Well, we’ve been in Tanzania now for close to 24 hours and it seems like I never left. It has become so familiar to me here in Arusha and Northern Tanzania that we always start without ever having missed a beat from the last visit. The stars were aligned for several reasons; Our flights were very uneventful (even with my jinx on Newark to Amsterdam flight) and on the flight to Kilimanjaro we each had an extra seat next to us to spread out. We were practically the first ones through immigration and amazingly our six massive duffels were some of the first ones out. Our ride met us outside of customs and we were on our way to Leonard’s home and a very late dinner on our arrival. Pendo is always the most generous host no matter how late we arrive.

I awoke early to see the boys off for school. Lennox is now 8 years-old and Lee is almost 5. They are now in the same school which is across town back in Sakina, a suburb of Arusha where the Tembas used to live, but they are now in Njiro which is all the way across town. Sound confusing? Well, it is. Gabrielle is the new addition to the family and is now a bit over a month old and very cute. She’s got two big brothers to look after her.

Our first business of the day (that is after breakfast) was to see a young boy who is currently 5 years-old and was born with arthrogryposis. Even though we haven’t made it to FAME yet, we’ve been put to work here in Arusha seeing patients. Junior (the name he prefers to use) is the only child of a friend of the Tembas and they had asked for our help. It’s always difficult to tell whether a family’s understanding, or lack thereof, is due to what they’ve been told or what they’ve heard. Junior was born with a genetic disorder that may have been inherited from one or both of his parents and they needed to be told that there was approximately a 25% chance that they could have another child with the same disorder. In addition, he needed to continue with his physical therapy which is perhaps the most important thing for him to continue with reasonable function. He is an extremely bright young boy who otherwise is unable to use his arms and, to some degree, his legs. Watching Junior play Temple of Doom on his mother’s phone, though, made it very clear that this young boy was going to defeat all the odds against him as his mother will be his tireless advocate. We will continue to follow him going forward and I very much look forward to watching him succeed

Junior, Christyn and Payal

Now, that’s a very happy child neurologist!

Next was visit to a patient I follow here with a chronic neurologic disorder that is currently well controlled and despite living in the inhospitable environment of Northern Tanzania while also taking immunosuppresive agents has managed to remain out of trouble from an infection perspective. They live in a lovely home with a lovely view of Mt. Meru and it is always a pleasure to visit.

Vanessa, Payal and Christyn

Following a brief visit to the Airtel store to secure SIM cards for Payal and Christyn to use in their phones and a data plan so I can keep up with my blogs, we returned home through all of the hustle and bustle of downtown Arusha during rush hour. I took a walk with the boys and then Pendo’s friend arrived during the evening with her 12 year-old daughter who has a static encephalopathy and seizures. Amazingly, they had taken her to Dar es Salaam and obtained an MRI scan – for what clinical reason I just can’t imagine other than a desire to know as it wouldn’t change immediate management. In any event, the MRI showed that she had had an insult to the right hemisphere that was very extensive and certainly explained her exam findings. We’ve made some recommendations with more to come after we consult with our epileptologists back in Philadelphia.

Tanzanian neuroradiology reading room

Tomorrow we leave for Karatu in the late morning after I wake up early to say good bye to the boys.  Stay tuned for more updates. I was luckily able to stay away to post this tonight as Pendo has been feeding us far too well. Considering I have very little sleep on either flight here and little sleep last night, I’m definitely ready to crash.

Lala salama..