Oh, how things have changed

“If you build it, they will come”

Dr. Mark and Dr. Monica with one of the triplets

Although that quote was most famously related to a baseball field in “Field of Dreams”, it applies to the Obstetric unit at FAME Medical as well. We first came to volunteer at FAME in December 2014, just a few months after the opening of the new unit. During our 2 week visit, we assisted in 2 deliveries and 2 hysterectomies. We also saw patients with the FAME doctors in the outpatient clinic. Although we didn’t have as many operative teaching opportunities as we had hoped, we both were overwhelmed by the enthusiasm of the doctors and staff and their genuine desire to gain as much clinical information as we could provide. We planned to be back for another visit as soon as we could arrange it.

In the same way that this blog was going to be sent to Susan within 2 weeks (it’s now been 6!), our next opportunity had to be delayed until we could schedule it in December 2016. Oh, how things have changed!

Whereas we had only 2 deliveries in 2 weeks in 2014, there are now more than 40 per month. The reputation of the staff and facility have spread so quickly that new facilities are being built for maternal and child health, and plans are being developed for a maternity wing that would include space for antepartum admissions as well as postpartum care. In this two week visit, we assisted the FAME doctors with several Cesarean deliveries, including for the mother who had the first Cesarean delivery at FAME returning for her repeat Cesarean. Another was for a mother with spontaneous triplets diagnosed only three weeks before she presented to FAME at 32 weeks with leaking fluid. (One week later, all three babies were gaining weight and were able to go home, thanks to a donor who funded formula to supplement her breast milk primary feedings.) We had the opportunity to participate in several other surgeries as well, tubal ligations, cervical cerclage, myomectomies: we began to wonder what we had wished for in 2014!

The donations that allow FAME to continue to expand have also funded an infant warmer, without which many babies might not have survived. The most astounding example is the infant born at least 12 weeks early (may have been more like 15 weeks early, as gestational age is sometimes difficult to document in Tanzania) who weighed <500 grams (1 lb 1.5 oz) at birth. We were blessed to be there the day the little one surpassed the 1 kg milestone! That is a miracle anywhere in the world, even more so in rural Tanzania. There isn’t a way to describe the joy in the mother’s smile as the nurse showed her the baby’s weight on the scale.

Which brings us to the best part of our visit – the staff! We knew the doctors we had met two years before had been enthusiastic to learn, but we didn’t have the opportunity to work then with the nursing staff as much. The staff in the “Operating Theater” wanted to review proper scrub procedures, the maternity staff sought information on post-partum hemorrhage, the staff in the outpatient clinic asked about cervical cancer screening, the doctors questioned surgical techniques…. We have never met a group of people so dedicated to the work they have chosen and so intent on improving their own abilities so that the care they provide is the best it can be. The new doctors and nurses added to the staff are just as enthusiastic as the “veterans” from our first visit.

It is truly humbling to help take care of more exceptionally high risk patients in 2 weeks than we would see in months, if not years, in the U.S. Two women presented with eclamptic seizures and several more with severe hypertension in pregnancy, one with a severe shoulder dystocia at delivery, another with post-partum bleeding, a case of infection after a miscarriage…. And the doctors at FAME take it in stride. Cases like these can intimidate anyone, even when the best facilities in the world are available. Watching the staff at FAME provide excellent care in creative ways, using the available equipment, is amazing.

We can’t wait to see what they are able to accomplish by the time we return next! Best wishes to the entire FAME family in 2017, with profound thanks to all of the friends and donors who have helped make FAME possible.

Dr. Monica Norwick
Dr. Mark LaRose
Waconia MN, USA