I think rainy season is upon Tanzania. Perhaps not officially but I don't know if there is a defined start date. Each afternoon it rains so hard that it is inevitable to get soaked if you are outside. From the entrance to the hospital (where reception is) I watch as Tanzanians run from all directions towards town, trying to make it home as quickly as possible. I brought laughter and smiles to some of the people as I sported my rain coat today. I don't know if they have ever seen a rain coat before... Umbrellas are nowhere to be seen.

This week is a little different because of the tropical medicine course taking place at Haydom. I am as likely to hear Norwegian as Swahili. In fact, I think I've learned more Norwegian than Swahili. I'm also pretty sure that I may return speaking as though English is my second language. The course is great- I'm getting to participate in lectures led by the Tanzanian and Norwegian physicians. The lectures include topics such as malaria, TB, HIV/AIDS, and other febrile illnesses.

I continue to work on the rapid malaria project. Today was a good day- 100% compliance of ordering rapid malaria tests in reception on all patients admitted with malaria yesterday. Elin and I have also finalized the goals for reception, list of equipment that should be in reception at all times, and triage classification. We've met with several of the Tanzanian nurses that asked us to work on this project and they seem to be excited about what we've developed. Next week we meet again to introduce and discuss with the staff nurses. I've been pretty emphatic about not presenting the changes but having the nurse officers bring it to the nurses so it doesn't seem like mizungos are coming in and telling the Tanzanians how to run the show. It's still their hospital and I am well aware of that fact.

I spent a lot of yesterday going through the supply room in ICU and equipment hunting. It is really frustrating; there is a lot of great equipment that was donated but is missing key components. For example, IV pumps were sent without the accompanying tubing. I found 5 different pulse oximeters but no probes.

I've spent more time in the child care unit this week. I'm happy to report that one of the babies went home with a family member yesterday. There are 2 new babies, though. I am learning about some of the Tanzanian traditions and superstitions. As it has been explained to me, if a mother dies in childbirth the child is blamed and considered unclean for 9 months. That is why the child care unit exists. After the 9 month period the child is accepted into the family. It's hard to imagine a world where those sweet faces are considered unclean but such a great thing that Haydom is meeting that need here.

*I should have mentioned previously that the physicians in Tanzania ended the strike pending negotiations shortly after the interns at Haydom joined.