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Thursday, June 28, 2018

A Few Pictures

Dr. John's consultation

Eye problems

Debbie's friend showing off his new shades


Stickers for the kids
Our Pharmacy

Eileen in pharmacy with one of our repeat patients

Emily working triage with a young admirer

Lance and Matron Seguru. Lance said he takes all tasks in order--the last thing Matron gives on the list is the one they do!

Problem Solving

Pati and Samwel

Nancy with Hezron reading her grandaughters' letters

BIG candle!

The birthday girl, Andie, and her sister, Evie

Suture Saga

Our main story today is about the hunt for the correct sutures. Emily has continued to work with her contacts in Dar es Salaam while Gamma sought out the few dispensaries in Morogoro that were rumored to be possible sources. As of yet, we have totally exhausted all possibilities in Morogoro but we have had a glimmer of hope from Emily’s Dar contacts. We hope to have a final resolution tomorrow.

Dr. Kivuma was in the OR with four of our surgeries and unavailable for clinic most of the day. That meant that Dr. John would see the majority of the patients today. We registered 35 patients in the morning before making the decision that we were at capacity for the day. An additional 15 patients were “pre-registered” for tomorrow. But there were more than 50 hopeful patients that were told to come back the next day and to be sure to be early—our queue is first come first serve.

One of the benefits of working year after year in the same place is that we often have prior patients come back to visit and let us know how they are doing. We had two such visits today—Christian was a young man that received our services two years ago and he formed a friendship with Debbie. They have stayed in touch for the past two years, and we were all glad to see him and greet him in person today. And Nancy, who spreads her love wherever she goes, became attached to a young teen boy, Hezron, also two years ago. Hezron was a very sick young man who had been admitted to Mazimbu for treatment. Nancy ministered to him and visited many times each day, using the children’s bible app on her phone to cheer him up and break through his stoic attitude. He seemed happy to see Nancy and enjoyed receiving the small gifts she had brought from home. But the most touching moment was when Nancy showed him letters written to him by Nancy’s young granddaughters, ages 10 and 7. Hezron read them aloud and actually smiled at the conclusion!

The highlight of our day was the third birthday celebration of Gamma and Emily’s oldest daughter, Andie. We gathered in the common room and enjoyed the delight on her beautiful young face at the site of her cake. We all got a chuckle when Andie got distressed when her mom approached the gaily decorated cake with a knife—definitely too pretty to eat!

Wednesday, June 27, 2018

Surgeries Begin

Tuesday saw our first day of work at Mazimbu begin with the usual fumbles and mis-steps as we relearned and updated our procedures. After several hours, the team was again firing on all four cylinders and ended the day with 35 patients on our registry. Before any surgical cases can be identified, we must first do clinic so that the doctors can evaluate our patient’s issues and take the appropriate treatment, which may mean only a simple RX, but could mean a surgery.

Dr. John’s specialty of ENT is somewhat more specialized than other practice areas so it is likely that only a dozen or fewer surgeries will fall under his area of expertise. He is still seeing all clinic cases, though, and will take “lumps and bumps” off of anywhere! Dr. Kivuma, a surgeon with Mazimbu, is again working as one of our team doctors. So Dr. Kivuma and Dr. John worked our clinic together and identified five patients who were then scheduled for a procedure for the following day, Wednesday—three for Dr. Kivuma and two for Dr. John.

Both surgeries that Dr. John scheduled require a thin, fine suture. The only sutures at Mazimbu that fit the bill expired in 2016. This makes them totally unusable, under government regulations. So the hunt was on for the appropriate sutures. A call to St. Harry’s, where the Tanzanian ENT practices, yielded some hope. Although they did not have any on hand that would work, they assured us that they would order them from Dar es Salaam and have them for us first thing the following morning. What a great solution!

It is sometimes a challenge to diplomatically manage the great numbers of people that come to the hospital hoping for services from the Mzungu doctors. Bear in mind yesterday was our first day, so word-of-mouth about our presence has only just begun. Although 35 patients were registered, another 50 patients were told that we were full for the day and to return the next day, Wednesday. Our senior translators, Epsilon and Tisho, were invaluable in skillfully communicating this to people who had likely been waiting all day, hoping for their chance with our doctors.

Today, Wednesday, most of those 50 were waiting for us when we arrived shortly after 8 am. And another 50 or so in addition. Again, our senior translators had the unpleasant task of telling the crowd that we had a waiting list and would not be able to add any additional names, but they could come again the next day.

Because of the issue with the sutures, Dr. Kivuma began his surgeries to give us more time to receive the delivery from Dar. Unfortunately, this delivery did not pan out, despite repeated calls to St. Harry’s. So both of Dr. John’s procedures were delayed for a future date. We have worked on the problem and think we may have a solution: Before Emily’s first daughter was born, she worked as an RN on the surgical floor at Aga Khan in Dar es Salaam so still has contacts in the medical world in Dar. She has reached out and once we find where we can buy the sutures in Dar, it will be possible to have them sent up on the bus in just one day. So we are hopeful that both procedures will be possible early next week. Stay tuned for more updates!

Monday, June 25, 2018

Puzzle, Latest Version

After arriving in Dar Saturday night, the first four team members checked in to the Catholic Guest House, the hostel where arrangements had been made for our first night in Dar. Cindy assumed the responsibility of staying awake and left a little before 11 pm to drive with Kilatu and the team van to the airport to meet the John and David’s KLM flight. The van arrived at the airport before the KLM flight, so seats were lowered to make cat napping a possibility. By 1 am, when the flight was still AWOL, Cindy got the news that the computer on the jet had malfunctioned and the planned quick stop in Arusha was the end of the line for that flight. It was 4 am in Arusha before KLM had John and David settled into a hotel room but they were given no word on KLMs plan for getting them to their destination.
Drive to Morogoro

Mt. Uluguru in Morogoro

Gamma and Emily and the girls arrived Sunday afternoon as scheduled, looking like they had been travelling for 55 hours with 2 tired toddlers after being harangued about luggage by airline staff multiple times.

The team met Gamma and Emily at the airport in Dar to take most of their 7 (SEVEN!) big bags off their hands, loading them into the team van, while the family received the return of their personal car, which had been in storage with friends. After shopping for necessities and stopping for dinner, they arrived safe at LJS Late in the evening. The team bus preceded their arrival by several hours.

Meanwhile, back in Arusha, the Houck brothers got tired of waiting on an ineffective KLM and took matters into their own hands. On their prior trip two years ago, the Houck family had made arrangements with a company to take them on safari in the Ngorongoro crater, near the Serengeti. That driver’s info was still in John’s phone and John’s info was still in the driver’s phone, so when John called, the driver answered. Sure, he can drive them to Morogoro!! The proper documents and permits were arranged and off they went for Mogorogo-town. As you can imagine, there is quite a bit of open country on the 11 hour drive from Arusha, with vast areas with no internet access. That meant they were unable to update the team waiting for them at LJS to let them know the progress of the journey. They finally arrived at 11pm and fell into bed.
Our daladala, our Tanzania transport

Dr. John, Dr. Kasui (Mazimbu Chief of Staff) and Cindy

Monday morning we planned our formal visits to the diocese and to Mazimbu hospital. Bishop Mameo Is out of town for a day or two so his assistant, Pastor Pendua, greeted the team. In conversation, the topic turned to hospitals and the difference here between government and private hospitals. When Pendua mentioned that one of their church members owned a private hospital that was right across the street, the team expressed interest in touring the facility.

At St. Harry’s hospital, we met the owner, Dr. Esily John, who proudly showed us around his domain. The hospital provides services in all areas and includes a resident ENT doctor. John will be trying to meet with his fellow ENT soon to see what this practice area is like in Morogoro.

Our day ended at Mazimbu, greeting our Mazimbu friends and coworkers. We unpacked meds and gear and are ready for our first day of work tomorrow, Tuesday.

Saturday, June 23, 2018

Our Trip Begins by Playing Traveler’s Jigsaw

God brought together a team for this year of all veterans to Tanzania. And our veterans sometimes like to make their own arrangements for side trips before or after our trip. So we had an interesting puzzle to plan out for our first day.

Cindy Pennie, RN, Stillwater, OK, is again our team leader. Nancy Bean, retired Veterinarian, Weatherford, Tx is assisting our nurses, putting her medical knowledge to use and will be again acting as our unofficial ambassador. Cindy flew to Dallas and joined Nancy for a direct flight to Doha, Qatar.

Pati Murdock, Rogers, AR, is again acting as our team manager. Debbie Jones, Xray tech, Tuttle, Ok will be assisting wherever she is needed but will be particularly valuable in reading any Xray results. Pati and Debbie met in Chicago and caught a direct flight, also to Doha, Qatar.

Both sets of the team met in the airport in Doha. An interesting part of their flight involved a 16 hour layover in the international city of Doha. But Qatar airlines has a wonderful way to overcome that and includes the cost of a room for each traveler at a 4- or 5-star hotel. A quick hop on a shuttle bus led them to the Oryx Rohara hotel. The foursome enjoyed a leisurely meal at a Tapas restaurant and hit the sack for a great night’s sleep before catching the last leg of their flight this morning into Dar es Salaam, where they arrived at 3 pm and were met by Tabita Kilatu. who is the representative from the Tanzanian church and helps the team in every way.

Dinner in Dar with Kilatu, waiting for the rest of the team to arrive.
From L to R, Kilatu, Cindy, Pati, Nancy and Debbie. 

Meanwhile, John Houck, ENT MD, Edmond, OK was enjoying a tour of Italy with his wife, Sally Houck, who is a pastor in the ELCA and joined us two years ago, along with John and John’s brother David. David is an engineer and lives in Millpitas, CA. John and Sally left Italy to go to France, where they visited with family. David joined them in France. After their time there, Sally returned home and John and David caught a flight from Amsterdam to Dar es Salaam and are scheduled to arrive about 11:30 pm.

Gamma Cyprian and his wife, Emily, RN, live in Neosho, MO. Emily has been on the team in two previous years and actually met Gamma on her first trip with the team. The couple later married and have two beautiful daughters, Andie and Eva. The family was able to arrange to serve on the team this year and will be introducing their daughters to their Tanzanian family. Gamma will serve as our advisor, guiding us in the social and political ways, and will be translating as well. Emily will be working as one of our RNs. They intended to join Cindy, Pati, Debbie and Nancy on the flight to Qatar, but were unable to get seats.  They were able to book a flight but were forced to leave one day later so will be arriving in Dar es Salaam tomorrow around noon.

Finally, our team will be complete once Lance Miller, retired engineer, Hot Springs Village, AR and his wife, Eileen, retired music teacher and their granddaughter, Courtney Giebel, Naperville, IL arrive on Monday night. Courtney is graduating today from Northwestern University, Il, so the Millers attended Courtney’s ceremony and will fly out tomorrow.

We will all be together for the first time Tuesday in Morogoro. So please continue to pray for safe travels for us all.