Thursday, March 13, 2014 – FAME Neurology Clinic

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Spending time in East Africa in March requires that one keeps an open mind as far as your schedule is concerned. And that may be for many reasons. Weather at this time of the year is most often the biggest concern as the monsoons are right around the corner and the long rains begin to fall. Yesterday we managed to drive around quite a big storm, but on other occasions we haven’t been so lucky. Two years ago while here in April I managed to bury my Land Rover to the axles while en route to mobile clinic. It took us three hours to dig out the vehicle and needless to say we didn’t make it to our clinic. That is why I now come in March.
imageAnother reason is that patients don’t always come to clinic when you plan for them or sometimes they may not be able to make it due to the difficulty of transportation. Our clinic in Upper Kitete left us with few patients to see there today so we scraped the mobile clinic originally scheduled and remained at FAME for the day. The good news is that it gave us plenty of time to spend on young Thobias, our seizure patient.

Our morning began with an hour meeting with his mother. She had told the nurses that she wanted to take him home today and didn’t care if he had any more seizures. We were concerned that something was up and it turned out that she had another young son at home that she was worried about as her husband was an alcoholic and undependable and she didn’t have any family to leave him with. The other issue is that unbeknownst to us she hadn’t anything to eat for several days – she had brought a little bit of food with her and though FAME feeds the patients they do not usually feed the families who stay here (they are often quite large) and she hadn’t said anything to anyone nor had the nurses been aware of it. We were able to take care of simple issue of feeding her, but the other with her son was a bit more complex and took a bit of wrangling. We were finally able to have someone from the Rift Valley Children’s Village come tomorrow to remain here with Thobias so she can go home for a few days to see her other son.

That was all the non-medical aspects of his care. As for his seizures we decided today (with the input from his mother) that his seizures were more numerous on the medication we had started him on and so we had to switch gears and orally loaded him on valproate today as well as stopping his carbamazepine. We all have our fingers crossed at this point. The valproate will cost about 50 cents to a dollar per day which is more than any here can afford so we’ll have to figure out some way to cover the costs for them if it works. We’ll make it happen one way or another.

We visited Daniel Tewa again this evening, but not for dinner. He is just a gem! On our way home we had the most amazing light show in three directions with lots of lightening illuminating all the wonderful clouds on the distance and a gorgeous sunset too boot. It’s been cool in the evenings with short rains in the afternoons and we’re hoping the weather holds for Sunday when we’re planning to go into the Crater on safari. We have two more days left here at FAME and we’ll be making the most of them.

As this trip ends I am already looking forward to my September visit here and counting the days.

Mike

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