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.