End of my first full week at work, and full it has certainly been.After the day in the hospital we had a day out visiting the millennium villages as my midwife colleague was trying to collect some data about the use of local herbs in labour.It was also an opportunity for me to have a look see and meet staff at the rural dispensaries.After a 2 ½ hour wait we finally got a driver and a member of the millennium village project staff to accompany us.The day unfolded as a dusty, bumpy journey to 5 different villages on dirt roads.Initially staff seemed surprised that I was interested in mental health issues and claimed that they did not really have any.Only after a bit of probing did theyconceded that there were a few people with epilepsy and psychosis and at one dispensary the doctor told me that there was a 11 year old girl with psychosis since the age of 4 (hard to believe).It was very difficult to get any information about the treatment for these individuals other than families cared for them or they had to go to the hospital in Tabora.

The following day the three of us: me, plus Lindsay, midwife and David, medic joined a medical team from one of the Christian missionary groups who run outreach clinics in remoter villages on a monthly basis. After a beautiful 1 ½ hour drive in a very over crowded vehicle we arrived at a 'mud' hut which served as the clinic.A huge crowd of people awaited us and after breakfast we all settled down to work.As a non medic I was assigned baby weighing duties with a couple of local girls.Scales were hung up in a mango tree, table and bench set up and the weighing commenced.Over the next 3 hours we weighed 240 + babies!!For the most part medical records seemed to consist of the very cheapest school exercise books in which was recorded weights, diagnoses and medication.The women were lovely and the children positively edible!! There were no obvious signs of malnutrition but a high proportion had malaria and a few seemed to have lost weight significantly since their last weighing.

An absolutely exhausting day for us all, with anti-natal clinic seeing over 100 and medics and nurses seeing goodness knows how many.

I've also spent time on the psychiatric ward at Kitete Hospital with the only professional member of staff, a mental health nurse who does all the diagnosing and prescribing of medication.He works alone with support staff (one at a time) so risk assessment, occupation and psychological therapy is nonexistent.Will return next week to see what I can contribute to this completely underfunded and staffed service.

I met with the mental health lead forthe millennium village projects, Simba with whom I'm going out to one of the villages next week to do a couple of home visits.What I am going to be able to contribute is still unknown!They seem to refer to Epilepsy under the mental health umbrella and the management of this seems to be a major part of the MH worker's case load.

On a personal front, we have had no water at home for the past 3 days and are rapidly getting through our stored buckets and bottles.Hopefully it will come back on soon or we will have to buy some in.Otherwise home is fine; my colleagues great, food filling if not cordon bleu and the beer cold.Life is good!