From Dr. Bower July 22

This morning I am making lists and preparing for my trip to Tanga, Tanzania next week. I will have a busy week at work next week preparing the office for my absence, and I want to make sure that I sure that my travel needs are organized, to avoid any last minute panic.

The list, while not too, long reflects a variety of anxieties. At the top, find my passport from that “ special “place where I placed it 6 months ago. The problem is the place that I thought was special 6 months ago is not the same place I would have placed it today. I am also trying to keep luggage to a minimum. It helps that we were advised not to bring hair driers or electric appliances, since they may blow the fuses at the hotel.

In addition, I want to down load a variety of articles on treating infectious diseases I will likely encounter in Tanzania. Most of which I have never seen. Most were taught in my undergrad and medical school microbiology classes. However, at the time, they were taught more like theoretical diseases. Microorganisms with interesting lifecycles, great examples of the powerful single celled organisms, but not information that applied directly to me.

Reading more about the culture and people of Tanzania, is alos on my list. Last night I down loaded a book with the title of Tanzania-Culture Smart! (i.e idiots guide to Tanzania). In the first chapter, the author describes the history of Tanzania. The northeast portion of the country has been named “ the cradle of mankind, with bones dating back 2 million years . Its history is relatively peaceful, no civil wars , no bloody independence fights. Their first president from 1963-1985, stepped down when he realized his socialist reforms were not in the best interests of the county. Despite this peaceful history, Tanzania is in the 20 poorest counties of the world. The author places some responsibility on the degree of corruption in the county. With this note I think of our shipping crate , which was expected to arrive in Tanga over 1 month ago , but has been held up by customs. We were careful to pack the crate with non consumables avoiding equipment including medication and expired supplies which could lead to delays. The supplies include incubators, ekg machines. surgical instruments, a microscope and the grand prize … an ultrasound machine. St. Raphaels, the hospital we are sending supplies to provides care for women , infants and children . There is one physician, a lab tech and nurses. They do not have access to any radiology equipment, I am interested to learn more about their anesthesia resources, pharmacy and lab. How can a facility with such limited resources provide care in an area of the world with such serious health care problems? Over 6 % of the population has HIV. A resource rich nation like the US would be overwhelmed if six percent of our population had that kind of demand of medical resources. I

I am a very traditional western doctor, I know how to treat diabetes, and hypertension and I am use to having access to incredible amounts of medical resources. I am certain that I will have much to learn on this trip, I am not yet convinced of what I have to teach.

We are told that God find us where we are, this week however, I am don’t know if I am where God thinks I am .

Dr. Bower