Today took an unanticipated turn, which is not at all uncommon in Tanzania. I had carved out some time to work on a grant proposal but first had promised our Head Nurse, Siana, that I would go with her to the District Office to pick up some “Plumpy Nut”, the nutritional food supplement we need for our severely malnourished patient in the ward. We can’t even buy the stuff anywhere in the country right now. Anyway, first thing this morning we went to the District Health Office to see if they had any stock they could share with us. When we arrived, we were introduced to the District Nutritionist, Jackie, who told us she had been trying very hard to get a resupply of Plumpy Nut because they also have many children in need of the product. Apparently, 40 boxes were waiting to be picked up in Monduli, roughly 2 hours away but the District car had been “out of fuel.” With the image of little John wasting away back at the hospital yet recognizing that this was a “quick fix” to a systemic issue, I decided to listen to my heart….”I’ll take you if you can go right now.” The three of us jumped into the car, drove the 2 hours to Monduli, loaded up the Land Rover with 40 boxes of Plumpy Nut and came straight back to Karatu. Once back, we helped unload 20 of the boxes at the government health center much to the delight of the RCH nurse and others and then returned to FAME with 20 boxes they gave us for our patients. I don’t know where one would even begin to address the larger systemic issue of crucial vehicles being out of fuel when patients are in need, but today that wasn’t for me to ponder. I just needed to get some help for John. And I think Jackie, and all her colleagues, felt the same way about their patients….as they helped us unload all the boxes. Yep, it’s complicated…

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picking boxes up in Monduli

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Siana & Jackie after packing up the Land Rover

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Off loading boxes at FAME.

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Meet “Nelson”, another young boy brought to FAME this week from Light in Africa. He too, in need of medical attention. A talented little artist, Nelson presented Dr. Frank with a beautiful drawing and “thank you” the next day. It’s these sweet little morsels in life that put EVERYTHING in perspective.

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John’s second day in hospital

I will call him “John”. Reportedly 12 years old, he arrived at FAME weighing only 7.8 kilos. Discovered just days ago by “Mama Lyn”, Co-Founder of “Light in Africa”, an orphanage located three hours east of here, it was obvious that he needed immediate medical attention. Severely malnourished, she loaded him in her vehicle and brought him to FAME for assessment and treatment. He was immediately admitted, and the FAME team began working to save his life. Of course, those of you who know us also know that we are no strangers to “miracles” — a least our definition of miracles:) It just so happened that when this little guy arrived, we had a pediatrician from the U.S. volunteering with us. Keep in mind, we almost never get volunteer pediatricians in this neck of the woods. They seldom can leave their home practices for very long. Dr. Howard was an invaluable resource for our team, supporting and mentoring them in the management of John’s care. Still in the hospital, John has a long way to go. But he also has angels in his life, like Mama Lyn. Our hope is that we will be able to discharge him to his new family before too long. He will undoubtedly have “special needs” but Light in Africa also provides for that. We are also in the process of trying to secure “Plumpy Nut” for John, a nutritional supplement that is actually medicinal and used for cases of severe malnutrition. Unfortunately, the only manufacturer of the product in Tanzania has stopped production for now, hoping to begin again after the first of the year. In the mean time, our Head Nurse is doing her best to source some from our local government pharmacist, where apparently there is an emergency supply for just such cases. Fingers crossed, we will be able to secure enough to send John home with the supply he will need to turn the corner. 

A little girl stole our hearts five months ago. Here name is Jackline. Her father carried her into FAME Medical in a ketoacidotic coma, probably triggered by a severe infection. With the emergency care she received from the FAME team and our telemedicine communication with a volunteer consultant and Endrocrinologist in the U.S, Jackline survived this crisis. Very weak, but finally stable, she was able to go home with her parents the following day. Unfortunately, her parents are among the poorest of the poor in rural Tanzania. Just putting food on the table each night is a challenge, let alone covering the costs of her twice a day insulin. We all wondered when the next crisis would hit. But then we were reminded......there are, indeed, "earth angels" among us. Someone in the community agreed to cover her medication costs on an ongoing basis, and one of our long-term supporters and volunteer doctors made the offer of a lifetime. Dr. Duane Koenig started seeing Jackline for follow-up visits and could see how precarious her medical situation was due to the poverty she and her family lived in. He wondered how her family might feel about her attending a neighborhood Boarding School, where she would receive three good meals a day, the necessary dietary supplements to keep her diabetes well controlled, and close monitoring by a School Nurse. With the help of one of our translators, he approached the parents about the possibility and offered to be Jackline's Sponsor. The family was ecstatic, as was Jackline. For a motivated, capable child, like Jackline, this was a dream come true. Our team rallied. Siana Nkya, our Head Nurse and William Mhapa, our Community Health Facilitator, met with the school Head Master and nurse to discuss Jackline's medical condition and needs. Dr. Duane donated the money to cover her school fees and school supplies, and Jackline began attending Tumaini Junior School on February 27th. She also came in for a check-up last week. She was smiling, laughing, quite literally glowing, and she left those of us at FAME Medical glowing too.

Volunteering at the FAME clinic in Tanzania was an incredible experience. Having worked with other international medical missions in the past, I always look forward to experiencing a new place, new friends, new food, new culture, and the new lessons that I will learn. One thing that I learned while working at the FAME clinic was the importance of teamwork when providing exceptional patient care. All of us had our own jobs from sweeping the floors, checking in patients, diagnosing and treating, running the lab, filling prescriptions, organizing finances, getting more donations, recruiting volunteers, etc. Each task was essential and required great thought and care given that money and resources were limited. When there was a challenging patient case, we would all work together to come up with the best possible solution for the patient. This is how medicine should be— individuals bringing their knowledge and talents together to create something better then anyone could have done on their own. One specific patient comes to mind—a 5 year old girl that was severely malnourished with little family to take care of her. We all played a part in trying to help her: the doctors examined her and discussed possible diagnoses, the nurse was able to start an IV, the cooks made her rice to eat, the lab was able to draw blood and run rests, one of the assistants was able to translate for her tribe's dialect, the pharmacy organized her medications, and a local social worker researched possible hospitals for her to go for further care. We all depended on each other. It's sometime easy to forget at FAME that we were lacking in some resources, as the hearts of the people made up for it. Now that I'm back home, I hope to continue to practice what FAME taught me: be grateful for what you have, work as a team, and love what you do.