Neena’s headache talk

It was Tuesday morning again and time for another education meeting during which I have the residents each cover a topic that Dr. Msuya, who is in charge of coordinating education for the doctors, chooses would be most beneficial for them to hear. This morning’s talk was on headache and Neena was giving the talk. She made it interactive and decided to have the rest of us pretent we each had one of the more common headache syndromes and that we would answer questions that she was pose to us as if taking a history from a patient.Whitley played a mzungu with a migraine and dressed the part of a safari going with migraine headaches. Neena selected me to play the role of a “bebe,” who is an old woman as in grandmother and who had muscle contraction or tension headaches. Sara played the part of a patient with a chronic daily headache. The talk went well and we did get the Tanzania doctors to participate which is often not easy for they are for the most part, quite a quiet bunch on the whole.

Whitley playing the role of a Mzungu with a migraine

Rift Valley Children’s Village, near the village of Oldeani, is an oasis in the center of paradise. Started over ten years ago by India Howell, it is a haven for children who have been orphaned or otherwise abandoned by their families for one reason or another and are in need of a home. India and her Tanzanian business partner, Peter, adopt all of the children who come when they are infants or older and remain here in separate houses run by “house mamas” until they are ready for college or to move on to other occupations. She has volunteers from the US that spend months up to a year working with the children and all of the children attend the government school that is physically next to the village. They have a nurse who provides physicals not only to the children who live there, but also to the residents of the community that is next to the village as India identified very early that no matter how well she took care of her kids, that if the community wasn’t healthy, it would affect her children negatively. This is perhaps an example of what we now know in global health. If you don’t use resources to help ensure your neighbors health, then it will very likely eventually your health negatively as there are no borders for diseases.

Schoolboys at Rift Valley Children’s Village

Dr. Anne and Sara evaluating a young women with microcephaly and static encephalopathy

The drive to RVCV is also a gorgeous one as it traverses some of the highlands and travels through more coffee plantations. The region is inhabited by farmers and coffee workers. Arriving to the gate of RVCV you realize that you are in a special place quite quickly. The children are one big family. As we drive in, there are quite a few patients waiting, though fortunately it turns out that many of them are for general medicine and will seeing the RVCH nurse during the day while we’re there. We have enough patients, though, to keep us busy and get started working in three rooms for the residents which will mean that things will go along quite speedily today. Dr. Anne will work with Sara today, while we have both Baraka and Emmanuel there to translate for us in the other rooms. They are both quite familiar with the Children’s Village.

Discussing the case

There are many children from the village to be seen, most with epilepsy and others with developmental delay, but there are also many adults from the nearby villages who have come to be seen. Some are new and others have been seen previously. A number of students were there to be evaluated by us to rule out neurologic issues as they were having difficulty in school, but we sometimes didn’t have the entire picture as they were unaccompanied for the visit. The children were very helpful, though, and could often give us surprisingly detailed histories.

Dr. Anne and one of the school boys.

Rift Valley Children’s Village has a large cadre of volunteers working there at any one time in addition to others working on associated projects such as microfinance and the Rift Valley Woman’s Group. Lunchtime is always a pleasure for us at RVCV, for as much as I love the rice and beans served at FAME for lunch, the meal there is always something new and is made fresh by the mamas who do all the cooking there. Today’s lunch consisted of freshly baked rolls, tuna salad and sliced cheese, along with salad and a wonderfully fresh soup that was either cream of celery or something very similar. For desert they had a fruit salad that was also incredibly fresh. Other times I’ve been there, we’ve had various cookies and sometimes cake for desert as well, but it was probably best that they had just the fruit salad today as I had seconds on the soup and probably would have overeaten.

Whitley evaluating a patient with complaints of memory loss

We had more patients for the afternoon, but it wasn’t overwhelming by any means. Again, with three rooms for the residents it meant that we were able to plow through patients quite quickly. After we were all finished, we still had plenty of time to run through all of the cases with Gretchen, their nurse, to go over the plan for each so she could follow up on them and make sure they were getting their necessary labs and refills. The trip home from RVCV is always gorgeous as I take a slightly different route that travels through rich farmland and small clusters of little structures where those who farm the land live. The homes are typically of thatched roofs and wooden sides and very basic. I’m sure it’s what they have lived in for hundreds of years in this region.

Whitley evaluating a patient with complaints of memory loss

We arrived home early enough to check on patients in the ward who we had been consulted on earlier and then get home in plenty of time to do some work. It was great to be able to relax and catch up on things.