September 15-17, 2014 – FAME Neurology Clinic

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I apologize for the long pause in emails, but things got hopping here pretty much from the get go and we’ve finally had chance to catch our breath.

Sunday after our safari was pretty much a day of rest and unpacking. We didn’t work, but were able to catch lunch with everyone in the canteen – my favorite, rice and beans with some Mchicha (a dark green vegetable similar to spinach but chewier) on the side. The weather has been cooler than usual with a bit of rain here and there so everything is green rather than the normal dry season shade of brown. Doug (our pediatric neurology volunteer) arrived right around 5 pm after 40+ hours of travel. His last flight was through Addis Ababa with an overnight layover that I’m sure he will never do again.

Reunited, we walked to clinic on Monday morning mostly refreshed and ready for new challenges. Rounds in the hospital ward here begin at 8:30 am and there was a little Masai boy on the ward who had been waiting there for a week or so for us to see. It was tough from the descriptions to tell exactly what he had, but when we say him it was very clear to the three of us that he had some post encephalitic encephalopathy with frequent seizures (multifocal) and probably progressing into Lennox-Gastaut syndrome. Very sad, but at least we were able to identify for everyone what the actual seizures were and to make some medication changes to benefit him. Overall prognosis, though, is very, very poor. That was just the beginning.

Doug examining a young Maasai boy who presented in status epilepticus

Doug examining a young Maasai boy who presented in status epilepticus

We walked to clinic a little late after our rounds and found that there was already a line of patients waiting for us. We split into two groups with Doug and Danielle seeing most of the pediatric and epilepsy patients while I saw most everything else neurologic. The patients we’ve seen for the last three days have been great neurology patients with lots of epilepsy for Danielle and lots of peds for Doug. They’ve seen newly diagnosed muscular dystrophy and a case Ohtahara syndrome among others. The clinic had a record setting day on Monday breaking 100 patients for the first time and beat it on Tuesday with 112 patients. We contributed 21 patients on Monday, 26 patients on Tuesday and 22 patients again today.

Unfortunately, because of the volume we weren’t able to work with clinical officers and had to use interpreters which means we weren’t able to do as much teaching as we’d like, but we still have lots of time here.

After work today we ran down to town and walked around for a while taking in all the wonderful sights. Doug summed it up well by describing the scenes as “authentic.” This is such a different culture here and something that is so hard to actually describe in print. It is an amazingly vibrant world here full of so many colors, so many different sounds and smells that your senses are on high alert. Anyone with even a thread of adventure couldn’t help but be totally in their element. This is a place for those wanting adventure and they will find it immediately.

Lala salama,

Mike

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