We have water again, yippee!

After a quiet weekend it has been another busy week.I've spent several days on the psychiatric ward which despite the horror I am gradually becoming used to.The days follow a similar pattern. We arrive around 8 when there are a group of people waiting outside.After checking whether there have been any admissions during the night the outpatient clinic starts.This will go on throughout the morning with patients, their families and odd staff coming in and out of the office of which the door is generally left open providing no privacy at all.Confidentiality seems to be an unknown concept here.

I had planned to run an OT low level activity group on Thursday morning with one of the support staff who is very keen, dedicated and speaks quite good English.I wanted to try to engage the woman and gently start encouraging the staff to think beyond the very basic care the patients need.I came armed with materials and then waited all morning for my staff member to be free enough to join me.One of the male patients is extremely unwell physically and his whole bed and surrounding area had to be changed and cleaned, then he had to be fed.Beds had to be changed, water fetched from some way away etc etc.Umpteen other jobs had to be completed so in fact I hung around all morning and never got to do my group.

As my role is to initiate 'sustainable' projects there was no point in me doing it alone apart from my very limited Swahili but 'good practice' would not recommend a single worker alone on a psychiatric ward.There is no such thing as a risk assessment here.A thoroughly frustrating morning!!!I am going to attempt again next week after meeting with the support staff re my role/plans and trying to instigate group work in the afternoons when hopefully the staff are less preoccupied with the domestic duties.

Anyway enough of that rant.

Tuesday I was back out in the field doing home visits with one of the local dispensary doctors.When I say home visits we didn't actually go inside as all our discussions with families and patients took place outside where the family would rush around to find us stools and logs to sit on.Sometimes there would be a group of neighbourhood kids come to stare at the 'mzungu' woman.It was fascinating to be right in village people's homesteads which are so basic but ordered, neat and evidently well cared for.A hundred times that day I wished I had a camera on the end of my nose as there were just so many wonderful pictures to take.We did 6 home visits that day which all necessitated a long and bumpy ride in the 4X4.I'd left at 7.30 in the morning and didn't get back until nearly 7 in the evening, pretty shattered.I found it a little unnerving as the doctor I was with was asking my opinion on diagnosis. Most seem to have either a diagnosis of epilepsy or psychosis for which they have very limited medications for.Any talking therapy is virtually unknown outside the only major psychiatric hospital in the country in Dodoma.

The country side was spectacular, mango trees in blossom, frangipani in flower and papayas ripening.We even saw some small monkeys that day.

Great excitement for this coming weekend as my colleagues and I along with some American interns are flying from Tabora to Kigoma on Lake Tanganyika on Friday afternoon and then on Saturday taking the lake taxi north to the Chimpanzeereserve of Gombe.We'll have a day and night in the reserve and then return to Kigoma before taking the 8-10 hour bus ride back to Tabora on Monday. Should be a great adventure.Will fill you in next time!!