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In March this year Abasi married his long time girlfriend and started a new job.

This neatly finishes this chapter of Abasi’s life story so I’ll leave it there. If you want know more drop me a note on the contact page.

As it’s nearly a year since I posted an update, here it is.

June 2018: Abasi was invited to a university to give 3 evening class lectures of 3 hours each on HIV, Sexual Health and General Health. It seemed to go down well.

Abasi started to use his car with Taxify (a service similar to Uber) to supplement his earnings as a doctor. On one occasion he lent his car to a close friend to drop an acquaintance home. Unfortunately the car got hit by a drunk driver and was badly damaged though the people were ok. It took some time for the insurance to deal with the car, so Abasi had a rather difficult journey to work for the next few weeks as there was no public transport that went to the hospital.

July 2018: The drunk driver was fined 10,000 shillings (about £5) and Abasi was left out of pocket for the cost of having his car towed to the garage. However he was insured so the insurance paid for the repairs.

Things continued downhill when Abasi got news that his sister had collapsed at school. She had a week resting at home but as soon as she returned to school she collapsed again. The local hospital couldn’t find anything wrong. However one of the psychiatrists at the hospital suggested she may have Conversional Disorder which causes her brain to shut down when something is causing her fear levels to rise. So she had to stay at home until Abasi could afford a counsellor.

Then Abasi got evicted from his house. Apparently the owner is known to do this halfway through the tenancy so as to get in someone paying higher rent. However Abasi was lucky to find alternative accommodation.

August 2018: Abasi moved into the new house and got all the cleaning and repairs sorted out, with help from his fiancée. As she didn’t have a job and the finances were tight, they decided to wait until 2019 to get married, rather than get married sooner. His fiancée sister was getting married in September so it would have been a bit tricky to have 2 weddings close together.

In mid August the car was ready and Abasi started doing Taxify to help pay for the insurance excess and other expenses.

September 2018: Taxify reduced the amount of money they were paying drivers so Abasi decided to stop as he would be out of pocket with the new rates. However he did have enough money to pay for his sister’s counselling and that was due to happen sometime this month. He was also able to go to his fiancée’s sisters wedding though that involved a 16 hour bus journey!

On a more positive note Abasi was appointed to a new position of head of Oncology and Palliative Care. This will involve writing a proposal, SPO and also plan a budget for onco-palliative care, as well as attending seminars, and linking patients with the Bugando oncology unit.

October 2018: This month was supposed to be Abasi’s annual leave (20 days). He spent the first 10 days of his leave doing taxi work to raise some cash. He then got told to attend a symposium on “Global cancer control in the 21^st century: a multidisciplinary approach” at Malaika beach resort which was a 4 star hotel! He was then asked to return to work early as some members of staff had left for better paying jobs. He then had to present an update to all staff. So not the annual leave he had expected.

His sister started to see the counsellor this month, and about half the hospital staff went to an annual network meeting in South Africa, leaving the clinic in the remaining staff’s hands. They went to present various research results, two of which Abasi was co-researcher on, so he was pleased.

November 2018: This was an eventful month. Abasi kept helping his fiancée apply for jobs, and his sister continued to attend counselling. But then came his first truly memorable moment since becoming a doctor. In his own words…

“It was a regular Thursday after completion of Life support training, and I was the doctor on duty that day when a relative brought in a child for exposed care. The relative suddenly fell down and lost consciousness. An Emergency alert was made and everyone ran to the client waiting area where quickly we carried the patient to the treatment room. Four doctors, three nurses and my supervisor were there. I was the one in charge of leading the whole situation. In my primary assessment the patient was not breathing and unresponsive so I asked a nurse to give oxygen while I was listening to her chest, but found no cardiac activity at all. Everyone panicked and I did as well for few seconds but I then jumped to the table,  sat on the patient and started doing chest compressions while others were drawing blood samples for more investigations. We had no one to tell us the patient history and so were in the dark. I kept on doing compressions for 10 minutes without any improvement so I decided to shock the patient. However no one knew how to use the defibrillator. I said I have seen it being done in medical series on TV several times so if that was what I was supposed to do, then I will do it! I asked my supervisor to charge to 200J which she didn’t understand so I instructed her while was still doing chest compressions. She did it and I gave  the charge to the patient but no response. Shot at 300J  no response but after few seconds we found a pulse. I was so happy so I kept on top of patient ventilating the patient while one of our cars took a patient to the Bugando Emergency  department. I gave my report to the specialist there and he was impressed by what we did to save that woman life. It was found later that she had  myocardial Infarction at the back of her heart which could have killed her if we hadn’t given emergency help. This was so far the best of all days since I came to the hospital.”

Later in the month Abasi got the news that his finance had secured a job at National Aids Control Program(NACP) in Dodoma. It took 49 job applications but she finally had a job, even though they will be some 600 kilometres apart!

December 2018: The first good news of the month was that Abasi’s sister had responded to treatment and was now ready to return to school. Abasi drove his fiancée to Dodoma to help her get settled in and ready to start her new job. In her first few weeks there she travelled to Dar and Tanga being introduced to the people and role she was responsible for. It turns out that she is getting more pay than Abasi and is technically his boss!

Back to work and Abasi had to pick up all the IT issues while the IT person was on annual leave, as well as his usual organisational role and attending to patients. He also did a session on the local radio on the essence of drinking water, safety and challenges especially in this rainy season. He was also happy as they had two more paediatricians come for the year, giving him some respite from the workload.

So after that it was time to look forward to going home for Christmas and to planning the wedding next year.

At the beginning of April I got an excited email from Abasi. He was about to get engaged to his long time girlfriend. However that wasn’t what the excitement was about. It was because in Tanzania they still have a dowry system (bride price) and he didn’t have enough money available. After much discussion we came up with a solution, and the engagement went ahead. The whole system is still steeped in tradition and is proscribed. It is a major social gaff if you don’t follow it. Abasi and his girlfriend had to wait until her older sister had got engaged and she had presented the new man to her parents, before they could proceed.

Work at the hospital has been hectic as ever. Abasi was being mentored by a couple of doctors from the USA who were really supportive. One task he was give was to update the medical records database. However the database hadn’t been updated for nearly a year so he had around 900 cases to enter. This was in addition to looking after patients! But as ever Abasi rose to the occasion.

After a few weeks another USA doctor returned to the hospital and she turned out to be a nightmare. She has a very combative approach and Abasi got quite down. Adding to his misery, the 2 nice USA doctors had to return home. Luckily at a doctor’s meeting at the end of the month another doctor confronted her on her style and things improved. Some time later she to had to return to the USA and things settled down.

In May Abbasi’s paternal grandmother passed away after some years suffering from Alzheimer’s. Abasi had to travel 900 km to the south of the country for the funeral. Whilst returning to Mwanza he got a call that his great grandmother had passed away, but as he couldn’t get any more time off he had to miss the funeral and return to the hospital.

Abasi regards himself as very lucky though. It transpired that most of the students he was with at med school or during his internship have not found jobs. He remains ambitious as ever. He’s hoping to do a Masters in Public Health using distance learning, while still working. Longer term he will want to specialise and do an appropriate masters course. Funding that will be a whole new challenge…

Well Abasi started work as a qualified doctor in early January.

The hospital put him up in a hotel for 2 weeks while he got sorted out and found a place to rent. Here’s some extracts from his latest email.

“As soon as I arrived at Mwanza, I was well received by the Baylor staff and orientation followed. When orientation was done, I was provided with systems clearance, organization email and later introduced to the system.

The first few days was shadowing different doctors in the morning and spending entire afternoons discussing different clinical management as well as lectures on paediatric HIV according to Baylor. Later on each day I spent my days hunting for houses with different Dalali (Middle men).

The routine was much like that for entire week and I would usually be back at the hotel at 9-10PM daily without success till yesterday when I finally got a house that was a good standard for living.

I am waiting for the house owner to finish up with minor repairs and painting before I can move in. As soon as I get my first salary, will be traveling to Mbeya to pick my items.

I am looking forward to settling as soon my things arrive here, so a couple of weeks to go.

I am loving my working conditions so much and I am already assigned to work with Adolescent, Research, Outreach and Reproductive Health teams. The clinical director told me that I have potential in Readership and Finance so she might have me trained in those areas too.

Currently there are three Paediatricians, two from USA and one from Tanzania, who is also a clinical director, and three Medical Officers including me. We have 4 nurses, 2 social workers, nutritionists, counsellors, and other departments.

We attend 100 to 110 paediatric patients of different age groups each day from 8:00 am to 5pm (From 7:30 we need to be at work). We serve 8 lake zone regions.

Today I was given my own office and also started to see patients on my own but had to discuss how I managed each of the 3 I managed with the Doctor Of The Day (paediatrician)
The working Environment is totally Western and everyone is so nice to work with.”

It seems so long ago this all started and here we are. Abasi has achieved his goal of becoming a doctor. But he is not finished yet. He will want to become the best doctor he can. I look forward to watching his progress…

Abasi finished his internship and got all A’s and B+’s, so that was pretty good. Unfortunately things got a bit tight financially as he was now unemployed. He applied for many jobs, and filled his time teaching in his local church. Then some good news! He was offered a post at Baylor Paediatric Hospital in Mwanza subject to acceptable references. Three days later his appointment was confirmed and he starts early January.

He is naturally very busy with the move from the south of the country to the north, and starting a new job. So it will be some time before we hear how this next stage in his career is going.

As Abasi himself said, I’m super excited!”

Abasis’ mother was recently unwell, but he was able to get her to the hospital to see a gynaecologist who sorted out the problem. His father also had an ongoing problem with his knees, but again Abasi got him to the hospital for some much needed treatment. Unfortunately another of his relatives died after being misdiagnosed by the local clinical officer. Clinical officers are medically trained but not to a high level, and misdiagnosis can happen. The charity I work for (http://virtualdoctors.org) helps with this problem.

Anyway, after Psychiatry came the Orthopaedic Department…

“As soon as I started my rotations at surgical department I was assigned to start with my favorite of all medical fields which I would love to specialize in. This department attends about 350 outpatients a week and has three wards and ICU (male, female and children) which has a total of 60 patients each. When you are first on call you are supposed to work for 36 hours. You will be responsible for all of the patients and all emergency patients coming to the hospital. The department has 2 specialist and 4 registered medical doctors

This is one of the busiest department, second to General surgery which I requested to rotate for 5 weeks instead of normal 4 weeks.

I was assigned to a ward that deals with pediatric orthopedic which has 30 beds. I started with minor jobs like putting on skin tractions and doing service ward rounds. Later on in the same week I was supposed to assist surgeries at the theater. We had more than 17 patients who had to get operated on per week and usually we were doing intra-medullary locking nail fixation, open reduction and internal fixation by plates and screw or by using compression screws. I assisted on more than a hundred surgeries and did less than 5 by my self, though I usually finished surgeries at their last point. I made a lot of friends with parents and their children. I loved seeing them waving goodbye see you in two weeks at the clinics. Many of them loved me to the point that they wanted nothing to proceed in the OR when I wasn’t there. They said in their own words that I want Dr Ayoub to be here and to do the surgery on me without knowing that I am just an intern who will only assist those specialized procedures. Those who were financially very poor, I made sure that their info reach to the administration so that they get helped. Many got helped and I went back home smiling.

Once I was in the ward I had to dress to all surgical wounds and all septic wounds like those of osteomyelitis. I also drew blood for investigation, and made sure that my patients received their medications. So many times those who were poorly attended by other doctors or nurses would come to me as soon as I show up to the hospital. There was a day that other doctor mistreated a patient and she really didn’t talk to her in a good tone. She yelled at her so much to the point that pregnant woman who has daughter with two broken bones at the thigh started crying. Other patients didn’t like it too so as soon as I entered the ward they told me. I had nothing I could do, as I know the doctor they were talking about. She was lazy and loves arguments and most of the time would fight with all of us. I told them to cool down as everyone has their own calling and do their job as their personality guides them best. They prayed for me to become a good doctor and told me that on days that I am not around, whether I was in theater or I was first on call at the entire department, they would look and wait for me and they wouldn’t tell any one their concerns. I felt really happy.

Four out of 7 days I spent in theater and later on to my assigned ward. I was literally living I hospital as I usually left to go home really late and sometimes as soon as I was home I had to go back as my seniors knew how ready I was when they had an emergency or when anything needed a quick attention.

All of the five weeks I was in OT I saw my self becoming an orthopaedic surgeon and I know that I love it with all of my heart and it is the thing that I want to do in my life. I spent hours in theater and clinic and in my heart all I wanted to do is MORE.”

Then it was on to General Surgery.

“This department also attends more than 400 patients a week with three days for elective operations and has got a total of 7 wards with 40-60 patients each.
They have three specialists and 4 registered doctors.

In this department, where I am still working, I was assigned a different ward which is a male ward. Here my daily activities are doing ward rounds, preparing patients for surgeries, attending all new patients coming to the ward via Emergency department or casuality as well as preparing patients who will be going for elective surgery. I also have to be first on call 2 days a week for 36 hours, attend surgical clinic once a week and lastly be in theatre once or twice a week. In theatre I get to assist surgeries and perform minor ones like lipoma excision, herniorrhaphy and surgical debridement’s.

I became well known to my seniors, I guess, due to my readiness but also my wanting to know. I usually bug them with questions until I understand something.
I also got lucky that my white coat is usually clean so several times my chiefs asks me to lend them mine in case they want to do something political as so many politicians do come to hospital regularly due to ongoing constructions around the hospital. We have a lot of ongoing programs like Hydrocephalus, inperforate anus reconstruction, thyroid and others. Politicians, NGO’s, and press come regularly to obtain information about ongoing projects and so they would want to speak to specialists and senior doctors about it.
In General Surgery a lot of deaths occur several times a week and they are so painful. I lost a child in my second call. She was 4 year old who sustained burn injury 27% of her body. I didn’t even know what happened as I was doing my work in other wards when they called me to review her. When I reached there she was already passed away. It was so, so painful and it ruined my day completely. I was so, so mad as nurses didn’t tell me anything that would have caused her death and the thing is the dangerous time for her had been already passed. I lost other two patients who sustained head injuries whom I tried my best but couldn’t save them.

I got to stay in the hospital more than how I used to stay when I was in OT.

There are so few of interns remaining so we have a huge load in terms of patient-doctor ratio. This week we had an outreach program around Mbeya city centre where we were providing screening for prostate cancer, Benign Prostate Hyperplasia(BPH), breast cancer, cervical cancer, blood donation, etc. All of the hospital sections were there. I was lucky to be among two doctors who were screening for BPH and breast cancer. We could screen up to 120 people a day. It was wonderful and by the end of the day today, hospital director, head of department and other larders came to thank us for our time and support. I felt really good to be recognized for our work by head of department and by the hospital director. The head of department asked me to drive him to the garage where he took his car to be fixed. It was an honour for me to drive him as he could have asked any one as so many cars were there. On our way we talked about his career and he asked what I will do after my internship.
After another week I will be shifting to the Urology department for two weeks and after that I will be done with Internship.”

Abasi and his girlfriend are still hoping to get married and trying to save up the “bride price”, but with the future unsure after the internship ends there is no knowing how long that will be. There was a notice at the hospital about a vacancy for one doctor at Baylor Children’s Hospital. 25 intern doctors applied and Abasi was selected for interview on 27th October.

We await news…

Obs and Gyn came to an end and was very draining on Abasi but also very useful. He wrote…

“I have been really busy with Obs and Gyn to the point I was literally living in the hospital. I worked closely with the specialists, registered doctors and nurses to my maximum capacity. I assisted hundreds of delivers, did Manual Vacuum Aspirations, assisted Evacuations, Laparotomies, hysterectomies, c-sections, lapascopic surgeries etc. I also ended up doing seven C-sections, the highest number of all in my group. I also participated in maternal death reviews, training for Post partum, IUCD cancelling for three days and gained a lot of knowledge from all that.
The head of department was very happy with me and he suggested that he might hire me during the time I will be waiting to do further studies. Fingers crossed for that one. I lost a lot of weight and I’m trying to regain it now that I am out of Obs and Gyn.

I have now reported to the psychiatry department where I will work for one month before going to the surgical department. We don’t see many patients and most of the time we are done by 11am Unfortunately we cant live so I use that time to observe surgeries going on at the main theatres. Honestly I don’t like psychiatry and I don’t find it attractive. I work there because it’s a must but again I don’t take it for granted. I treat seriously those who come seeking our help and most of the time I seek a lot of consultation’s from our psychiatrist and senior doctors available.”

Abasi is now getting very serious about settling down with his girlfriend, but there have been complications. In Tanzania it is still common to pay a dowry (or bride price as they call it). This is about £1,000 which is not easy to raise when your and intern just about surviving on your intern allowance. But another fly in the ointment appeared when his girlfriend seem to cool to the idea. After a worrying few days it turned out that because of all the long hours he was doing, she was feeling a bit ignored. So he has been making extra time to see her and things appear to be back on track.

Relationships and money. Always a problem…

Abasi took a weekend trip with friends to Ruaha National Park and returned to start his rotation in Obstetrics and Gynaecology. It was something of a hectic time. As he wrote…

“Well this is one of the busiest departments at Mbeya Zonal Referral Hospital as it serves 400-500 new patient’s every week. Once you are there you have 4 weeks at the postnatal ward, 4 weeks at the Antenatal ward and 3 weeks at the Gynaecology ward. With all that you are subjected to a roster that requires you to attend patients at the Outpatients department(OPD),Antenatal clinics, Fertility clinic, Labour ward, ICU, and operating theatres.
I started with Postnatal ward for a whole month and my main job was managing post operative patients, managing post partum haemorrhage cases and caring for post spontaneous delivery mothers. In the ward we could have up to 90 mother who gave birth and we had to do ward rounds (minor by ourselves, daily and major with specialists with a few chosen difficult or special patients twice a week).

It was not easy as they were only two to three doctors and we had to attend every single patients and discharge those who had recovered. We would do up to thirty discharges a day and once we had gone for lunch we would find almost the same number or more of new patient’s had been admitted to the ward either directly from labour ward or from the operating theatres.

Luckily I was not assigned to any night calls for three weeks as I was new and a new timetable was in play.
After three weeks things started happening especially on my first call. I was the first on call for the first time and due to the size of the hospital, two doctors will be first on call. I went to the hospital as usual at 7:30am to attend the morning meeting which is a must and we have our names called out and sign our attendance. I then went to the ward and did all the work but from 3:30pm we were alone. I had to see patients who were still there at OPD alone up to 9pm. The other doctor who was with me and had more Obs and Gyn experience than me was really lazy and annoying. He went home and came back really late and he was of no help at all. As soon as I finished seeing all of OPD patients, I was called in the ward to review a patient who needed an emergency caessarian section, so I ran to the ward, reviewed the patient, took blood samples for a full blood picture and cross-match, then ran to lab, prepared the operation list, where I was supposed to send a copy to central sterility department and a copy to the operating theater and one copy would remain in the ward. After all that I had to go the theater scrubs and assist all the C/S. As soon as we were done I was called to the labour ward, over there I found that all the nurses were really furious as they called the other doctor to reviews patients in labour and with complications, but when he went there he talked down to them and made them look stupid. On top of that there was a patient who was really fat, and the nurses took ages to find a vein for fluids to run. When he reached there he was told that the same patient had obstructed labour so he wanted to prep her for surgery, he went to the same vein took some blood and somehow disturbed the vein to the point it was swollen and useless. He left the patient without looking for another vein.

Nurses were mad so they didn’t do anything and by the time I reached the labour ward and mind you it was my first time in that hospital the atmosphere was really bad. The nurses were so mad, I greeted them but got no reply. They told me that all the patients supplies had run out( Ivs, cannula, fluids, syringes, and giving sets).So I sat down to do the orders from patients files while more than 10 patients required a doctor’s review. While still doing that the other doctor and the nurses had a fight because of what he did. He didnt care and replied really bad to them. They kept quite but didn’t want to do anything. Three patients were actively delivering at that time. I helped and all of them suffered perineal tears. The nurses wanted me to repair them. (The good thing is I had very good teacher and I paid attention on my clinical rotations and did a couple of perineal repairs in med school). So I took all the requirements and stiched all the patient in a dim light alone for a few minutes. I was done and nurses didn’t say a word as many intern doctors including the one they were fighting with had difficulty doing the same thing I did. He left, but I stayed to help. We did several deliveries together and by the time it was almost morning all of us were laughing and happy and the mood was clear. I was joking with them and they really liked me. They told me face to face that I was a good doctor. I felt really happy. The nurses planned to teach the other doctor a lesson that he needed them. I dont know how that went, though I tried to explain that we are different and everyone does things according to how their conscious is. So my on-call went successfully though I was really tired.I had couple of night calls every week after that and all were successful.

Last week after I had asisted over 15 c/s, a total abdominal hysterectomy, and other many obstetrics surgeries I was given a chance to do my own operation by my self as a surgeon. I was really excited and thank God it was successfully. I did a c/s for 35minutes delivered a health baby and repaired the mothers womb very well. My senior doctor was happy as I’m pretty fast for an intern. She told me other interns would use an hour for their first surgery. I thanked her for the opportunity and brought her apples the next day. She was so happy. From that experience I did one more c/s with a different doctor. I am seeing my self doing more c/s in the near future. Almost all staff at the operating theater and surgeons have grown found of me and that makes me so thankful to them. They taught me a lot. I left them my number to call me in case the get any procedure at any time where there will be short of staff, which happens all the time. Sometimes they do more operations than they should do because its a referal zonal hospital. I get to go to theater more often now than I should usually go. I spend all of my extra time a the hospital and I stopped going to gym and sometimes I don’t finish church services on Sunday’s….”

Of course being an intern, money is tight and prices rise. The new president is on an anti corruption drive but, as this is pushing up prices, Abasi has had to economise. He now no longer goes to the gym but does push ups at home. His father has been unwell so that has cost money for doctors and medication. Abasi is thinking of bringing him down to the hospital.

He’ll certainly get some great personal care from Abasi then…

Abasi and his friends had a few days off with, as ever, some interesting twists…

“Last weekend, which was a long weekend, we organised a trip of 12 of us. We had three cars and everyone contributed for fuel except the car owners. We started by going to Matema lake shore (lake Nyasa) which was so beautiful. We swam, did a boat trip to see coloured fish, saw old caves and finally we went to a water fall near the lake. It was amazing. In the evening we had karaoke and live singing, as I took my keyboard and subwoofer. We were cooking our own food as everyone had contributed and we bought everything we needed at Mbeya before we left. We also had geography and general knowledge quizzes and I was surprise to find that I was better than most of them in general knowledge to a point where almost all question ended up being answered by me. The others Googled my answers to check if I was wrong only to find out that I was right! The were wondering how I managed to know how to do a lot of things and still remain good at the hospital. I was teaching most of them to swim, I could play keyboard, cook, dance and I was a champion at table top football table!

On our way home a few minutes from the beach shore one of the cars has a puncture and they didn’t know how to change it. I was in front so they called me back. I was suprised to find that they were trying to lift the car by hand so that their driver could put a jack to lift the car up. I took my cars jack, lifted their car, changed the tyre in few minutes and soon we were in our way back.

We went to the Malawi border and we decided to pass by God’s bridge on our way to back to Mbeya city. Unfortunately the same car that had a puncture got into an accident near one of the bridges that had a sharp corner. He was trying to avoid a minor hole in the road while he was going fast so his car went into the bridges side guards, scratched the car, broke the steering rack and wheel. He managed to stop on the other side of the road but in the process he injured a pedestrian, hitting his leg though it was not a severe wound.

Because I was in front again, they called us for help. Luckily no one was injured in the car so we gave first aid to the injured pedestrian from the first aid box that was in my car and later I took him to the district hospital nearby. I showed my Id and helped to treat some of the patients as there was only one doctor on call that holiday and he had a lot of patients. The doctor had a little to drink too so he was super slow.

After my introduction, I helped him with a couple of patients at the outpatient clinic then we managed our patient together. We took him to the minor theatre where we cleaned the wound well and dressed it nicely. It was a soft tissue injury without complications or fracture. It was 3cm by 0.3cm and was not bleeding much.
I thanked the doctor who then took me to see around their hospital and we covered all the medical bills as the pedestrian had no health insurance. We took him and his brothers to their home, gave them medications and also little money for antibiotics and pain killers. We left our contacts and drove back to the accident site.
The car was towed to the nearest garage. We hired another car and by 11pm we arrived back at Mbeya safely.

After three days of adventure, I am the first on call again and I am writing this email while waiting for any patient that might show up. I’ve had two admissions so far. Lucky day. One more on-call to do before I am done with paediatrics. I’ve been coming in for regular calls and have been covering for calls that some doctors would not show up for. I never understand some internship doctors, full of excuses and because I am the chief intern its my duty to fill their places or find someone who can. They think that they are favouring themselves without realising that I am gaining more experience than them. The head of department knows that I have no problems coming in to fill in when anything happens and I do it always with joy.

I enjoy every moment of my internship as I get to be a better doctor everyday and every time I get to touch people’s lives in one way or another. I also gain many contacts from parents and people with different careers who ask for my contact details after helping them.”

Says it all really.

Abasi had his mum and sister to visit recently. His sister had a few struggles at school in the early years but since changing schools had faired better. Abasi had always promised her that if she did well at school he would buy her a plane ticket to Dar. She had never been on a plane but it was something she had always wanted to do. She had done well in her December and March exams so Abasi surprised her with a flight to Dar. Abasi and his mum escorted her to the airport and Abasi helped her through security. At first the security personnel were reluctant to let Abasi through to help his sister. They asked for id and when he showed them his doctors id they let him through as he wrote “without a problem and with respect. I felt really happy!”

And so to “Adventures in Paediatrics”. In Abasi’s own words…

“Last time I wrote to you I just started working at the general paediatrics unit. Well things were not easy at that ward. The first time I was first on call (for the whole paeds department) I had a couple of admissions. Most of them were the usual routine admissions. Everything was fine until 6:30 am when I received two challenging patients who needed immediate help. One of them was a Sickler in crisis that needed my immediate attention with very low blood count(anaemic), while the other one was a cerebral palsy individual with rapid chronic convulsions, a high grade fever and very pale (he was anaemic too). I gave him phenobarbital injection as rectal diazepam while asking his mother to go and pay for a Full Blood Picture(FBP) investigation. She was panicking and all of my nurses attending are elderly, so I took the money and ran about 100m to the cashier, paid for samples, ran back to the ward, drew samples from both children then ran to the lab(about 150 metres) with the samples to do an emergency FBP and cross match, waited there till till I got the blood then ran with it to the ward,and gave it to the nurses for infussion. At that time everyone was waiting for me to present all of my cases at the morning meeting, so I didn’t have time to write anything about the last two patients other than what was in my head.

I presented my cases for the first time thinking that my superiors would be impressed. I can’t forget that day as one of the paediatricians made me sweat plasma. She was so tough on me, judging every sentence I said, no believing anything I said. She said I mismanaged all the patients that came that night. She asked why I didn’t document the two patients who came earlier that morning. I had to explain to her the scenario and told her that I managed to stabilized all the patients before I came to the meeting and they were doing fine. I also left instruction with the nurses on what to do if the convulsions recurred. She didn’t believe that either so rejected everything I said. I felt really bad in front of other specialists, interns and nurses, so I kept quiet. She also told me to go along with her to see the patients. As soon as we were in the ward, my patient had another episode of convulsions and a nurse was giving her a maintenance dossage of phenobarbital, so the “mean specialist” started blaming me. Why did I leave? I told her the patient was stable and not showing any sign of getting another convulsion episode and it was obvious the convulsions reccured after two hours as we were done with morning report.

She talked to the mother and found out that there was a single piece of information that I missed about child’s illness when he was three- years old. You can imagine what followed (the child was 11 year old by then). I kept quiet till she finished talking,because she was stubborn. What I found out later was that she was pregnant (hoooòoooooooo …exhaling deeply). I took her to review every patient I admited that night, showing her I was stubborn too. Every time she wanted to go, I told her there was another patient she should review. She got tired but I insisted she review all my patients as she didn’t believe my management decisions. Obviously she got tired as I had many admissions, so she left at last really tired and I was smiling.

I though it was over, but the next day the head of department called for me. I went to see him and found that he was very angry. He told me that they were punishing me by adding three more weeks to my rotation. I was shocked, so I asked his permission to speak freely. I explained to him the scenario step by step as he wasn’t at the morning meeting. He then decided to go to the patient for second opinion and to nurses who were on call with me that night for third opinion. He came to realise that I did my best and I was right. yeaaaaaaaaaaaaaaaaaaah……

So he told me it was not right for them to add three weeks so instead he gave me one week for missing information about that patients illness when he was three years old (there were no record’s back then). I accepted it thought I could see in his eyes that he knew it wasn’t fair as I managed to gather a lot of information when the patient was in distress and the mother was panicking while I was stabilizing that patient and all the information was in my head. He knew that if I went back the second time which is the protocol, I wouldn’t have missed anything so he gave me a week instead of three to make peace with the other specialists.

Everyone started calling me “abasi mawiki” as in weeks in English! I told them that in two weeks every specialists including her will be my friend. They didn’t believe me as they were in the department much longer than me and they usually avoid the “mean specialist”. Time passed and I thank God everyone started seeing my potential for managing patients, when I helped IT staff during meetings, when I fixed my superiors PCs, the way I talked to nurses and to be honest all were my friends. Nurses loved the way I worked with them and the way I respected them, calling them “mama” as they are my mother’s age, so things started turning around.

After three weeks I shifted to the Diarrhoea ward for two weeks and the specialist over there is a friend of mine. Everytime she arrives she asks for me, we talk about a lot of things at length. She was sharing her knowledge and she would listen to and appreciate what I had to say. She talked about her children, her masters study in China and joked with me as if we are on the same level. She commented on my presentation to other doctors and even the head of department, who is her husband, was impressed.

When my theee weeks were finished I moved to the malnutrition, HIV and TB ward, which receives most of the patients who are in a special program funded by the Texas children’s hospitals, abort fund and Baylor hospital. They have their office and branch here. So we have ward rounds with a lot of white doctors from America working here for charity. We usually have interesting major ward rounds on Mondays and Fridays. I am still in this ward for one more week and later I will do my final (bonus punishment week) at Baylor hospital here in our facility.

The “mean specialist” is now very friendly with me and she never doubts me now and she hasn’t shouted at me even once in all the service ward rounds or in any of the major ward rounds. A few days ago when I was in the cafeteria she came and found me eating so she told her husband (who is also a specialist of internal medicine ) to come sit with me. I was surprised, and we talked a lot until we both had to go back to our jobs. She is not mean any more and I like working with her.

Mission Accomplished…”

I think Abasi should have been a politician.