Day two in the clinic and we still have interesting neurology patients coming. After a few initial patients for the day we decided to have Megan work with Dr. Gabriel and touch base with me regarding them while I began to work with Jacob as an interpreter so we could see more patients and not run as late as we did yesterday. One of the first patients we had was a little 5 month old baby born with a myelomeningocele and hydrocephalus (a Chiari II malformation) and who had been operated on in Arusha for the both the spinal cord problem as well as having a VP shunt placed, both at Arusha Lutheran Medical Center. The baby had done very well, but had no lower extremity movement. We really had little to offer then other than to take care of referring her to the rehab facility at Monduli where her family can get the instruction they need. The mom asked if we thought the baby would ever walk and it wasn’t easy to tell her that she probably wouldn’t, though I’m sure she had been told that before.

Roza Andrea came back to clinic to see me. She is the young girl with Sydenham’s chorea bacterial endocarditis who I had seen a year ago with Danielle and who we’ve continued to treat. She had another exacerbation of her movements in November and saw Gabriel at the time. We treated her with another course of steroids at the time and she had some significant improvement in her movements. She is a real success story all in all, but I sure wish her movements would go away for good at some point. She is doing tremendously better, but I can tell that both she and her mother seem frustrated at times. Time will tell.

We worked straight through until 2:30 in the afternoon and finally took a lunch break, but found that we had few patient later in the day so things were much slower. We were actually able to leave on time today and took a nice long walk along with Joyce right before sunset. A nice breeze started up and it was another gorgeous evening. We walked for over an hour and had a relaxing dinner on Joyce’s new veranda watching the final wisps of sunlight coming over Mount Ngorongoro and finally the local bats making their rounds searching for insects over our heads. It doesn’t get much better than that!

Here’s a photo of our busy clinic during the midday today. Roza is standing in the foreground in the read jacket.

Best to everyone,

Mike