The FAME Journal shares inspiring patient, staff, and volunteer stories, illustrating the impact of FAME’s work and transporting readers to our hospital on a hill. Each story is shared with consent, ensuring privacy and anonymity as requested, while raising awareness about medical care at FAME. "Stories from the Field," a new extension to the Journal, highlights FAME's outreach efforts, showcasing our commitment to delivering health education and care in hard-to-reach rural communities. Together, these narratives embody FAME’s dedication to improving health and empowering people in our community. We hope that you find these stories as inspiring and powerful as we do!
Three beautiful babies brought into the world so far at FAME Medical. The second and third were emergency C-sections. Two have been discharged and one is recovering well in the ward right now. Lots of joy around here.
“I could not get my fill of looking.There should be a song for women to sing at this moment or a prayer to recite. But perhaps there is none because there are no words strong enough to name that moment.” ― Anita Diamant, The Red Tent
Remember the days when you didn’t need an alarm to wake up? When you woke with the sun rise, and your body was so anxious to rid itself of sleep that it was insufferable to stay in bed? The song in your head is not one you heard on the radio and can’t shed, rather it’s the background music of your life. You knew that the day ahead was one to remember. One where you will experience the payoff of weeks, months, or perhaps even years of planning and anticipation. Possibly one in which you will meet challenges or opportunities you have never had before, ones you feel prepared to overcome, with meaningful experiences as your reward.
That’s what this morning was like. That’s what nearly every morning has been like during my time in Africa. At night, the darkness is absolute, an almost palpable heaviness to the air. The lack of sensory input gently and slowly turns the brain off. It is disarmingly relaxing, and I find myself in bed and asleep well before I had intended to rest. Come morning, the energy of the world changes with the sun rise. The light calls to action dozens of songbirds and crowing roosters. You can nearly feel the world waking up, and the call is hard to deny. Then you remember what you’re here to do, and it really is impossible to stay asleep.
This is my view while I eat breakfast. I can literally see where my morning coffee was grown.
The medical experience thus far dwarfs my time in Botswana. Morning starts with 8:30AM rounds. FAME Medical has just 6 general inpatient medical rooms, each with 2 beds. Despite the low numbers, the acuity and complexity of patients is impressive. Currently, over half of the admitted patients are children. We spend a particularly long amount of time with one child who became neurologically devastated over the past three months; I come up with some answers, but without significant testing abilities, I’ll never know if I’m actually right. The father, a proud warrior whose stretched earlobes and traditional garb could just as easily grace the cover of National Geographic, tears up at my explanation. He will not be the last person to receive bad news today.
5 kids from a nearby orphanage, awaiting their turnto see me.
The rest of the medical load, while significant, is African-casual paced. Today, two orphanages delivered half their children to our doors, having heard that for the first time ever, a pediatrician has come to town. I see five of them today. The experience is exactly what I have come for.
For two of the boys, I can make a diagnosis: muscular dystrophy. They will never walk again. It is not all bad news, though. A large percentage of families here do get the answers they've been seeking for a long time. Down syndrome, Ohtahara syndrome; in these cases, I can offer a somewhat clear picture of the future, even if it is not the one they had hoped. For others, they get confirmation of what they had suspected: that their severely weak, "disabled" child in fact has a full mind, capable of learning.
This is no small reward. You see, schools here are very limited in their resources. Any child with any somewhat significant problem is refused entry to school. As an example, one 10 year-old boy was refused entrance to school his whole life because of a very subtle tremor, and they came to meet me to get a note saying he was medically cleared for school. After TEN years! In a more heartbreaking example, a boy with severely dystonic cerebral palsy, where he has basically lost control over all of his muscles (including his mouth and face), has a very full cognition, as far as I can tell. When I asked his caretaker what I can help with, the boy replied, "I am a cripple."
Where schools have failed, the generosity of others have succeeded. He was taken in by a Norwegian man, whose name I can't pronounce, let alone spell (it sounds like Skroli, but I'm sure there's an umlaut or two in there). He has spent every cent he owns and has raised money from Norway to build an orphanage of sorts for children like him, children with significant physical handicaps but a lesser extent of cognitive impairment. He takes them in and teaches them, not just basic schooling but also life skills, with the hopes of one day reintroducing them to their families. So far, I have seen 7 of his sickest, and have given him half the money in my wallet to continue doing what he's doing.
Were it not for the FAME clinic here in Karatu and for Dr. Mike Rubenstein, the Penn neurologist who introduced me to the facility and is here with me now, none of these neurologically impaired children would have ever found the care they need. Thanks to their charity, they are on appropriate medications now, and being cared for by people with the right mentality towards disability.
Skroli will have many more children for me in the coming days. I hope I have the emotional wherewithal to handle them, and that I brought enough money to leave with a clear conscience.
Waiting to see the doctor at FAME
Remember little Elibariki? Well, he is definitely on the mend. Dr. Duane is very pleased with the post-op progress. I think Elibariki is pretty happy too:) Our other burn patient is also doing well after her skin graft. She still has a long way to go but is looking better every day.
The ward is almost full just now. We had two evening emergencies. The first was a tourist who had a bicycle accident and required some major suturing on the chin. The other a 26 year old man with Typhoid we had to admit. Already sick for 2 weeks, he was in very rough shape upon reaching us. Now on the appropriate medicine, we hope he turns the corner soon. He was doing better this morning.
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!
