I spent 4 years of my childhood in western Africa and always knew that when I became a doctor, I would go back to Africa to help. When I actually got into medical school and subsequently into emergency medicine residency, returning to Africa was still my goal. I was lucky enough to find Dr. Frank and the FAME clinic through a friend who had worked with him. Dr. Frank was gracious enough to take on an emergency medicine resident.

After months of correspondence with the volunteer coordinator, I found my way to Karatu and the FAME clinic just in time to go off on my “African bush” mobile clinic experience. I didn’t know what to expect or what we would see. The 4 hour road trip to Babati was spent picking Dr. Frank’s brain apart. At the mention of snakes, I began to wonder what I was thinking.

We hopped off the bus when we got to our clinic destination. We were given a tour of our ‘clinic.’ The building had several rooms but no windows. I looked outside and saw the farm animals walk past our examination area. I kept thinking, what did I get myself into.

The first day of the clinic, after seeing the 2nd patient, any apprehension I had was gone. I was reminded why I wanted to come to Africa. We had a father bring in his 2 young sons, a boy of 8 or 10 and a young man of 16 or so. His younger son was brought in with an infection cut to his leg. His friend and he were playing with a machete and he was cut. Luckily, the cut was not deep, but he was developing infection to the leg. While I was tending to the younger son, the older brother was sitting in the chair and initially I could not understand why he was “ill.” It was when I turned my attention to him that I realized that he was guarding his right arm and had an improvised bandage around his arm. As I began to unwrap the ‘bandage’, I noticed the drainage coming from the wound. When we finally exposed the area, we found that he had an old extensive burn to his arm which had exposed bone. I was shocked. He was an epileptic who was unable to obtain his seizure medication, had seized and fell into fire. This had happened at least 4 months prior and he had not obtained any medical care. We were able to make this young man comfortable, clean his arm, and bandage it properly. We gave antibiotics to him and were able to refer him to a hospital for proper follow up care.

This was just one of many incredible stories that I experienced. I have only begun my journey as a physician and my time in Africa will stay with me forever. Even before I left, I was planning when I could return and work with Dr. Frank again. The work he does and the care he provides is life saving for many of the patients. The people in these regions don’t have access to medical care and being able to see over 800 patients in 6 days was life altering not only for the patients, but for those of us taking care of them.

Over the last two months at FAME, I have learned and experienced much more than I could have expected. There is one day, though, that stands out from the rest and it involves a little girl and her family. Renata is an eight-year-old FAME patient, who is currently in congestive heart failure due to rheumatic heart disease. During one of her follow-up visits, her weight, which had dropped since her last visit, became a major concern, so we all pulled together to determine how best to put some weight back on this frail little girl. Armed with a shopping list and some pocket money, Jacob (FAME's translator), and I headed into Karatu town to purchase some food items for Renata and her family. After getting all the items on our list, Jacob and I visited the family in their house, and we explained exactly how we wanted Renata to eat in order to gain weight. We bought very simple items: eggs, peanut butter, honey, bread, bananas, biscuits, and chocolate. Had anyone been there to observe the thanks we received, they would have thought we had bought them a new house. Everyone in the family individually thanked Jacob and I, and then they prayed for several minutes. I asked Jacob afterward what the prayers were, and he told me that they were thanking the director of the hospital and the people who were helping Renata to have a better life. This day is one of those days that makes me realize I am doing exactly what I want and need to do. Renata and her family inspire me to continue the work I am doing with those that need it most.

Perhaps the most striking thing about working at FAME was the rhythm of the day. I woke up with the sun to the serenade of birds and other morning sounds. After a leisurely breakfast with my volunteer bungalow roommates, we walked around the hospital construction, through the red clay, to the clinic, arriving as the staff pulled in. Working side by side with Tanzanian providers, nurses, lab technicians and interpreters, I helped to take care of a range of patients with a multitude of problems in an efficient, cost-effective manner relying a great deal on clinical skills. It really did feel like the way medicine is meant to be practiced, unfettered by appointment schedules to follow, e-mails to return, insurance issues to deal with, prescriptions to refill. By the end of each clinic day, there was an unmistakable feeling of collective accomplishment, perhaps most profound during the busy days in the bush. Nights were short. After enjoying a prepared dinner, I crawled into bed, reading by flashlight so as not to use electricity, before falling asleep to the nighttime sounds of Africa.

It is hard to come up with a single word to describe the experience. It covered a range of emotions from inspiring, beautiful, and amazing to sad, upsetting, and desperate. I feel this reflects Tanzania, and the contrasts its tribal and western cultures hold. Returning to California has been jarring. We are so spoiled with lives made busy by self-imposed schedules and possessions. We have lost the rhythm of the day, rising and retiring with the sun. It is my hope that I will be able to hold onto a piece of this experience each day, to simplify, and to focus on what is truly important.

On one of my first days at FAME Medical as the new Volunteer Coordinator, a very young girl arrived from Oldeani Village with one of the worst cases of funzas to date.  Funzas are worms, found in the local red clay dirt, that start off microscopic in size and, burrowing into your skin, grow to the size of small peas.  I have seen some pretty bad cases, during previous trips to this area, but nothing compares to this little girl. We were told that she lives in a mud hut and is raised by grandparents, too elderly to care for her properly.  After sedating her, Dr. Ivan and Nurse Safi went to work removing dozens of funzas from her fingertips and toes.  It was a long and intense process.  Luckily for this girl, she didn’t feel a thing, and the funzas were removed before permanent damage was done.  Thank goodness for the kindness and skill of the staff here at FAME who treated her like she was their own!

It’s so strange to sit here writing to you - everything in Karatu still seems so close as though I’m going to wake up there tomorrow and walk to clinic.  It’s hard to explain, but I’m sure you’ve had others describe some difficulty making the transition home, even after such a short visit.  I think it’s obvious that my time at FAME Medical and in Karatu was an experience unlike any before it and it’s been difficult to put it into perspective with the world here - they are so different.  Everyone here asks me how my trip went and I don’t really know what to say to the - I tell them “fantastic,” “wonderful,” or maybe “amazing,” but none of those can really capture or even come close to the true magnitude of the experience.  I haven’t been able to really get my arms around it yet.

So I’ve found myself telling everyone now that it’s really impossible to describe because it’s so different, so foreign, so unlike our lives here.  Perhaps because every moment is so meaningful there, I really can’t explain it.  I’ll tell someone what it was like walking up to the clinic in the morning for a new day, but it doesn’t capture the real emotion of that moment on the other side of the world in such a different land.

To tell you that I’ve thought about the clinic, Karatu, red clay and dust, the smell, the sun, every single person there, those whose names I knew and those who I never really did, every day, if not every hour, since my return would be the truth, but it would still not express the full extent of the impact my visit had.