Mnazi Mmoja Hospital

Operation: thyroid liberation

I was supposed to go to Mbweni yesterday. Instead I stood in the ENT 'Sea View' theatre and watched people - happy looking people - heading out on snorkling trips or sailing past on traditional dhow, whilst I was left trying to dodge the fine sea-sprays of blood emanating from an obese woman's neck.

About five minutes into the operation I think we all realised it was going to be a marathon. The goitre was enormous and the woman was, what we in the industry like to call, a bit of a bleeder.

By the third hour, the usual theatre chit chat had died away and we worked in silence, save for the odd imperative ('suction', 'gauze', 'forceps') or exclamation from Dr Tao, a man with a knack for capturing the collective sentiment in a way that only someone with broken English can.

"Argh" he said as yet another geyser arced into the air, "too mucha blood. Want go home."

Having foolishly agreed to assist in the operation I felt a bit like an American soldier in Iraq - in the middle of a bloody battle I only half understood, with no exit strategy. So I stood there with sweat pooling in my gumboots and tried to concentrate on the various token tasks I was given (sucking up blood, cutting sutures, holding back neck fat) instead of staring out the window and thinking about my housemates who would probably be sitting next to a pool somewhere drinking colourful coctails with those little umbrellas in them.

Ultimately, the operation ran so far over time that the patient woke up and the generator packed it in and we had to complete part of the closure under torch light.

The ENT theatre

Around Stone Town

Thanks to Jenny for the photos!

Manny's

My favourite hangout in Stone town is Manny's coffee shop.

Its not actually called Manny's coffee shop. It's just a coffee shop run by a guy named Manny. Its also not really a shop. Its more of a wooden bench, but its a really nice place to sit and have a drink and I think Manny's coffee shop makes its sound more impressive than Manny's wooden bench. So that's why I call it Manny's coffee shop.

I'm not really sure if Manny's name is Manny, but he seems like a Manny. So I call him Manny. He hasn't corrected me yet.

You can find Manny's coffee shop in the heart of stone town in a place called Professor's Square. If you believe the signs, Professor's Square is actually called Jaw's Corner but I prefer to call it Professor's Square because it is squarish and there are lots of pictures - political campaign posters I think - of a man named Professor Lipumba. The posters don't say what he is a professor of but I think he is definitely a professor of either agriculture or macroeconomics.

Stone town, David Bowie, Communism

Stone town is a bit like the maze (or labyrinth if you will) that confronts a young Jennifer Connolley in the classic 1986 movie 'Labyrinth'. By which I in no way mean to suggest that the locals resemble Jim Henson creations* but rather that its narrow, winding alleys - which would be easy enough to get lost in - are very dynamic. Wooden shutters set into the stone walls of each street open and close throughout the day, meaning the shops inside can appear or vanish in about the same time it takes to realise a wrong turn and backtrack. My early attempts at constructing a mental map of the place... 'past the pharmacy,turn left at the tea shop...' were completely useless and I spent quite a bit of my first week wandering around lost and cursing David Bowie.

Still, its a very friendly and beautiful place to be lost in. You can walk down a tiny dingy alley, past the rusting carcass of a old car (how on earth did it get down such a narrow street?), climb over a pile of rubble and suddenly find yourself in front of a set of beautiful carved wooden doors opening into an immaculate marble-floored cafe. Which makes it a bit like going to most bars in Melbourne.

In addition to the Arabic, Indian and Portugese influences around there are still little reminders of the islands 1964 revolution and its communist sympathies, from the Childrens playground at the waterfront that plays Chinese nursery rhymes throughout the day to the Mao Tse-tung Football Field (Mao being a well known soccer afficionado). I even had a young guy ask me yesterday why I would choose to come to Zanzibar instead of pursuing my medical training in the USSR. (I didn't have the heart to tell him that the place no longer exists).

I was reminded of these ties again yesterday when a group of Cuban doctors and medical educators arrived at the opthalmology department as part of their hospital tour (Cuba is responsible for much of the undergraduate training here). Unfortunately, at that precise moment, Dr Ji was in a back room underneath a desk trying to fix his computer. This left me as

the only person in a busy clinic sporting a white coat. Naturally the Cubans took me for the man in charge and lined up to shake my hand and ask me questions about the facilities. I was so confused, I went with it.

*What are you, some sort of racist?

Opthalmology

Its the simplest things that bring the department to a standstill.

Its not a lack of qualified staff. The head opthalmologist, Dr Ji, is a highly qualified Chinese doctor on loan to Mnasi Mmoja for the next two years.

Its not a lack of equipment. They they have a whole lot of, as my inner-bogan might say, 'shit-hot' ophtalmology gear which was donated by the Chinese government along with Dr Ji.

Its not the three-years-out-of-date eye drops, which noone seems to have a problem with.

Every day the opthalmology outpatient clinic grinds to a halt due to a lack of glue-sticks. Not some sort of special eye-glue either. Just the regular paper kind which is used to stick intra-occular pressure printouts into the patient notes.

Every day we run out of glue. Dr Ji gets angry. And nothing much happens until an assistant manages to go and borrow some from another department.

Cool bananas

Solomon, the twenty year old son of our host, dropped round to say hi to everyone the other night, and we had a very frank discussion about my poor use of his native tongue.

I can always tell when Solomon is over because the girls in the house suddenly become scarce / overdressed. This particular time I saw Em in the living room wrapped in a blanket despite the thirty-plus-degree heat. I found Solomon in the kitchen playing with his mobile phone.

'Mambo?' he asked me (how are you?)

'Poa' i said 'kachisi kama ndisi' (I am cool like a banana)

Solomon then very ernestly explained to me that it would be very uncool for me to talk like this.

'No, do not say this. I have not heard this since I am a child. You must never say this.'