The residents had prepared a talk on the neurological exam, both in the adult as well as in the child with Yoon Ji suppyling the latter information as parts of the examination can be very different in several obvious ways. Having a 6-month-old child follow directions can be a bit challenging, so much of their examination is done through direct observation. The talk was well received, and they were planning to do the second half of the talk on Thursday when we’ll be back at FAME. After the talk, it was time to regroup and get everything together for day two of our mobile clinics and head back to Mang’ola.
Having survived the previous day’s drive, it was now time for round two as we were heading back to Mang’ola and a town in the general vicinity of Barazani, though just a bit further from the lakeside. The road is the same for about 90% of the way, but you make a turn just before reaching the outskirts of Barazani and head over an awesome bridge that spans a bit of a canyon, then deposits you in the village of Mbuga Nyekundu and the local dispensary where we have seen patients for several years now. The area is all farming and livestock, similar to most in this region, but the dispensary has enlarged over the last years and now has an outpatient building with a lovely open courtyard in the center. Around the perimeter of the courtyard are numerous rooms sufficient to serve as exam rooms for us as long as we could come up with the necessary chairs and desks. Thankfully, I had supplied this clinic with furniture, similar to what I had done with Barazani in the past, and in short order, we were able to get four rooms running for the four residents each with their translator.
The dispensary here is larger than that at Barazani with more buildings, though some remain unfinished. Driving into the compound, the first thing that hits you is a large painted sign that states, “God hate corruption, join him.” There were numerous comments about wishing our current administration back home would take heed to such a message, but somehow, we all knew that was wishful thinking.
There were plenty of patients for the start of our clinic, though once again, Annie gave her triage talk to the patients, several of whom did have questions. I’m not sure any patients left this time which was perfectly fine as we were getting started at a reasonable time and had plenty of capacity. Once again, there were a number of follow up patients, many with epilepsy, while there were plenty of new patients to make things interesting. I’m not certain there were any spectacular diagnostic dilemmas, though there are always patients who we have a difficult time explaining their symptoms fully. Patients requiring labs would again have to go to FAME and there were several of those whom we asked to so during the day.
Lunch on the mobile clinics has always been the typical box lunches one is served while on safari, though ours have never been quite as fancy as those I’ve eaten in the Serengeti for reasons of cost. Buying 13-15 lunch boxes for each of our mobile clinics adds up and we certainly have to keep an eye on our budget all things considered. A year or so ago, I had requested lunches from one of the nice lodges with the hope that they would lower the price for the relationship with FAME – it worked out well for that time, but unfortunately it wasn’t an arrangement that wa sustainable. For a brief period of time, though, we were eating high on the hog, and I must say that it was pretty spectacular.
Meanwhile, back to our more mundane lunches that we bring with us these days – consisting of fried chicken, French fries (don’t get excited as they are pretty soggy by the time we’re eating them), a hard-boiled egg, a juice box, and an apple. Occasionally, there are fried plantains and/or a banana. As most of our patients and their families are already having a hard time putting food on their tables, we have always either eaten our lunches in the car or somewhere remote from the clinic so as not to eat in front of them as that would be somewhat insensitive. We have always practiced this way, so I’ve eaten the front seat of the Land Rover quite often which isn’t easy considering how close the steering wheel is and no room to set down my box. Today, there was a nice porch on one of the buildings that was in the shade and out of view from our clinic. Certainly not the comfort of a nice picnic table, but it served its purpose and it was nice to outside in the fresh air.
We were able to leave today’s clinic early enough to take the residents out to look for fabric to make some nice clothes out of the colorful cloth here. There’s a very nice fabric store on the one of the main shopping streets in town that we have gone to now for several years to by our kitenge and conga cloth. I really haven’t had anything made for a several years as I’ve always felt the cloth to be somewhat stiff and have never found it comfortable. I’ve managed to have things made for my home, such as napkins and placemats, or shoulder bags, though. The residents shopped for fabric with Dr. Annie keeping a close eye on them to make sure the prices were fair and all seemed to work out fine.
Afterwards, we all went to visit Teddy, who is the seamstress who has made all the clothing for my teams for at least the last five or six years. She does a wonderful job, and her work is very reasonably priced. She’s been a wonderful friend here and had even helped out working with one of my patients who had suffered a neonatal stroke and is hemiparetic. She didn’t have a trade and Teddy agreed to train her to make clothes with the sewing machine which was challenging given she only had the use of one arm. We bade Teddy good night and were on our way back up to FAME with a touch of daylight left. Tomorrow it would be a much closer clinic, Mang’ola Juu, though the road is far less well maintained and that could be a challenge given all the rain we’ve been having.