Refusing to Give Up!

Mary's Healthcare Providers, Dr Ivan & Sehewa (Anesthetist/Wound Care)

Mary's Healthcare Providers, Dr Ivan & Sehewa (Anesthetist/Wound Care)

For 58 year old Mary, feeling healthy and strong seemed completely out of reach. A poorly managed Type II diabetic, Anna had never taken her medications regularly, nor had she ever fully understood the havoc her diabetes was wreaking on her health. Feeling terribly ill and discouraged, she heard about FAME and decided to make the 40 minute road trip between her village and Karatu.  She arrived at FAME with a high fever and an old wound on her foot – one she had been battling with for 9 long years -- septic and oozing. The team quickly discovered that her blood sugar was dangerously high as was her blood pressure. She was immediately admitted to the ward and over the next 4 days, cared for by our team.  They cleaned and dressed her wound and treated her infection with IV antibiotics.  Having a well stocked pharmacy at their fingertips, they managed to bring both her blood sugar and blood pressure back into normal range.

So began the long road to healing for Mary. A few days later she was discharged but not without a rigorous follow-up program in place and a new understanding of her diabetes --  that it was a chronic disease and would require lifelong medicine and management.  With this new understanding, she began taking her medicines regularly and coming in for follow-up visits.  Despite careful attention to her diabetes, after nearly a year of weekly dressing changes and care, her wound was still not completely healed. The FAME team decided to try something that hadn’t yet been tried. Equipped with skin grafting equipment, some previous training from a volunteer and a visiting surgeon on hand, they scheduled Anna for a skin graft. Once in the OR, the donor site was prepared and draped and the recipient site cleaned and debrided. They completed the long and tedious procedure and hoped for the best, and sure enough the graft took! Anna was discharged with the wound clean and dry, and we are happy to report that it has finally healed up completely. Mary is feeling healthy, strong AND mobile again, and it is largely due to the comprehensive care she received at FAME Medical from a committed team of providers who refused to give up on her.

Susan Gustafson
Birth Is Miraculous

By Volunteer Olivia Herrington

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Birth is miraculous. You know this before you see it, but seeing it makes you certain. This birth, the first I had ever observed, was by C-section because the baby was breech and because the mother had previously had a C-section—there was concern her tissue was therefore more likely to tear if she delivered vaginally. So the doctor took the baby out feet-first, and, with only her head left inside, Hosiana, one of the nurses, exclaimed, “She is crying inside the womb.” She was, indeed.

When she fully emerged, she was pink and smeared all over with cream-colored paste—the vernix caseosa—and beautiful. Hosiana told me that all babies are born pink, that any other hue is a concerning sign. This baby tried very hard to shut her eyes against Hosiana’s tetracycline ointment, which it is government-required protocol to squeeze into all newborns’ eyes. But her eyes were beautiful, too, a very deep brown.

The next birth was to a young woman who cried out to Jesus as the agony of labor overcame her. Her sister-in-law left the room and wept for the woman’s pain. She had lost her first baby, so terror, if this was what she felt, would have been entirely understandable. From the moment her daughter became visible, delivery was smooth, instantaneous—faster than I could crack open the tiny vial of oxytocin and draw up the liquid with a syringe.

The baby’s head was large and elongated, and her emergence into the world was exhilarating. Her color was more purple than the first but not unusual enough to alarm anyone. She opened her eyes for the first time in my arms. “Mrembo sana,” I murmured, holding her warm body, “very beautiful.”

“Mrembo sana,” Lydia, another nurse, agreed, “kama wewe—like you.” I laughed. Outside, I congratulated the new mother’s own mother. She, in turn, congratulated me.

Caroline Epe
Meet Nurse Salimu
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By Volunteers Olivia Herrington & Emma Duge

Salimu has some family members in medicine and knew even before beginning secondary school that he wanted to pursue a career in the field. As he got a bit older, his heart told him that nursing was his calling.

He came to FAME almost fresh out of college, graduating in 2015 and joining FAME’s staff in 2016 as a Registered Nurse. He grew up in Karatu and has been familiar with the hospital for some time. He loves the work environment here, the good equipment and supplies, and the opportunity to be involved in providing advanced medical care.

Salimu works hard in the inpatient ward, giving injections, taking vitals, providing medications, performing catheterizations, and completing a variety of other tasks in the ward to help FAME's most seriously sick and injured. He is glad he chose nursing and particularly enjoys being with patients and doing what he can to decrease their suffering and promote their healing.

Susan Gustafson
Meet FAME Nurse Anesthetist, Sehewa
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By Volunteers Olivia Herrington & Emma Duge

Sehewa was born outside Dodoma, Tanzania’s capital. He began primary school at age eleven, having spent the previous several years caring for his younger sister. Throughout primary school, he sang in his church’s choir. One day, as his graduation was approaching, his pastor made an announcement: the church had decided to facilitate applications for young people at his stage of education to enter nursing college. This was when the country had only a handful of formally trained Tanzanian healthcare workers to serve a rapidly growing population, particularly in rural areas. His mother, a farmer, had always wanted the best for her children and applied to the pastor on Sehewa’s behalf. After an interview, he was selected. So, straight out of primary school, eighteen years old and entirely uncertain what this new stage in his schooling would hold, he began his studies at the Kilimatinde School of Nursing in Tanzania’s Singida Region.

These years were difficult ones for Sehewa. He returned home every college break to help his mother farm in order to raise money to pay his school fees. But, in the final year of the three-year nursing program, even their extremely hard work did not earn enough to make the payment. Five months before he was due to take final exams, the school sent him away. The situation was desperate, but no one at home was willing to give up on Sehewa’s studies. A close family friend sold one of the cows her son was herding. The price of the cow still did not quite meet the full cost of the school fees, but it came close enough to persuade the college to let Sehewa take his exams. The college deducted the remainder from his salary over the next few months, as he transitioned from being their pupil to working in their hospital as a TN III (Trained Nurse Grade III).

Sehewa remained at Kilimatinde for five years and learned there how to work as a surgical nurse. He assisted ophthalmic surgeons and became fascinated by the field. Pulled by the voracious intellectual appetite that has defined his adult life, he sought further education to pursue specialized ophthalmic training, this time in Mvumi—back in the Dodoma area. When he returned to Kilimatinde, he was moved from the surgery department to the eye department. He served the surrounding communities through mobile clinics, screening people in their home villages for cataracts and glaucoma.

In 1998, the physicians he had assisted, who visited Kilimatinde regularly but were based in Mvumi, convinced him to work for them full-time in Mvumi. Sehewa spent the next fifteen years providing crucial medical care there. At Mvumi, ophthalmic treatment included the full suite of outpatient, inpatient, and surgical care. Just as he had been trained at Mvumi, he at that point took on the responsibility of training others. He also continued his mobile clinic work, treating patients with minor concerns immediately and bringing those who required surgical intervention to the hospital for care. The Christian Blind Mission (CBM), then based in Germany, provided funding to expand their reach and annually increase the number of patients served. CBM also supplied intraocular lenses, car maintenance, medications, and food for the hospital, in addition to paying for students to travel to Mvumi to learn.

In 1999, Sehewa again felt inspired by the needs he saw at the hospital to enhance his medical expertise. Babies were coming to Mvumi with congenital conditions, and, unlike adults, infants cannot undergo eye operations with only local anesthesia. They squirm too much for a procedure to be performed safely. Sehewa moved to Kenya for three months to learn more about putting babies under general anesthesia. Eventually, Sehewa completed his secondary school education through evening classes while working in Mvumi and then continued his formal education in nursing, ultimately becoming a Registered Nurse and Nurse Anesthetist. 

In 2012 he learned of FAME through his cousin, who was already on the hospital’s staff. He applied for an open position at the hospital and was accepted, beginning work here as a nurse anesthetist and eye clinician. Sehewa is “very, very proud” that he is able to work at FAME and that his sons, Steve and Stanely, are receiving an excellent education at the Tumaini Junior School and Tumaini Pre-Primary School, respectively, just a few minutes down the road. He loves how much he is able to learn here, particularly through comparing techniques and exchanging knowledge with the volunteer doctors. He is also grateful that he can send money regularly to his mother in Dodoma, showing his appreciation for her commitment to him—without which he could not have become a nurse.

Sehewa enjoys the challenge of working with complex equipment at FAME. He is also glad he can seek advice from Dr. Frank, whom he very much admires, when he has especially difficult questions about operating such equipment. He finds deep meaning in his capacity to work hard and care for people in critical condition. Sehewa looks forward to spending the rest of his working life here.

 

Susan Gustafson
Meet Nurse Evelyne
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By Volunteers Olivia Herrington and Emma Duge

Mama Evelyne was first inspired to pursue nursing when she was in primary school. 62 years later, she continues to work with the same passion that she possessed at such a young age.

She was born in Tanzania’s Kagera Region, a part of the country with a long history of accepting refugees from neighboring nations. Evelyne worked in the region’s refugee camps from 1988 through 1995, serving countless people who had fled extreme violence in the years leading up to, during, and following the genocide in Rwanda and genocidal civil war in Burundi. Her responsibilities as a clinician in the camps were varied, challenging, and rewarding. She recalls the anguish her patients felt, the chaos of an environment in which people’s shared reality revolved around losing all that had grounded them. Evelyne was devoted to their care, which often involved delivering babies—work she continues to this day.

Years later, when visiting her son in Karatu, she discovered FAME. Her extensive clinical background was appealing to the hospital which, at the time, was in need of experienced nurses. The hospital offered her a position on the spot, and she was delighted to accept. She enjoys being challenged by her work here at FAME and has extended her contract so that she can continue working in FAME’s Maternity Ward. Her commitment, wisdom, and masterful expertise are evident in all that she does.

Susan Gustafson