The Trek to Seliani

Selian Lutheran Hospital is approximately 3.5 miles from our house in Il Boru. My housemates love to walk in the mornings, so I have been joining them on the hour-long trek through the hills of Arusha into Maasailand. Not only is it good exercise, but walking is a great way to explore the area and be part of the community. In one hour walk, we say "Habari" (the Swahili greeting meaning "How are you?") about a hundred times. The children laugh and scream when we go by, shouting "Mazungo!" (Swahili for white man), sometimes grabbing our hands and walking with us. As the road approaches Selian, which is on the edge of where the Maasai live, we see elderly Maasai men and women with stretched earlobes and beaded jewelry, wearing draped plaid cloth and walking barefoot. Once out of the city, the rural road reveals an incredible view to the north of Mount Meru, the 15,000-foot sister mountain of Kilimanjaro. Jason climbed Meru in 2001 when he first visited Aunt Nancy.
Nestled among tall shade-bearing pine trees and fan trees, Selian Hospital is a small campus of buildings on two quads. There's the medical and pediatric ward, the OB ward, the surgical ward and ICU, and three operating rooms. The patient rooms have 10-15 beds each--often which have two patients per bed in the pediatric ward. Routine care includes daily rounds by the team and nurses, and medication administration by the nurses. Vital signs are not routinely taken except when requested by the physicians. Intensive care at this hospital includes more regular nurse monitoring with vital signs taken every four hours and the option of giving oxygen up to four liters, but there are no ventilators. The neonatal intensive care unit is a small room with three working incubators, often which have two to three babies per incubator. The hospital has an intern training program, and currently four interns are at the hospital, taking call every fourth night for the entire year! On call, they cover the whole hospital--all admissions, any problem deliveries, and emergency surgeries. If they are in over their heads, they contact the Registrar on call, who is one to two years out of intern year. The interns do not get the post-call day off; they have to work every day. Luckily, they all live behind the hospital and often help one another out if the person on call is swamped.

And we think that we have it bad being US residents!