with huge bellies or huge tumors that had been growing for months and months. It was hard seeing the struggle their family had to pay the $5 bus fare to get here and that’s why they couldn’t get treatment started months ago. It was hard seeing two patients in one bed, and more needing to be admitted. It was hard seeing and knowing that the cure rate is still only 50% and that many children come in palliative. It was a lot to take in. More than I had anticipated.
But.. what was also surprising was, despite all of that.. the ward is busy, and fun, and lively, and there were kids..everywhere…happy, and playing.. despite their big bellies, or one eye. And these kids… let me tell you, they are tough. They are so strong and brave, and resilient and don’t complain, and take their medicine and get their shots.. all with barely a whimper. It’s amazing, really.
And the mamas. And babas. The culture here… it always amazes me. These parents are tough. The way they carry around their 10yr old child, wrapped on their backs because their child is too weak to walk, and sit by their bedside day and night, giving meds, emptying their foley bag, taking temperatures, while never once complaining about having to share the bed, and sleep 4 people in it, or that the food isn’t good, or the sleep room wasn’t quiet enough. You can tell they have built such a strong community with each other- always looking out for the new mama who just arrived and doesn’t know where the cannulation room is, or where to get food. They look out for each other, and take care of one another. It’s a very beautiful thing to witness.
So, overall, my time here has been great. I’m seeing and doing and learning so much..more than I ever anticipated. I feel like a proud mama bear when I hear the nurses talk to the doctors about a patient they are worried about, or advise a new intern on how to care for a patient with a new fever. I can see their confidence growing and the knowledge we are teaching them in the classroom being carried out at the bedside. I feel lucky to be a part of all of this, and to continue seeing the growth as we start to wrap up the course in a few weeks!
So.. that was the work part. Now, the fun, vacation-y part.. Basically, my nights and weekends have consisted of the following: sleeping in, laying by some sort of pool or beach, going to Zanzibar or one of the other small islands, eating delicious seafood, relaxing, reading, and enjoying the visits of some special guests.. my friend Alyssa from Denver, Joel’s family, and Joel himself!! You can get a recap via pictures below… haha.. enjoy 🙂
More to come as I finish up the course, and my time here…..