First week of emergency department construction

Like Sandra wrote last week, the construction of the Emergency Department has now begun! We have been walking by the construction site every day and would like to show you some pictures from the progress so far.

Saturday (last week):

            

Monday:

                                 

          

Tuesday:

                  

     

       

Wednesday:

Thursday:

Friday:

 To be continued....

The one with the Safari

Two weeks ago we decided it was time to see something new, a different part of the country and some other animals than chickens, goats and scorpions. So, we hopped on a bus and went on a Safari to Tarangire National Park and Ngorongoro Crater. The bus trip was an experience in itself. It was 11 hours long with one 'bathroom' break next to the road where ladies went to the left side bushes to squad, and gentlemen to the right. Must have been a lovely sight for those who stayed inside the bus...

Once we came to Arusha, the journey was much more comfortable. We were picked up by our lovely driver Sam who guided us trough all the animal and nature experiences we could have imagined. Enjoy the pictures!

6 down & 2 to go

6 weeks ago I had squeezed the final items I had on my detailed packing-list (that I started in November) into a big backpack and was more then ready to head of to Tanzania.

Overwhelmed by the new impressions, strange distractions and the adaptation to having no personal space what so ever, the first period at Kolandoto made me so exhausted that my bedtime became the minute after I finally shut down my computer.

But it is supersizing how quickly you adapt to a complete change of lifestyle, find solutions to problems you have never came across before and how fast you establish new routines while the oddest things become ordinary.

It might not always seem like it but times really flies here and even though it does not always feel like it, effort does pay off. I have, since day one, struggled a bit with the feeling of always being just a small step behind, putting down fires as we go. This without really having the impression of a clear advancement of the project. For me, this changed today


WORKSHOP DISCUSSING THE FLOWS OF THE RECONSTRUCTION

When summarizing the work of the previous days I realized that there might actually be a good solution to the puzzle of the maternity ward that seemed completely impossible to solve a few weeks ago. And on the way back from a successful workshops for the new private ward we passed the site of the new emergency department and saw that they had now started the construction work.
DAY ONE AT THE CONSTRUCTION OF THE EMERGENCY DEPARTMENT 

With two weeks left, it now feels like we are back on track and in a good phase. The hospital will most likely have an emergency department before the fall starts and feasible solutions for a future development of the hospital by this summer.

Just another day in Kolandoto

We are now finishing our fifth week here in Kolandoto, and as Emelie talked about the other day, time really flies by. We are starting to get some routines, and therefore, I would like to invite you to follow us around for one day here in Kolandoto. This is what our Wednesday looked like this week.

The morning started as usual, with breakfast on the porch. Today I ate banana pancake with fresh mango and of course, coffee. 

Emma and I walked up to the hospital area, passing the church which was extra pretty today.

We were going to meet up with N'kaka, one of the hopital staff who were going to take us to see the water pump. While we waited for him, we walked past the area where the Emergency Department is to be built, to see the absent electricity pole.

The whole were it used to stand was covered and neat. 

 

The pole now has a new spot outside the administration building.

After looking at the electricity pole, we found N'kaka and walked to the location of the water pump. The chloride system connected to the pump is currently in need of some maintenance but will hopefully work smoothly soon.  

After the visit at the pump station, we went back to do write on our thesis. When in need of a change of scenery, we use the hospitals meeting room for studying. Very nice of them to lend it to us.

Later in the afternoon, we walked down to the village to get some tomatoes and bananas. On our way there, we met up with a bunch of bees, it was not a pleasant meeting so to say...

To sooth ourselves, we decided to get some mango juice, it made it feel a little bit better at least. 

After treating our stings with some hydro-cortisone, we did some more writing. Unfortunately in the dark since there was a power shortage. We are used to them now, so we make sure to charge our computers when there is power, so we can work on battery power during the shortages. 

To have a gas powered stove is a good thing during power outages. This very nice meal with pasta, aubergine and tomatoes was prepared in the light of a flash light so we could have some dinner despite the lack of electricity.


After dinner it was almost bedtime, so this picture will conclude the day. Thank you for following us around!

Sketching

The last days we have spent all time on sketching and designing the new private ward and the extension of maternity ward, which is very fun!

Another good thing is that next week they will start the construction of the emergency department. Already now they have cut down the tree and moved the electric pole that were in the way. We are very excited for next week :)

Reconstruction of maternity ward and a new building for private ward

This week after we have both submitted applications for a building permit and finished the drawings for the construction document and the contract was signed for the construction of the emergency department, we Sandra and Emelie, have been able to spend all our time with the main topic of our master thesis - a design of an extension and reconstruction of the maternity ward and a design for a new building for the private ward at Kolandoto Hospital.

Entrance to maternity ward

Currently the private ward and the maternity ward are in the same building and our intension is to move out the private ward to a new building. Today the private ward provides income to the hospital, since patients who are able to stay here, pay a higher fee than other patients to get higher standard – staying in single patient rooms or sharing ward room with a maximum of 4 patients instead of 20 - as it is in the other open inpatient wards at the hospital. With a new building with even higher standard in terms of sanitary facilities and indoor environment, the hospital can charge more per bed – and in turn it can provide a higher level of income for the hospital, which can be used to finance future investments in the development of the hospital.

The building today

The other big motivation to move out the private ward and extend and reorganize the maternity ward, is the current overcrowded situation at the maternity ward, partly due to the reason that this service of care, is now provided for free at the hospital. So at the moment there is not enough beds and space and no flows are separated, they lack proper waiting room and nursing station. Women are almost sharing beds sometimes, and the doctor told us that they sometimes have up to five births at the same time but only two delivery beds – which put them in situations where they need to be “creative” he told us – meaning they give birth a little here and there if it's urgent. Also the 7 pre-delivery beds and the 9 post-delivery beds where the mothers keeping their newborn babies, almost shares the same room today, which poses a high risk of transmission of diseases and infections between patients and to the newborns.

This is the pediatric ward - but it was the only empty ward suitable for a photo

 

Examination room/ observation room sometimes a delivery room

So there is a lot of things to work with here. We have used participatory design with a lot of workshops with the staff to get a good picture of what is needed and to understand the work flows etc. Very interesting!

 

Coming from Sweden with our background, you sometimes get a bit uncomfortable of what you see - even if everyone seems happy and everyone is really doing their best. The biggest difference we think is the integrity and privacy. Everything is done open here and sometimes when you're on guided tour at the hospital, they try to pull you into the delivery room just in the middle of a childbirth - and inside, already 10 people are watching a mother giving birth – many is of course students from the college but it still feels very strange for us. Or when people want to take photos with us and them - posing in the front of patients. Similar situations also happened at the study trip to Mkula Hospital 3 hours north of Kolandoto, where they guided us through the surgery theatre in the middle of a surgery. But even if you see a bit uncomfortable things here, everything is super interesting and very exciting. You get another perspective on things and this work feels very rewarding and meaningful for us.

Fantastic outdoor waiting room at Mkula hospital