Mt. Meru Hospital Round 2

Instead of making a really long post each week, I’ve decided to split things up by topic – this one is about the second trip we made to Mt. Meru Hospital last Friday.

After another full week of alternating between Swahili classes and medical instrumentation classes in the afternoon, on Friday we made a return trip to Mt. Meru Hospital in Arusha to continue to fix new equipment from the graveyard and hopefully finish up the projects from last time.

I was excited to keep working on the hydraulic operating table lift that we had extracted last time after much difficulty, making a mess of hydraulic fluid all over the floor, our hands, and any tools we tried using to get the piece out of the bed. The first objective for me and Conor, my partner who helped me work on the lift last week, was to find some replacement hydraulic fluid and some grease for the load shaft.

At least it was moisturizing

At least it was moisturizing

We ended up at a nearby gas station in Arusha, and after searching around the shop for a bit deciding which automobile-related fluid would work best, we decided some heavy-duty brake fluid should do the trick. We also picked up a tub of lithium-based grease.

Casually bought 8 cans of brake fluid; no questions asked

Casually bought 8 cans of brake fluid; no questions asked

As we made our way back to the hospital grounds, looking forward to cleaning out and filling the fluid tank again to put back into the table, we got some bad news. While we were gone getting replacement fluid, Larry (our professor) had gone back into the operating room we were working in to check on the table, and was really surprised to find a bunch of doctors in full surgical garb with a patient on the table staring back at him. The table we were working on was nowhere to be seen.

 

Apparently, the hospital had decided to use the extra operating room we had been working in as a temporary location for some American doctors doing cleft palate surgery for the week. They had also taken the table we were working on into another operating room to do other surgeries on, making it inaccessible for the day. Now, keep in mind, last week we had completely removed the hydraulic lift keeping the bed up, so now the bed was resting completely on its base at thigh level. Picturing the doctors bending over so far just to perform surgery really drove home the need they had for this bed – but unfortunately, we wouldn’t be able to finish working on it until the next week. All we could do was hope that the bed would be available by the time we returned to Mt. Meru.

That bit of news put a damper on the day, but I didn’t want to let it get to me too much – setbacks are very common in developing world healthcare. The next items available were a couple of large laundry carts that had loose metal panels due to some broken rivets. A rivet gun wasn’t an easily available tool, but a few screws would do the trick. Back in the US, this would mean a quick trip to Home Depot to pick up some screws, but here in Tanzania, nothing was that easy. Hardware shops were small and spread apart, and the selection at each one consisted of a few boxes of screws the shopkeeper managed to scrounge up – unlabeled and inconsistent. I was on this screw finding mission with Emmanuel, one of the local students at Arusha Technical College, which took the burden off my limited knowledge of Swahili, but we still had a lot of trouble finding these screws.

Me and Emmanuel working on the carts

Me and Emmanuel working on the carts

We must have hit 7 or 8 different shops all around Arusha, taking samples from each, until we found few that seemed like they might work. Then we walked back to Mt. Meru hospital, figured out the one size that worked by some miracle, walked back to the shop, bought a bunch of them, and walked all the way back to Mt. Meru. This ended up taking up much of the morning, and between this and the operating table situation, gave me a taste of the frustration that so many technicians in the developing world face. It really highlighted the differences in infrastructure between Tanzania and the United States, and also made me realize why our medical instrumentation curriculum was so focused on using spare parts and improvised solutions. If finding simple screws took so long, finding more complex parts would be basically impossible.

After lunch, things started going a little better. The laundry carts were fixed, and Conor and I did the best we could on the hydraulic jack to get it ready for the next week. We figured out where the oil intake and outlet were inside the mechanism, and we decided that there was likely some kind of gunk blocking this pipe that had originally prevented the table from lowering under its own weight. We didn’t have a clear idea of how to flush it out if it was still in there – we were worried water would rust the mechanism, and oil was expensive – but we felt a lot more prepared for next week when we would (hopefully) be able to access the bed again.

Conor and I working on the jack

Conor and I working on the jack

You can see the intake valve at the center right by the spring, and thought the closed box in the center had some gunk in it

You can see the intake valve at the center right by the spring, and thought the closed box in the center had some gunk in it

The last thing I worked on was an infant phototherapy cradle. These machines use a specific wavelength of light to help break down bilirubin in an infant’s blood caused by decreased liver function, which could be dangerous at high levels. Some other girls in my group had gotten the lights working, but the mechanism for holding one of the side panels preventing the infant from falling out was broken. We ended up using a couple of pieces of metal hacksawed from the rails of some old cabinet drawers and a bit of epoxy to hold up the panel, making the machine ready to release to the floor again.

Lisa working on the phototherapy unit side panel

Lisa working on the phototherapy unit side panel

Our solution for the broken panel

Our solution for the broken panel

It felt good to finally get a piece of equipment working to end the day, but I felt like it was good to experience the frustration earlier in the day – I’m sure I’ll experience plenty more of it in the weeks to come.

Our after-hospital meeting

Our after-work meeting

The view of Mt. Meru from the hospital grounds

The view of Mt. Meru from the hospital grounds

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