It had rained last night so we knew that the roads would be less dusty, though the African Massage Road still had its charm as we left the tarmac. These roads become quite miserable and nearly impassable in the heavy rains and more like a Slip ‘n Slide (reference to an old Wham-O toy that was sold when I was a child and is actually still available) – I’ve always made it there and back each and every time, though I will admit not without some tense moments at times. The Land Rovers are a perfect vehicle for the trip as they rarely become stuck in the mud with full-time all-wheel drive and a coil spring suspension as opposed the leaf spring suspension on the Land Cruiser. Driving up and down through the gulleys, it is essential to have the vehicle in the low gear range for the transfer case and to never, ever touch the brakes, which is almost guaranteed to have you sliding downhill very quickly. All that being said, though, the incredibly talented drivers who come and go from RVCV multiple times a day to transport people and other chores, do so in small, two-wheel drive vans multiple times a day and rarely have an issue.

We were greeted by the RVCV staff as we arrived in front of the administration building, and while walking to the clinic had to pass by the kitchen and dining building – I heard the offer, “have you had breakfast yet?” and, as expected, the entire team immediately detoured to see what was for breakfast. I knew that we had a ton of patients waiting for us, so continued on to the clinic while everyone else decided the enjoy the delicious French toast (I only knew it was delicious based on what I was told and the reputation of the chefs here) they were being offered. There were, in fact, quite a few patients sitting out in front of the clinic waiting to see us, though today all were on the porch under the roof as the sky continued to threaten precipitation. As the group had wanted to get a tour of the village and do some shopping in the duka (shop) there, I was getting a bit anxious as the entire team remained at breakfast a bit longer than I was comfortable with, though I suspect in reality they hadn’t been there very long, and soon arrived back ready to begin the day.

There were, of course, many patients as this clinic is very different from the other mobile clinics we provide in the district. Here, Africanus actively manages all the patients who come to see him from the Oldeani region and then refers them us for evaluation or continued care if needed. Many of these patients we have followed for years, some with epilepsy and others with development delay or static encephalopathy, and have come to see us every six months for medication refills or merely to follow up with us for recommendation of physical therapy and such

Once everyone split up into their respective teams, we began to see patients in earnest, and it wasn’t long before everything was humming like a well-oiled machine.  We moved through the patient list rather quickly, and by lunchtime, the bulk of the patients had been seen and there would be a far smaller number for us to get through in the afternoon. Lunch was again an incredibly delicious mix of Tanzanian and Western foods prepared by the cooks at RVCV and which was enjoyed by all. As I had mentioned previously, the lunches here are something that everyone looks forward to each trip and we have never been disappointed. After lunch, it was a visit to the duka for the group.

We were finished with clinic at a decent time, but there was still the tour of the village for everyone that had to be completed, as well as the visit to the RVCV duka, so I actually sent the other car with all the FAME staff on its way home since they wouldn’t be taking the tour nor buying anything in the shop, and there was no reason to delay them from getting back to Karatu on time if we could help it. All the clinical staff – our interpreters, Dr. Annie, the neuro team, and Dr. Ivone – took off with one of the RVCV volunteers to look at one of the houses and to hear the amazing story of Mama India’s village and the children who grow up here as a family, now numbering over 110.

We were due for a visit to Phillipo’s house for coffee as none of the current team had been there this trip and everyone was in dire need of this amazing coffee to bring home as gifts. I had found Phillipo’s home while on a walk only a few years ago, only to discover that my good friend Leonard had been buying his coffee there for years. It is now a mandatory stop for each group that come as it’s a way to see a small, family-owned coffee plantation and enjoy learning how coffee is processed to reach your kitchen. Phillipo’s father had originally grown maize on their five acres, though they were constantly fighting off the elephants in the area from ruining their fields of maize. At some point, Phillipo decided to switch to growing coffee as the animals don’t bother it and, as they say, the rest is history. He now grows and harvests coffee not only from his own 5 acres, but also one of his neighbor’s 5 acres and is also planning to acquire whatever land become available for sale in the community to enlarge his own acreage.

After the coffee beans have been harvested, they are put through the first process of removing the outer shell, after which they are put into a large cistern and fermented for several days. They are then dried after which they are pounded to remove the innermost shell and then they are ready for roasting. This is accomplished by placing 5 kg of beans into a canister that is then rotated manually for 45 minutes to produce a medium roast coffee. They start smoking after about thirty minutes, but you have to keep turning them constantly, so they don’t burn. When they’re finished roasting, the next step is to put them into a sifter (a screen fine enough for the beans not to fall through, but to allow the minimal remnants of the burnt shells to fall through) to remove any remaining debris, and to allow the beans to cool for about 15 minutes. At that point, they’re ready to bag or to grind and brew.

I’ve had plenty of photos of little Eliza, Phillipo’s 8-year-old daughter, who I’ve watched grow up and found it harder each year to put her on my shoulders (or perhaps it’s the combination of both of us getting older). We ended buying lots of coffee from them, all to bring home as gifts. Next to the Phillipo’s is the wood carver, Mbuga, and Athumani, the artist. I mentioned maybe stopping in for a short visit to shop, only to find that everyone was interested in spending lots of time there looking at their art and ebony carvings. We were in no rush, though, as it was just a matter of heading home for dinner, and that could happen at any time. Tomorrow would be Patrick’s last day, and he was leaving at around 10:00 am, so it was important that we get the up-to-date database from him as well as a primer on loading the data considering he had been doing it up until now.