It has been a very rough night. Home from boarding school, a 14 year old boy arrived at FAME late last night. He was on school break, returning home to the nearby orphanage where he grew up. Dr. Gabriel called for Frank’s assistance but the child died before Frank could get there to help. This is why I don’t think I could ever be a doctor. I can only imagine how it feels when something like this happens, even when you have done everything within your power to save someone. Dr. Gabriel is such a caring and compassionate physician — so dedicated to his patients. True to form, when Frank asked if it would be o.k. for this case to be addressed at Clinical Conference on Friday, Gabriel graciously agreed. Frank and he both wanted to go over the fine details with all the Clinicians, including two visiting doctors, in case there was anything else they could have done or could do should they be faced with another case like this in the future. After reviewing the child’s history (which was sparse), labs, his critical condition upon admission and his response to everything that was done to intervene, the team concluded that he likely died from a post streptococcal glomerulonephritis complicated by either toxic shock syndrome or a pulmonary embolus and that everything that could be done here was done. Knowing that doesn’t begin to remove the sense of loss and sadness, but hopefully one day will provide some closure for those who tried to save him and those who will forever miss him. May this beautiful soul rest in peace.
I just received the above photo from Dr. Ivan, along with this message: As you can see, today is my graduation ceremony, I'm so much happy and thank you! Thanks to Dave and Jeanie, a lovely couple from New Jersey, Dr. Ivan was able to fulfill a long-standing dream. One of 32 graduates, he received his Advanced Diploma in Clinical Medicine on August 17th. He has practiced as a Clinical Officer in Tanzania for many years and began working with us at FAME when we first opened the Outpatient Clinic in 2008. As our patient numbers grew and cases became increasingly complex, we started trying to find a way to provide additional training for our most dedicated and talented Clinical Officers, Dr. Ivan among them. We learned about the Tanzanian Training Centre for International Health (TTCIH) in Ifakara, Tanzania, and the two year Assistant Medical Officer Training Program they offered — a program particularly well suited for Clinical Officers keen to advance to the next level of expertise and training. The AMO program represents a cadre between a three year “Clinical Officer” Diploma and first degree holders in clinical medicine. Practically speaking, AMO’s are recognized and valued almost equally with holders of a first degree in clinical medicine (doctor of medicine) in Tanzania and in many other countries in Africa. Dr. Ivan will be returning to FAME with additional knowledge and hands-on training in Internal Medicine, Pediatrics, Surgery and Obstetrics and Gynecology. Congratulations Dr. Ivan. Welcome back to your FAME family!
Remember the young woman with the severe burn covering her entire upper torso? She was badly in need of skin grafting but could not afford the travel and hospital costs involved in going to the nearest city for the procedure. Well, next came a two year old…
Elibariki’s mother brought him in with a terrible burn to the head, also in need of grafting. Frank and Dr. Gabriel, put the word out to Dr. Duane about both patients, sending photos and seeking medical advice. Having already donated the machine and certain that they were both good candidates for skin grafting, he immediately jumped on an airplane and flew from Nebraska to Tanzania to help. He did the procedures the very next day, teaching and working closely with our team throughout. He also released a burn contracture on Elibariki’s leg — a surgical procedure that will allow him the mobility every two year old deserves. Both patients are recovering well, and Mama Elibariki is rejoicing. Needless to say, the word is out that Dr. Duane is here for a short stay. Surgical requests are coming in left and right. Not surprisingly, he’s also busy in the Clinic. Just yesterday, I noticed two Maasai elders, one a patient — the other a relative. Dr. Duane was standing outside in his unassuming, quiet way. They both grabbed his hands, and began thanking him for taking the time to help them. I went home smiling.
There are details and then there are DETAILS! Blood supply is a constant challenge in Tanzania. As a result, medical facilities, like ours, must have emergency plans in place for necessary transfusions. We’ve recently been given permission to collect, screen and store blood on campus for emergency surgical situations. With a “scheduled” delivery on the calendar, we want to be ready for any and all eventualities.
One of our Lab Technicians has the same blood type as the pregnant “mama” who wants to be the first to deliver her baby at FAME. Learning this, he volunteered to be our first donor. Lab Tech, Anthony, oversaw the process with Dr. Joyce and Fatuma looking on. Once complete, the blood was screened and put into the special fridge to be stored at the appropriate temperature. Hopefully, we won’t need it, but it’s comforting to know it is there if we do. We plan on typing volunteers and other staff so we have a ready blood supply when we need it for emergencies.
I always forget how many details go along with introducing a new service at FAME. As we prepare for Labor & Delivery, we need more sheets, slip covers, blankets, pillows, curtains for the ward…. Of course, here there is no Target or Costco or Bed, Bath & Beyond so this takes some serious planning. With the help of Nurse Siana and my dear friend Annie Birch, we managed to find the perfect fabric in Arusha. For the sheets, we got pink 100% cotton from Pakistan — a fabric that looks like it will withstand multiple washings and lots of boiling water. For the curtains, a lovely shade of turquoise. Next step? Arranging for Haji, the tailor, to come up to FAME and measure windows, gather up the fabric and begin working his magic on the sewing machine! We’ve got to get these stark rooms warmed up for all the pregnant women about to show up! We want our mamas and babies comfortable.