An Update From the Foundation for African Medicine & Education August 4th, 2011 • by Matt Holmes A few years back a group of Boundless Journeys guests on our Tanzania: Migration Safari shared a special experience. They engaged in volunteer work at the Foundation for African Medicine & Education (FAME). FAME was created to improve the quality of medical care in East Africa, and it endeavors to help bridge the gap between a critically under-resourced healthcare system and first-world medicine. FAME is currently focused on improving the quality and accessibility of medical care in Tanzania and making a difference in the day-to-day lives of the Tanzanian people. FAME has come quite far since Boundless Journeys guests first spent time there. The facilities they have created, and the scope of their work and the number of people they can now help is nothing short of miraculous. Here is an updated from their founders about some of their current projects that I would like to share: Greetings from Karatu, Tanzania. The last few months have been very exciting for FAME. Our patient load at the clinic is growing by leaps and bounds. Our new diagnostic facility is off to a fantastic start. We are taking our mobile medical services deeper and deeper into the bush, where children have never been vaccinated let alone had access to medical care when they get sick. We hope these stories capture the spirit of our work over the last few months. Thanks for sharing the journey with us. Outpatient Services at FAME Medical Since January of this year, 5,261 patients have been cared for at FAME Medical. While we have seen fewer cases of malaria this past quarter, we continue to see endless numbers of patients suffering from acute respiratory infections and waterborne diseases. We are also beginning to see more diabetes, even Type I. We suspect many children with juvenile diabetes simply die in rural Tanzania due to limited access and resources. Needless to say, we are thrilled to see these little patients finding their way to our clinic on the hill, where they can receive the care they deserve. We have also seen our fair share of burns, snake bites, injuries and wounds over the last few months. Dr. Duane Koenig, a long-term FAME volunteer, had an immeasurable impact on our community during his six-month stay, during which we could rarely persuade him to take a day off. As a family practice doctor and general surgeon, he treated hundreds of patients at FAME Medical and on mobile clinic, saving the arm of one Maasai woman and the foot of another along the way. Dr. Duane worked tirelessly, alongside our Tanzanian nurses, recognizing from the start what the lives of these women would be like in a Maasai boma without two good hands and two good feet. Every day for weeks on end he debrided and dressed their wounds and gave antibiotic treatment until their infections healed and they were able to return home to their families. Due to an outbreak of measles and whooping cough in the neighboring District of Ngorongoro, we’ve treated a number of Maasai patients suffering from these diseases as well. In fact, the District recently hosted a meeting for all clinicians where we learned that the National Vaccination Program for measles and polio will be rolled out in our District in October. Dr. Ken Karanja recently joined our clinical team as well and is helping us keep pace with our growing patient population. We have also hired Monica Koillah, a Maasai nurse, who is serving as a translator for the many Maasai women coming to FAME Medical who do not speak Kiswahili. FAME Mobile Medical With the help of Malaria No More Netherlands, Rift Valley Children’s Village, and Mwangaza, 0ur Mobile Medical Team continues to spend roughly 10 days a month in the field, bringing medical care to those who would otherwise go without. In our new locations of Endesh and Gidamilanda, we are seeing patients primarily from the DaToga and Hadzabe tribes. Neither village has electricity, so we continue to run our laboratory via our solar powered mobile bus. The village of Endesh has no running water, so we bring our own water supply when we provide services there. Our health education program continues to incorporate a local drama troupe and educational DVD’s to convey important health messages. Patients are visibly engaged in learning, particularly the children. One of our biggest challenges is the road, particularly during the rains. Many of the roads turn into rivers in the days after a heavy rain. You can imagine how completely isolated and cut off the people of this region feel when a child is sick or a loved one injured. Our advance team makes every effort to make the roads passable for our mobile clinic bus. The District Medical Officer continues to insure that we are supplied with malaria drugs, as well as a government nurse to carry out the Mother Child Health program for pregnant women and children under five in the area. We also continue to spend two days every other week at Rift Valley Children’s Village, providing medical care for the 70+ children there as well as people from the surrounding village. New Diagnostic Service The new diagnostic facility at FAME Medical opened its doors to the community in April of this year. The generous support of the Izumi Foundation made this possible. Dr. Joyce Cuff, a Professor of Microbiology and Parasitology, is nearing the end of a one-year volunteer stay with FAME. She has made an incalculable contribution for which we will be eternally grateful. Between helping with the layout of the new lab, mentoring and teaching our Lab Team, and spending countless hours working along side Yusufu, Julius, and Josephat, she has taken our diagnostic service to a whole new level for the people of Karatu and greater Arusha region. She will be sorely missed but has forever left her mark on FAME Medical and our team. FAME Volunteers FAME has taken great pleasure in already hosting 22 volunteers in 2011. Our volunteers represent a variety of specialties and backgrounds, including pediatric infectious disease, neurology, cardiology, pediatrics, general surgery, internal medicine and family medicine. The exchange of medical information between our Tanzanian doctors and American physicians this year has been vital to the growth of experience and knowledge for everyone involved. A father daughter team from Washington DC recently spent time at FAME, he a cardiologist, she a pediatrician. They worked in tandem on our monthly mobile clinic in the bush. Together, they walked away knowing that they would be returning to FAME to volunteer when they again had the time. Back in the US for only a day, Dr. Reed was already coming up with ways he could help from abroad. Reed and Rachel remind of us of how lucky we are to have such giving, loving volunteers. Additionally, a mother daughter duo, Janet Hamilton and Emily Boone from Maine, did massive amounts of data entry for our lab in June, helping us to analyze trends with our patient populations. As we enter the latter part of 2011 and look to the future, we will need general surgeons, family practitioners, internal medicine and ER docs, pediatricians and OB/GYN’s. A retired hospital administrator keen to rough it volunteering in Africa for an extended stay would bring a smile to our faces as well. TALES FROM THE BUSH by Katie Williams, MD Perhaps the most striking thing about working at FAME was the rhythm of the day. I woke up with the sun to the serenade of birds and other morning sounds. After a leisurely breakfast with my volunteer bungalow roommates, we walked around the hospital construction, through the red clay, to the clinic, arriving as the staff pulled in. Working side by side with Tanzanian providers, nurses, lab technicians and interpreters, I helped to take care of a range of patients with a multitude of problems in an efficient, cost-effective manner relying a great deal on clinical skills. It really did feel like the way medicine is meant to be practiced, unfettered by appointment schedules to follow, e-mails to return, insurance issues to deal with, prescriptions to refill. By the end of each clinic day, there was an unmistakable feeling of collective accomplishment, perhaps most profound during the busy days in the bush. Nights were short. After enjoying a prepared dinner, I crawled into bed, reading by flashlight so as not to use electricity, before falling asleep to the nighttime sounds of Africa. It is hard to come up with a single word to describe the experience. It covered a range of emotions from inspiring, beautiful, and amazing to sad, upsetting, and desperate. I feel this reflects Tanzania, and the contrasts its tribal and western cultures hold. Returning to California has been jarring. We are so spoiled with lives made busy by self-imposed schedules and possessions. We have lost the rhythm of the day, rising and retiring with the sun. It is my hope that I will be able to hold onto a piece of this experience each day, to simplify, and to focus on what is truly important. Learn more about FAME and the great work that they do at www.fameafrica.org.