My arrival to Kilimanjaro International Airport was as uneventful as one can get this trip. After having flown on KLM for my last twelve trips to FAME, I had decided to fly Qatar this time as it departs from Philadelphia rather than Newark, NJ. That and a $300 difference in cost in my favor made it more than a no brainer. We flew from Doha, Qatar, in a narrow body jet which isn’t as nice perhaps, but it’s also about half as many people descending on this small airport waiting to go through immigration making the experience more of a pleasure than those of previous years. Having a residency permit is also very helpful as I no longer have to fill out any paperwork. I just show my stamped passport and walk through to baggage. Customs has also become a bit more of sticking point here, but without going into detail, it was a breeze this visit.

Pendo and her sister-in-law picked me up at the airport and we made our way to Njiro, a suburb of Arusha, where they live. I am normally arriving at around 8:30pm on KLM, but Qatar also arrives much earlier in the afternoon so we have plenty of daylight to get home and enjoy the evening. As the title of my blog implies, this has become much more than a second home for me. It is another home, much like that in the US, and other than not speaking Swahili fluently (mostly as I’m not very good at languages and am not able to speak it at home), it has become as comfortable and familiar as the streets of Philadelphia or the mountains of California for me. People now know me here and expect my visits. And as I drive to Karatu and FAME tomorrow, I will be heading to an even far more familiar place than Arusha. Leaving Mt. Meru and Arusha, traveling west, I’ll cross through the rolling hills that will lead me to the Great Rift Valley, the single most significant spot on the planet for mankind and our species, Homo sapiens. For it is here that man first walked on two legs and began his long journey to all regions of the globe.

I can’t resist putting in one photo of little Gabriella, or Gabby for short. I brought a bunch of clothes and she couldn’t resist putting on a fashion show for us.

Gabby putting on a fashion show

We spent today, Tuesday, running errands around town in Arusha. One of them, though, stood out in importance tremendously more than the others. A good friend of Leonard’s had had a stroke about three months ago and they had asked me to visit him to see if I could offer any help. Imagine having a stroke in a country where there are only perhaps eight neurologists and the closest hospital may be hours or a day away. Then imagine surviving your stroke only to find that there are very few physical therapists and only a single speech therapist in the entire country and that’s in the capital city. We arrived at his home in Usa River to find him lying on a mattress on the dining room floor. He was about 50 years old and probably had a history of hypertension, though hadn’t seen a doctor regularly nor was he on any medications. He had gone to Kilimanjaro Christian Medical Center (KCMC) initially, where a CT scan had been done and apparently demonstrated a hemorrhage involving the basal ganglia or the deeper structures of the brain. He had then been discharged with no movement on the right side of his body and no speech, though he could understand well. The family and his employer had rallied, though, to find an incredible physical therapist who I had the privilege to meet today. His name is Good Luck (a more common name than you would imagine here) and we were lucky enough to have been there when he came for the afternoon therapy session. Good Luck spent time explaining to me what he was doing, which was simply amazing, and then got him up to attempt to walk. Outside on the porch was a tilt table, built by Leonard’s brother, John, that was an amazing piece of equipment and designed after what John had seen at KCMC. Good Luck “walked” him out to the tilt table, a feat that brought tears to my eyes, strapped him in and then tilted him bolt upright. Staying upright for as long as possible and exercising that way is so important for a patient after a stroke. As for the speech therapy, Good Luck was at more of a loss. I suggested a letter or word board which we use with post stroke patients who have expressive language deficits. They can point to common words or spell words by pointing to the letters. We had actually created one in Swahili previously at FAME for a patient so I immediately emailed Sokoine, my outreach coordinator at FAME to see if he knew where it might be. We will find him a word board shortly and, in the meantime, I will speak with Speech pathology back home to see if there’s anything else we can offer him in the short run.

Imagine having a stroke in a country of over 50 million where there are fewer neurologists than a baseball starting nine, very limited rehab opportunities and a single speech therapist who resides in the capital city, an 11 hour bus ride away. Good Luck actually works for an NGO in Usa River though visits his home every day which is paid for by his employer. Without that, he would have been left on the mattress on the floor and without hope for even the smallest of recoveries. Now his family will at least know that he has been provided the best of what Tanzania has to offer. But is that really enough? And what is enough?? Questions that beg answers and answers that will continue to remain elusive. I so wish I could do more…..