Finished with Paeds and started on my Gen Med rotation. It was nice to have a change and a variety of conditions to see, including all sorts of infectious diseases (malaria, TB, meningitis), HIV-related illnesses (diarrhoeal illnesses, Kaposi’s sarcoma) and the usual hypertension, CCF, etc. It’s quite interesting that they have separate wards for males & females, and there’s also a separate TB/Leprosy ward that I haven’t been on but would like to visit some time (don’t want to catch anything though :X).

Ward rounds are done by the interns and students. Don’t ask me where the senior doctors are, we’ve only met 1 once because we had a difficult case and we were pretty certain he was drunk when he came to the ward. Dr Ismal and Dr Focus (one of the interesting names I’ve come across. Not sure if I’ve mentioned this, but our cook is called Witness and our security guard is Innocent) are the interns on the female ward. Because I was introduced to them on the first day and because Dr Ismal is so nice, I’ve just stuck around them for the whole week. So we got paired up with one of the local students each, and they acted as our translators, which was alright I guess. But I felt like I wasn’t getting the whole picture because I don’t think she told me everything the patient said – like the patient will be going on for a while and she’ll only tell me 1 sentence. There were times I asked her to ask the patient some questions, which she did some of the time, but ignored my question for the rest. Ah well.

On the first day we stayed till 3pm, which is the latest I’ve stayed so far (yes we leave at 1pm on most days), because we had a very sick patient. Ms V was a 24yo female who presented with a 3-day Hx of seizures, confusion and lethargy. The seizures happened at 5am every morning, of tonic-clonic nature, and last for half an hour each time. She looked jaundiced, and apparently had yellow discolouration of the eyes at childbirth. Past Hx of multiple admissions with malaria + anaemia, needed blood transfusions twice. Mum also said that she lost 40kg in the past year, and amenorrhoea for 3 years. On examination she was not rousable (to be honest, if I had to score her GCS it would have been 3), and she seemed to be in status epilepticus because she was like stuck in a tonic posture.

Dr Ismal thought it was kernicterus, with hyperbilirubinaemia since birth. It’s sad that she had been sick all these years yet no one had ever figured out what was wrong with her, and despite multiple hospital admissions, we didn’t have records of them. Not helpful at all. Before I thought about the jaundice, a brain tumour was on my list of DDx, and it’s something the doctors also agree that we should rule out, but CT/MRI don’t exist here, so too bad (imagine someone comes in with a stroke, they have no way to confirm if it’s ischaemic or haemorrhagic).

Anyway, apparently LFTs were ordered the day before but I didn’t think it was done. Really frustrating, and I was happy to take the bloods and send them to the lab myself, only that I had no way of accessing her cubital fossa because of her persistent tonic posture. And the annoying thing was that her original IV cannula was falling out, so they were going to replace it and hence could have gotten the bloods then, but the nurse was efficient (for once) and before I knew it she had already put in the cannula and started the drip.

So no bloods, no tests. The best we could do for her before she left was to put her in the left lateral position, hoping that she would be able to maintain her airway, as there were no facilities for intubation. I asked if we could at least put her on some oxygen. They only have 1 oxygen machine on the whole ward, and I was happy to find out that it wasn’t in use. However, the patient was on the furthest bed that the machine couldn’t reach and we couldn’t move the patient because she was unconscious / the bed didn’t have wheels. So unfortunately, she wasn’t able to get any. Like wth right.

The next morning I got to hospital and found out that she had passed away overnight. It saddened me that we didn’t manage to figure out what was wrong, and that we couldn’t do anything to help her. Apparently 2 other patients passed away that night as well. We’ve heard that 1 death a night is average.

That day we had another dying patient. Mrs M was a 50yo lady who presented in a acute confusional state. In the notes it said she had some neck stiffness, so DDx on presentation was meningitis/cerebral malaria. When we reviewed her, her GCS was 3, she was tachycardic & tachypnoeic. She also had coarse creps bilaterally and a fever of 39 degrees. We thought one of her pupil reaction was slightly sluggish, so we weren’t sure if there was increased ICP and therefore quite wary about doing an LP. BP was 120/80 so she wasn’t in shock, but she must have been septic.

So anyway, somehow there were people who came to carry her to a bed close enough to the oxygen machine and she got some oxygen (don’t ask me why it didn’t happen the day before, perhaps those people were the patient’s relatives). I wrote up some antibiotics, but Dr Ismal told me the next day that she still hadn’t gotten them when he left at 6pm. He said some drugs have run out of stock at the hospital and the relatives have to go and buy them from pharmacies outside. So if patients don’t get their meds, it’s either no one has bought it for them or the nurses haven’t administered them.

If you haven’t guessed it, yes, she passed away that night. 2 patients assigned to me to manage, 2 patients dead in 2 nights. Great. I really should start doing the Inx and giving the meds myself rather than waiting for the nurses to do them.

On a lighter note, we visited Paradiso orphanage on Friday afternoon and it was really fun. The kids were amazing =)

We bought some slippers because we were told some of the kids don’t have shoes to wear, and they were all queuing up orderly to get them from Babu (grandfather), the director of Paradiso. And then they also queued up for colour pencils – it was cute how they refused certain colours; and also the lollies that we bought them.

After that we started playing with them: bowling, skipping, Limbo and what-nots. They were climbing all over us and doing somersaults, haha.

They took our cameras and happily snapped away, it was cute to look at the photos afterwards, quite impressive I must say! My camera had heaps of close-up portraits.

It was interesting to visit that part of town, it was like a village/kampong where people lived, very different from the town centre that we frequent. I guess that made me feel that I’m really in Africa. I definitely want to go back again to see the kids, and Babu & Bibi were so warm and friendly. According to last year’s expenditure, it cost ~$1000 per child, so really, it isn’t much. Perhaps when I start work (and have the money) I’ll sponsor one of the children.

It was like a dream come true. Some people may know that before I decided I wanted to do medicine, I was really interested in biology & animals, and I had wanted to be a zoologist, or a presenter on Animal Planet, or something along those lines, hehe. I had always wanted to go on a safari and finally, I got to do it =)

We went on a 4D3N camping safari to Lake Manyara, Serengeti & Ngorongoro. It was AMAZING. We saw so many animals close up (including the Big 5 – lion, leopard, elephant, buffalo, rhino), and we even had hyenas/elephants/pigs at our campsite. No, I didn’t get eaten by a lion, otherwise I won’t be here to tell the tale. It was indeed Mother Nature in its best.

Managed to capture a couple of good shots, and thank you very muchie Terrence for the 55-250mm lens that you got me the Christmas before last, it has finally come into good use. Though at times I wished I had an even more powerful telephoto lens (which I probably will not have any other opportunity to use, so kinda useless in a way). Some other people we met had massive lenses that must have been at least 500mm.

So here are some photos for now, my 10 favourites =)

Baby giraffe in the middle of the road.

Baboons.

Elephant & baby.

Lion cub having a siesta.

Leopard & baby. They were crossing the road right in front of us, and the cub even walked under one of the other jeeps.

Sunset on the Serengeti.

And Sunrise on the Serengeti.

Zebra & baby. If you haven’t noticed, I have taken quite a few pictures of animals with their baby, cos they are just so cute :)

Wildebeests having a friendly fight.

Hyena with its kill. It’s a female, cos apparently the males are the lazy ones.

More photos on Flickr after I get back!

I’m almost halfway into my trip, time’s flying way too fast.

And so, the 2nd week in the hospital was quite similar. Every admission was either malaria, pneumonia, or gastroenteritis. Or a combination or all of the above.

I spent some time in the other wards though. On Monday I was on P3, ie gastro & malnutrition. Learnt a bit about helminth infections & mebendazole. And it was really shocking to see how marasmic some of the children were. Imagine a 4-year-old girl weighing just 7kg, she really only looked like she was barely a year old.

That day we had to test some kid & his mum for HIV using the rapid test thing, looking for antibodies. This is something that I’ve never seen before so it was interesting for me. It’s like a finger prick test onto something that looks like a pregnancy test kit. If the test is positive, the patient will then be referred to the CTC for further Inx and counselling.

I was quite horrified that the doctor performing the test didn’t even use any gloves. Granted, she washed her hands afterwards, but still, I would be more careful. Anyway, the kid tested negative but his mum tested positive, so we had to break the news to her. There wasn’t much confidentiality/privacy because we were doing it at the nurses’ station of the ward, and the patient wasn’t asked if it was alright for me to be there (not that I understood much of the conversation anyway, haha). Oh well.

There was this other case where the doctor wanted to do HIV testing, but the mum is a Maasai lady and there was a bit of difficulty communicating (I think they must speak a different dialect/language or something). So we needed an interpreter, who turned out to be the father of the child in the next bed. Talk about consent, confidentiality & counselling – nah, they all don’t exist here. She declined in the end though.

And then on Tuesday I hung out at P2, ie everything else but gastro & malnutrition. Saw a case of schistosomiasis cystitis, so I was quite excited about that, haha. Our study group’s obsessions with freshwater snails and sandflies and caves and what-nots ;) I wrote some discharge summaries & prescriptions, prescriptions being patient’s name + date + list of medications + my signature. I wonder how legit that is, but well, I guess TIFA. Apparently the pharmacy will give you anything you want as long as you have something that LOOKS like a prescription cos they just want to earn your money. Dodgy dodgy eh.

I did something different on Wednesday – went to the CTC with Dr Rose for Paed HIV clinic. It was pretty sad to see such young kids being stricken with a lifelong disease like this. Imagine having to be on medication from the moment you were born for the rest of your life.

One really memorable patient was this girl who is 14 years old but looks like she is 7. She came in alone (though I’m not sure if her parent(s) was just outside in the waiting room), and she seemed to have everything organised. Her appointment cards etc were in a plastic bag, and she knew all the meds she is on and when she takes them. I was impressed, yet at the same time I felt really sorry for her.

The good thing is that, I found out from Dr Rose, all these clinics, HAART, Inx etc were free for the patients. That sort of removes the access problem, doesn’t it? Most of these kids have HIV due to vertical transmission, which is hard to avoid here. I asked Anna, who’s doing O&G, and she told me that all women who are pregnant go through HIV testing and if tested positive, they can start her on HAART. But she’s not convinced that every mum gets it. And I’m sure compliance isn’t perfect either. Besides, C-sections don’t happen all that often here, and bottle-feeding + hygiene standards here = kids admitted to P Block for gastro ± dehydration. Thus, we can see that it’s a difficult problem and the methods we use back home to decrease rates of vertical transmission won’t really work here.

But at least newborns to HIV positive mothers get a dose of HAART shortly after birth (that is if they don’t run out, I was told), and the mum counselled, and there are follow-ups to be done. So it seems like there are some measures in place to try and tackle this problem, though it will definitely take a while before the rates decline.

Finally on Thursday I hung out in P1 again and worked with Dr Katumba. He really respected me a lot and asked for my opinions on every case. Eg of our conversation:

Dr K: (referring to kid with meningitis) So, what would you do in this situation?
Me: Well, back home we give benzylpenicillin or ceftriaxone, depending on the bug.
Dr K: Yes yes, that’s good, we give X-pen and chloramphenicol here.
Me: Oh ok. Erm, has an LP been done?
Dr K: No, do you think we should do one?
Me: Erm, ideally yes so that we can find out exactly what bug it is and which antibiotic it is sensitive to (but I’m not sure if your resources here are up to it?). But the child looks relatively well and his temperature has decreased since yesterday so maybe we’ll just observe for a few more days to see if the antibiotics are working? (And not like you have many other choices of antibiotics around anyway)
Dr K: Ah yes, that sounds like a good idea, I agree.

To be very honest, I’m not 100% sure about certain things, but I do hope that I’ve learnt and remembered things over the past 4 years correctly. I don’t want to kill anyone :X

Anyway, Dr Katumba is very thorough, compared to the other doctors I’ve worked with here so far. He tells me the nurses complain he’s too slow and they want to finish faster to go home, aww. Funny enough, he tries to elicit Babinski’s sign on EVERY child, and he does it with his pen so by the end of the ward round each child has a blue line on each sole of the foot, haha. Maybe he’s just trying to rule out meningitis, or maybe that’s his quick way of doing a neuro exam. Shrugs.

Got to talk to the boyfriend on MSN on Tuesday & Thursday, so that was awesome. Love you =)

Some photos:

Mount Meru Regional Hospital

Sarah and I in the “change/locker room”

Ward P1. The other half of the ward has 6 beds, I just didn’t take a full picture cos there were a few patients on the other side and I didn’t know if it was ok with them. Like I mentioned before, in the mornings when they clean the ward they chase the patients out (except the real sick).

Me at P Block.

Will blog about the safari next, stay tuned! =)

On Saturday, we headed out to one of the nearby villages for the day. The Maasai people are kinda like the Aboriginal people of Tanzania I guess? According to Lewis, the guide who took us there, the Maasai people originated from Egypt, and places such as Cairo, Ethiopia, Sudan, Kenya, Nairobi, Serengeti, Ngorongoro were all named by the Maasai.

When we arrived, we were greeted by the mamas and the kids, and a massive number of flies. I have never been surrounded by so many flies before :S It was quite interesting how there was this little girl who had so many flies attracted to her face, I really had no idea why.

Anyway, we started with the mamas teaching us how to make bead jewellery, and I now have 2 bracelets =) They were trying to make conversation, but unfortunately we had no idea what they were saying. What a pity. So we just kept smiling and using the univeral sign language, haha.

Later on Lewis talked to us about female genital mutilation (FGM) & male circumcision. He said that by law FGM is illegal now, and there are some mamas now who are against it but there are still some who do it secretly. He also said that when men get circumcised, they are not supposed to cry out or even bat an eyelid. Apparently if you close your eyes it’s akin to crying, and then word will spread and you will never be respected in the tribe or be a warrior, ie you probably will never get married too.

A typical hut is built by the mama (the men are damn slack) from cow dung (explains the flies now!) & other tree parts etc. It contains 2 bedrooms, which are really quite tiny actually. The man sleeps in one, while the women & children sleep in the other. It’s normal for Maasai men to have multiple wives. We were told that all he has to do is get in bed and call for any one of his wives, then they will have “jiggy jiggy time”. LOL.

It used to be the case where men would share wives. So each wife lived in a hut, and if the man was having “jiggy jiggy time”, he would put his spear at the door of the hut, so that if another man comes along he’d know that there was someone else in there.

Interesting.

After the story-telling/discussion session, the mamas proceeded on to sing for us. We gave them the gifts we brought (sugar, flour, etc) and we also gave out lollies to the kids & mamas. It was scary how they all swarmed over and surrounded me when I had the whole bag, but thankfully we bought a fair bit so there was enough to go around. They were even happy to keep the plastic bags which the sweets came from.

We then were taken on a walk to see some medicinal plants. And the finale was where the men would jump as high as they can, while the women would dance as best as they can, in order to pick a husband/wife. They made us do the dance as well, so it was pretty fun and interesting =)

I had kids wanting my sunnies, my watch, and even the soft toy hanging on my bag. Obviously I couldn’t give these to them, but well I guess we did bring some sweets for them.

So all in all it was a really great experience to be able to see the traditional Maasai people and how they live. We all had the option of living in one of the villages for a week (at an extra cost of course) & learning about their traditional medicine, but none of us are going for it. Matt, one of the other medics studying in Adelaide (he’s from Melbourne, so it was nice to be able to speak to someone from home. Unforunately he’s already been here for 7 weeks and he’s going home on Monday), went on it and he did stuff like skin a goat and drink its blood and eat its kidney raw and eat BBQed liver. Sounds interesting but to be honest, I’m not sure if I would be able to live in those conditions for a week.

Edited with photos =)

My house for 7 weeks. Ok technically 6 cos I was on Mt Kili for 1 week.

First dalla dalla ride
The dalla dalla is the local form of public transport. It’s a minibus that is about a 12-seater, and is usually packed to the brim. From our house to town, it costs 25c, which is relatively cheap?

The staff took us on one back from town on Monday, and to be honest, I think I’d much rather walk than get squashed in one, haha. On Tuesday we were taken to the hospital by the staff again, but on Wednesday, we went on our own. It was scary because it went a different route today, probably cos the road ahead was packed. For a moment we were worried that something bad will happen, but I guess I wasn’t THAT scared since there were many other people on the dalla dalla anyway. And on Thursday, we made a new record of having 25 people in one. We’ve got this book in the house where people write down their experiences, and apparently the going record is 30. We’ll see, we’ll see.

First trip into town
As I’ve mentioned, on Monday the staff took us to town and showed us around. Learnt where things were, and managed to get on the internet for ½ hour to check my email after a week. Pretty familiar with stuff now so that’s good =)

Swahili lessons
Because it’s our first week, we had intensive sessions 3 days in a row. I now know basic greetings, numbers and how to bargain for goods :P Next week we’ll learn medical terms, which should come into good use.

First blackout
Tuesday night we were all gathered in the dining area, wanting to write in our diaries/do some reading when the lights suddenly went off. Everyone was so excited and we were playing with the candles & our torches. Thankfully it came back after a short while, so we counted our blessings.

First week in the hospital
And so officially I started final year. It wasn’t too bad of a start, and I’m currently based at P block – P for Paeds and not Psych. In the same department as me is Sarah, a student nurse from UK. Kinda glad that I have someone else with me in the same department for company.

So a couple of things that I observed:
- P1 is the ward that accepts the new cases and where patients first get assessed.

- There are, on average, 2-3 patients per bed (talk about infectious control).

- Most of them have the Dx of pneumoniae, malaria & GE. But to be very honest, I’m kinda doubtful in some cases, though I don’t know the full Hx. Everyone seems to be given quinine IV 10mg/kg in 10ml/kg of 5% dextrose + gentamicin IV 5mg/kg + ampicillin IM 25mg/kg 8-hourly. I’m not sure if that’s the standard dosage back in Melbourne, and I have serious concerns about antibiotic resistance.

- The doctor writes notes on ANY scrap paper available, even if there are already words printed on the piece of paper.

- P3 is the gastro & malnutrition ward, and P2 is for everything else.

- Everyone has a nonchalant, no-sense-of-urgency attitude. Like during ward rounds, the doctor can just walk away to do I-don’t-know-what or pick up her phone and chat for 5-10 minutes. I got pretty annoyed, and I really wanted to continue seeing the patients on my own and taking Hx, but unforunately my Swahili is not good enough, so yeah, very frustrating. Ah well, I guess as they say, TIFA (This is F-ing Africa).

- Some kids were seriously malnourished and I have one patient with kwashiorkor (I thought of you, xiang!). Never thought I’d see one, but he was so skinny that it wasn’t even funny.

- Every morning, they’d chase the patients out of the wards into the garden in order to clean the wards and change the sheets. I thought that was kinda amusing.

First death on the wards
On Wednesday morning, I was reading in the nurses station prior to ward round. I suddenly heard a woman wailing/crying from the ICU, and Sarah, who was changing the sheets in there, walked out crying. I kinda guessed what happened, and Sarah told me that the doctors were like so heartless and didn’t comfort the child’s mum. Sigh. Well, TIFA =(

When ward rounds finally started at 10.30am, the doctor I was with didn’t know about the death – she actually flipped open the blanket and very casually went: oh, I think the baby’s not breathing. I was taken aback by the sight of the dead baby, and I guess I was too stunned to tell her what happened. The other med student was like trying to take the pulse, and I was just thinking to myself, shouldn’t the information of the death be communicated to all the staff? It was only finally after she asked the neighbouring mum that she covered the blanket back. I had to try very hard to control my feelings.

First night out
So on Thursdays, there is usually a BBQ going at the house, and the students & staff will all sit down and spend some time together.

We got some alcohol on the way back from the hospital, so after dinner we proceeded on to some drinking games, which brought much fun and laughter. We tried Konyagi, which is their local spirit, and the girls told me it tastes just like gin (I don’t drink enough to be able to tell what tastes like what). It was really cheap, like a bottle of 500ml cost only $4.50, and it’s like 30+% alcohol I think. We also had Malibu, which I love so I was happy, haha =)

At about 10pm we got 2 taxis, and 7 of us + Witness headed to Via Via, which is the local nightclub. As you know I’m not much of a clubbing person, but I just thought I’d go once to take a look. It was a pretty cool place, open air with little huts, so we were practically dancing under the stars. Music wasn’t too bad either. It costs $3 to get in and a beer costs $2.50, which is really cheap. But I don’t think I’ll go again, I really don’t like dancing much.

The journey back was a scary one. As our taxi approached the roundabout, I had no idea why another taxi in front just stopped at the junction, not moving. So our driver honked a couple of times, and Sarah (who I think was probably a little high/drunk) was shouting WTH etc, but the taxi wouldn’t bulge. So our driver tried to overtake, but then the other taxi started moving as well, and like driving into our way. We had to stop, and someone got out of that taxi and came over to shout some stuff which we obviously didn’t understand. Luckily we managed to get out of the situation and drove off, then the driver was like, don’t worry, and he pulled out a HUGE knife from the gear area. Sarah even wanted to take a picture of him with the knife but we were all like no, just keep quiet until we get home please. I probably never have been so scared in my life. Though the journey back was less than 5 minutes, it seemed forever, and I only relaxed once we all got in the house and the door locked behind us.

Thank God for keeping all of us safe. I don’t want to be in such a situation again.

First lala day
They call Friday ‘lala day’, lala meaning sleeping. So as you might have guessed, we all didn’t go to hospital on Friday after the late Thursday night (not that late really, we got back at 1am). I really didn’t mind going in, but no one wanted to, and I wasn’t going to make the trip there and back alone. And surprisingly I didn’t even sleep in, I automatically woke up at 8.30am and couldn’t really get back to sleep (I’m sure the boyfriend wishes that I did that every weekend so he needn’t wait for me in hunger for brekkie, hehe), so I got up to do some work on my MacBook and some reading (I found Life of Pi on the bookshelf so I’ve just started on it).

In the arvo we headed to the pool where we chilled and plugged in our iPods and read.

A really relaxing and awesome arvo it was =) I’m dying to get rid of my fugly sunnies tanline (I put sunblock on the bottom part of my face and hope that the top part of my face gets a shade darker), but I guess I was too tanned/burnt when I was on Mt Kili and it’s still very obvious =( Oh well.

To sum it up, it was AMAZING.

Kilimanjaro is the highest mountain in Africa. It comprises of 2 dormant (Kibo & Mawenzi) and 1 extinct (Shira) volcanoes. It is also the world’s highest free standing mountain (I have no idea what that means, I’m no Geography student), and was declared a World Heritage Site by UNESCO in 1989. Uhuru, the highest point on Kibo peak, is the highest point in the world that can be reached without any technical or life supporting facilities.

So yes, I summited at Uhuru Peak (5895m above sea level) at 12pm on 15th Jan 2010. One of the proudest moments of my life =) But not without difficulty, and for this I really have to thank my guide for encouraging me along the way and believing in me. Thank you Daniel, I really wouldn’t have done it without you.

Day 1, Marangu Gate to Mandara Hut
Well, to be honest, there was some cheating involved. I didn’t exactly start at the foot of the mountain; it was 1970m already at the gate, haha. Anyway, I climbed for about 3 hours to Mandara Hut at 2700m. On the way, I kept thinking of myself: why the hell did I pay so much to torture myself? It wasn’t extremely tiring; I was coping alright physically. But I guess mentally there was doubt as to why I was actually doing this when I’ve never done any climbing/trekking/mountaineering all my life. Kinda like, I’d much rather be somewhere else doing some other thing, thank you very much.

First day without a shower, still manageable. Toilets with no water for washing hands, but luckily I took some alcohol swabs and chlorhexidine solution with me. My biggest regret was not having any wet tissues on me, BOO.

That night my hut’s lights were faulty, so I wasn’t able to do any reading and I went to bed at about 8pm I think? Just in case you were wondering, on the Marangu route we slept in huts instead of camping in tents. Each hut has 4 beds, or rather, mattresses. With a sleeping bag, it was pretty warm and comfy.

Day 2, Mandara Hut to Horombo Hut
Walked for about 5 hours to get to Horombo at 3720m. Felt slightly better, I guess I kinda gotten used to things a bit? ‘Pole Pole’, they say in Swahili – slow & steady certainly wins the race in this case.

Met many other people along the way, so it’s nice to know that I’m not alone. Moreoever, we all have our meals at a designated dining area, so it was nice to be able to chat with the other people on the same route. There were Canadians, Kiwis, Spaniards, Americans, Russians, Japanese, Koreans and many more. I was mistaken thrice in the same day to be Japanese or Korean. Haha, maybe to them all Asians look the same? Just like how all Africans look the same to me (and I’m NOT being racist!).

Second day without a shower, I think I stink. But well I guess so does everyone.

Day 3, Horombo Hut to Kibo Hut
Change of plans. I was meant to spend the day acclimatising, ie walk up to a certain altitude and then come down again. But Daniel suggested that we head up to Kibo and attempt to summit at 6am in the morning instead of the usual midnight (so as to see sunrise at the summit). He thought that would maximise my chance of summitting since I won’t be climbing in the dark & cold & windy. Now, he has been a guide for the past 9 years, so I trusted that he was suggesting this from experience and I agreed.

So we walked about 5 hours up to Kibo at 4700m. The sights were beautiful. Seriously, sunset never looked so wonderful. I actually didn’t take any photos because I spent ALL my efforts concentrating on climbing; thankfully Daniel offered to double up as my photographer. He didn’t capture everything the way I would have done myself, but hey, I’m too exhausted to complain. I’m actually pretty impressed with my dSLR on its auto mode. Doesn’t matter, I’ve seen the perfect pictures and they have been captured by my mind =)

Day 4, Uhuru Peak, then back to Horombo Hut
I made it! This was definitely the hardest part of the trek. We had to go in a zig-zag fashion so as to avoid the steepness of the slopes, and it took us at good 6 hours before we finally summitted. Many times along the way I wanted to give up, I thought I wasn’t going to make it, and I swear I was delirious at some point with the lack of oxygen + exhaustion + sleepiness.

I mustered up enough energy to get me up, only to have none left to come down. Whoever thought coming down is easy is wrong. You still need heaps of concentration and leg muscle power to control your speed. We were like sand-skiing down, if you get what I’m trying to say. I really just wanted to roll my way down, lol.

When we finally made it back to Kibo, we celebrated with a cup of pineapple juice, only for me to throw it up less than 10 seconds later. So there you go, my altitude sickness experience. But I’m quite proud of the fact that I didn’t have to take Diamox or any other medications to help me make it to the top, hehe. Anyway, I slept for about 2 hours and then it was decided that we should go back to Horombo so that I won’t get more sick from the altitude.

I don’t know why, but I had been praying a bit, given the boyfriend’s necklace on me. I think I was really blessed with the awesome weather; a fantastic guide who pushed me on when he needed to / let me rest when the time was suitable; and the strength to complete it all =)

Day 5, Horombo Hut to Mandara Hut
Short day, as we took about 3 hours to get back down. Having not showered for 5 days, my hair was in a dry, tangled, yucky mess – GROSS.

Gave the boyfriend a call, miss you heaps :(

Chilled for a bit, did some reading, and we took a short walk to Maundi Crater. Haven’t seen such luscious greenery in a while.

Day 6, Mandara Hut to Marangu Gate
Another short 3 hours down. Got my certificate, felt very satisfied & happy, woohoo!

So all in all, I’m really glad I did it. The ice caps are melting, and I think by 2020 there will be none left on Kili. It’s such a pity.

That means ‘Hello!’ in Swahili.

Yup, this is my first blog entry from Tanzania. Before I talk about anything else, let me tell you a bit about Tanzania. Many of the people around me had absolutely no clue where Tanzania is when I told them I was heading here for 7 weeks (actually, to be honest, neither did I until I started researching for my elective).

“Within the space of several hours, it’s possible to go from lazing on idyllic beaches to exploring moss-covered ruins of ancient Swahili city-states; from climbing mist-covered slopes in the Southern Highlands to trekking through the barren landscapes around Ol Doinyo Lengai, guided by a spear-carrying Maasai warrior. Yet, despite its attractions, Tanzania has managed for the most part to remain unassuming and low-key. It has also remained enviably untouched by the tribal rivalries and political upheavals that plague many of its neighbours, and this – combined with a booming tourism industry – makes it an ideal choice for both first-time visitors and Africa old hands.” – Lonely Planet Tanzania.

A week ago, I was sitting at Dar Es Salaam Airport, waiting for my flight to Kilimanjaro International Airport. Boy was it a long wait. I didn’t want to wander around for fear of getting harrassed by people, yet I couldn’t check in until 2h before the flight. So all I did was sit with my luggage around the check-in area, doing my sudoku puzzles because I didn’t dare take out my laptop/iPod. I remember thinking to myself: Why am I here? Why am I doing this? I remember sitting there just thinking, I want to go home NOW.

A week here now, I guess those feelings have changed a bit. I haven’t quite settled in as I’ve been up in the mountains (that’s for another entry!), but I’m looking forward to the next 6 weeks – working in the hospital, experiencing the differences in the healthcare system here, and immersing in the Tanzanian culture. Tomorrow, I’m officially Final Year Medical Student from Monash University. No more holiday, school’s in.

I miss home & Melbourne, I miss the family & the boyfriend. But I know the next 6 weeks will just fly by, so wait for me, I’ll be back.

I’m sitting at Mrs Fields, Changi Airport Terminal 3, where there is a power point and free wireless. I’m sitting here with a cup of hot tea, trying to make myself feel better. I don’t know why, but when the boyfriend handed his crucifix necklace over to me to keep me safe, I just started crying. Maybe suddenly the fact that I’ll be going somewhere foreign to the people around me, somewhere not many have set foot upon, all by myself, has finally sunk in. I won’t say that I’m afraid, I guess I just don’t know what to expect. I know that by choosing to do this I’m making everyone worry about me, yet at the same time I’m looking forward to this once-in-a-lifetime adventure. I will stay safe, I will take care of myself, I will come back a better person, a better doctor.

Till the next time I update, tata.