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2007 Field Journal archiveAuthor - Jim It's now been a week since we returned from Africa. I believe that all the members of our group are convinced that the trip, besides being a ball, was successful in achieving its basic mission - to improve healthcare delivery in an impoverished region of Africa devastated by the HIV epidemic. Clearly the operations I witnessed and performed produced more good than harm. My disappointment was based on the compromises made on my ability to provide ideal surgical care because of limited equipment, supplies, and organization. Simple examples include my necessity to close an incision on a child with thick, inflammation-inducing suture material. While the wound will heal just fine, it will probably be somewhat unsightly as compared to a wound closed with ideal material. A similar concern was expressed by a Tanzanian obstetrician performing a c-section. He felt that his abdominal wall closure was at increased risk for development of a hernia because of the lack of appropriate suture. My low productivity was directly related to my failure to help organize a surgical clinic prior to our trip. In the future, patients with surgical needs should be identified ahead of time and then scheduled for operation. Breaches in asepsis were present, not because of ignorance or laziness of the OR staff,but because of inadequate provisions. The performance of operations was made more difficult and potentially dangerous because of the paucity of adequate surgical and anesthetic supplies. The ability to efficiently perform the many procedures indicated in the region was probably limited by supplies but also by the above mentioned organizational issue. By the second day, Vicki and I were able to improve the situation by simply digging into the supplies we all collected and transported from Pasadena. Our gowns and drapes, scrub brushes, prepping solutions, etc., improved asepsis. Scalpels with a sharp cutting edge, simple retractors, and suture material resulted in an operation virtually identical to one that I might perform at HH. While the physicians, surgeons, and hospital staff we met at Arusha were impressively well trained and competent, there are limited numbers of these professionals and gaps in coverage of specific specialties. Assisting and filling these gaps, at least temporarily, is achievable. That will require the recruitment of specialists and the assistance of our Arushan peers in assuring the appropriate patients and facilities be available for surgery when our Team is in town. This is a significant challenge. Good! A greater challenge has greater potential for greater reward. Jim B.
Author - Vicki We're now at the end of a memorable journey. It's been two weeks of new team and African friendships, medical and Safari experiences. The common denominator being we are all here for each other and we are better together. In Swahili "tutuzane" means "helping one another" and that we did. See you all very soon. All my love to my friends and family. Vicki
Author - tom Good morning everyone--today is our last day here and what an experience it has been. I got up early and took a walk around the grounds this morning since we will be sitting on a plane for a loooong time starting this evening. Oh it is so beautiful here and I will cherish the sites and sounds in my heart. See you on the other end,
Author - SusieL So what was the best part of the trip? Was it the people I traveled with? The new ones I met in a foreign land and befriended? Was it learning about a new culture? Seeing my profession practiced with less than basic supplies? Or was it the scenery, the animals or what? It was the PEOPLE!!! The ones who crossed half the World with me and the new ones I met. I would like to sign off with a beautiful epitaph that our most-capable driver and compatriot, Jackson, showed us upon leaving the Serengeti: "It is better to light a candle than to curse the darkness." Thank you Kim Shriner for your incredible drive and passion for introducing us to AFRICA. STL
Author - Asndy (Mama Simba) We returned last night from an amazing adventure! Our safari team consisted of Denny & Ann Kleeger & Tom Warren in one vehicle and Alison Hadziosmanovic, Phyllis Hollingsworth, Mihoko Nelson and me in the second vehicle. New friendships were formed and much laughter was shared with this special group. Our first night was spent in a tent camp at the top of the Norongoro area. We all agreed that this was the best meal we've had in Africa and it was elegantly served in a dining tent in the pouring rain with the cooking being done over wood fires! This was Masai country and we were privelged to be taken on a walk by two Masai men who also demonstrated their spear throwing technique. This was very interesting to Alison, a former javelin thrower! Their friendliness and hard work on our behalf was really humbling. There was thunder and lightning and pouring rain (and I thought I knew what rain was like having come from Oregon!) all night and for a short while I was dismayed thinking we would not be able to continue our Safari. But I had underestimated the fantastic Land Rovers and the experienced African drivers. The next day we really began to see the animals as we traveled to the Serengeti. We saw thousands of zebra and wildebeasts and at one point crossed a wildebeast migration. As far as the eye could see was a long line of these animals making their way to Lake Eses sp? for water. Some of the highlights of the day were two young male giraffes sparring, nine young male lions basking in the sun and a group of about 20 elephants including several babies. The next day we descended into the Norongoro crater where, among other wildlife, we saw 5 Black Rhinos including a baby! This was a real treat since there are only 20 of them there! What amazed me was the vast variety of beautiful birds in the area. Our driver, Mtili instantly knew all of them by name. Our last night was spent in the luxurious Kifuru lodge on a beautiful coffee plantation in the Norongoro highlands. The flowers were georgous! It had been unseasonable rainy so the roads at time were quite harrowing or actually non-existent but our driver got us safely home despite performing some flashy 360s in the mud. He earned the nickname "Cookie Monster" from us for his spinning cookies! We never got stuck for which we were thankful. We had far less trouble than our other two teams. All together we must have seen over fifty species of birds and animals! This has truly been a trip of a lifetime. Sandy (Mama Simba)
Author - David Schulman Images of Safari: Parked in a cool, shaded grove of trees and tall grass, surrounded by a herd of elephants, the only sound, that of the herd pulling up the grass and rustling through the undergrowth. The excitement of our first animal sighting, a lone Impala running in the distance. Encountering hundreds more Impala next to the road and laughing at ourselves for all of the long distance photos we initially shot. Rounding a corner to discover a group of 26 girrafe feeding in the forest of accacia trees on a nearby hill. Two lions lazily resting in the grass 6 feet from our Land Roover, seemingly unconcerned by our intrusion. The indescribeable vastness of the Sarengeti plain stretching to the horizon, its flatness interrupted only by the innumerable herds of Zebra and Wildebeast. Our group of eight walking in silence through the meadow toward our campsight as the mist and dusk settle on us. Awakening the next morning to discover a view from our mountain top camp of lush valleys and rolling hills, the sun rising above them. The sounds at night - beatles flying into the tent wall, frogs crooking in our tent, a hyena brusing against the tarp and "laughing", and a million crickets lulling us to sleep. If one does not believe in a higher power, he need only come to the national parks of northern Tanzania, and he will question his assumption.
Author - tom Hello Everyone, For the past few days we've been on safari and I'm sure you've read the other journal entries and had described for you what an awesome experience it has been for each and every one of us. Today is our last lecture at Mount Meru this morning and some of us will be going on some home visits...I'll join the latter and am looking forward to it. See you all Stateside...hope all is well with each and every one of you!!
Author - Mama Fisi Group 2 safari members: car 1 with Lesikar (the old folks car): Dr. Shriner, Jody Casserly, Mickey Singer, Sally Eastman, Cheryl Arteaga. car 2 with Pasqual (the fun car): Dr. Wafaa Alrashid, Dr. Christa Chandy, Cheryl Prigodich (aka Mama Fisi), Gyonyver Sovago (aka Mama Picture), Susie Icaza Ok. First things first. Safari was amazing. If you haven't gone, you should, because my words cannot begin to describe. Second... not only was it a Safari, but it was an adventure. We began Monday morning with a long and arduous trip to Lesikar's (our driver) Masai Village in Ngorongoro Crater. I say long and arduous because it took us 3 hours longer than expected...but once we were there, I decided that it was worth the wait. We visited with his family and took tons of pictures, but the best was giving the children in the village M&M's...(note: in Tanzania, M&M's melt ON YOUR FACE not "in your mouth"). After that Group 2 made the long trek (about 6 more hours) out through the Serengeti to Ndutu camp where we lodged for the night. Along the way we had an amazing time with sightings that include (but by no means limited to): wildebeast, zebra, giraffe's, hyenas (aka Fisi in Swahili... which by the way, my nickname has become Mama Fisi...explanation later), Maribu storks, vultures, warthogs, etc. We get to camp, and wouldn't you know it but it starts to POUR. POUR POUR POUR like you couldn't have imagined... now with the heavy rains that have already insued in the area, we were not too optimistic for the next days safari. but anway, they fed us well and we had a great time at the camp despite the fact that the lightning was soooo bright that it woke me up through my eyelids. So the next morning, just as Wafaa the meterologist predicted, the rain cleared up by 815am and we were off on what would become the craziest adventure we could imagine. It all started when we came up upon a pack of Fisi (hyenas) feeding on a Zebra that a lionness had killed. Now, being that i LOVE Fisi (i blame whoopi goldberg from the lion king) we had to stop and take a bunch of pictures. All was great...but the fisi were kind of far from the road and unlike my old, rich safari compatriots, i can't afford a great big lens for my camera...so needless to say, i was not satisfied with my pictures. So a few yards down the road, i spy a lone fisi next to the road. "SIMAMA!" i yell to pasqual our driver ("stop" for all of you english speakers) "I need a picture of this fisi!" Pasqual obliged and i took my pictures... and then we tried to move... and we tried to move... and the wheels were spinning and the mud was splattering and WE WERE STUCK... our back tire was COMPLETELY sunken in the mud... and all because i needed a picture of THAT FISI! so...an hour later and with the help of a canadian safari group with their chains and jack's, and me with my new nickname, Mama Fisi, we were on our way. But not for long. After a few lion and cheetah sightings, the rain started again...and before you knew it, we were stuck again. But this time Lesika (the driver of Group 2's second vehicle) was able to simply (not really) push us out with his land rover. Ok. so, by this point it's time to start heading back to Ngorongoro crater where we were to spend the night. We're driving along, about to leave the Serengeti, when FLASH FLOOD! we can't get past the newly created river. So we're stuck in a line of about 40 or so other safari cars waiting for the water to go down so we can cross. Well... our drivers are way too smart to wait, so we drive on down to a different part of the "river" where they think we can cross... but when we get there, it doesnt look all that promising... the white water is flowing, and FAST. so we stand outside and contemplate what to do. Then, as luck would have it, we watch a few daring souls cross the river successfully in their rovers... great, we can do it! eh..not so fast. just as we're loading up to head across, one car gets stuck and the engine stalls... boo... luckily the Masai were there to make a human chain, tie the stalled car up to another rover on land with a chain and pull it out... but now what do we do? well... Lesikar thinks we can make it. Ok..we all know how to swim...let's try. So i willingly jump on in the rover and my younger safari-mates happily jump along in beside me for an adventure. We crossed successully... but not without a good scare...the water was up past window level and we got stuck on a few rocks for a few seconds...but no worries... So Lesikar drops us off on that side of the river and heads back across to make a second trip for the second half of the group (wait... didn't we have 2 cars, you ask??? yes, but one was without "snorkle" so we couldn't safely make it across without the threat of stalling). So, he goes back for the second group and again, makes it safely across. So now there are 10 of us, 2 drivers, and one car on one side of the river and another car all by itself on the other. What to do? So all 10 of us load up...and by load i mean SMOOSH...into one car with Pasqual driving, and we head on to the lodge, leaving Lesikar behind to figure out how to get the car. But the adventure doesn't stop there. We get to the crater entrance at 1930 hours... too bad the park closes and the gates lock at 1800... so we're stuck at a locked gate with no one in sight. wonderful...now the 10 of us will spend the night smooshed into one landrover. not to worry! pasqual finds a gatekeeper and convinces him to let us through (amazingly, no bribe involved). Homefree... not. 2 hours of being smooshed together and we finally pull onto the road to the lodge... too bad it's soooo mudly that the car is slipping and sliding everywhere and can't make it up. great. the lodge is 10km away...and it's 9 o'clock... what to do??? so we call Lyn back home and get the number for the lodoge...we call on up... good, they'll send a car that can actually make it down for us (note: people who pop out of bushes in the middle of the night in Tanzania are actually helpful.... ask if you want details). So, after 2 trips up the road to the lodge (scariest car ride of my life, by the way...and i think i speak for everyone when i say that) everyone is safe... but by now it's 10pm and we haven't had dinner...and you all know how Jody can get when she hasn't eaten... but surprisingly we're all still in good spirits and can't help but laugh at our adventurous day. So what happened to Leskiar you ask? well, we didn't find out until the next morning, but turns out he was able to get somoene to give him a ride back across the river, which he was finally able to cross at about 10pm... but at this point it's too late to drive to the lodge, so he stayed the night at the local Masai village (how fortunate he is Masai and speaks the language) and then he drove to the lodge the next morning. Well... I've already written a book... so, i'll make the rest short. The next 2 days were amazing and not nearly as adventurous (thank the lord). The crater was absolutely gorgeous and we were lucky enough to see some rhino's. we spent the next night at a beautiful lodge in Tarangerie park and then today we finished up our safari adventure driving around Tarangerie and getting charged by elephants (not nearly as scary as it sounds, unless you ask Wafaa). And i'll leave you all with these final words: For all of you who have been on safari, you understand what i'm talking about...
Author - Mihoko Nelsen, MD - AKA. Dr. Matsushita 2-11-07, Sunday 10 PM Finally it is my turn to do the journal entry. Christa has already introduced the subject, the medicine man, Dr. Maretu, presumably a 60 year old Masai man with one eye. The left eye has been injured. We never found out what happened to his left eye as we thought this question was not appropriate. I checked this with our interpreter, Livingston, a Masai himself. He advised me not to bring this question up. It is simply too rude. Dr. Maretu was a farmer before becaming a doctor at age 40. He apparently became spiritually advanced enough to become a doctor/healer by that age. He stated that he heals his patients from his heart. There were many small children around him. He stated that he is training these children to become future doctors and healers but only a few will make it. Being a doctor/healer is not for everyone. Dr. Maretu gathers herbs from many diffent places, from hill tops, valleys and near the streams. Apparently they have different healing properties. Herbs were partially dried and had a very "green" odor. A hand full was wrapped in flat leaves and tied with thin strip of dry banana leaf. Patients are to boil the herbs in water, make tea and drink it. This tea is good for a number of ailments, such as asthma, stomach aches, headaches, etc. He also had a jar of yellow powder which is made of ground roots of plants and trees. We just about fell off the benches and stools when he offered a pinch of it to Dr. David Schulman to taste. David was gracious and couragous enough to taste it. We were all holding our breaths expecting him to keel over and fall off the bench, so we were all greatly relieved when he said it tasted like cinnamon and kept on smiling. Dr. Maretu is a Christian, a Lutheran. This was a big surprise to me to find a Masai doctor/healer to be a Christian but it is apparently quite common. When he was asked what might be the secrets for a long life,(as despite the average life excectancies of 50 years for men and 53 years for women, there are many 80's and 90 plus years old Tanzanians around), he said to use little sugar, little salt, limit alcohol, and use NO tobacco. He did not have an answer for my question - what causes DIS-EASE. Do illneses come from outside or inside? What triggers the very first changes in - genes, DNA, protein, cell, tissue, organs - ultimately manifesting as diseases and illnesses. He seemed to care a lot about his patients. He is available 24/7. Patients were lined up outside his office to see him. He also appeared to be the village elder - people came to him for advices and arrurance as well. He looked like a gentle old man with a kind right eye. We left after an hour's visit. He had a sweater, a jacket and a baseball cap. His consulation room was small and crowded. We all sat on low wooden benches or low wooden stools. There was very little air circulation. I was persiring like I were in a steam bath. He did not even have a bead of sweat on his forehead. He seemed completely comfortable in his environment. Is that being COOL for what?! I just discovered that there is no SPELL CHECK, so please excuse me for typo's. Mihoko Nelsen
Author - Alison B. Hadziosmanovic Sunday night brings us to the end of our first week here in Arusha. I'm sure you have all enjoyed reading everyone's entries and are up to date with all of our activities throughout the week. My second trip to Tanzania has brought new adventures and experiences. It has been good to see the friends I made here 3 years ago. What is the same are the smiles that the people always have for us. We were also privileged to work in St Elizabeth's HIV clinic with Dr Palapala. I met a 5 year old girl named Masha, who is HIV+ and also has TB. She is so smart that she could sing and dance and counted to 20 in English! We also saw Oscar, who was HIV+ and was brian damaged by meningitis. He is in need of a medicine that his family cannot afford. We hope to send the medicine back to Oscar so that it would improve his quality of life with his family. Many patients are in need of our care, attention, medicine, knowledge and love. I look forward to coming back to Arusha to continue to provide the care that Masha, Oscar, and others in Arusha and Tanzania they so desperately need. Alison
Author - christa Today the physicians with the exception of Dr. Shriner (John Cho, David Schulman, Bill Blitz, Mihoko Nelsen, Wafaa Alrashid and I) decided to visit the local shaman to compare notes on how we treat people. We drove up to a tinroofed hut made from cow dung where there were several people milling around, one old lady who appeared quite drunk at 11:00 in the morning. Children in rags posed for us like movie stars and squealed with delight at the images on our digital cameras. We crowded in to the hot airless hut with the shaman, wearing a wool sweater, blazer, and baseball hat,as well as several patients, and children. The shaman sat down at a table with some green herb mixture and some white powder and proceeded to answer our questions with great wisdom and humor but I will let Dr. Nelsen tell you all about that.
Author - Jody Casserly, LCSW The social workers, I think, have a very unique experience as part of this medical team. We don't dispense medications...we can't read an x-ray...we all got a little queasy listening to Dr. Schulman's lecture on gastric bleeding at Mount Meru hospital...but Ann Kleeger, Susie Icaza and I have been hard at work practicing our own skills this week. As she mentioned, Ann met with her HIV+ group on Monday morning. For the fourth year in a row, the men and women of the Living Positive group were waiting for her at 8am waiting to share their experiences of the year -- who has been sick, who has started on antiretroviral therapy (ARV), and who has died. During his visit to California in October, I had the opportunity to work with Dr. Solomon on writing a proposal to fund a Home Based Care program to be operated out of Upone Charitable Medical Centre. This was actually an idea first put forth by one of my students in the MSW program at California State University, Long Beach -- Scotty Enyart, who decided his thesis project would be a proposal to fund this HBC program. HBC involves training of volunteer community health workers -- many of whom are HIV+ themselves -- to conduct home visits to families infected with and affected by HIV/AIDS to provide basic medications and supplies, psychosocial and spiritual support, linkages to resources and Voluntary Counseling and Testing (VCT) centers, and to those hospitals providing ARVs. We were able to put together a comprehensive proposal, and Dr. Shriner decided that it would be worthwhile to provide funding for this project. This week has been my chance to experience first hand the wonderful work of the HBC volunteers in the Elerai and Sombetini Wards of Arusha. Susie Icaza and I spent Tuesday in Elerai with four of the HBC volunteers conducting home visits. With several stops along the way at the small village markets to purchase tea and sugar (it is the custom to arrive with something for each family), we walked for about five hours visting 10 families -- the first four hours in the blazing sun, the last hour in a torrential downpour. On Thursday, the HBC supervisor for the Upone program, Gladness Jacob, accompanied Dr. AlRashid, Luisa Schulman, Cheryl Prigodich and me to the Sombetini ward where we visited 5-8 families (we all counted a different number -- delerious from the heat, I guess). Because these homes were more spread out than in Elerai, we were forced at one point to board a Dala Dala (see my entry from last year) -- sort of the public "bus" system of Arusha. These vehicles are about the size of a minivan in the U.S., and Cheryl P. counted 21 passengers in our vehicle. For this social worker who suffers from claustrophobia, I was needing a bit of psychotherapy and Ativan after this trip! I have had the incredible opportunity to experience the people of Arusha over the past four years I have been a part of this project. Seeing the "city" of Arusha on foot this week has been amazing, and quite different from the view from the Landrover I have seen on my way back and forth to the clinic. You may remember my camera project, Through African Eyes (see photo gallery). Walking from house to house in Arusha has been like stepping in the these photos. Through African Eyes continues this year with the wonderful support of the fifth graders at Holy Family School in South Pasadena. On Friday we visited the orphanage and once again the children put on an amazing show for the team. I had the opportunity to share the photos and stories set with me by the Holy Family kids, and to give the orphanage kids their photo "assignment" for this year. During this week, both these kids and the Holy Family kids will be taking photographs of scenes that represent Love/Upendo, Hope/Tumaini, and Faith/Imani. At the end of the week I'll share more detailed stories from the home visits, which have been amazing.
Author - Mickey Well, at the risk of repeating everyone else...what an amazing week its been. As I remembered from the 2005 trip, Tanzania and Arusha are a very surreal study in contrasts...poverty and wealth, natural beauty and industrial grit. Like the clothesline drying bedsheets between low, dingy stucco buildings at Mount Meru Hospital literally in the shadow of a gleaming, glass-and-steel high-rise hotel being built. Then there was the visit Ezekial's house. I'm sure others have already written about it, so I'll just say that it was a great sight to see the look of surprise on his mother's face when she realized that the Land Rover of nzungus rolling by had her son in it! He was so proud to take us to his family's house and introduce us to his grandmother. Then, to top it all off, today Sally was able to present him with a laptop that her company donated to the project! Now he can keep up with the rest of the med students. Tomorrow we're off on safari. With all the rain they've had in December and January everything is extra green and lush, so we're hoping to see lots of animals. Unfortunately, that also means our time is winding down, so we'll try to squeeze every last drop out of the next few days. See you all soon,
Author - Susie Icaza Today marks one week in Tanzania. The overall experience can most acurately be described as "hands on" and I am certain that each team member's perception of the world has been altered in some significant way. I have had the remarkable opportunity to:
The many Tanzanian women, men and children I have met have touched my mind, my heart and my soul both personally and professionally in so many sparkling moments. I hope that in some way I too have had the ability to touch lives and make a difference.
Author - Gyongyver Sovago I am the eye behind the camera. I have a chance to see many of the remarkable details concerning our work in Tanzania. The reality coming through the lens is incredible as are the emotions engulfing us each day. For me, the most extraordinary thing is to see how much of last year's work came to be a reality this year. All the meetings, all the hospital visits, all the encounters with different medical personnel, city and goverment officials laid the path to our instrumental presence here this year. The doctors worked with patients who waited for hours to be seen, surgeons operating, social workers going out on home visits, carpenters building tables and chairs for the orphans....everything happened this year the way it could have only been imagined last year! On the first day I had the chance to walk through the different wards with Dr,. James Blitz and the Tanzanian doctors. During the week, I was in the operating room filming Jim and Vicky in action. Having the opportunity to film the surgeon perform the first incision was a landmark moment for me. And,I didn't faint. It was great to watch Jim and Vicky working in tandem while the Tanzanian doctors and nurses were glued to the scene. When the time came to be in a small operating room filming Dr. David Shulman doing his first endoscopy and teaching the doctors how to use it, I felt quite at home. Because of the limited resources, David and Jim had to improvise on the spot in order to be able to operate and perform the endoscopy. The Tanzanian team was very eager to listen to David and learn the nuts and bolts of endoscopic procedure. Suzie's presence in the recovery room not only made the patients post-operative moments more bearable but mine too. She took care of all the details before going into an operating room, during the procedure and after. A filmmaker's life is colorful because there a chance to be in many different places looking at many fascintating things. I have a chance to film all the team members in action sharing their craft and knowledge with the people here. As I panned my camera in the operating room, or examination room,or the play room or the lecture halls, I could see a colorful group of people, Americans and Tanzanians weaving their efforts toward one common goal: to fight HIV/AIDS and make each day more bearable for the ones living with the disease.
Author - Luisa Schulman 02/09/07:Jambo from Tanzinia The Tanzanians are warm, friendly people. We started our day with lectures at Mt. Meru hospital and proceeded to Upone clinic to see patients. We had 4 MDs and 5 RNs. In 2 hours we managed to see over 50 patients!!!Dr. Anvekar, you would have been very proud of me. We worked as a team; the Americans and the Tanzanians. It was an amazing feat!!!We ended our day visiting the orphanage (around 300 children all together). They welcomed us with their songs of prayers and dance and embracing smiles. Warmth, peace and hope all transpired as we interacted with the children.These moments will never be forgotten in our hearts an dwe thank these kind people and pray that with hope and faith, they will continue to endure with harmony. 02/10/07: Today we commenced at Moivaro Lodge with an HIV symposium put together by our team of physicians. Dr. Blitz presented on hernias; Dr. Schulman on GI manifestations of HIV; Dr. Nelson on migraines; Dr. Alrashid on HIV and Malaria manifestations; and Dr. Chandy on peripheral neuropathy and HIV. We invited our friends, the Tanzanians from Mt. Meru hospital, St. Elizabeth Hospital, and Upone clinics as well as others. What transpired was an exchange of ideas, education and again warmth. Our interactions were one of professionalism and comradie. We have learned so much from the Tanzanians that we say Asante Sana (thank you very much)for this unforgetable experience. Kwaheri and asante,
Author - tom Hello Everyone--today was our symposium and it went very well. I think we were just shy of 50 participants and all the Doctors presenting did a great job..it was nice to see the local people arrive in native dress and in such bright colors. I think it was enjoyed by one and all. Missing you Lyn, Raffee and Rhonda
Author - Cheryl Arteaga What a great day it was. We started out at Mt. Meru Hospital, where Sally and I went to the microbiology lab to work on our cultures. We are doing a research project to see if MRSA (methicillin-resistant Staphylococcus aureus) is present in the Tanzanian population. The research is going very well. Next was a lecture on epilepsy given by Dr. Nelson, a neurologist in our group. From there, we went to an orphanage, where some of the group worked with the children, and Mickey (a master furniture maker), Denny, and I built a table and chair for the orphanage. The children sang and danced for us, and it was wonderful to spend time with them. The highlight of the day was with Ezekiel Noah, who is a 26-year-old Tanzanian that our group is sending to medical school here in Tanzania. Ezekiel is a wonderful, caring young man who wants very much to be a doctor and help his people here. As a surprise, the Phil Simon Clinic project flew Eziekel from Dar es Salaam to Arusha. It was his first airplane ride, and he had great stories to tell about it. Ezekiel spent the day with us, and later we drove him to his home, where he surprised his mother, grandmother, and family, who did not know he was coming. What a great experience it was to see their surprise and happiness to see him, and their happiness to meet Dr. Shriner and others in our group who are sending Ezekiel to school. Ezekiel was very happy to have us to his home and meet his family. It was a very emotional experience. We are so busy here. Every day is filled from morning til night. We have a great team, and I feel lucky to be part of it. This is my third year on the team, and my second trip to Tanzania, and I hope to continue.
Author - PHYLLIS JAMBO EVERYONE, WELL TODAY WAS A TEAR JERKER FOR ME. WENT WITH DR. NELSON AFTER HER WONDERFUL LECTURE ON SEIZURES TO SEE 2 PATEINTS WITH PARALYSIS. ONE WAS A QUAD, THE OTHER A NEW PARA. THERE WERE AT LEAST 10 BEDS TO A LARGE ROOM. I ASKED DR. MEKULE WHERE THE CRASH CART WAS. SORRY, I FORGOT WERE I WAS! THEN ASKED ABOUT THE MEDICATION CABINET. THERE WAS ONE. WELL, DR NELSON GAVE GOOD ADVICE TO THE DRS THERE ON HOW TO ASSIST THESE PATIENTS AND GET THEM THE CARE THAT THEY NEED. I FEEL SO BLESSED TO HAVE WITNESSED THESE CONSULTATIONS IN AFRICA. THEN WENT TO UPONE CLINIC TO ASSIST THERE, THEN WENT TO THE ORPHANAGE TO HEAR A WONDERFUL CONCERT FROM THE CHILDREN, THE LIKES I HAVE ONLY SEEN ON PBS. IT WAS OVERWHELMING TO TAKE IT ALL IN. I WILL REMEBER IT ALWAYS.
Author - tom Jambo, After that we headed off to Upone clinic and there were 52 patients waiting to see us!!!! We ended up setting up 3 triage rooms, and had 5 doctors seeing patients and we cranked them out in 2 1/2 hours--can you beleive that...it was such awesome teamwork and felt so good. After that we headed out to the orphange where we were serended by the children and we passed out gifts to them..toothpate, brushes and some art supplies....they in turn gave us some paintings that were increidible. I will let other team members give more info and be off to dinner.
Author - Wafaa Today was a great day for me! Jodi, Cheryl(P), Luisa, and myself all went to five different homes here in Arusha, Tanzania. Lesika, was our guide today, and what a sensitive, kind person he is! On a lighter note, Christa and I became quite acquainted with some of the creatures here in Moivaro lodge. On our second night here, not only was there a geco in our room, but Christa practically showered with a slug, and I practically slept with a frog! Needless to say, Denny and Anne next door, heard us half laughing and half screaming at night. Good times!
Author - Sally Eastman Yet another amazing day. Tanzania is a country of contrasts. Extreme poverty with extreme beauty. Emotions range from being hopeful that this incredible team can make a difference to feeling overwhelmed with how much is needed and how can we possibly make a dent. Then you work with the people at the clinic and hospital and realize that even a small effort does help. Yesterday, I spend several hours with one of the Mount Meru Hospital doctors taking samples during the HIV clinic. We saw some really sick people but most had the anti retrovirals and were doing OK. That was heartening. The Lab at the hospital looks great due to the help of Abbott Labs. Today Cherly and I spend the morning processing samples in the lab then Sandi and I spend the afternoon in the Orphanage with the kids. We had a great time learning Swahili 101. Friday we'll spend more time in the clinic and then off to a party at the orphange doing art and listening to music. Should be a great day!
Author - Cheryl The trip so far has been absolutely amazing!!! I am so impressed with the ingenuity of both the team members and the Africans. Here, it's important to be adaptable, and everyone seems to be doing such a wonderful job. Today I had the privilege of joining one of the women from the women's group at Upone (along with Wafaa, Luisa, and Jody) on some home visits. Words can't describe the experience. Seeing patients at the clinic is one thing, but being in their homes, seeing where and how they live and joining them for some conversation really opens your eyes to life behind the simple formalities that we experience at the clinics. These women that we visited lead such hard, yet rewarding lives, and it truly was a pleasure to take part. Along the way we met this one boy, who was inevitably, mocking American tourists but getting on the ground and pretending to take picture with his camera made of clay... so of course we fit the mold and ended up taking pictures of him. :) Tomorrow we head off to visit some of the children in the orphanage and i hope for it to be just as great of day as today.
Author - tom Wow is insufficient to say how well this day went. Started w/ morning rounds at Mount Meru hospital and then the team divided in several directions. I went w/ Dr. Shriner, Chandy and Alison to St. Elizabeth's hospital to the HIV clinic and we had an awesome experience while we saw patients with their clinical officer. We admitted 3 patients to the hospital, started 4 patients on anti-retroviral meds and saw age range from 13 months to 62 years---it was so awesome. Must be off to dinner but wanted to say hello to one and all back home
Author - Ann This is a late journal note for Monday February 5, 2007. The living positive group met this day deciding to give them a new name, Maisha Fourteen members showed up Monday, most from the original group plus a few more new people. Two people of the thirty have died since last year. They discussed the differences between last year and this year as “home based care, following the doctor’s advice, less people going to hospital and feeling freer to talk and be counseled. What is giving people hope is education knowing they can survive and that others can learn from each other, sharing. They focused on what it has meant to them to be a member of the group. All shared. There are still many problems, social and economic, concerns about the ability to pay meager rent costs and take care of their children alone. There is much they need.
Author - phyllis Well another wonderful day in Arusha, Tanzania. Today at 0800 we attended a session on GI Bleeding given by our Dr. David. It was attended by the Doctors, residents, and nurses of Mt Meru. It was a full house. It was quite informative for both sides. Then I and Dr Chandry went with Dr. Mekule to his Hiv clinic and saw 2 patients in 2 or so hrs. He is quite informative and thorough. He loves to teach. We learned his clinical thinking process as he examines his complicated patients. Since they cannot order Ct Scans,MRI's, 2D ECHOS ,CXR, and Venous Duplex all on the same day or at all,,,he uses strong assessment skills, history and extensive physical exam to determine the problem. If that fails,he will order labs,cxr, and maybe ultrasound which is available to them. Alot of paperwork for each patient, including the use of carbon paper.!
Author - Jim This is a great place to wake up in. Perfect temperature, crystal clear weather in a spectacular setting. Breakfast is with a great group of people. And then it's off to the hospitals and clinics where we experience the challenge of treating severe, and often exotic disease with minimal resources. The thrill is that at times we can make a difference. Just today we were able to raid the supplies we brought and find a foley catheter drainage bag. This was presented to an unfortunate 17 year old whose needed catheter was draining onto her sheets simply because of the shortage (abscence) of cath bags. We began today listening to a great presentation on GI bleeding from David. Because of the talent of David and other gastroeneterologists we surgeons are only rarely called upon to salvage these patients. Fortunately they haven't yet figured out how to steal appendectomies from us and I was able to perform one this morning. We even used the gloves, gowns, drapes, instruments and suture donated by HMH and HOSC. All in all, a good day now being punctuated by a BBQ dinner. Tomorrow we do it again which will be fun.
Author - David Schulman Jambo from Tanzania. Today (Wed.) was another remarkable day in Arusha. Dr. Mukule was able to coerce many of the physicians and nurses from Mt. Meru hospital to join us for a morning lecture at 8AM (I think he even made his family come so it would be well attended) and then we were of to our respective clinics. A group returned to Upone to see a large volume of patients, others attended the HIV clinic at Mt. Meru and I am told that Mickey completed the 2007 shelving project. For me, it was personally a very moving and extraordinary day; with much improvisation and creativity, we were able to do the first three endoscopies at Mt. Merus hospital. Dr. Shriner had told us that each of us would have a moment when we would be brought to tears during our stay here. For me (although I am sure it will not be the last time for tears) it was as I was about to start our first endoscopy. A flood of emotions overcame me - both the joy that this part of the 2007 project had come to fruition and the profound sorrow that I felt for my patient. Seeing the condition of so many of the patients on the medical ward and thinking about what their future holds is very difficult. And the impact of it overwhelmed me as I was about to start the procedure on someone who I know will be dead soon because he is in Tanzania and not in the U.S. If the camera had not been filming or the patient looking to me for reassurance, I would have burst into tears. My hope is that with time, and with some of the help The Phil Simon Clinic Tanzania project is bringing, the health care future for these extraordinary Tanzanians, will continue to improve.
Author - Tom Jambo again,
Author - PhYLLIS JAMBO EVERYONE, MONDAY MORNING WE WERE UP BRIGHT AND EARLY. WENT TO THE CLINIC,ARRANGED OUR SUPPLIES AND MEDS AND SAW 20 PATIENTS. TUESDAY MORNING WE HAD THE PLEASURE OF ATTENDING MOUNT MARU REGIONAL HOSPITAL
Author - Sandy Wow! I can't believe I'm really here! Thank you Kim & the Phil Simon Clinic for giving me the opportunity to fulfill a life long dream. I am awed by the incredible beauty of Africa,dismayed by the incredible poverty and enriched by the incredible friendliness of the people. This was brought home in a most amusing way today at Mount Meru. We were being greeted by a retired African pediatrician. He was moving down the line shaking all of our hands and when he arrived at me he threw his arms around me and said, "I'll take this one!" This got a good laugh from the group. I have helped with coordinating the different teams and I have been the laison between our group and Moivaro lodge where we are staying. I have also helped the patient flow at the Upone Clinic and am so grateful to be given meaningful work to do here. The most gratifying aspect is being able to share this trip with my daughter, Alison, and watch her in her element. Asante!
Author - Jon Jambo! It was our first full day of work. We just had our debriefing for the day over cold beers. Dr. Blitz recounted his experience in the operating room and wondered if he was doing more harm than good due to the lack of proper equipment and general disregard for aseptic technique. The physicians and nurses attended morning report and worked in clinics. Wafaa and Christa started on their research projects. Home visits were made and shelves were built although the power tools did not work which slowed things down. I am not sure how much we help and when I look at the overall conditions, it's overwhelming. We may not be making big changes but I do believe that we are helping. I think the people really do appreciate our presence.
Author - Tom Jambo everyone in the States. We arrived last night after our 30 hour ordeal....all intact and tired to be sure. As the plane doors opened, we saw a full orange moon and smelled the wood fires we have come to know as Africa. Getting through Customs was not as easy as some times that we've come, but we made it. After unloading all our bags and some personal belongings in our room....most got a quick shower and hit the sack. We awoke to a beautiful day full of sun and several team members went on a walk around the perimeter of the grounds to start the day before breakfast. Then we were off to the Municipal council to be gretted by Dr. Solomon Ole and then the group split in two..some going to Upone Medical clinic and some to Mount Meru hospital. I was at the clinic...Alison and myself triaged patients and Dr.'s Chandy, Cho, Alrashad and Shriner saw them. Chief complaint of the day..chesty pain which is not uncommon here due to cooking indoors without proper ventilation. We also saw several HIV patients, some already on medications which was nice to know. Just had a swim to refresh from the day and tonight we'll be off to be greeted and have Dr.'s Blitz and Schulman presented with the Tanzanian medical licenses over dinner. all for now, tom
Author - kim shriner Pasadena, California It’s been a busy year for The Phil Simon Clinic Tanzania Project. After our successful trip back to Arusha, Tanzania in February 2006, we gave several lectures updating our work here and in Africa. Our second annual fundraiser in April 2006 was a huge success thanks largely to the incredible talents of the children of Creative Planet School of the Arts and the Holy Family School fifth grade class. Raffee Reyes, our event planner, pulled out all the stops and once again, recreated the Serengeti at Pasadena’s Castle Green. In October, we launched our Healthcare Worker Sponsorship program and welcomed Drs. Solomon Ole Logilunore and Clement Makule to California. The two weeks of their stay was a whirlwind of lectures, meetings, clinical work and exchanging ideas on the worldwide HIV epidemic. In addition to Huntington Hospital, the doctors were welcomed by Caltech, Cal State Long Beach, UCLA, UCSF, San Francisco General Hospital and the Mayor of Pasadena, Bill Bogaard. Their visit was capped off by a command performance by the children of Creative Planet School of the Arts. Throughout all of this year’s events, we have been busily planning and organizing our fifth trip to Tanzania. Team Tanzania 2007 is the largest collection of talented people we have assembled. Twenty four in all, exhibiting an enormous range of skills and dedication. One half of the team are return visitors and will guide the way for the newly initiated. New team members include Jim Blitz, general surgeon They will join veteran team members, Jody Casserly, Tom Warren, Alison Hadziosmanovic, Phyllis Hollingsworth, Ann Kleeger, Cheryl Arteaga, Mickey Singer, Sally Eastman, Gyongyver Sovago, Suzie Icaza and myself. Armed with 24 bags of supplies and medications and 30 hours flight time, Team Tanzania 2007 will arrive in Arusha February 4. On the ground in Tanzania will be waiting Drs. Solomon, Makule, Juvenatus along with Joyce Sagala, Ezekiel Noah and all the wonderfully dedicated staff of Upone Charitable Medical Centre, Mount Meru Hospital, St. Elizabeth’s Hospital and the Kisonga Orphanage. The work week will be packed with clinical work, home visits, lectures, instruction, tutorials, art projects and most importantly, a sharing of ideas, hopes and wishes in dealing with the HIV epidemic. You can follow the trip by logging into our diary. Team members will be describing their experiences and impressions throughout the two weeks. It is my privilege to work with such dedicated, talented and compassionate people. I know they will love Tanzania and its people as much as I do. Fika Salama! Jambo Africa! |