Day 2 (Day 1 at Muhimbili)

First, a little more information on Day 1:   I was able to, somewhat pitifully, extend the tradition established by Erica and Shelton by playing a soccer match with Hilda’s son, Dick.   However, unlike my predecessors who kept adding children to their matches, I had the opportunity to play an intense one-on-one match with Dick. I’m proud to say that I 1) survived the match and 2) only lost to him by one goal!

After arriving at Muhimbili by taxi this morning, Sue showed me around the Upendo and Tumaini units.   Walking into Upendo, we were immediately greeted by little 2yo Helen with acute leukemia, who within about 5 seconds stole my heart (I’m sure she does that to everyone!).

We started the morning with a teaching conference, which was Part 2 of Sue’s palliative care talk. I was pleased to see that this was much more of a discussion than a lecture. Palliative care is difficult topic anywhere, but due to some cultural differences, the discussion was even more interesting. Then, it was on to rounds. I was somewhat mentally prepared for what I saw on rounds—children extremely large tumors involving the abdomen, jaw, eyes, buttocks. I knew I would see extent of cancer burden that we don’t typically see in the US. But what I wasn’t completely prepared for and what really struck me is how many patients like this there actually were. We rounded on about 30 children with cancer on Upendo, many of whom had disease to an extent that we would not typically see in the US. In my career, I’ve seen tumors that have eroded through skin or become very large and ugly, but I’ve never seen 10 or 15 of them on the same day!   But of course, the kids here are tough as nails, so somehow, it didn’t seem to be as bad as it sounds. And the for the resources available, I think the team does a very good job of caring for these patients. I’m exciting to be part of this for the next 2 weeks. I’m sure that I’m going to learn a lot!


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