October 6, 2016 – Another excellent beginning to clinic….

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I don’t want anyone to think that living here at FAME is a hardship in any way. We are certainly not roughing it, though in the old days here it may have been a different story. Before we had hot water it was a bit of struggle to get myself into the shower in the mornings as the water came straight from a well and was quite chilly. These days we have a wonderful “kuni” boiler to heat our water – this is a wood fired hot water heater that is loaded up with wood each night and fired up in the early hours by the Askari who are the Masaai watchman that keep an eye on the grounds at night. Amazingly, there is still often hot water in the evening for those who like to take late showers or may choose to run after work. During my first years here at FAME, we did leave on week long mobile clinics where we did rough it having to take “bucket showers” each morning and sleep on mattresses on the cement floor of a cinder block building that managed to collect all the heat of the day and release it for us at night. Oh yes, and a bucket shower is when you’re given a five gallon bucket of tepid or steaming water (though never just right) along with a cup that you use to both douse you and rinse you squatting somewhere private. Definitely not for the faint of heart.

I readied all of my neurology tools and gathered up whatever else was necessary for the day and headed off to make rounds with the FAME doctors. We always start by discussing the ward patients and listen for any that may benefit from a neurology evaluation. None was necessary today and so I checked in with Sokoine to learn what the schedule was for the day. We hadn’t advertised today as a neurology clinic as I would be here by myself, but someone shortly after opening we already had seven patients waiting to see me. As the day proceeded, the number grew, of course, and when Sokoine asked how many patients I would see today I somehow knew that whatever I said it would end up being a larger number. So I told him ten knowing full well that it would be more, and when I finished at 15 I wasn’t surprised in the least. I saw many returns today, some of who I had initially seen in 2011, and a large number of epilepsy returns, all doing very well and just coming to check in. I also saw our two young brothers with muscular dystrophy who continue to decline over time with very little to offer them whether they were in the US or here. Another sad case is a young boy with severe muscle weakness likely from a viral infection several years ago (polio? West Nile Virus?) who has such severe kyphoscoliosis and joint contractures that he’s no longer able to transfer or maneuver his wheelchair. He resides at an orphanage run by an amazing gentleman from Norway who is also providing help to the two brothers with muscular dystrophy.

A birthday celebration

A birthday celebration

So the day was long but very rewarding in so many ways. So many of our epilepsy patients are doing well and many are seizure free. Much of this is due to the hard work of Danielle Becker on past visits. At the end of the day there was time for a birthday celebration for Dr. Ken. As you may have gathered from my birthday celebration last March, there is lots of singing and pronouncements followed by cutting the cake. The tradition is that the guest of honor must feed all of the regular guests a piece of cake on a toothpick after receiving one piece of their own first. Mama Mshana gave Ken his piece of cake than Ken feed all the rest of us as we were called out. Quite an affair and it’s not over until each guest has been feed.

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After the birthday celebration, six of us (all volunteers) went to have drinks at Gibb’s Farm where the view is to die for and the veranda at sunset is the best place to be in all of Karatu district. I took some photos in the waning light of the lovely flowers surrounding the ponds that are covered with water lilies. It is a dreamy place where all that is amazing about Northern Tanzania unfolds before you as you sit under the jacaranda trees with their purple lavender flowers that turn iridescent and dramatic in the fading light. It is the most appropriate place to finish another wonderful day and ready myself for a tomorrow that will hold equally amazing experiences….

The view from the veranda at Gibb's Farm

The view from the veranda at Gibb’s Farm

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