Kishiri is located about 30 minutes drive outside of Igoma and our clinic here took place in the home of a Lutheran minister who had actually been killed while building a different family home. It was rather sad. Our host for this clinic was Bishop Buchafwe, who must be in his early 70's with failing eye sight but a heart the size of Africa itself! He always has on a sharp white fedora and his "Canada" tie. It's interesting that one of the things we discovered about the Pastors in this area is how hard it is for them to find ties to wear! For them, it is important to wear a tie with dress pants or a suit, but the reality is that the cost of that is too much for some and the variety is low. Another Bishop we met wore a Santa Claus tie...and I think it was the only one he had. Definitely a good gift idea for the future!
The house was a good size, with six different rooms, all dirt floors and many open windows with iron bars through them. From my journal: "The breeze was initially wonderful at the start of the day, but as the day went on, the dirt and dust flew about and the flies were nasty and aggressive. I looked in the mirror tonight and thought I looked a bit tanned but realized it was just dirt! When I showered tonight I had huge rings of dirt around my ankles! Oh my...much dust!"
We were without our teammate Lindsay today as she was diagnosed with Malaria the day before during our second clinic at Nigeze. She seemed a bit stronger today but still overall quite weak and so we left her at the hotel to rest and knew that the hotel staff would watch over her. We still can't quite figure out how she contracted the disease while taking her meds, but two blood tests later...she was still positive.
Today was my second day to be in Pharmacy and it was a great challenge! At the start of the day we set up and at the beginning it's a little slow (thus, I was playing hangman in the dirt with Nancy in the picture below). But, once the patients start to be seen, the line starts to grow and the dispensing begins and the teaching takes place. It becomes a harried place! and of course is the busiest by the end of the day. It's a very discouraging feeling when you run out of medications and that happened for us today with parasite medication. There are certain meds that can be substituted but today there was nothing left to substitute with.
In the photo above you'll see Sheri weighing some patients on the scale we brought with us. Regular weights are a key way of monitoring adequate nutrition is both adults and children...a simple yet vital piece of information. You'll also see above the beautiful smile of a woman with a significant hump on her back. This woman was full of so much joy!, she was amazing.
Rose, from Urafiki, registering some patients.
There are many stories from this day but just a few I will share on here...
The first is a young man with a mass who we consulted in Nigeze. He had traveled from Nigeze to Igoma to see Dr. Mukulla for follow-up...this would be a 30-40 minute drive and he traveled by bicycle. When he arrived at Igoma he discovered that Dr. Mukulla was out in Kishiri with us. So he came out to Kishiri but in fact the ultrasound that would have to be done was in Igoma and that was the only place it could be done. And so we had to ask him to come back to Igoma the next day. He was so gracious and simply said, "okay, I will come tomorrow to see Dr. Mukulla again". I couldn't help but think how we, as Westerners, would have been furious in such a situation. For this young man though, he was just grateful to have any medical care at all and so he had remarkable patience and persistence.
The second story is of a mother several young children, whose husband has left her (an all too common story in Africa). She is so poor that she breaks rocks for a living and struggles to support herself and her children. We provided her many vitamins for her and her children and also gave her the peanuts we had for ourselves.
The third is the story of Pendu (pictured below). I found Pendu outside the house where we were, just as clinic was closing down. She was standing there with this tiny bundle in her arms, which quite honestly I thought was a little puppy. When I looked in her arms I saw a small, malnourished baby about 2.5 kg (just over 5 lbs maybe). I brought her into the house and through two translators received the message that this baby was 2 months old (in fact the next day, we found out he was 2 weeks old!...I was greatly relieved). His skin turgor was not good and she said that he was only breastfeeding twice a day. This poor Mommy looked so overwhelmed and scared. We arranged for her to come to the Urafiki Centre the next day for more in depth follow-up. Her story continues in the next post from "Last day at Urafiki".
The fourth story comes from my journal..."the little girl in the tattered dress - ripped with large gapes in at least 3 spots. I SO wished we'd brought some clothes and could have given her a new dress. I wanted to take her picture to show the extent of poverty for this child but an adult male told me not to. I don't know that she ever came through the clinic - she was a beautiful young girl. So many needs. So much poverty. In this moment it feels very overwhelming - the problems are so huge and it feels like we do so little, yet the little can become a lot. I never want to forget the face and dress of that little girl."
Pendu and baby, dressed in a sleeper from a baby pack we had...including the blanket.
As we headed back to Igoma tonight, we stopped at the home of Bishop Buchafwe for Marilyn to assess his wife. She has dementia and is being cared for primarily by her own mother (who must be in her 80's, I would think). As the rest of the crew (Urafiki and Canadians) waited out in the van, the local children gathered around and stared at us (the muzungos). As a team we sang the Swahili praise song that we had learned a few days earlier and it was beautiful to share in that moment with our Tanzanian teammates. The children would look in a laugh at us...I was sitting on top of a box of supplies with my leg out the side window because we were so crowded into the van. At one point, I laughed at the children and they all took off running and screaming! It was pretty funny.
The area around Kishiri is open fields with large rock formations (of course!) and fields of Kasaba plants, as pictured above.
Our Lab Technician, Aron made an amusing statement today. I had my hair in a bandana today and he said, "Julie, I think that you are becoming more Tanzanian" (with a big smile) "Maybe after one month you will be fully Tanzanian!" (with another big smile). I think I should take that as a compliment (:
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