bulletin - Allegheny County Medical Society

○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○MEDICAL STUDENT MUSINGSProviding a Forum for ExpressionALAN ROSENBAUMThis past summer I found myselfin Tanzania, a nation known forbeing one of the more stable, accessibleand beautiful places on theAfrican continent. Home to thebeaches of exotic Zanzibar, theheights of Mount Kilimanjaro andthe wilds of the Serengeti, it is nosurprise that Tanzania is such apopular destination to those who arewilling to sacrifice some of thecomforts of home.I was drawn to Tanzania by anopportunity to volunteer in a ruralgovernment-run health dispensary inthe small town of Kwala. When Idiscovered that even GoogleEarthcouldn’t pinpoint the location ofKwala, Tanzania, I knew it was timeto purchase the plane ticket. I hadhoped that working in a sub-SaharanAfrican rural setting would be anexciting opportunity to learn adifferent kind of medicine from whatI was accustomed to in westernhospitals, but by the end of thesummer, I had discovered that it wasreally the same.Upon arriving, I toured thevillage to become familiar with mynew surroundings, navigating the dirtpaths that surrounded the only road.I eventually came across the dispensary,a cement and sheet metalbuilding consisting of a large, openwaiting room, a few small closets,one examination room, a basic laband an open-air doctor’s office. Thewindows had horizontal metal barsthat lacked any glass, permitting theoccasional gust of wind to give theworkers a reprieve from the heat,although the bars also allowedinsects, birds or bats to swoop in andout. In fact, a space under the roofwas a favorite haunt of bats; despiteattempts to remove them, theirpresence persisted. The floors werecovered with pervasive dust and dirt,making it appear as though the dull,gray cement was covered by a browncloak. The ceiling was littered withspider-webs, and throughout theday’s work I could turn my eyesupwards and witness the demise ofsome unfortunate creature thanks toa spindly-legged arachnid. It wasevident that the walls were painted atsome point, but over time chunkshad disintegrated away, leaving gapsin the finish. In the sole examinationroom, the walls had been splatteredand stained with various liquids overthe years, as if it were the setting of agory video game. Indeed, the aestheticsof the dispensary were more akinto a haunted house than a health carecenter.Working there certainly met myexpectations and, throughout thecourse of my stay, I saw manyconditions that were relatively aliento me: terrible infections, cripplingtraumatic injuries and debilitatingdevelopmental disorders. While that12 Bulletin : January 2011