The Rift Valley Children’s Village (RVCV) is an institution in the Karatu district and Northern Tanzania and is one of the main reasons that FAME is located where it is. After Frank and Susan came back to Tanzania with the intention of creating a health center, it was through Mama India’s, suggestions that FAME be located in a place of great need, close to her Children’s Village, and, even better, on the safari circuit so that any visitors to the area could be cared for by the center. Karatu fit the bill perfectly as it sits immediately adjacent to the Ngorongoro Conservation Area, the home of over 100,000 Maasai in great need of medical care and is only 45 minutes from the Children’s Village that India had founded near Oldeani that was also in need of medical care for its children and the residents of the nearby village. The fact that it was also on the “northern safari circuit” was very important not only to provide care to tourists traveling to the Serengeti, but also for exposure to many tourists who come to visit FAME and are interested in assisting with support. Many of the current volunteers, including myself, first visited FAME while on vacation just to see the facility.

India Howell had come to Tanzania originally with the tourist industry over twenty years ago, but quickly realized the incredible need for support of young children who were either homeless or were unable to be cared for by their families due to poverty. After taking in several children, it became apparent to her that creating a children’s village, rather than an orphanage, was what she would do, such that the children would have their own home rather than waiting for, or fearing, adoption. The Rift Valley Children’s Village has become a true home for these children, numbering greater than 100, all of whom have been adopted by India and her business partner, Peter. The children are raised and go to school either in the village or next door at the primary school, eventually going to secondary school in the nearby village of Oldeani, and then finally to college all over the country. Regardless of where they go, though, Rift Valley Children’s Village will be there home forever, and they can always return here during school breaks.

In addition to the Children’s Village, The Tanzanian Children’s Fund (TCF), which is the overseeing non-profit, also funds several other initiatives that are more than amazing. They have been working for several years with the women in the area creating microfinance opportunities and cooperative groups to empower women to generate income for their family through various crafts such as sewing and beadwork. They have also worked in cooperation with the local village in providing lunches for the schools to prevent children from having to walk long distances home at lunch with the risk of not returning for the afternoon session. More recently, they have also joined forces to help finance dorms at the secondary schools, initially for women to prevent predatory attacks while walking to and from school, but also now for boys. Lastly, the TCF has funded healthcare not only for the children residing in the Children’s Village, but also for the entire community as it was recognized very early that for India’s children to remain health, the community and the other children in school needed to be healthier as well. Today, we will be working in the new health center that was built by the TCF for this very reason. And Africanus, the clinical officer who had originally worked with our neuro clinic and then with FAME, now overseas all the healthcare for the broad swath of the community.

The route to RVCV is a gorgeous one that travels out of Karatu on the tarmac in the direction of the crater, but then leaves the hardtop in favor of the traditional dirt road that is interrupted frequently by large humps that are used to divert water from the road when there are intense downpours and to prevent the road from washing away. As you make the turn from a tarmac, there is a sign (somewhat blocked now from the high brush) that foretells what everyone is about to experience. “The African Massage Road” is a fairly accurate representation of the remainder of the trip to RVCV. What the road lacks in comfort, though, it makes up for in sheer beauty. Turtle is packed full of the neuro group plus Dr. Anne and one of our interpreters, all of whom tolerated the ride, though I must admit that it was eerily silent in the car for most the journey. What they didn’t know at the time, though, was that this drive was to be tremendously less bumpy than our return home.

Driving up to the RVCV, one would think they have arrived at Shangri-La, as that is pretty much what this place is to those who live here and those who visit. There is an immediate sense of wellness and safety as you drive through the gate and even more so getting out of your vehicle and walking through administration. The old health clinic occupied one hallway of the open administration building, but there is now a brand-new health center that is just outside the children’s village and on the grounds next door. The health center is one of the nicest we’ll work in and was designed to provide room for clinics such as ours as there are four offices for the residents to work in, another office for registration, and another to set up our pharmacy. In the back, there is a small room with a desk that Marissa and I can sit at while staffing the residents for their patients. It is the perfect clinical space for us.

Patients have come from the surrounding community of Oldeani and have been mostly triaged by Africanus, so there are few patients here with non-neurologic disorders, though, not surprisingly, a few patients with back pain and joint pain will always make it into clinic as it often very difficult to sort that out until you’re taking their history.  There were a number of children, which makes Marissa and Gina very happy, as well as Megan, who is planning to go into child neurology. As expected, headache and epilepsy make up most patients, though numbness and tingling seem to make up a close third. None of the patients are as sick as those we saw yesterday in Kambi ya Simba.

Before we know it, it’s lunchtime, which is one of the highlights of coming to RVCV. There is a large volunteer staff there and they are well taken care of in a much different fashion as at FAME where everyone, volunteers, and employees alike, eat lunch together and have the same menu. Here, volunteers eat meals that are as close to what we eat at home as possible – we had pizza, salad, and fruit salad today – all were equally delicious. I haven’t had salad in sometime, so that was a real treat. Most of our Tanzanian staff, other than Dr. Anne, have chosen to eat a more traditional African lunch that is served elsewhere. I remember the first time I visited with other volunteers and was somewhat uncomfortable with the Tanzanian staff eating elsewhere, but then came to realize that it was their choice and not in any way discriminatory as they preferred to eat food that was more familiar to them.

After lunch, it was time to continue working with our patients and making it through the charts that had been stacked in piles of pediatrics and adults. Though our residents, whether adult or pediatric neurology, are trained and willing to evaluate both children and adults during their residency, they are far more comfortable sticking within their specialties, and it is no different here. I will say, though, that dealing with hypoxic-ischemic neonates is not something any adult neurologist would feel comfortable with, and for this reason, I am so glad that we have had child neurology residents with every group since last fall, and hopefully, that will continue to be the case. When it comes to evaluating neonates or very young infants, they are invaluable.

We finished a little bit later than anticipated (which is often the case, so I don’t know why we don’t anticipate it more) and headed back in the direction of Karatu. There is a lovely road that I usually take going home as it is different than the one, we came in on and has fantastic views of the crater wall beyond near endless field of crops. I have taken this road countless times and have never had any difficulty on it, though today was not to be the same. Between the recent rains (prior to our arrival) and the fields having been recently plowed and, along with it, some of the road (basically two tire tracks), the driving was completely treacherous and not for the feint of heart. There were huge holes in the road, water diversion trenches that had been cut, and between the two tire tracks of a road, the grass was super high as there had been little traffic through there in some time. Meanwhile, the width of the trail, as far as the brush lining both sides, was much narrower than my vehicle for most of the drive adding to the excitement.

Then there was the steep descent into a deep valley and an ascent up the other side. I will often shift in low range for the descent, though didn’t need to do so this time, though on the other side, while ascending, it became a must as the road was heavily rutted and having to slow down for the bumps to avoid a mutiny by those sitting in the back seat, losing my momentum on the climb necessitated having it in low range for the climb. Even with that, I could feel the tires losing grip on several occasions, though, thankfully, Turtle performed marvelously, and we successfully made it up the hill. There were still some difficult rutted portions of the remaining drive, though the end was in sight as we could see vehicles zooming past on the tarmac. Once I reached the main road, there was a resounding round of applause by all the passengers, though little did they know that I was breathing a huge sigh of relief myself that we did not get stuck along the way as the other vehicle had taken the normal route home and we would have been entirely stranded.

We had rescheduled our visit with Teddy for tonight, so after arriving home, everyone cleaned up and we loaded back into Turtle again to head across town to her shop. Visiting Teddy has become a highlight of our trips to Tanzania as having clothing made from the wonderfully colorful cloth here is a real treat for nearly all the residents. Normally, I will take a chair and sit on Teddy’s porch with my computer, working on my blog, but tonight, the residents were incredibly efficient, and they were finished before I knew it.