Traveling west from Arusha to Karatu crosses some of the most amazing landscape on Earth – specifically through the Great Rift Valley of East Africa. Across the valley and finally to the town of Mtu wa Mbu (or mosquito river) which is a rough and tumble frontier town with lots of shops and street hawkers selling their wares to safari guests as the vehicles stop on the roadside for view the scenery. The Rift Valley complex, though, contains some of the most fertile land to be seen in Northern Tanzania and traveling from the dust valley floor up the escarpment, one encounters almost the sense that you are discovering Shangri La. Early man must have felt the same as they have inhabited this area for as long as man has existed – we are traveling through the cradle of humanity and despite having taken this drive dozens of times now, it has not lost one ounce of its impact for me. The importance of civilizations and their impact on the present day can always be debated, but without a birthplace there wouldn’t be man at all.

Karatu sits atop the escarpment and in the Ngorongoro Highlands, some of the richest coffee growing acreage anywhere on earth. Ascending from Karatu you will immediately encounter Ngorongoro Crater, an ancient collapsed volcano that is so representative of this regions violent and dramatic past. On the other side of the Crater is Oldupai Gorge (the correct spelling rather than the originally misspelled “Olduvai” that was first published and stuck for many, many years) where Louis and Mary Leaky did find our earliest ancestors.

Having essentially minored in physical anthropology as an undergraduate, you must understand that this region has always been my Mecca. Several years ago I had the opportunity to work with the Hadza, or Hadzabe, who live adjacent to Lake Eyasi and are the last hunter – gatherers in Tanzania. The significance of this region was clearly evident to me as I went out hunting one morning with two young boys (I am not even sure they were teenagers) and watched them shoot small birds from the trees with their ancient weapons. Larger game has been scarce for them for several years now, but they continue to practice their primitive way of subsistence as they have for so many centuries. How much longer can they exist in this manner is unclear at the moment.

So it was on this backdrop that we left our friends home in Arusha this morning to travel across this timeless land to our ultimate destination – FAME Medical. On our drive, though, we ran across a small group of giraffe and zebra close the roadside and positioned just perfectly for Christyn and Payal to photograph them. As neither of them has been on safari before, I am certain that this moment was quite impactful for each of them. This wasn’t a zoo, nor, for that matter, was it a park. We were merely driving along the tarmac of the major highway here and ran across the animals likely in transit, but they had little concern for our presence. I know I’ve mentioned this before, but in Tanzania, parks are located where the animals congregate and have no fences. Animals roam freely through the county hence our encounter today traveling from point A to point B. I told them that now we didn’t need to go on safari since they had seen everything, but somehow I don’t think they bought that.

Arriving to FAME I immediately noticed a new building and later discovered that it’s the new administration building! When I began here in 2010 we had the outpatient clinic and the hospital foundation had been laid. There were two volunteer houses and Frank and Susan rented a house in town. Now, in addition to the outpatient clinic we have the laboratory building, the hospital building, the OR and ER building, another volunteer house, four houses for Tanzanian staff, the Lilac Cafe, and now the administration building. Also, Frank and Susan are now living on the grounds in their own home. We have labor and delivery up and running. The concept here has been amazingly successful.

But among all of the new buildings and new faces, there remain quite a few old ones. The clinical officers I first began to work with are still here, as are reception staff and nurses. The staff has grown out of necessity, but so many have remained. There is an energy and a passion here that remains undeniable and continues to be fueled by those who experience it, both as patients and as caregivers. It is for this reason and these attributes that I have continued to return each year and will continue to do so for as long as I can continue to contribute to this incredible cause.

Tomorrow we travel to the Rift Valley Children’s Village to provide a neurology clinic there and I know that we are all three very much looking forward to that visit.

Photo courtesy of Dr. Payal