Shama Cash-Goldwasser, Epidemic Intelligence Services Officer, CDC

Dr. Shama with FAME’s doctors.

Dr. Shama training FAME doctors.

Dr. Shama hiking with FAME staff and is joined by volunteer Diane Berthel (second right).

I currently work for the Centers for Disease Control and Prevention (CDC) as an Epidemic Intelligence Services Officer based at the Minnesota Department of Health in St. Paul, Minnesota (https://www.cdc.gov/eis/who-we-are/index.html). Before joining CDC, I lived and worked overseas for years and trained as an infectious diseases doctor.

I first heard about FAME in 2015 when I lived in Moshi for a year. My team was researching brucellosis in the Ngorongoro Conservation Area (NCA), based at Endulen Hospital. We traveled between Moshi and the NCA quite a bit, and on one of those visits, we stopped at FAME to talk to Dr. Frank about brucellosis. 

After this experience, I wanted to return to Tanzania. I wanted to use my specialized training to provide clinical consultation and teach with permanent local staff rather than dropping in as a foreign doctor, seeing patients myself, and leaving – a less sustainable model. FAME offered a short-term opportunity to do all those things. 

I felt very welcome when I arrived at FAME in 2022. The volunteer program is well organized. Communication before my arrival was excellent. All of the travel and other logistics were managed. When I arrived at the hospital, everything was set up for me. Whenever I needed anything or had any questions, Prosper [FAME’s Volunteer Coordinator] was available and cared for everything. The living accommodations are spacious and very comfortable. 

FAME is located in one of the most beautiful places I have been. It is in a gorgeous and quiet setting close to the NCA. It is also within walking distance of the town of Karatu, which is convenient. It feels very safe. The food at FAME is fantastic and in no short supply. For lunch, volunteers and hospital staff eat excellent Tanzanian food prepared by Samweli and his team, and for dinner, food shows up hot at your doorstep! 

The Tanzanian medical team was welcoming to new volunteers. Volunteers are integrated into the schedule depending on what they can offer. The medical staff were eager to welcome new clinicians and learn from them. I worked mostly with doctors and I learned a lot from them about the realities of working in that setting. I found it is best to observe and ask questions to truly understand the issues and realistic potential solutions and then to discuss ways to practice evidence-based medicine in keeping with those realities. 

I gave several morning talks. I found it best to teach on topics the clinical staff asks for or to observe on rounds for a while, then come up with topics that feel salient to the realities you observe and discuss those ideas with clinical leadership. Like medical and residency training talks in the US, it is great to go back to basics and give solid bread-and-butter talks on chosen topics – everyone can benefit from that. 

Unfortunately, because of my work schedule in the US, I have only been able to volunteer once. Still, I want to encourage western trained doctors to consider volunteering at FAME. It can be a very positive experience. But I encourage people to think carefully about why they are doing it, what they think they can contribute, and what they want to get out of it. It is a big trip. You function as support to a self-sufficient organization and the key is to integrate and provide the support that is asked of you. 

Volunteer Dr. Shama Cash-Goldwasser (center) is pictured with FAME's social worker, Nganana Kitashu (far left), during their trip to the village to find rabies-infected persons

Editors Note: Dr. Shama was instrumental in helping FAME save the lives of children in our catchment area who were exposed to rabies leading to the death of one of the children. You can read the story in the FAME Journal here. This story was featured in Resolve to Save Lives (RTSL)’s annual report called “Epidemics That Didn’t Happen.” You can read the report here. It was also picked up by the English newspaper, The Citizen Tanzania, as an example of Tanzania’s swift response to rabies and you can read it here.