Goodbye - Hello

Today was a very interesting day at Ilula!  We had morning report this morning and sadly we learned of a young HIV patient that had passed in the night- we had been following her and had hoped for the best.  We also discussed ectopic pregnancy - interestingly, Frank the pharmacist at Ilula must procure Methotrexate at a cost of 10,000 schillings (~$5) for one dose. Not only is it expensive for the hospital but difficult to come by- he must procure it from Dar Es Salaam- over 300 miles away.  To compare, a full course of antibiotics for out-patients is approximately 3,000 schillings (~$2).  Again, we are constantly in awe of the amount of good work that gets done with challenging resources.  

Elizabeth and I spent the morning in the Hypertension/Diabetes Clinic too.  This is a combination out-patient clinic that also serves the government benefit patients.  The patients are all walk-in.  The range of disease is from Hypertensive Crisis to chicken pox to pneumonia and everything in-between.  There are core medications in categories we are accustomed to but they may not be optimal dosing - for example taking medications multiple times a day as opposed to once a day.  In short, patients are treated and the regimens are similar- perhaps just a little less convenient.  Paul Burnett rounded on the medical rounds today and yesterday and Marissa was in the theatre (OR) and on the mom-baby unit.  We have brushed up on our malaria in pregnancy knowledge- not common to dose this in the US!  Marissa did witness a mama that barely made it to the hospital and delivered her little one on the floor- all safe!  
We had fun getting caught in the rain yesterday following a visit to the local orphanage.  Amazing work being done there too- somewhat self-sustaining by growing crops, taking care of livestock and generally working together.  Three of us caught a Bujaji (like a Tuk-Tuk) back to the hospital just in the nick of time for huge downpour!  Some of our team was soaked however!  
We said goodbye to John Zurek and Ann Wildwerding today- they will be missed.  We welcomed Ellen and John K though.  The Ilula social worker- Happy- was “happy” to see Ellen as she is a professor of Social Work.  
The work continues to inspire joy and it so wonderful to see friends on the campus.  Jill

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