By Mary Davis
The minor theater where I first met and treated Precious
We’ll call the baby in this story Precious, because his mother looked at him every day like he was the best gift the universe had ever given her. Precious was a newborn baby who I first saw this summer in the minor theater of Levolosi Health Center in Arusha, Tanzania when he was nine days old. He had two large incisions on his stomach from a colostomy he had been given soon after birth. The hospital the mother had gone to did not have colostomy bags available, and neither did Levolosi. So, the mother would change a piece of gauze over baby Precious’ intestine every thirty minutes to an hour. When he first arrived, I remember being sure he wasn’t going to survive. He was so small, skinny, and weak, unlike the pudgy squalling babies I saw every day in the labor ward. The wounds from Precious’ surgery were ringed with a layer of infected pus. But every single day Precious’ mother brought him back to the minor theater. There, I cleaned out his wounds and around the piece of colon using Normal Saline. I then lathered on a layer of triple antibiotic and redid his dressings. His mother was not rich, had another baby to care for, and no job, but her healthcare for Precious was free, like all healthcare for children under five in Tanzania. Precious’ mother would sometimes need to wait an hour to get her baby’s dressing changed. But she was still thankful for the care provided by Levolosi. She still came back every day, and every day I would redo his dressings. In the month I helped take care of Precious, one of his wounds closed and the other got dramatically smaller. Precious’ mother recently reached out to me and told me that when he reaches six months of age, he will get a surgery to repair the colostomy.
Caring for Precious and his mother gave me joy. But it was not because I offered any life-changing care. I have limited knowledge of medicine and just followed the directions of the trained doctors and nurses in changing Precious’ dressings. I am still worried about Precious and think he will have a hard life ahead of him. It is easy to see how the medicine in Tanzania could be better. Some of the practices are outdated and have not been used in America for years or even decades. After being in Tanzania I shadowed doctors in the United States and was shocked by American healthcare’s luxury.
Gleaming white linoleum stretched over the surface of the massive labor ward, contrasting the stained cream tiles in the single labor room of Levolosi. All the tools in the trauma room were single use, unlike Levolosi’s rusting tools that were cycled through the sterilizer at the end of every day. I am grateful for being able to observe the contrast of Tanzania and the United States. But I am also grateful that there were so many similarities between Tanzania and America. ‘Do no harm’ is still the guiding principle of medicine. It still helps more than it hurts.
The sterilizer that all the instruments are cycled through on a daily basis
Many of the Tanzanian doctors who I worked with were volunteers. Medical jobs are scarce since most of the openings are for government positions and the government budget cannot pay the salaries of all the necessary doctors. Because of this, many fully trains doctors work for several years as volunteers after medical school. But they still work eighty hours a week. They work all night and then stay into the next day because the hospital is short-staffed, and sixty patients need to be seen by three doctors between nine in the morning and noon. The doctors work hard and do their best. Tanzania, like the United States, gets better and better in the medical care it offers its citizens. Sixty years ago, baby Precious might not have survived. Now, with luck and continued maternal care, he will be able to grow up to go to school and have his own family. Sharing the beginning of Precious’ journey and seeing a piece of the healthcare journey in Tanzania is what made my summer worthwhile.
The photos above depict the labor ward of Levolosi Health Centre. The right photograph shows the labor beds and nurses station, while the left photograph shows the bench where babies are placed after and the hand/tool washing station.
I spent the first four weeks of my summer internship volunteering in the labor ward of Levolosi Health Centre. After the second day in a row when only one baby was born between 9 am and 3 pm, I decided to try and come to Levolosi for a night shift. One of the nurses had mentioned that most babies were born during the night and while I was nervous about a twelve-hour shift, I was determined to gain more experience in the labor ward.
The above photo shows the scale used to weigh babies.
Not only did I gain more experience by watching the nine babies born my first night and the many babies on nights thereafter, but I also garnered the respect and friendship of the nurses in a way I hadn’t done in two weeks of daytime volunteer work. The nurses shared dinner every night, welcoming me to share food with them and showing more interest in teaching me both how the labor ward worked and the Swahili language
Pages summarizing some of the Swahili I learned during night shifts.
Without the other volunteers who came during the day and with far more babies being born, I learned much faster. At night I was able to prepare delivery packs, clamp umbilical cords, test patients for HIV and hemoglobin levels, and at the end of a week of night shifts, even perform a delivery under the supervision of one of the nurses. She was ready to step in if any complications arose, but the delivery went smoothly.
The tools used to prepare ‘delivery packs.’ These are given to the nurses right after babies are born to cut the umbilical cord, deliver the placenta and potentially suture any tearing.
These are the medical records currently in use in the labor ward. They are sorted into antenatal, postnatal, and post-cesarian section.
Written By: Mary Davis
Thanks to Sabrina Fay for uploading the photographs
By Leah Smith
As many of you are finding I am sure, mere words cannot contain the realm of experiences that one is given when weaving the paths of their lives in with communities that are not of our origin. If the service life were a very large flowered quilt, these experiences would be the unique blooms that splatter the quilt randomly; the flowers that catch one’s eye, weaved within an already beautiful background. Those blooms, these seconds of service, are serving us as well. They are moments of reflection, whether present or future, but reflections that can change the course of the flower vines on the quilt, and similarly our lives.
As many experience in their summers of service, I am astonished at all the activities I managed to fit into 8 weeks. I traveled most weekends and taught two English classes a day, along with countless games and lesson planning, hit the gym, made local friends, and still kept in contact with my home. I felt so in the moment at the time, that this first day home almost doesn’t feel quite real. My brain still thinks I am seeing my kids in class tomorrow.
This trip is just not explainable for me; I am fumbling here. This was my first time being abroad (thanks princeton) and I just have so many things to say that I can say nothing at all.
But I can reflect on how Health and Care looks different in each society, and how we should stop coming at it with our postulated ideals. It is different within each society, each community, each person;incredibly necessary for mental and physical health and our abilities to function in society. In cambodia, after the Khmer Rouge, mental turmoil played a large role in depleting the country of it’s free thinkers and therefore the average societal lifestyle was transported back to “ground zero” (the way Pol Pot, the leader of the Regime, put it). Many children have never DRAWN before, never created their own art or poems or had the ability to study MORE than what’s given. . Their ideas are not cared for, or nurtured, and so creativity and passion shrivels up in the absence of care.There is no bandaid for the wounds that open when health and care needs that aren’t met in communities.
Health and wellbeing looks so different in America, where many of us have parents, live in homes that are more than one room large, and people we know aren’t often sick from diseases carried by mosquitoes. We learn about recycling in the third grade, and take for granted the reusable bags we bring to the store. We have never even considered a city almost entirely covered in trash. Our school system is mocked with cliques; students paste themselves into our societal boxes that we are now trying to break down. Health for us is more than a roof over our heads nowadays; it is equal opportunity for communities to thrive and have physical health and wellbeing. Care, for the average american, resides on family responsibility, within a community; in activities, in politics and sports/performances. It is showing up to your little brother’s soccer game, or going to visit your grandma in the nursing home. Care for us is not scary. If our teacher doesn’t like us, there will always be another. If we don’t make school our first-most priority in high school doesn’t mean we won’t get into a top school. And I am not faulting our society, may we continue to grow. But we still have to be able to approach health and care without our own experiences biasing us.
Health and Care for the students I taught was so much different. Some without proper nutrition that hindered their focus in class, some whose home was the dumpsite, some without fathers, some with mothers that worked long hours in factories. Health in this case is met by the social organizations around the city and organizations like the one I volunteered for that gave out deworming pills and had fresh water and handwashing soap. But care, care was provided by the community center staff, and I was able to administer care every day.
Care was through the playground and art supplies, the extra time after class one on one with me for sounding out words, and positive smiles when they are having a bad day.
Even though the school was miles and miles away from my friends, and my home, I found my own health and care in the tenderness the cook would put into the rice soup, with the gentle laughter of the little ones, and roughing around with the older boys. I gave care and received care. I experienced a different kind a mental healing. A change in my perspective, and a value for each flower that pops up on my life- quilt.
And so, I sit in my very nice chair in the comfort of my home in the USA, with pictures and yarn bracelets and paint stains in my clothes to remember the love I felt and gave during my 8 weeks. I write about my changing perspectives of health and care, thinking back to two days before when I was sitting under the hot sun reading an English book out loud. This is my tribute. My tribute to my first journey abroad, my first time considering the holistic well-being of a community that I was a part of. May many more changing perspectives come with the time I am in service focus and beyond. May I always weave my life through others lives; pouring a lifetime of experience into a beautiful quilt.
By Mina Musthafa
As I reflect upon my internship at Montefiore Medical Center’s Housing at Risk Program, one particular day comes to mind. That was when I truly understood how diverse a day could be while working with my team, where we help patients with chronic and complex medical conditions find suitable housing. Such a housing crisis becomes especially evident in the backdrop of the rising housing market and public health policy infrastructure of New York City, where I quickly caught on to the jargon the social workers on my team professionally threw around.
This was the office building where I worked every day–non-descript, yes, save for the big blue sign declaring its affiliation to Montefiore. What I initially thought was a strange outpost of a building to house a Montefiore program was actually quite common–all over the Bronx. It seemed that the entire borough had scatterings of these buildings which seemed like multi-family homes on the outside, but were populated by hardworking individuals dedicated to the care of their patients on the inside.
It was on the third floor of this building where I shared an office with two social workers, my Project Manager Keona Serrano and Madeline Gotay, who I often visited the hospital with.
In fact, on one such visit, Keona and I visited an elderly patient who had been living in his car for the past few years, and who had self-admitted for illness. He was getting close to discharging from the hospital, so Keona and I were educating him on his available housing options, with the goal for him to decide on one that could provide a pathway for him to become stably housed. By the end, however, he expressed his decision to remain living in his car. As this was his choice, we consulted with his attending physician and floor social workers to assess if this was medically safe for him. While it was not advisable in general, we needed to ensure it was at least medically clear for him to continue living in his car. After some speculation, the patient gave us the color and brand of his car, mentioning that he thought he had parked on the second level of the garage over a week ago. With some doubt as to his memory and his car keys in hand, Keona and I went to the parking garage and checked the second floor: no luck. We reasoned he must be mistaken and checked the ground floor, then the first level. Still, the key never fit. We worked our way up all six levels over an hour, hoping as we got to the top that it would be sitting, waiting for us.
We were rewarded with a gorgeous view, but little else. Now we were starting to wonder how the patient could leave if we couldn’t find his car. Our doubt expanding further, we decided to give the other parking garage a shot, though I had little hope given it was two blocks further from the hospital. Yet, there it was, parked on the second floor in the exact color and brand the patient had indicated. We were shocked to have found it, and after a quick assessment, went back to report to the patient on the condition of his car. When we told him we had found his car exactly where he said he had parked it, he responded, unsurprised:
By Grace Simmons
This summer, I am working as a Global English Camp intern for a company called Come On Out Japan. The goal of the program is to help Japanese high school students improve their English speaking confidence and reflect on their future goals with a 5 day curriculum.
So far, my days have been spent navigating the Tokyo subway system during rush hour, exploring cities with my coworkers, and learning more about Japanese culture and education through training week.
Tokyo Rinkai Disaster Prevention Park Rooftop Garden
Like California, earthquakes are very common in Japan. Due to this, in Odaiba, all of the interns underwent Disaster Training in Tokyo Rinkai Disaster Prevention Park.
Signs like the one above highlight the emphasis Japan places on citizens working together to help each other when disaster strikes. Fun Fact: In the case of an emergency, it is possible to MacGyver an arm sling out of a plastic bag.
Color Coded Trash Bags My House Manager Gifted Me
Speaking of plastic bags, another thing covered during training week was trash. Garbage is sorted according to Bottles, Cans, Plastics, Paper, Combustible, and Incombustible waste in order to be more eco-friendly.
Pro-tips to keep the electricity bill from jumping unexpectedly on your housemates
My Shared House Post Floating-Noodle Party
During Training Week, Come on Out also covered cultural differences related to living in a shared house: Everything from common sense things like not leaving the air conditioning running in an empty room to how to cope with the rarity of dryers in Japan.
Ringing in the end of training week with an overnight trip to Hakone
Overall, Training Week has been fun and informative! Tomorrow is my first day teaching, and I am really excited to meet my students, apply what I have learned, and help them to improve their English speaking confidence as well as think about their life missions.