After our long days at Mang’ola and the drive that accompanies it, everyone, including me, was looking forward to a somewhat tamer route for our mobile clinic. Still, we wanted to get there at an early hour in case the clinic was swamped, so had decided to depart Karatu at 8 AM for the 45 minute ride to the village of Oldeani and Rift Valley Children’s Village (RVCV). Since it was Thursday morning, we had again been asked to do an education presentation and Mike agreed to speak about seizures and epilepsy, a topic that cannot be reinforced to often given the number of epilepsy patients we see here and the fact that there are a number of new doctors who haven’t heard our presentations before. His talk was wonderful, of course, and provided a very practical approach on how to treat these patients in Tanzania, where not all medications are readily available or affordable.

Rift Valley Children’s Village is an amazing home to around 100 children that were either homeless or otherwise unable to be cared for by their families and have been adopted by India Howell (Mama India) and her Tanzanian business partner, Peter Leon Mmassy. The children range in age from infants through the mid-teens and all live at the village in houses that are run by house mothers who care for them. They attend school next door in the government school that India has partnered with to provide more teachers than the usual ratio of one teacher to three classrooms and not only do India’s children benefit, but so do the children from the local village.

One of the next important chores was to work on the health of her children and for that, India turned to Frank and Susan. One of the important reasons for FAME’s location in Karatu was the proximity to Oldeani and RVCV and India’s relationship to the two founders of FAME. India also found, though, that the health of the children going to school with her children was extremely important as was the health of the Oldeani community meaning that by providing better access to medical care would ensure the health of all. FAME was the key and from the very beginning they provided medical clinics at RVCV not only for the children at the village, but also for the community and all was funded by Tanzanian Children’s Fund, the parent organization for RVCV. When I first came to FAME, I also accompanied the medical team to these clinics, providing neurological care, and when I began the program with Penn that included residents, we developed a separate neurology clinic that ran in conjunction with the medical clinics. For a number of reasons, the medical clinics to Oldeani were ended in the last several years (patients from RVCV and Oldeani are now transported to FAME for their care), though we have continued to provide neurological care through our neurology clinics there every six months. Katie, the current nurse at RVCV, provides continuity care and communicates with me by email with any questions.

So, it was on this framework that I was again on my way to RVCV for well-more than the twentieth time, driving through the incredible countryside that makes up the area that surrounds the village. For today’s drive, we had decided to take only one vehicle, that being Turtle, though we had a total of twelve people that included the residents, Leah and all the support staff. Turtle has seating for nine people, though with two beer crates in the aisle and four people seated across the back, we were able to fit everyone, albeit not the most comfortably. The road to Oldeani is thankfully not as rough as that to Mang’ola, though it does have its moments. The road initially runs along a ridge for several kilometers, but then descends into one deep valley and then another such that there are angled berms every dozen yards or so to divert the water from the road surface during the heavy rains to keep it from washing them out. Therefore, we descended and ascended in first gear to keep everyone happy given the tight quarters. The final part of the drive is through a coffee plantation where it is much love level.

RVCV is like an oasis and there is something about it that will lift anyone’s spirits. As you might imagine, this is a very desirable position for any volunteer and there are many, most of whom come for several months at a time. They also have internships for a number of the more dedicated positions that require more continuity and they may stay for a year or more. I should also mention that once the children finish secondary school and are ready for college, they move to quarters that are just outside the village and, then, when they finish their schooling, they will find a job and move on. I have known many of the older children there that have gone on for additional schooling and one of those is currently working as a nurse at FAME.

When we arrived at RVCV, it was apparent that everything was under excellent control as Katie, their nurse, had already prescreened all the patients for us, registered them, obtained charts for those patients who had them, and had pre-sorted the charts into the pediatric and adult cases. In addition, she had prepared four examination rooms for us to use which meant that the residents would be incredibly efficient in seeing patients. Unfortunately, the only thing we didn’t have waiting for us was the mob of patients that we had expected to see. What we later came to find out was that coffee picking season was still ongoing and given the fact that this was the main employment for the local population, they couldn’t afford to miss a day of picking as the season is on forty days. The pay for picking coffee is the equivalent of $2 a day which is a significant amount considering the average annual income in the region can be as low as several hundred dollars a year.

Despite the fact that Katie had called many of our prior patients to come in for follow up, they didn’t show. We did see a number of children, much to Marissa’s delight, that were both from the children’s village as well as the local village, in addition to a number of other patients that we had seen previously. There were many epilepsy patients that were seen which has been quite typical of our patient distribution here and there were also a smattering of developmental delay patients. We ended up seeing perhaps 16 or 17 patients by the time lunch was ready for us. The mamas (house mothers) cook lunch for all the volunteers and interns and today’s lunch was a very delicious version of the Tanzania burrito – chapati with beans, ground beef, cheese and vegetables – and then homemade (everything here is homemade) brownies.

After lunch, we went to the duka, or store, where items made by the local women’s group were being sold. In addition to the RVCV, there has also been an ongoing project to empower women in the area by utilizing both microfinance opportunities along with vocational training that has continued to grow each year allowing women to earn money and support their families. The Rift Valley Women’s Group, in addition to selling their work in the small duka on the premises, has also begun to partner with many lodges throughout the northern safari circuit with plans to expand further to the coast of Tanzania and perhaps eventually to internet markets such as Etsy or to organizations such as Ten Thousand Villages in the US. Based on the reaction that everyone had today to the handicrafts for sale in the duka, there is little question that they would be incredibly successful. We all bought plenty of gifts for those at home and for ourselves and I am certain that every group I bring there will have exactly the very same reaction to their visit. For anyone who wishes to find out more about that the RVCV and the Rift Valley Women’s Group, you can find it at the Tanzanian Children’s Fund website:

www.tanzanianchildrensfund.org

After our visit to the duka, we walked back over to the clinic hoping that perhaps patients had come after working in the coffee fields, but there was no additional clientele for us to see. So, we packed up our equipment and the medicine box we had brought with us while I worked on scanning all the charts of the patients who we had seen and Katie made a duplicate copy of the notes for FAME. We loaded up Turtle with all the passengers and were on our way back to Karatu much earlier than we had been in the last several days, thankful that we had a bit of personal time considering the long days that we’d had previously during the week.

The drive back was equally gorgeous as I take a little diversion that skips some of the bumpy road and instead passes through a somewhat breathtakingly steep valley inhabited by local farmers that is far steeper than the road we took in the morning. Despite the extra passengers in the vehicle, Turtle performed as I expected her to in that great Land Rover Defender tradition. I have often said that I am the luckiest guy in the world for as a child and young adult, I had always been an explorer at heart, and sometimes in practice, but had never thought that I’d be driving a Land Rover in East Africa. It is something I am now able to do twice a year and, while doing so, provide services not only to those in need here, but also education to the doctors of FAME and to my residents who become both better neurologists for having worked here and better persons for further realizing their potential in helping humanity.

We arrived back in Karatu early enough for us to take the short drive down to Manyara village to visit the African Galleria so that everyone could shop for some additional gifts before we left the area. I was also able to get to the local bank here to pay for our transit across the Ngorongoro Conservation Area which must be done in advance of our upcoming trip tomorrow the Serengeti. I was also able to stop in at Soja’s shop, the FAME mechanic, so that he could possibly replace the water temperature sensor in Turtle which had broken. He didn’t have a new replacement, but used one from another vehicle in their shop so that the gauge would be function for our trip over the weekend, while he would order the new part and swap it out with the temporary replacement that he installed.

While at Soja’s, I bumped into Nixon, a good friend and local businessman (who owns the Lilac café both at FAME and downtown), who reminded me that the meeting for the Karatu Rotary Club was tonight and that I had said that I might try to go. I ran everyone home and then drove back to the Lilac Café in town where the meeting was being held. I was glad I went as I know more than half of the members and their current project for the community is to install trash receptacles first along the main road. To understand this, you must first realize that there are virtually no public trash receptacles anywhere in the country and that trash is usually just discarded by individuals on the street. It is a very worth project and one that I hope builds momentum so that these receptacles can be placed through the town and not just on the main street.

I arrived home following the meeting to find everyone intently making sandwiches for lunch tomorrow on our drive to the Serengeti as well as getting packed for our two night stay there. We would work half a day in the morning and then try to leave shortly after noon. I had met a guide recently who I liked very much and asked him if he was possibly available for the weekend to take us to the Serengeti. His nickname is “Dodo,” and all of us are quite enthusiastic to have him accompany us.