Wednesday, March 14, 2018 – A day of wellness and so much more…


I had designated today as a wellness day for the residents. Now you might just ask yourself, “isn’t everyday in Tanzania a wellness day?” and you would be entirely correct in your assumption, lending yourself to the expected follow up question that would be, “why would anyone need a wellness day in Tanzania?” In fact, these were exactly my responses to Ray Price when he asked me to schedule these days for the residents here on rotation, but it actually turns out that the GME (graduate medical education) office had asked all residency programs to schedule these days into the resident’s schedules and who am I to buck the establishment when it means accompanying the residents on their half day off.

Johannes and Mindy outside clinic

But first, we had plans for clinic in the morning and would finish by lunchtime so that we could make it to Gibb’s Farm for their fabulous buffet lunch. Now mind you, I had absolutely nothing to do with the fact that the residents chose to spend their wellness day at Gibb’s Farm having a wonderful lunch, but anyone who knows me has already realized that if I did have any say in the matter, this would have been it. OK, back to clinic….

Angel, our fearless leader

Mindy’s favorite patient of the morning was gentleman who had eight different complaints and was not very happy when she tried to narrow them down to those that were the most important and were neurologic, which of course is what we are supposed to be doing here. We certainly encounter this issue in the US when we’re seeing patients and it can be very similar here at times. Our job is to try to get the patient to focus on the issues that are most bothersome to them or the ones that we feel are the most likely to do them harm. Fortunately, Mindy’s patient had no life-threatening issues, but unfortunately, he did have quite a few that were bothering him. We ended up treating him for neuropathy as he was a diabetic with poorly controlled blood sugar along with headaches, so amitriptyline, our most commonly prescribed medication here, would work well for him as it would treat several of his problems quite well.

Johannes and Mindy chatting with Dr. Julius

Drs. Ivan and Asanga chatting with Jacob

We were able to wrap up the morning clinic with little time to spare to begin our trek up to Gibb’s, when I discovered that there was a patient who had traveled from Arusha and who would need to see us for an assessment. Since it was getting just a bit late and I didn’t want the resident to miss out, I told them to go ahead with one of the FAME drivers and I would meet them there. It ended up though that the patient had nothing acute neurologically and had actually suffered trauma several years ago so there was very little I had to offer. I gave my recommendations to Frank, who was also planning to see the patient and I arrived back at the house just as the FAME driver was pulling up. It was a pretty comical scene, but I asked him to wait to make sure our car started, but he understand me and drove off just as I was trying to start the Land Cruiser, which, of course, didn’t start. We were eventually able to get someone over to jump the car and as we were finally getting under way, very much later than I had planned, it began to rain on us.

Susan on the ward discussing her patient with Drs. Badyana and Mbogo

I typically take a very nice short cut to get to Gibb’s and, since we were running late, decided to do so today as well. As soon as I got up on top of the slight ridge it rides upon, the road suddenly became mush so that it was a pure slip and slide trying to stay on the road and required that I drive mostly in second gear and, at times, first gear just to keep from having to hit the brakes which would mean a definite off road excursion in the pure muck. It probably took us twice as long to get to Gibb’s as I had to take some different routes to keep from getting stuck and drive so much slower than normal. The drive seemed like an eternity and when we finally reached Gibb’s I took a very deep breath and let out a huge sigh of relief.

Johannes and Dr. Julius examining a patient

Once there, the blue skies opened up and it was once again gorgeous, so much so that we were able to eat out on the veranda looking out over the valley and once of my favorite places on earth. The lunch buffet at Gibb’s is a wonderful feast of mostly local dishes and all grown on their farm there. There were cheeses, breads, a ginger carrot soup, quiches, many salads, samosas, grilled chicken and so much more. And then there was desert. We all just relaxed in the shade of the umbrella over our table and enjoyed the good food, good company and unbelievable scenery.

Susan and Susanna evaluating a patient with Baraka’s help

We had plenty of time after lunch for another adventure, so it was decided that I would drive everyone down to a friend’s gallery in the town of Manyara where everyone could buy gifts for family and friends. There are so many amazing crafts here from the local tribes with beautiful jewelry and carvings that are probably the nicest. We were in no rush so everyone had plenty of time to spend shopping to his or her heart’s desire, although the shop was closing up around 5pm, so there was a bit of a deadline, I guess.

Johannes evaluating a patient with Dr. Julius’ help

Once finished with the shopping (of which there was plenty), we headed home in time for dinner as we had plans later that night to meet all the other volunteers in town at Happy Day, the local pub where everyone meets on here on Wednesday nights. Everyone enjoyed the night out as we later moved on to the Golden Sparrow, which is the new club in town that was opened by the owners of Carnivore. Carnivore, a place of lots past memories, was a fine joint that served only grilled chicken, chips (French fries) and fried plantains. The Golden Sparrow has all the same food, but also a separate dance club, which was our destination that evening. It was quite crowded for a Wednesday night, but everyone seemed to be watching a soccer match and had less concern with dancing, though we well made up for any lack of enthusiasm by the locals. We all made it home safely that night and with a 7:30am lecture on management of acute appendicitis, it wasn’t going to be a long night of sleep.

Enjoy the sights and sounds of our precious weavers here at FAME


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