The Hospital..

The hospital isn't very big as its purely specialised for cancer and it's treatment, so my orientation around didn't take very long at all. It's different from what I thought it would be like! It's all on a campus with different buildings that are all white and look very modern, but aren't! One of the building contains all the wards and clinics, which is really new but the others containing a canteen, church, mosque, chemo day unit, diagnostic imaging and radiotherapy is not as new. 

There are lots of wards which are all full as most of their patients are admitted. This can be due to their poor health, late stage of disease, the poor healthcare system that they have near their homes or the distance that they have to travel from home for their treatment. For patients that are Tanzanian this is free as the hospital is government run, but for those who do not originate from this country only abide here, they have to pay a fee to use the ward. I'm hoping to spend a day there during the next three weeks, but have been warned that I will probably cry! 

The clinics there are all very over-run and very non-confidential! There are many people spilling out into the corridors waiting to be seen by doctors, some very ill! It is very strange because when I was being shown around, the doctor I was with would just walk into clinic rooms without knocking and with no regard for the patient in there. The staff and doctors would then all ignore their patients and just talk to each other and me then, I felt very awkward about it and very sorry for the patient, but this is just how their country is - there is no privacy or dignity for anyone! 

The diagnostic facilities are better than I imagined and the equipment looks surprisingly like that I have seen in the UK! They are equipped with 3 X-ray units, 2 ultrasound units and 2 gamma cameras - no CR or MRI. The gamma cameras are very new, but the rooms are very dusty and still remain looking a bit like a construction site. Privacy in this department is like the clinics too and I ended up walking in on a lady with her skirt around her ankles, they all acted as though it was just the norm though! 

In chemotherapy I didn't get to see much, but I'm hoping to go back again! There was a fume hood being used by nurses with masks on and aprons, but no gloves?, to prepare and mix chemotherapy agents under. All the needles with the drugs in were being re-sheathed after being prepped, so it wasn't actually very safe anyway! In the corner next to this there was a nurse sat in the corner and then two lines of plastic chairs where people were queuing to be cannulated before being hooked up to there drugs. There were a few beds and a line of chairs across the wall, which were all being shared by numerous people. The queue outside was very big, with the courtyard outside the door full of people waiting for their treatment! I don't think that their organisation provides that best efficiency and time management. 

The radiotherapy department isn't very big, but does provide a massive service to the population, treating upto 150 patients a day with hours between 7 until they finish, which can be at 2 the following morning! (Which makes our country seem very lazy, as we complain about 1 hour over time, whereas these guys don't complain about 5 hours overtime they just want to help all their patients!) So they have two machines like a knew, along with a simulator and brachytherapy equipment. 

Both machines were in use when I first arrived last week, but one had a very broken table that they were trying to utilise to cope with the amount of patients. It has now been completely taken out of use, so all the patients have to treated on the one working machine. Although I had been told one of the lasers on the working machine was broken, it is actually working so this is functioning the majority of the time. Although the bed cannot be lowered completely, so a wooden step has to be used to get on and off the bed and the X2 jaw has been very tempormental over the last few days, with the engineers having to be called a couple of times. The machine also completely broke down on Thursday, so not all the patients could be treated! The source got stuck in the open position and the jaws got stuck again too. 

Going into the room there is a 'maze' so to speak, but it is more just a straight corridor down to the room. The door in is very heavy and very big with a red and yellow light outside the room, the red is on when the radiation is on - like in the UK. In the room, the cobalt-60 machines are huge! So much bigger than linacs, there is a tennis racket section of the bed and the handset is hung on a metal pole over the head of the gantry. Along one wall are two very dirty and dusty tables which have all their immobilisation equipment on. There is no organisation though and barely any equipment. They have headrest A to F, a plastic plate with two Velcro straps across and a very old breast board! Most patients have a headrest, with the straps being used for whole brain treatments. The breast boards is positioned on a plastic slant which isn't indexed and then one arm is elevated, which ever side is being treated as the arm cup moves from both sides. I have seen a leg support being used just once, for a very very ill young man in a lot of pain! 

The computer system outside the room is very very simple! There are three monitors in total - one general computer used most of the time for watching films, safari documentaries and a but of Kenan and Kell! Another monitor is not used because the camera inside the room is broken so there is no need for it. The third controls the linac! So there is a section where the parameters for the individual treatments are entered and that is all! No patient information is stored on there and the only record of the patients treated that they have is a notebook with all the patients names from that day written in. On the control panel there are auto-set buttons which I was surprised about, but they no longer use them as one time when no-one as paying attention (which happens 97% of the time!) the gantry head crashed into the wooden steps used to get on the bad and there is now a big hole in the top of it!! 

I'm yet to take my camera in, but will be a few times over the next three weeks, so either when I get back or whilst I'm out here if the Internet allows it I will upload them all so that you guys have a better picture of what it's actually like, as I don't think my descriptions are very good and pictures will be much easier to understand!