Mzee Tajiri

78-year-old Mzee Tajiri* has never had surgery in his life before. He has managed to stay, in his words, “very healthy” and has needed little to no medical intervention over the years. Sadly, he recently suffered a traumatic illness that almost left him dead and surgery was the only way to save his life.

“My stomach was very big, painful and I could not pass any stool. I asked my family to take me to the hospital. They carried me four miles to the local village clinic, where I was admitted for three days, but my condition worsened. I quickly resigned to my fate, that I was going to die. My time had come.”

— Mzee Tajiri

As Mzee Tajiri’s condition quickly deteriorated, his family wanted to take him to a bigger hospital, hoping he would access better healthcare. But Mzee Tajiri was not having it.

“I knew I would die and wanted everyone to leave me in peace. Finally, my family called my brother, who works in a big town. He came and forcibly discharged me from the clinic, put me in his car and drove me to FAME. He said FAME was a good hospital that saved lives and that I should give it a chance. Since I was too weak to fight him, we drove to FAME.”

— Mzee Tajiri

Mzee Tajiri and his brother arrived at FAME at 3 am. He was coherent and conscious and knew what was happening, but he was in severe pain and begging for help.

“When we received him at FAME, it was clear that this was a fight against the clock. He was very sick and we reckoned we had little time to save him. We quickly summoned FAME’s surgeon, Dr. Emmanuel Erick Manjira, to consult on the case and he determined that Mzee Tajiri needed an emergency laparotomy to save his life.”

— Nurse Joram Sumawe

Mzee Tajiri presented with an abnormally swollen outward abdomen. Dr. Manjira ordered an abdominal X-ray which revealed he had intestinal obstruction, which occurs when a loop of the intestine twists around itself, causing bowel obstruction. The team had to perform a laparotomy to repair this as it was impairing blood flow, causing him much pain. 

The operation was a success and Mzee Tajiri was discharged after four days. He was asked to continue dressing the wound in a hospital closer to his home and to return for a check-up after four weeks.

“This condition can occur to anybody but mostly people with excess redundancy in the sigmoid colon [a redundant colon is an abnormally long colon that cannot fit inside the body without looping or twisting]. Another possible cause is a tumor; however, in Mzee Tajiri’s case, it was just the redundancy of the colon.”

— Dr. Manjira

Mzee Tajiri poses with his son in FAME’s Ward 1.

“When the doctors told me that I had to have surgery, I was not scared, even though this was the first surgery ever in my life. I just needed the pain to stop. This surgery saved my life and took the pain away. This has been my first time at FAME and I’m so glad my brother insisted on bringing me here. I have received good care. I’m looking forward to going back home and starting my healing journey. I feel like a young man!”

— Mzee Tajiri

“When Mzee Tajiri woke up from surgery, he immediately looked at his abdomen and exclaimed, ‘Where is my stomach?!’ in response to the fact that his big stomach when he came to FAME was now flat. We had to explain it was part of his healing process!”

— Nurse Joram Sumawe

*The patient’s name has been changed to protect their privacy and permission was secured to share her story. The quotes have been translated from Maasai to English.

Joyce (left) poses with Monica (right) and their babies at FAME's Special Care Nursery.

"The babies are already friends!" says Monica

Hospitals the world over can be difficult and overwhelming for parents with premature babies. However, for two mothers, FAME’s Special Care Nursery (SCN) became the place where they found a lifelong friendship. Monica* and Joyce* met in FAME’s SCN because their babies had been born prematurely. Monica's baby was born at 27 weeks and Joyce’s at 28 weeks. Together, they have been navigating the ups and downs of having premature babies and have offered each other support and strength through this tough time.

While Joyce’s baby was born at FAME, Monica gave birth to her daughter in a local hospital that did not have the resources to care for her premature baby.

“After giving birth at 27 weeks, the baby was put in an incubator for a few days. Then the doctor asked me to stay with the baby in the ward, as many children needed the incubator. I stayed with the baby for 17 days in the ward until we were discharged to go home. The baby, born at 3.3 lbs, was now 2.2 lbs and looked very sick, so instead of going home, I came to FAME.”

— Monica

Monica’s and Joyce’s babies required extensive medical care and support in the SCN and the mothers shared a room. 

“This is my third baby. The other two were born full-term, which made having a preemie new to me. I was scared when they told me I would have to deliver the baby at 28 weeks because of my high blood pressure. Luckily, the FAME team is experienced in caring for these tiny babies.”

— Joyce

As Monica and Joyce spent more time together, they began to open up to each other and share their experiences, realizing they were not alone in their struggles. They found that they had a lot in common and bonded over their shared experiences of having premature babies. They shared tips and advice on coping with the stress of having a baby in the SCN and offered each other emotional support during the ups and downs of their babies' medical journeys. They continue to support each other as they navigate the challenges of parenthood.

““We have formed a powerful friendship! We are sisters! We have a strong bond that will continue long after we leave FAME. Monica lives 30 minutes from home, but I plan to visit her often. I am very grateful for this friendship. It has helped me through a difficult time. As much as FAME doctors have provided me with reassurance and guidance, I found more hope and comfort from Monica as we share a similar experience. The encouragement from this friendship has been very uplifting. I am happy that FAME recognizes the value of peer support in patient care and they have encouraged our friendship where we have found hope and strength to keep pushing forward.”

— Joyce

*The patients’ names have been changed to protect their privacy and permission was secured to share their stories. The quotes have been translated from Swahili to English.

Anita.

World Health Day advocates that everyone should have access to quality healthcare services when and where they need them without facing financial hardship. Unfortunately, many people still lack access to essential and life-saving health services, especially those living in rural areas, which can result in preventable illnesses, disabilities and even death.

FAME continues to work towards health equity and improved healthcare access to underserved communities in rural Tanzania. FAME believes everyone should be able to achieve good health and well-being regardless of where they live or their social and economic status. 

Today we share a story about the lack of access to healthcare due to financial difficulties. Anita* is a 35-year-old single mother of one who is suffering from Multiple Sclerosis (MS). MS is a chronic autoimmune disease that affects the central nervous system. Unfortunately, MS is a relatively rare condition in Tanzania and progress has been very limited regarding the diagnosis and treatment of MS in Tanzania (MSIF).

After diagnosis, Anita could not afford the MS medication due to its unavailability locally and high prices in neighboring countries. Access to affordable MS medications is not just an issue in Tanzania but also a critical issue in the United States (NMSS). The cost of MS drugs has doubled in the last seven years, despite introducing a generic form of the widely used drug. Access to treatments is difficult in many countries and often impossible in others.

Anita’s Story

Anita* lives in Arusha with her 6-year-old son. She works in a rehabilitation center for disabled children as an occupational therapist. Her first symptom was muscle weakness and stiffness, making it difficult to move around or perform everyday tasks. Then came the deliberating extreme fatigue. She also had difficulty with coordination and balance, leading to falls and challenges performing activities that require balance. 

“When the symptoms started in 2019, I went to an Arusha hospital where the doctor ordered a brain MRI, but she ruled out MS and gave me medicine to reduce my symptoms, which worked. However, in early 2022 the symptoms became worse. Eating became a problem as anything in my mouth, whether food or a toothbrush, would trigger numbness on my right side, which stopped me from talking. I would faint in public and be completely out for around five minutes, which was most embarrassing. I returned to the doctor, who sent me to KCMC referral hospital in Moshi for another MRI. It is here that I was diagnosed with MS.”

— Anita

Step 1: Dr. Wells demonstrates to Anita how to self-administer injections with a dummy injector for optimal medication management.

Step 2: Now for the real thing!

Step 3: Anita winces in discomfort as compassionate Dr. Wells administers the injection.

Step 4: “It’s not so bad!” A relieved Anita flashes a smile after Dr. Wells administers a successful injection.

“I was in denial of my diagnosis and refused to believe that I had MS. Sadly, my symptoms worsened and started affecting my job performance and I had to share my struggles with my supervisor. She recommended that I come to FAME and see Dr. Rubenstein for a second opinion.”

— Anita

Dr. Michael Rubenstein has been coming to FAME for the past thirteen years with neurology residents and fellows from the University of Pennsylvania and Children’s Hospital of Philadelphia. In partnership with FAME, they provide neurological care for those living in our catchment area both at FAME and in outreach clinics where they venture into the villages.

“After Dr. Rubenstein confirmed my diagnosis, I quickly realized that MS medication was unavailable in Tanzania. This added to my feelings of depression that I already had after my diagnosis. I didn’t know what to do. While the medication does not treat MS, it helps with the symptoms and pain and would give me some normalcy and quality of life. I was told I could get it in a neighboring country at $8,600 per year. Not even in my wildest dreams would I afford this.”

— Anita

For a year after diagnosis, Anita did not take any medicine. It just wasn't attainable. In 2023, after sourcing for approval from the Tanzania Ministry of Health, Dr. Rubenstein and his residents brought her MS medicine from the US, which had been donated. They brought enough medication to last her for more than six months, with plans to bring additional medication when they return in September.

“I cannot thank Dr. Rubenstein and his residents enough! They have saved my life. My biggest worry was that this disease would affect my job so much that I couldn’t provide for my son.”

— Anita

Anita says that she has suffered a lot of stigma surrounding her disease, including from her own family. 

“My family did not and still does not understand this disease. My auntie always tells me: ‘This disease of yours is so weird one would rather have HIV!’ They have taken me to church many times to be prayed for as they believe only God can cure me!”

— Anita

“The biggest challenge is losing my independence. I often have to rely on relatives for help. The other day I fell in front of my son and he was terrified! So we can’t be just two of us in the house alone.”

— Anita

Neurologist Resident, Dr. Wells Seldes Andres, teaches Anita how to inject her medicine. He assures her that the medicine has no significant side effects except maybe a sore arm. He also tells her that MS doesn't change life expectancy with proper treatment.

“I’m so happy! Looking forward to getting my life back.”

— Anita

Dr. Michael Rubenstein (far left) talks to Anita and reassures her.

Dr. Michael Rubenstein

“Multiple sclerosis is a disease that is thought to be very uncommon in sub-Saharan Africa. However, recent data suggest its incidence is increasing here just as in other parts of the world. 

There are several reasons why it is uncommon here, including environmental and hereditary reasons, the lack of specialists (neurologists) and the lack of technology used to make the diagnosis that has only recently existed in this region of Africa. Unfortunately, due to the belief that it is uncommon here, there are also very few studies looking at MS in East Africa, which will hopefully change in the coming years as we learn more.

In the thirteen years that I have been coming to Northern Tanzania, there have been a number of cases in which we were concerned about MS. Still, due to the very limited resources (monetary and technological), we have been unable to pursue the diagnosis fully. 

Anita is one of the more fortunate patients who were not only able to have the appropriate study done but, more importantly, was able to come to our clinic where we confirmed her diagnosis and were able to begin treatment against all odds as there are no medications in Tanzania that are specifically designed for MS.” 

*The patient’s name has been changed to protect their privacy and permission was secured to share her story.

Magdalena breastfeeds her newborn child at FAME’s maternity ward. This is her third baby, but she says she is still learning new things about breastfeeding!

FAME continues to provide breastfeeding support to new mothers to ensure successful breastfeeding outcomes for both mothers and infants. Breast milk is ideal for infants, as it contains all the necessary nutrients for growth and development. In rural areas such as our catchment area, where there are often higher poverty rates, breastfeeding is a simple, smart and cost-effective way to ensure all children survive and thrive.

According to FAME’s Reproductive Health Clinic (RCH) nurse, Kitangile Masheyo, breastfeeding can be challenging for some mothers who may require support and guidance from healthcare providers.

“With proper support and education, most mothers can successfully breastfeed their infants and reap the benefits for themselves and their infants.”

— FAME’s Kitangile Masheyo, Nurse, RCH clinic.

FAME understands that before educating mothers on the importance of breastfeeding, it has to educate its healthcare providers to enable them to offer the best possible support for newly breastfeeding mothers. As part of these efforts, FAME encouraged Kitangile to attend a two-week breastfeeding course offered by the Tanzanian Ministry of Health in Karatu. 

“The course trained me on breastfeeding support techniques, such as instruction on proper latch techniques, common breastfeeding challenges and how to address them promptly. This course taught me how to provide one-on-one support to new mothers by answering questions, providing guidance and troubleshooting any issues. I received books from this course that I still refer to occasionally.”

— Kitangile

FAME’s Reproductive Health Clinic (RCH) shows a breastfeeding video in the waiting area. These short videos educate mothers on different issues concerning breastfeeding and how to overcome them.

“At FAME’s postnatal clinic, breastfeeding is a central theme. We provide one-on-one consultations to mothers who encounter breastfeeding challenges such as latch and positioning or how to increase milk supply. We also provide educational materials in the form of short breastfeeding videos in the waiting area that educate them on different things, including how long you should breastfeed your child, among others. We also encourage HIV-positive mothers to breastfeed as some are unaware that this is an option for them.”

— Kitangile

Maureen’s Story

Maureen.

Maureen’s son, undergoing phototherapy due to his jaundice.

Maureen* just delivered her fourth child at 32 weeks, weighing 3.6 lbs. She has been unable to breastfeed for two days, which the doctors think is due to stress. You see, Maureen was not prepared to go into labor so early. All her other children had been born to term. So when she woke up at 4 am to her water breaking, she was scared.

“My water broke at around 4 am. I woke up panicked. My husband rushed me to FAME, where they confirmed I was in labor. But it was too early! I begged the doctors to help me; I didn’t want to give birth to a premature baby! I was terrified of all the complications that come with it, but sadly, it was too late and I had to deliver.”

— Maureen

Maureen’s baby spent a night in FAME’s Special Care Nursery (SCN) and on the second day, was placed under FAME’s phototherapy units as he had jaundice.

“The medical staff have educated me a lot on breastfeeding. When I got the baby, my milk did not come immediately as it had with the other children. I was very stressed! My child was very small and I couldn’t even feed him! But the staff has educated me on what to eat and to reduce stress and now two days later I have milk! I can pump some milk for him and he is fed by bottle. He’s slowly learning to suckle.”

— Maureen

Maureen is confident about going home soon.

“Being a fourth-time mom, I immediately knew I wanted to breastfeed. However, I was aware that breastfeeding could be challenging in my case as my child was born prematurely. So I was nervous about whether or not I could do it successfully. The guidance and support from the nursing staff at FAME were invaluable and I am very grateful. I have overcome the initial difficulties I encountered while trying to stimulate breast milk and am confident my milk supply will increase as I continue to breastfeed my child.”

— Maureen

Dr. Ken Karanja explains how breastfeeding a premature baby can differ from breastfeeding a full-term baby, how it can be challenging and why the mothers of premature babies may need extra support and guidance from healthcare providers to help them establish and maintain successful breastfeeding. 

“Sometimes premature babies have not fully developed the reflexes needed for successful breastfeeding. For example, they may be unable to coordinate sucking, swallowing, and breathing. On the other hand, full-term babies are generally born with fully developed reflexes. Mothers of premature babies may experience delayed or reduced milk production due to the baby’s early arrival. In contrast, mothers of full-term babies may have an easier time establishing milk production. These are key differences to keep in mind while supporting a mother of a preemie.”

— Dr. Ken Karanja

Carol’s story

Carol and her 3-month-old baby at FAME’s Reproductive Health Clinic (RCH).

Carol* is 27 years old and has two children. She has brought her 3-month-old to FAME’s RCH for routine under-5 vaccinations. She is happy to have discovered FAME, although she wishes she had discovered it earlier. 

“When I had my first child eleven years ago, nobody talked to me about breastfeeding and the benefits. When my daughter was two months old, I transitioned her to solid food and stopped breastfeeding. I didn’t know I had to exclusively breastfeed for six months as everyone around me gave solids and liquids to infants at the two-month mark. Looking back, I am so sad that I was not well educated and informed on the benefits of breastfeeding.”

— Carol

Carol first came to FAME a year ago when she was five months pregnant. She had been working outside Karatu and when she returned, she was looking for hospitals where she could deliver her child. That's when her friends recommended FAME.

“I came for my first prenatal class at FAME’s RCH and was blown away by everything I learnt about pregnancy from that first session, so I kept coming for the prenatal classes and delivered here three months ago. This time, I am breastfeeding my baby with much support from RCH. When I got the baby, I struggled to breastfeed as my milk supply wasn’t enough and the baby did not know how to latch onto the breast; thus, he couldn’t get anything from the breast. It was all very stressful. The RCH nurses answered my questions, advised me when my milk supply dwindled and taught me how to position the baby so they could latch properly on the breast and feed. My baby is now exclusively breastfed and is healthy, happy and thriving. I want to encourage new mothers considering breastfeeding to try and seek help when they face difficulties.”

— Carol

*The patients’ names have been changed to protect their privacy and permission was secured to share their stories. The quotes have been translated from Swahili to English.

Mama Ntimama and her daughter during the interview.

World Tuberculosis (TB) Day aims to raise public awareness about TB's devastating health consequences and highlights the efforts to treat and eliminate it. 

Tanzania is one of 30 “high-burden” countries for TB, with only 65% of TB patients receiving treatment. Poverty, malnutrition, HIV infection and diabetes are the main determinants of TB disease in the country (USAID).

In the first few months of 2023, FAME has already treated 29 TB patients, an increase from 19 patients treated by this time last year. 

This week, the same week we are recognizing World TB Day, FAME had two TB patients in the inpatient ward. One was Mama Ntimama, a 79-year-old woman from Ngorongoro who traveled 60 miles to FAME to access TB treatment.  

Accompanied by her daughter, Mama Ntimama came to FAME after months of being sick: suffering from an extreme chronic cough and chest pains. 

“I had been to my local dispensary twice, but the medicine they gave me did not work. So I turned to local herbs and roots for treatment, but my condition worsened.”

— Mama Ntimama

Mama Ntimama’s children decided to send her to a hospital, as her condition was worrying.

“My children told me that I needed to go to a hospital or I would die. I remembered FAME, where I was admitted in 2019 when I was very sick and was cured after a few days, so I asked them to bring me here. At this point, I couldn’t eat or walk. My children could not afford the long journey to FAME or the treatment, so they sold some cows for the money.”

— Mama Ntimama

Mama Ntimama passionately tells her story.

Once at FAME, diagnostic tests were done and Mama Ntimama was diagnosed with TB.

“I knew nothing about this disease before the doctor told me. I thought I had a bad cold that couldn’t go away. I was admitted five days ago and after the medicine, I already feel better than I have in months. I’m looking forward to going back home.”

— Mama Ntimama

Cases like Mama Ntimama’s are not uncommon. According to WHO, TB remains a significant concern in rural areas of Africa, where the disease often goes undiagnosed and/or untreated. Factors such as poverty, poor living conditions, limited access to basic healthcare services and social stigma contribute to the high incidence of TB in rural areas.

“The doctors at FAME have educated me about this disease. Now I understand what it is and how dangerous it can be if left untreated. If I adhere to my treatment, I will be completely cured.”

— Mama Ntimama

TB is treatable but early diagnosis and treatment are needed to prevent serious complications. To combat TB in our catchment area, the government-sponsored TB program at FAME continues to focus on prevention, early diagnosis and effective treatment. Educating communities about TB and its symptoms and increasing access to diagnostic tools and treatment options are crucial services in order to combat TB in the communities FAME serves and throughout Tanzania. 

“On World TB Day, I would like to tell people if you have symptoms like mine or have been in contact with someone who has TB, get medical attention immediately. People with TB should not have close contact with others until they receive medicine because they can spread the disease when they cough. I want people also to know that local herbs and roots will not cure TB. It is only cured by medicine from the hospital and following what the doctor says about how to take it.”

— Mama Ntimama

Acknowledging this year’s theme of “Yes, We Can End TB!”,  FAME’s TB and HIV/AIDS coordinator, Dr. Jacob Olekeiya, says: 

“Tanzania bila kifua kikuu inawezekana. Tuungane pamoja kutokomeza kifua kikuu (A TB-free Tanzania is possible. Let’s work together to eradicate TB.) ”

— Dr. Jacob

*The patient’s name has been changed to protect their privacy and permission was secured to share their story. The quotes have been translated from Maasai to English.