It was an exciting first week in Tanzania! Monday, I spent the day wandering around town. Or more accurately, I spend the day getting lost in town. Eventually I found my way back home with some groceries. Tuesday, was my first day at Magu District Hospital. The photo above is from inside one of the treatment rooms. At the hospital, I have the pleasure of working alongside a medical doctor and local medical officers. I’m excited about these relationships. I think they will be productive for all of us. One of my roles is to pass on as much information about physical medicine and rehabilitation as I can. At the same time, I am learning a ton about infectious disease and the later stages of metabolic conditions. 

I was back at Kanyama on Wednesday and while I saw many fewer patients it was just as challenging, because I had no one to translate. I did my best with the little Swahili I have, and it seemed to be enough. We’ll see if they come back next week… or at all. I’m not confident I translated that part correctly. 

Thursday was much the same as Tuesday. I was back at Magu. Most were new patients, but there were a few returning patients as well. After clinic on Thursday, the District Medical Officer took me to the local fish market where he selected a fresh tilapia from the local lake. I was a bit concerned about the actual freshness of the fish given the heat and the amount of flies on it. But it tasted great grilled, and I feel good today. 

Overall, I saw 36 patients in three days this week. About 60% were female, and 25% were under age 5. The common presentations were mechanical back pain (due to muscle or joint dysfunctions), cerebral palsy, peripheral nerve conditions, and osteoarthritis. Something I haven’t seen in the clinic before that presented to Magu was phocomelia, affecting a single upper limb. 

One cause of phocomelia is maternal exposure to certain drugs. As people in the 60s probably remember, thalidomide was associated with phocomelia in thousands of children. Other substances and genetic factors also contribute to the interrupted growth of a limb during development, which occurs roughly from the 26th to the 56th day post-fertilization.