

We had decided to leave for our mobile clinic a bit earlier today as we had plans later for dinner, though it was only to miss morning report so it put us 30 minutes ahead of schedule, which seemed to be just enough time to make a difference, or so we thought. Gathering the troops (which I lovingly refer to here as “herding cats” as it alternates to between which group is running for coffee, tea or seeing a last minute patient in the ward), we loaded into Turtle, which, by the way ,was a task in itself as only two of four doors were working requiring a bit of gymnastics on Alex’s part to get into the front passenger seat where he wasn’t planning on exiting until we got to our destination. We were off to the Mushroom Café, or usual meeting spot with Dr. Anne and the others in town as it at the junction with the FAME road and the tarmac and Anne must have her breakfast items – samosas, chapati, crepes, donuts and vitumbua (delicious fried rice cakes) – that she buys for everyone in the car. This is much loved tradition on mobile clinics, or basically any time we have Anne with us on an outing.


It was another cool morning, though so much as yesterday, and we traveled the tarmac out of town towards the Loduare Gate of the NCA, exiting just before beginning the rise up the crater rim onto the road leading us to RVCV and the Crater Forest Lodge nearby. There is a sign on the road identifying it as “African Massage Road” which is pretty accurate for this passage, and though it is not the most outrageous example of this phenomenon, it is, in fact, pretty darn bumpy and made even more so by the water erosion humps placed across the road throughout the drive to prevent the road from essentially washing away in a rain. On level ground, these are spaced out reasonably far, but on the steep slopes, they are more frequent, requiring us to slow down for each so the individual in the back seat doesn’t end up with a head injury bouncing into the roof. Either that or the laughing machine, which we have discovered lacks an on/off switch, will begin in earnest.




A few years ago, we installed a stereo in Turtle in which you could plug in your iPhone and listen to tunes as I also replaced the aging front speakers and a nice set of rear speakers. Typically, I have little involvement in the selection of music as I am not allowed to DJ, and admittedly it would be difficult for me to do while driving, but this morning I decided to play some classic music (not classical, mind you) and had Crosby, Stills, Nash and Young playing for the group, all released before any of them were board, but what I had grown up with. The residents will tolerate me for a short while only and later, on our return ride home, I once again lost control of the radio, though I will admit that the music selection was actually very nice.




The road to RVCV can be incredibly treacherous, as the residents had discovered back in March, as the steep inclines and descents can become nearly impassable in the mud. When these situations occur, it is almost impossible to navigate them without having our transfer case that allows the use a super low gearing that is essentially a slow crawl, but does exactly what it’s supposed to do by allowing me to use the engine as a break. When heading downhill on a slippery road, it is critical that you don’t hit your brakes as you then begin sliding and have little control of the vehicle. Last year, they had done some work on Turtle’s gearbox and not having needed low gear prior, I suddenly discovered that there wasn’t enough clearance for the transfer case gear shift to get it into low on a rainy and muddy drive to RVCV. It was pretty touch and go and I don’t think the others in the vehicle were aware of just how close we were to sliding down the hill. Thankfully, I was able to have it fixed that night prior our drive back the following day as I don’t think we would have been so lucky. This morning, I did require low gear once just to get us moving up hill as the slope was too steep for high gear and I didn’t have the momentum I needed. I think the others were concerned, but the road was dry and there was no need for worry.
Arriving to the clinic, it was immediately apparent that there was a gaggle of patients sitting outside waiting to see us, quite a few more then the day before, and we knew it was going to be a busy day. Thankfully, though, everyone was up to the challenge given they all had the prior day under the belts and now knew the system here. We were again going to be seeing patients from both the children’s village as well as the local village of Oldeani. By late morning, the residents had plowed through a significant number of the patients and by the time they were ready for us at the dining room for lunch, the bulk of the patients had already been seen, leaving a rather small number for the afternoon and making it very likely we’d finish up with enough time to make it for our dinner date at the African Galleria.




Lunch was again an amazing affair of wonderful dishes that included quesadillas made with chapati and peppers that tasted very much like jalapenos, but weren’t as spicy as I thought they might be. There were refried beans and salad and fruit again. We still had to pick up the things we had set aside yesterday at the duka, but the person we needed to pay hadn’t gotten in yet, so we decided to knock off the last group of patients first and then pick up our things and pay afterwards. The residents chose to divide and conquer with each grabbing several charts and digging in for the final push. After each team had finished their patients, they went to the duka on their own to pay for things which probably worked out better so we didn’t overwhelm the duka with all of our purchases at once.




Unfortunately, a young patient’s chart had somehow fallen out of the queue and even though everyone had finished their allotted charts with an early departure imminent, there was no way for us not to see this last patient as it would have been a hardship for to have had to return or come to FAME. Cara and Dr. Anne were incredibly good sports about it, though what was initially billed as a follow up epilepsy patient just needing a refill of her meds, instead turned into a rather social mess as it turned out that the young girl was doing well on her meds when her mother picked them up, but not so when her mother failed to get them. Initially, there was a concern that it was somehow a financial issue, but that was not the case as the medications were actually provided by the clinic since they lived in the catchment area meaning that it was really an issue of another matter in that her mother was just remiss at picking up her daughter’s refills and there was no clear reason this was happening. It wasn’t really a medical issue, but rather up to the social workers or the clinic to find out what the issue was and why her mother was getting to clinic for the refills.




In the end, we finished up early enough, but still later than we had wished and we started back towards Karatu, having another lovely drive by the same route home we had taken yesterday. After dropping Joel (our nurse/pharmacy tech) and Prosper, our volunteer coordinator who had accompanied us to the village to take photos, we left town driving directly to the African Galleria where our friend, Nish, was waiting to have dinner with us in his restaurant, Ol’ Mesara, which he opened just at the beginning of the pandemic (talk about bad luck with timing), but since then has turned into one of the premier dining spots in the Karatu area and well worth the drive to Manyara for dinner.


The dishes at Ol’ Mesara are mostly traditional and family recipes that he and his mother worked on. I will have to admit that the pumpkin soup and the cheese samosas are to die for, though the rest of the menu is also simply amazing. The short rib nyama choma (barbecue) and grilled chicken breasts are also pretty incredible. Everyone went shopping before dinner while Nish and I sat at the bar having drinks until everyone was ready to sit down and eat. The food was incredible, but equally so were the cocktails, with the Dawa (medicine) and the Rumbling Mountain being our two favorites.
Tomorrow we would be back at FAME for clinic for one day and then leaving for the Serengeti on Friday. The first group’s trip was now half over, but there was still lots to accomplish.