A place to return….

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Returning to FAME each time is like a homecoming for me and traveling companions are greeted and accepted by the community here as if they were family from the moment they arrive. That is just one of the things that makes this place so special. We arrived on Tuesday late afternoon after our somewhat delayed journey from Arusha. I guess it shouldn’t be that hard to describe what it’s like for me to drive up the escarpment of the Great Rift Valley and closer to Karatu. It is more than my second home. When I have brand new volunteers, though, it is an extra special treat. March here is lush and green and the hills are vibrant with color. We drive along the Rhotia Valley towards FAME and the farms are alive with activity and planting. There is a peace in the air that is both calming and reassuring as if life has slowed to a different pace in the few kilometers we have traveled. This is the Africa that I know and love.

I drop off Jess, Jackie and Nick with Pauline for their introduction to FAME and a tour of the facility while I make my rounds to the various building to greet everyone on my return. It has taken me some time, but I now know most everyone by name which is quite impressive for me. I give each and everyone a big hug on greeting them and it is clear they are so happy to see me on my return. The neurology clinic will soon be in full swing as the FAME outreach team has been scouring the countryside making everyone aware of our arrival.

Our Wednesday began with bang as we had lots of patients lined up to see us and I quickly had Jess and Jackie working seeing patients with Sokoine (our interpreter) and Dr. Anne (our clinical officer). It was quickly apparent that we had a tremendous number of return patients and a far greater percentage than we have had in the past. This was a great sign as we have in the past seen 2/3 new patients and 1/3 returns, but it may be more even now or even more returns today. This is the transition that needs to occur and seems to have happened with our repeated visits.

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Having Jackie here has already made a difference as we have plenty of kids to see and some of the syndromes are beyond Jess and Me and in need of a real pediatric neurologist. She saw two kids with new diagnoses of infantile spasms and several others that wold have been tough for us to put together so it was great to have her. Meanwhile, we had the normal smattering of patients with epilepsy, headache, movement disorder and, yes, the occasional psychogenic symptoms. Jackie was able to see two muscular dystrophy brothers that we’ve seen in the past which was great for her.

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The day was busy as we saw 24 patients for the day which was quite good considering that Jess and Jackie were totally new to this. They were both very excited about how things went and the overall experience which is a totally amazing one for so many reasons. But it all comes down to one’s pure clinical skills as we most often have very little history to rely on (no EMR) other than what we glean from the patient through a translator (and sometimes two) and then our neurological examination. You must rely on your instincts and everything you’ve learned over the years.

We had dinner on Joyce’s veranda last night and the stars were absolutely amazing in the clear evening hours. Somewhere to the north a thunderhead amassed with an eventual show of lightening in the distance that only added to the magic. Some light rains began in the early morning hours that lightly brushed our metal roof and ended shortly after sunrise. A short walk to the clinic along a gentle path and our new day had begun. The earlier rains meant that clinic would start slow, but it picked up before lunch with many more patients to be seen again. Children and adults, some puzzles that will require more thought, but all that we hope to help in some way or another.

We leave early tomorrow morning on safari to the Southern Serengeti and Lake Ndutu to view the Great Migration. It should be very exciting and we’re all looking forward to the adventure.

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