Moving to Past Tense

I am now on my way home. The screen in front of me says that we are somewhere above Nova Scotia and will be landing in Boston in a little over an hour. With time on my hands, I look back at the past two weeks and try to see what stands out, as well as predict what will be lasting.

I was not nearly as prolific with my blog as I would have liked. There was more work this time around and less time for contemplative thought.

This past week was pretty busy with getting the project off the ground. In addition to the clinical project, we were interested in figuring out the number and etiology of amputations performed at KCMC and this meant sorting through decaying logs books trying to decipher hand writing nearly as bad as mine. Anthony, Ayesiga (the general surgery resident involved in the project) and I did have a fare well dinner at Salzburger Café on Wednesday night before I left. Anthony is the more laid back and easy going of the two while Ayesiga is a bit more driven and inquisitive. They are a good pair and the conversation ranged from Ayesiga’s skinniness (Anthony says he needs a wife) to the need to have side business projects in Tanzania if you want to make any money as a doctor. During the week, we ran through enrolling patients into the study both in the surgical and orthopedic outpatient clinics. We also submitted our ethical clearance proposal the day I left. All in all, I probably got about 95% of the things I was looking to do accomplished. That is pretty good. Now the project is in Anthony and Ayesiga’s hands and we will see what happened. It would have been fun to have a bit more time for R+R, maybe a trip to a game park or the mountains. Hopefully there will be a next time.

Looking back, a couple of things stand out.

• This trip differed from the last three that I have taken in my role as a researcher. I was no longer a student, there to simply observe and absorb, but rather I had an agenda. My research plan allowed focus and goals, which at the same time brought about frustration and stress. For the project to get underway, it was an absolutely necessity for me to travel and have a face-to-face interaction with the principle players. It helped me to understand the barriers to the project being successful and allowed me to form stronger relationships with my Tanzania colleagues. In my conversation with Mark Jacobsen, among the many paradigm shifts he cited, was the ability to work internationally on more of an interim basis. This is driven by both the proliferation of air travel and that of the Internet and technology. A big part of this trip was not only the amputation project, but also trying to divine how global surgery will play a part in my career. I cannot say I reached any great epiphany, but I certainly did add some data.
• I know I harped on this before, but road traffic has exploded in the past 4 years. I would think that as average income increase, motorbikes and cars become more attainable to more people. This will undoubtedly lead to more road traffic accidents and more gridlock. Both of these will place a strain on Tanzanian’s health and economic growth. For a government already strapped for cash, it is hard to make road improvements a priority. But if no action is taken, I think a crisis looms in the coming years.
• Technology continues to improve in Tanzania. This time around I had a wireless modem, which meant access to the Internet wherever there was a cell signal. This was a huge step up from being chained to Internet cafes. There was also good access to decent wifi around the hospital and medical school.

The wheels just went down and I have to shut my computer. Will offer up any more reflections later.