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Saturday, August 5, 2017

Last Thoughts

It is Saturday late afternoon and the team is packing in preparation for our departure tomorrow morning for Dar es Salaam.

Friday afternoon we wrapped up our last bit of work—Doug and Chris and Ashley and Zach had three minor procedures that kept them busy while the rest of the team inventoried and packed supplies being left for the hospital and those being given to a remote dispensary, Mkulazi. 

Medical team with (L to R) Epsilon, Kishumu, Eliah and Christine (Nurse anesthetist)
And Will and Lance were tapped for a final repair on the cautery machine. As evening fell, we said our farewells to the Mazimbu staff and to the Tanzanian part of our team, Kishumu, Eliah and Epsilon. Goodbyes are tough but, God willing, we will see each other again next year.

Kristen and Tisho and their baby Ethan dropped by Friday evening to visit. Kristen and Tisho are missionaries who have worked with the team in the past and now live full time in the Morogoro region. They are preparing a move to an area a bit far out from the town because Tisho has accepted a position as director of an orphanage. He is also working with an organization called GO (from go and make disciples) to bring a school to his home village of Melele. It was so good to catch up with them!

This morning we became tourists, getting up before dawn to drive to Mikumi National Park, about an hour and a half away. A little more than a year ago Tanzania elected a new president who won election based on his promise of sweeping change and stopping corruption. This means that there are many changes happening in the government. We were told earlier that one of those changes requires that the entrance fee to national parks be paid before going by loading the amount on a pre-paid debit card designed just for that use. The parks no longer take cash for the entrance fees. That little errand took Cindy and Kilatu 3 hours at the bank yesterday to arrange, but we arrived with debit card in hand. What we were NOT prepared for was a new rule that will not allow vehicles into the park unless they have a permit and have already paid the taxes for the fees. This cannot be done at the entrance to the park. That meant that our comfy mini-bus would have to be left in the parking lot and we would have to use the vehicles and drivers provided by the park. These only seat a maximum of 9 so our party of 12 required 2 vehicles. It was an additional expense that was not budgeted but we found that we really enjoyed driving around in the open-air vehicles. One of them was an old Toyota 4Runner that had had the top cut off (Will says this is a no-no since it is a uni-body frame but that won’t ever stop a Tanzanian who wants to solve a problem) and 3 tiered rows of seats installed so that each row could see above the heads of the row in front of them. The second vehicle was on old mini-truck that had a similar modification of tiered seats added to the bed of the truck.

Click the link below to enjoy a few of the pics taken of these wonderful animals!

Our driver is picking us up in a few minutes for dinner at the diocese with Bishop Mameo. We have not seen the Bishop yet as he has been in the US studying for his PHD. He has just arrived back in Tanzania so this evening will be our only time to pay our respects.

As we wrap up this year, we want to thank all of you—our friends, family, church families and other supporters—for your prayers and encouragement. We are so far away here from all that we call dear, but the people of this beautiful land have become a part of our hearts. Your support allows us to go and, most importantly, to return to your warm and loving welcome.

Thursday, August 3, 2017

Final days at Mazimbu

Our surgeries over the past few days have gone smoothly. Chris and Ashley, our surgical technologists, have enjoyed working with their Tanzanian counterparts. For all of our non-medical folks back home, a surgical technician is responsible for ensuring all necessary supplies—sutures, instruments, medications, etc—are ready for each procedure. A surgical technician also scrubs for the case so that they are sterile and can assist the surgeon. That can include clamping blood vessels, suction, cutting suture, retracting tissue and passing instruments. Peter and Faudha are the technicians at Mazimbu and, as they have worked with Chris and Ashley over the past week, their set up has begun to mirror our surgical setup.
Ashley with our anesthesiologist, Christine

Faidha and Peter

Chris with Faidha

This streamlining of prep seems to have resulted in a faster turn time in the theatre. It is Thursday, just before noon, and we have just begun our third case of the day. In past years it was not uncommon that the SECOND case of the day did not begin until afternoon.

Cindy and Pati were approached yesterday by a Maasai mother, Lukia, seeking help for her oldest son, Papaa, a 17-year-old-boy. Because our schedule has been full since last week, the initial reaction was one of sorrowful regret that we cannot help. But Lukia was persistent. As we talked with her, we learned that she is raising her six children alone since the death of her husband and that she came from a very far distance to see the team. Papaa has been suffering with an abdominal distension for six months and has been to hospitals and to doctors and none have found the cause. When we examined the records, we saw that Papaa has an enlarged spleen and liver. Lukia has sold cows to pay for this medical treatment over the past six months and has none left to sell.
From L to R, Cindy, Papaa, Lukia, Goa and Pati

In the evening, before dinner, we were able to relax at Rosemary’s duka again so the problem was brought before the team. It is a difficult problem because the next step is to go to Dar es Salaam, where there is advanced medical treatment available, but there is no way to know in advance the cost of those tests and treatment. After discussion, we decided to give Lukia the bus fare to Dar, money for meals and lodging for a few days, and enough additional to cover consultation with a specialist and for at least some more testing. Our hope is that they will receive a diagnoses and that Papaa’s condition will be treatable with medication.

However, we encountered another problem today when we met again with Lucia and Papaa. She has never been to Dar in her life and does not think she would be able to navigate the challenges of this city of 4 ½ million people. Eliah, who helped with translation, said it would be like “leading her to the lion and leaving her”.  This is when God stepped in again, in the form of Goa, a man who was treated by Doug four years ago. Goa had heard about the team and brought one of his family here this year, who had surgery a few days ago. Goa is evidently a distant relative of Lukia’s. It is not clear if he even knew her but just realized from her description of her village that he was related. But Goa stepped forward and offered to take her and Papaa to Dar. They have Kishumu’s phone number and will let him know the results, and Kishumu will then communicate with the team. We will be praying that the money is enough and that God will send him to a doctor that is able to treat his condition.

On another note, Cindy had a bit of a mishap while flossing one evening and lost a crown. She caught it in the sink and brought it with her to Mazimbu today. The dentist, Dr. Patric, had everything he needed to pop that crown right back in and Cindy reports that it is even better now than before!
Cindy with Dr. Patric

Replacing a crown

Our fundis have continued to be tapped on the shoulder for one repair after another. Today they were troubleshooting (successfully) computers that were not functioning. Thanks to Will and Lance!

Tomorrow will be our last day and it is a short one. Doug will only do outpatient surgeries because we will not be here for him to follow up on any inpatient surgeries. So we have set aside the morning for six of the team—Doug, Nancy, Will, Chris, Ashley and Zach—to climb Mt. Uluguru with Kishumu, Epsilon and Eliah. The rest of the team will sleep in and then enjoy a bit of shopping in Morogoro before meeting the climbers for lunch. After lunch, we will be packing up our supplies to donate to the hospital or to another dispensary, and then saying our farewells.
Pre-packing supplies

Kishumu has a few inches on Pati, despite the puffy hair!