As you may recall, because of the elections last October we were unable to travel to the villages for our mobile neurology clinics. The reason was two-fold. Though there was no violence, there was some unrest and demonstrations that were concerning enough to avoid so as not to be caught up in them. The other was that we were concerned we might become part of the propaganda machine going on during the election if someone tried to claim that we were being sent by the government or even the opposition party. It was a lose to our program not to have made this available, but in the end a necessary decision for everyone’s safety and for FAME.

Our first stop for mobile clinic was Kambi ya Simba, a small village in the Mbulumbulu division of Karatu district where I began my clinics five years ago. We used to see patients in the middle of an open field sitting at a desk, but they now have a nice infirmary set up there with offices that can use for our evaluations. Sokoine was working as our coordinator so he worked to triage patients and to determine that they were clearly neurology patients as we try our best not to do general medical care while we are on mobile as the clinic is being supported by neurology funds. We ended up seeing 15 patients, the number being a bit low as it was also market day in Karatu which meant that many people were in town so we’re hoping there will be additional patients tomorrow.

Jess and Angel getting a history having to use an Iraqw translator to Swahili

An Iraqw Elder

Jackie and Dr. Anne evaluating a pediatric patient

Our patients spanned the normal spectrum that we see in the villages. We had headaches (several of which were classic migraines), back and neck pain, generalized body pain (know here as GBM – kind of freaked me out when I first saw it written on a chart), and epilepsy. Non-epileptic events are very common here which always makes things interesting considering the difficulty that is often present in obtaining an accurate history. Overcoming this can be a real challenge and is obviously critical in caring for patients. We had a number of children for Jackie to see which was good, though several of them were new cerebral palsy children who we could only refer to Monduli which a government rehab facility near Arusha. She was able to spend extra time with the moms though, going through some of the necessary exercises to help with their trunk tone, etc.

Jackie, the pediatrician

Jess and Angel obtaining a history with Pauline observing

A young cerebral Palsy patient with Jackie

Jess and Angel with a patient

Jackie and Dr. Anne

Jackie doing an eye exam

Dr. Anne performing the neuro exam under Jackie’s tutelage

We returned to Karatu early enough to visit the Maasai market which happens there twice a month and which I’ve never visited before. It is a massive outdoor market where they sell lots of goods, but it is mostly clothing that is placed in large piles by each vendor. Then everyone sits around the piles and sifts through them with the intent to find something they like and which fits. The clothes arrive in bales that are shipped in and I have to imagine originated in the United States based on the appearance of most of the clothes. I hadn’t really researched their origin before, but one look on the Internet quickly answered my question along with the controversy that has been created by the practice. The clothes are all from charities in the west that have been donated, but were either unsold or unwanted and they are then shipped predominantly to Africa. Unfortunately, these clothes are not then donated to the impoverished, but are sold in large markets such as the Maasai markets here in Tanzania and others throughout Africa. Based on the amount of clothing present, this would produce a very significant profit to someone along the way. This practice apparently began in the 1980s when before the clothes were donated to the poor. The textiles industries in many countries have been significantly harmed by the practice.

Jess and Jackie checking out sizes

Pauline, Jackie, Jess and Anne shopping for clothes

The vendor for these clothes

A view of the Maasai market

After the Maasai market, we all ran home to shower and was off all of the dust and sweat from the day and make ourselves ready for a visit with Daniel Tewa and his family. I’ve mentioned Daniel in the past, but he is a friend who I met while on our original safari and we have remained close ever since. He has graciously entered us with authentic Tanzanian dinners and long discussions of Tanzanian history and politics. He has an amazing memory for details and it is always great to hear what he to say about a subject as it is always guaranteed to be enlightening. He and his family are incredibly gracious and we were again presented with a wonderful traditional Tanzanian meal including Chagga stew of bananas and meat. Jess had a 7:30am lecture to give so we had to excuse ourselves by 9:30pm otherwise I am certain we could have stayed until midnight with the same intensity of discussion and continued hospitality. These are just some of the reasons I continue to return to Tanzania year after year and why everyone who I introduce to this country and its people falls in love with this small part of Africa.