FAME’s pharmacy

Our time at FAME had now come to an end and it was time to load everything into Turtle for the trip back to Arusha and then to the airport as Lindsay, Steve and Hannah would be flying out this evening. It is no longer as difficult for me as it is for the residents given the fact that I will be returning in less than six months with the next group so for me it’s really not a true goodbye, but rather “baadaye” which means “see you later.” Neena Cherayil coined the term “post Tanzania sadness disorder” to refer to the feeling one has leaving this amazing place and returning home. There is little question that anyone who has worked here will return home with an entirely new perspective on medicine, humanity and equities and will be changed forever and for the better. Working in a low resource area where people are happy and always so appreciative of your presence cannot help but give you a new outlook on life. It is genuinely a gift.

Reviewing the CT scans on our patient

We had planned to be on the road at around 8 am and, to everyone’s credit, we were packed and in the car at 8:15, perhaps a record for getting everyone moving in the morning when it didn’t involve the excitement of traveling to a park to do a game drive. I had planned to stop at the clinic on our way out for everyone to say goodbye as morning report would be ending and it would be a good opportunity to do so. As we were in the hospital ward, though, Sangale, who works in reception, came up to me with a CT scan folder and told me that it was from the gentleman who Hannah had seen the day prior. I had assumed that they would have sent the patient to Arusha for his scan and that he would have been in the hospital when he returned, but, somewhat to my surprise, he had just been discharged and was now sitting in the night office waiting for us to come see him.

Hannah and I reviewing the CT scan with Steve and Mark looking on

I informed Sangale that we were actually about to the hit the road, but that we’d be happy to look at the CT images before we did so. After reviewing the scans, which were very unimpressive (i.e. no large territory infarction, hemorrhage or mass that we could see, but the study was done without contrast as he had very poor renal function and could not have tolerated contrast), we spoke with his sons, one of whom was actually a medical student, to give them our assessment and recommendations. I also spoke with Dr. Gabriel later to let him know what we had discussed with the family and what we were recommending for treatment. It obviously took some time for all of this to occur, so it was now past 9 am and we would be getting a bit of a later start than I had hoped for leaving Karatu.

Charlie waiting outside the hospital ward door

Peter was remaining in Karatu for one more day as there was a Halloween party he had planned on attending and so would be traveling to Arusha on Sunday to meet up with me at the airport for our flights. The morning in Karatu had remained cloudy and with a light rain, but as we traveled along the tarmac with Lake Manyara and the Rift Valley in the distance, the clouds began to break up and the sky was blue in the distance. The drive to Arusha, which I have now done dozens and dozens of times has become so much more routine than it was in the past when there were “diversions,” or detours, every few miles that shunted you off to an old road or trail that was always dusty, dry and bumpy when it was the dry season or a sloppy mess in the rainy season. The drive, which used to take three plus hours is now an easy two hours, even when driving a beast of a vehicle like Turtle. A fast Noah can do it in a fraction of that time.

Looking towards the OPD from the ER

I had wanted to take everyone to the Shanga Shop as we entered town and, though we were running a bit late, everyone still wanted to visit the shop. The Shanga Shop, which is now at the Arusha Coffee Lodge rather than across the street and is now owned by Elewana, a travel company, was started ten years ago to employ local residents with disabilities and to train them to become artisans. Shanga, the organization, continues to employ these individuals who now have the opportunity to support themselves and have learned trades such as glass blowing using recycled glass, sewing, and jewelry making. Their work is lovely and it is always very easy to find things here to bring home as gifts knowing also that it is going to a great cause. I have always managed to sneak in a visit to the Shanga Shop with guests to support them in their efforts.

Looking up towards the laboratory

As we entered Arusha proper, traffic was very heavy despite the fact that it was a Saturday. After some discussion, it was determined that we should probably drive straight to the airport rather than stopping by for everyone to say goodbye to Pendo and her family. Though we weren’t necessarily pushing our luck, I think everyone was very interested in getting to the airport and checked in sooner than later. There is an airport club there and I know that all three of them were excited about finally having access to something a bit faster than our cell service internet that we had been struggling with for the last month.

The canteen at FAME where we eat every lunch

As we parked in the drop off area and unloaded all the luggage from the Land Rover, I was reminded of just how many times I’ve done this now and of what an adventure my fellow travelers had had. Tanzania had truly become their home for the last month and they had weathered the trials and tribulations and have a much better idea of what it is like to live here both for expats and locals alike. They have had to make those medical decisions that are unique to a low resource, low access, third-world country where treatment is far from a given and families must make choices that take into account many more variables than we ever have to consider back at home. They have also survived being stranded in Turtle twice, once with no attached gear shift and another time with a seized alternator (“alternator dege dege”), not to mention having to both bump and push start the car on several occasions. Life is different here in all aspects, and whether it is in regard to health care decisions or vehicle breakdowns, you just have to learn to change your perspective on things and look at them through a different lens. Things are always relative and no more than here can one says that. For, this is Africa, or as everyone has learned, “TIA.”

Hannah having one more Tanzanian beer in the Tanzanite Club at the airport

My drive home to the Tembas was without event. No run-ins with the traffic police, no breakdowns, and no “diversions.” Gabby was thrilled to see me and little Gabriel is now becoming more accustomed to seeing me, this mzungu with a beard, in his home. For this is really my home, too, and I am a so glad to be here.