I realized today that all I’m doing here is basically picking up where Shelton and Erica left off. I’m not sure if I can live up to their legacy, but I’m trying. There are the soccer games with Hilda’s son Dickson, the safari with Sanjay including the exact same itinerary, and the love for Africafe instant coffee, which was a wonderful surprise on my first morning here. The coffee is amazingly good! And it’s instant! I went to the supermarket today and bought a couple of tins for myself as well as one each for Erica and Shelton. A tin of that coffee has been at the apartment, so I’ve been drinking it since the first day I arrived. When I read Erica’s blog about the amazing coffee she had on the way to Mikumi National Park, I told Sanjay that we had to stop there. I thought if it’s better than Africafe, it must truly be amazing. I was expected some fancy coffee shop with an espresso machine and everything. We stopped at some roadside restaurant, and when I ordered coffee, guess what they brought me!—a tin of Africafe and hot water. What’s up with that? Erica, did you not have Africafe the entire first week you were here? Imran, the resident, told me that Africafe is the “McDonald’s” of coffee here and that there are better brands. I’m still looking for the ones he suggested.
Something else that I share with Shelton is a total insentivity when greeting Muslim women. Imran rotated to the general wards this week, and I met our new resident Khadijah. And of course, despite reading Shelton’s blog, I didn’t learn anything, and I tried to shake her hand when I met her. You’re not supposed to do that! I guess I can be a dumb American sometimes too! Like Imran before her, Khadijah is excellent! I’ve been very impressed with the knowledge base, work ethic, and general personability of the 2 residents with whom I’ve worked here. Khadijah presented the article for pediatric journal club today. It was a very interesting study done in Kenyan school children that showed the association between hookworm infections and pulmonary tuberculosis. It was an excellent presentation. Apparently, kids with hookworm infections have 4-fold increased relative risk of having pulmonary tuberculosis. However, the most important things that I learned are 1) Don’t walk around barefoot in Africa, 2) There are an estimated 700 million people worldwide infected with hookworms (700 million!—that’s more than 1 out of 10 people), 3) pulmonary TB is 10 times more common than cancer in Tanzania.
I have updates on a couple of kids mentioned in a previous blog by Sue. Sweet little Joycee, with the tracheostomy and large rhabdomyosarcoma involving the entire left side of her face is doing well. Her tumor is shrinking with chemotherapy and she is able to eat pretty normally now, and she seems comfortable. I’ve had a couple of discussions with Shakilu about the long-term effects of trying to cure her. There is really no way to resect this tumor without it being completely disfiguring. And while local control with radiation can be achieved, it will definitely leave her with long-term residual effects, including lack of bone growth on that side of her face. No decisions have been made yet.
Henri, the boy with ALL and huge smile has moved to Tumaini (the unit for less sick kids). That’s bad for me because we working on a special complex 30-second handshake—you know, like when the starters get announced before basketball games. He’s still comes over to visit sometimes, so we’ll get it down before I leave. Hopefully, we can get some video of it too! (attached is photo of Henri dancing with 2 other children and the “clowns”)