So back in East Africa, and realizing, sort of surprisingly, that I am not quite the same person I was two years ago. And realizing, also, that I recognize many things here, things that I didn't even remember making a mental note of. These didn't make the "final cut" of my memories of Tanzania, so I hadn't really thought about the orange-red color of the dust, or the way every little corner store sells chips and chicken as a combo meal, or the way you have to haggle for some things (tomatoes) but not for others (cell phone minutes).
But now it all comes rushing back. It's couched in a quite different context - I'm among other Americans, in a much cushier living situation, and I seem to know a bit more medicine - but I do like feeling, for once, that not everything is completely new. Yesterday, when I broke my sandal on the first walk through town? Didn't even blink an eye. Walked right over to the corner market and found the shoefixing guy that I KNEW would be there, because he'd always been there in Tanzania, who promptly repaired the sandal for the equivalent of $3. Done. Felt savvy.
But the big story today was our first trip to the Kamuzu Hospital Skin Clinic, where we six students, under the supervision of Dr. Sethi (from the University of Chicago) and the Malawian dermatology officers, see any and all patients that care to show up on a given day. Queueing outside the clinic appears to begin well before we arrive at 9, and continues until we either run out of patients or run out of natural light. (No electricity in the clinic.) A bit of somewhat organized chaos seems to be the order of things.
But exciting! I emerged today having seen several patients with skin conditions I'd only ever read about in textbooks before - most notably pellagra, which truly hasn't existed in the US since the 1930s. It's like seeing someone riding a pennyfarthing bicycle - except, you know, a rather miserable condition that'd could only happen to someone suffering from some serious malnutrition. Amazing and a bit disheartening at the same time.
Looking forward to going back tomorrow. I VOW to recognize measles this time.
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1 comment:
I have Pellagra and I live in the US! Although I was the one that figured it out, the diagnosis has been confirmed by a MD. I can assure you that this sneaky disease is very under-diagnosed and actually quite rampant in alcoholics, especially those on low carb diets! The only reason that I figured it out is because I live in the south where I can wear shorts year round and I developed the skin bizarre problems form daily sunshine. After gaining interest in niacin due to a friend's doctor recommending it to her for a recent heart-attack. I immediately saw progress in my strange skin phenomenon , my 5 year long daily diarrhea, mental confusion, fatigue, and in invasive acne on the back, legs, and stomach. I then became totally fascinated with niacin and hence quickly figured out Pellagra. i just know that so so so many other people around the world have the same problem, but with not as many visible symptoms because they live in non tropic weather,. Therefore I can guarantee that this is this most missed health problem in whole world! non exisitant ? NOT! so maybe you have a bamboozle load of vintage bikes and need to go to ebay or medscape and cash in..or potentially something...!heh :D If adding niacin to breads and pasta (enriched) is supposed just be enough to prevent Pellagra here then you just wonder how many people actually have heart problems due to niacin deficiencies--or near deficiencies ... Heart disease is the #1 killer after all. You know some things that may absolutely seem minute and perhaps dead or dormant, upon illumination -under the proper light and inspection, may be so pervasive gargantuan that it is literally a godzilla rampage everywhere. I am convinced. but then again I am the one with Pellagra that has grown to know the intricacies well! Congratulations on the hospital work...I really think it is really great!!!!
I can answer any questions about it if you want..
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