My final days in Arusha with some parting thoughts….


[I do apologize for the tardiness of this post considering I’ve now been home for almost a month. Work is not an excuse, but it is a reality]

Three Tanzania veterans sending me greetings from Doha, Qatar, on their return trip

Having safely deposited the residents to the airport the day before, it was now my weekend to spend visiting friends in Arusha, and, perhaps even more importantly, spending time with the Temba children and their extended family. With both Lenox and Lee home from school in Nairobi, the house was full of teenagers and little ones. I’ve watched the two boys grow over the years, having first met them in 2010, and they have grown into two fine young men. Wesley, Leonard’s nephew, is a few years older and has also been a constant fixture as well since he had grown up with the family, living with them until just the last couple of years. And now there is Gabriella and Gabriel, two additional little Tembas, that have come along during my friendship with the family. This weekend, there were more children than I could count, which was fine with me as I had really planned to spend much of it just enjoying all the kids.

Max and Dina visiting us at FAME while on safari

On Saturday, I met with Jones (Leonard’s brother) and his children, with Lenox and Lee in tow, as there was a school outing for his oldest child, Janey. It brought back so many memories of doing this with my children, the hectic pace of kids running everywhere and enjoying their friends as only children will do. It was much as you’d expect, with four teams (each named appropriately for an African animal) all comprised of students from their school, competing in sports such as soccer (albeit on a much smaller scale than I’m used to here with Leonard’s all-star teams), three legged races and, finally, a tug of war between the parents, first the fathers and then the mothers. It was lots of fun as I sat on the sidelines with Jones, watching all the kids run and play with their friends and, for a brief moment, lose myself with a sense that I was back home with my own children in the past. They are wonderful memories.

A school outing for the kids, Janey front left

I had set Sunday aside to visit with all my old friends, as well as some new ones. Dr. Elibariki, the surgeon in Arusha who had brought some of his seizure patients (yes, everyone here does general medicine) to see us at FAME last week, had expressed an interest in getting together to meet before I left. Daniel Yamat, who had originally introduced us last March, was also to come along, so we all met at Ellen’s, a small coffee shop near the clocktower in Arusha. Daniel is a wonderful man, who is a veterinarian and currently the conservationist at a private reserve next to the Northern Serengeti, where he is working on repopulating 5000 acres of savannah where the animals had left due to farming and humans. I had met him several years ago during a brief visit to the reserve as a guest of the owners and we had taken hikes and gone on night drives together, something you can really only do on private property here in Tanzania. Daniel is a Maasai, whose father was an amazing and wise man that had attended college in the final days of the colony before independence, and had wisely sent Daniel to school and eventually college. I had the honor of meeting Daniel’s father during my last visit, though unfortunately, towards the end of his life when Daniel had asked me to evaluate him neurologically. When I had met him at his home, even with his incapacity, he was a truly remarkable man and, despite his inability to stand, was someone whose stature clearly could not be measured merely by his height. Shortly after my visit, he had succumbed to his illnesses, and both Tanzania and the world had lost an incredible individual, though I know his spirit will live on in his children and grandchildren.

We had decided to meet after church and as we sat sipping our coffees (me, a Caffé Americano to their cappuccinos, they shared with me their vision and hope of what healthcare could be in Tanzania given the right circumstances and access to medical care. Elibariki is one of four general surgeons who currently place ventricular shunts in children, such as the child with hydrocephalus that we had seen at FAME at the beginning of this visit, but soon there will be a neurosurgeon here to help. A colleague of his is currently doing a neurosurgery fellowship in Dar es Salaam (she has already completed a surgery residency and was already practicing) with plans to return to Arusha. That would be an amazing turn of events for us, as currently, neurosurgical care in Tanzania is only available in Dar, an eleven-hour bus ride away and in a big city incredibly difficult to navigate. It is a trip that is out of the question for most of the patients we see at FAME. It is news such as this that brings hope to the future of what we are doing here, for as much as we can work to train clinicians to evaluate neurological disease, diagnosing conditions that require neurosurgical intervention is still nearly pointless as it is not accessible to the population of patients that we are seeing.

Boys are the same everywhere

I ran home for a bit, and then headed off to meet Jones at Andrew’s, a nyama choma joint that has the most amazing grilled chicken and goat that is to die for. In addition to Jones, Simon met us there (he had driven us to the Serengeti), along with several other friends/guides who I had met in the past. We sat for a long time just relaxing in the wonderful atmosphere here, both weather and company-wise. Lunch is usually well after noon and, as I had also planned to meet some ex-pat friends for coffee at 4pm, I just sat and soaked up the friendship and sun rather than running home for such a short time. As I left Andrew’s on my way to the Mt. Meru Hotel for coffee, I threaded the bumpy back streets and ended up on the Njiro road along my normal route that takes me away from the center of town towards the Nairobi road. Having thought that I was totally finished with the traffic police here (which was not to be), I rolled up to the road to make a left turn, when I spotted the traffic police dressed in their white uniforms standing across the road and far to my right. Suddenly, I realized that I had forgotten to put my seatbelt on, something I would never ever think of doing in the states, and as I reached over to draw it across my shoulder, the eagle-eyed officer spotted me and waved for me to stop. It was rather comical as I sat there while he crossed the street to come over and address me, for I already knew what the fine was going to be. Yes, the ubiquitous 30,000 TSh (approx. $14), that I have, unfortunately, come to know all too well. I just couldn’t bring myself to lie when he asked me why I had been trying to put my belt on and despite telling him that I had just left the restaurant (a rather lame excuse, admittedly), he proceeded to admonish me prior to giving me my receipt for the fine I was paying. It was a rather appropriate parting shot to have received, though, for this is no longer the rugged frontier that it once was, and I was soon to discover in, perhaps, an even more disheartening way.

The Mt. Meru hotel is a bit of luxury in Arusha (there are others, of course) with its golf course (really?), the only one in Northern Tanzania, if not the entire country, immaculately trimmed lawns and a host of other amenities. Dignitaries stay here when in town for obvious reasons. It has ample security for those who need be concerned (not me) and restaurants with safe food (OK, maybe this is a plus). I visited with my friends, Ruth and Wes, filling them in on our recent results from the trip (having seen more patients than ever) and some of my plans for the future. I have known them pretty much since I have been coming here so they have watched our program grow with time along with FAME.

Mount Meru from Arusha

Leonard had been out most of the day working and doing errands, but we had planned to meet at the new mall in Arusha with all of the children since they have a “play zone” there for kids that would best be described as a Chucky Cheese in Africa. For those of you who don’t know what a Chucky Cheese is, I can only describe it as a place that you would do anything possible to avoid, as it is filled with dozens and dozens of screaming kids (only a few of who are your own) and I have memories of having to rescue my children, on at least one occasion, having gotten stuck somewhere climbing or inside a tube. With that traumatic experience still in my mind, we departed for the new mall with all the children, and once there I was relieved to know that we could merely drop off all the kids and then head over to some outside tables where we could enjoy a cold drink. Jones and I sat and talked while we were waiting for Leonard, who eventually showed up to join us.

Outside the new mall in Arusha

So the disheartening part that I mentioned above has to deal with this new mall that only recently opened. Not necessarily with the Chucky Cheese aspect of the mall, but rather the mall itself, which could easily have been teleported from somewhere in the USA. Escalators and all (I have never before seen an escalator here), it represents the epitome of what one comes here to escape and, while one can’t deny that it represents, in some way, a positive change for the country here, it also makes me feel like they have lost their innocence. But who am I to deny progress to a country and people that have struggled for so long to bring themselves out of the dark ages of colonization and having been one of the very poorest countries on the globe? I guess it’s all in the view of what progress really is and therein lies the problem (or “rub” as Shakespeare put it). I cannot help but view the creation of the “mall” as we know it here and elsewhere as anything other than progress and a metaphor for all that we seem to despise. So I spent the evening sipping beers with Jones and Leonard at a mall that seemed so out of place with the lovely backdrop of a sunset in Africa, wishing I were back on the Serengeti with my friends and the flat-top acacias. After the kids were finished, we toured the inside of the mall and its escalators, representing much of what we all detest in the west, that now served as a novel “ride” for the children, who had never seen one before, riding it up and then down repeatedly, while no one was the wiser of what it truly represented.

Inside the new mall in Arusha

Monday was my day of departure and, having packed the evening before, I spent it relaxing with the children and running some errands. Jones and Simon had both planned to travel to the airport with me as Simon was going to visit his family outside of Moshi on the slopes of Mount Kilimanjaro and Leonard had left on Safari that morning. I put my bags inside the Land Cruiser this time, rather than in the boot, so as not to repeat the previous fiasco at the airport when the boot door wouldn’t open. I drove the three of us to the airport, getting my last bit of left-hand driving in before I departed, not to mention my love of driving in general here in Africa. This time, the traffic police left me alone, perhaps having been fully satisfied with the 70,000 TSh they had bilked from me over the last three days, or possibly because I made absolutely sure this time to wear my seatbelt, not exceed the speed limit and not pass a single car or truck without first making certain that I would do so while still having room to complete it with a broken center line still remaining. I’ll never know for sure, but I was just happy to have made it to the airport without a hitch this time.

A view of Kilimanjaro while departing

Amazingly, I had an entire row to myself on my first flight, and as we rose above the clouds, the top of Kilimanjaro, in all it’s glory, came into view, bringing back memories of our ascent of the peak two years ago, during a full-on blizzard. I hope to do it again someday, minus the blizzard, of course. Africa, and Tanzania specifically, is such a land of ultimate contrasts, from the heights of Kilimanjaro, to the Serengeti with its Great Migration, to FAME and my second home here, and, finally, to the escalators at the mall. Some of its landscape will hopefully never change (though the snows of Kilimanjaro are disappearing at an alarming rate), while others must change with progress, whatever that may be. For me, though, it will always remain magical here in ways that will never cease to amaze and I will always continue to return to make it a better place in my own way.

Postscript…If there is a story that best captures the magic and lure of Africa, it is Out of Africa, and the movie of the same name that is such a classic. A week after our return, the four of us reunited for a viewing of the movie as it had been some time since I’d seen it the full way through, and neither Neena nor Sara had ever seen it. It is a long movie, but having just experienced much of the same adventure (minus the near death experience of an attacking lion), it kept everyone’s attention until the very end and was a wonderful finale to such an incredible journey we had undertaken together.



2 thoughts on “My final days in Arusha with some parting thoughts….

  1. Patricia Kraft

    Besides being the best doctor, you are surely a great writer. I feel like I’m right
    there when I’m reading.. It’s wonderful what you have done for these people.
    Thank you and I will see you on Jan 11th!

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