Video of Cows at Rosemary's Duka

Faudhia Goes Home

Faudhia before discharge

Great news when we arrived this morning to begin our second week at Mazimbu! Fuadhia has shown marked improvement every day since her surgery and was well enough this morning to be discharged!

And then Doug began the big surgery for the colostomy reversal. We thank you for your prayers because all in all, it went as well as could be expected—it did not take longer than Doug had anticipated and he did not encounter any complications during the surgery. So now our prayer is that Salumu's pain will be manageable and that he will recover without suffering infection.

Our translators are invaluable to our mission and we could not do our work without their help. But as our work has shifted from the front desk and triage over the the surgery part of our work, we do not have as many patients that need the help of a translator to talk with us. So today we had to say goodbye to three of our translators, Juliana, Sarah and Magreth. All three have worked with us in past years and we look forward to seeing them again in future years.

From left to right, Sarah, Eileen, Juliana, Glennis and Magreth

From left to right, Sarah, Magreth, Cindy and Juliana

Will doing another emergency repair on the Bovie, with Cindy and Glennis looking on

Soldering the Bovie

We were able to leave the hospital at 5:30, which meant we arrived back at LJS at 6 pm. Although dinner is served at 6, several of the team enjoy walking the short distance off campus to a local duka where we can enjoy a beer. This is a small, local storefront owned by Rosemary, who lives in back with her family. When we arrive, we walk behind the duka and shout “Habari” until the family waves to let us know they will be right there to help us. Chairs are brought out for our comfort and we can watch the local life around us. It is very relaxing.

Beers after work

Rosemary's duka

Tomorrow will be a long day for us again—the team will be assisting Dr. Swai, who is doing a gynecological surgery on two of our patients. And we have three more procedures in addition to those two. Since it will be a late night, we are planning dinner at one of our favorite restaurants, the Oasis. Which means we will not be posting to the blog tomorrow night. But we will catch up with you on Wednesday.

Benedictor, our first patient tomorrow morning

Worship at Sokloine

As in many past years, we were again welcomed to worship in Sokoine parish with our brothers and sisters in Christ. Hospitality among the Maasai is of the utmost importance. When our daladala pulled up into the churchyard, there were chairs arranged under the trees waiting for us. We were invited to sit and one of the village elders brought water to pour over our hands before eating, holding a basin below to catch the overflow. 

Georgia riding under the seat in the daladala

Our daladala

Boiled sweet potato and Maasai chai were offered to all of us. The sweet potato here is not a yam, but a white sweet potato. And the Maasai make wonderful tea by boiling the tea in milk, not water. While we were being fortified before service, many of the men and women of Sokoine came over and shook our hands, one after the other, welcoming each and every one of us.

Tea before worship

Maasai do not adhere to a strict time schedule but, instead, move on to the next activity once the preceding one is done, like moving the cows or preparing our lunch. So the 10 am service actually began at 11:30 and lasted 2 hours.

Worship included performances by three different choirs. We may not understand the Swahili, but the joy of praise needs no translator.

Sokoine altar

Georgia was given to the pastor as the offering from the team. She was very well received by the congregation and, when the pastor was thanking us, he assured us the nanny goat would bear twins! He added that next year, when we visit again, one of her offspring would be in our dinner pot. We are opting for beans and rice that day.

Cindy presenting the nanny goat Georgia to the pastor

Chairs were assembled in the church after service and we were ushered in and offered the luncheon meal—rice, meat in a flavorful broth, beans, a squash similar to spaghetti squash, and stewed beef. We all enjoyed it and were bid farewell by our friends until we see them next year.

The team with Sokoine friends

Maasai Cattle Market Slideshow

Maasai Cattle Market

End of our First week and Maasai Cattle Market

Our work week ended at 7 pm Friday, after another long day of surgery. During that day we filled our surgery schedule for the rest of our time here. So the front desk will not be checking in any new patients next week. This is the fastest we have ever filled all available slots on the schedule. Dr. Kivuma and Dr. Swai will continue to work with the remaining patients who have been registered but not yet been seen by a doctor and it will take several days for all of their test results to be received and reviewed by the doctors. That means the team will still be busy facilitating that part of our mission, but the focus has certainly shifted over to the surgical side of our trip.

We invite your prayers, not just for the rest of the trip, but for a specific surgery Monday morning. A young 20-year-old man, Salumu, suffered a sudden, severe volvulus last year requiring an emergency colostomy. He was told to return to Dar es Salaam in December to have it reversed, but when he arrived and was told the price was 1,000,000 shillings, that was so far beyond his means as to make the repair impossible. We met with him on Friday, and this is a surgery that Doug can do, so other patients were moved to later days to allow Salumu’s procedure to be done on Monday morning. It is a long procedure with a higher risk of infection, as it deals with the bowel and large intestine.

Dinner Friday night was a celebration of the end of our first week’s work with pizza at a local favorite, Dragonaires. It was a great start to our weekend!

And our weekend continued with a trip to the Maasai cattle market, accompanied by Kishumu, Eliah and Epsilon. Eliah gave us a bit of history, which helped with our understanding of some of the Maasai traditions. We were warmly welcomed and greeted by the Maasai and strolled among the milling cattle as buyers and sellers discussed prices. Eliah ordered a portion of fresh roasted goat and beef for our lunch. This is sliced into strips with a machete and then bite-sized pieces of meat are sliced off of each strip and passed around. We added several portions of chips mayai which are French fries fried with scrambled eggs, seasoned with salt and hot sauce and eaten with a toothpick.

The highlight of our day was witnessing about a dozen Maasai warriers, including Eliah, singing and dancing. They stand in a circle and sing/chant rhythmically, following the cues of a leader. Some songs feature jumping where they will take turns, singly or in pairs (or even threes!) coming into the center and jumping as high as they can in time with the chanting. American Basketball coaches must not have seen how high these warriors can jump or our NBA teams would be full of Maasai!

Just before leaving, Eliah happened to talk to a man and discovered he was suffering severe after-effects from a spider bite. Eliah asked Doug to look at the injury and when the man, who we learned was called Edwin, rolled up his pant leg, his lower leg was overwhelmed by an area of dead skin about 6” X 8” and the leg is still, 6 weeks after the fact, swollen to more than double the normal size. In addition, there was a marked swelling and bulging of a vein that snaked up the inside of the leg and past the knee. We learned that he had consulted a doctor and surgery was recommended, but that the price was 350,000 shillings (about $150). He was trying to raise the money and had collected 130,000 shillings so far. Could we help? The team withdrew to discuss privately and we all felt like this man needed our help. So each of us chipped in personally and the money was raised to make his surgery possible. His gratitude was obvious to all of us and he welcomed our prayers. We all joined hands to pray with him for his recovery.

Before we left to head back to LJS, the team bought a nanny goat to bring to worship tomorrow as our offering. Lance has named her Georgia.

A Few Pictures to Share

Slideshow with scenes around Mazimbu

Here is a slide show with pictures from us with our translators at work at Mazimbu.

Faudhia

It seems as if every year God clearly shows us the reason why we are here. That happened yesterday. It was our first day of surgery and we had a full schedule-5 cases in the major theater and 1 in the minor theater-so there is no way we could take any additional surgeries for that day. On top of that, surgeries keep the docs in the OR so we cannot see many new patients to evaluate for surgery. 

But yesterday, despite all of that, Doug was consulted by a family with a 12-year-old girl that, according to an ultra sound, had an abdominal cystic mass. This is normally benign and asymptomatic, except for causing some abdominal distention. When he examined Faudhia, her pulse was 148 and her respirations were 36. These are seriously bad numbers. One of our team happened to walk in to Doug's exam room when he was making notes on her chart and he remarked that he was really worried. The young girl had extreme pain, both on depressing and releasing pressure, which would indicate a problem far more serious than a cystic mass. Doug was very worried and wanted to do surgery asap, which he knew meant the following day IF we could get lab results in time. In past years, we had been able to get lab results in about an hour. However, Mazimbu’s machine is broken this year and they have been sending the blood samples to the main hospital campus, Sua, just a few miles away.

So, if Sua has the same machine, why the longer wait for results? It seemed a consultation with the head of the lab, David Mwanuka, was the logical next step. Well, it turns out the delay in results is due to a transportation issue. The hospital only has one transport--the single ambulance--and it goes to Sua once a day, at middday, delivering new samples and picking up results from the previous delivery. We asked if WE could send a driver over to Sua with the sample and wait for the results. Sure, no problem. So that is what we did. We had results back by 4 pm and started her surgery at 5 pm. And it is a very good thing we did. Faudhia had a ruptured appendix, which, by the timing of the onset of pain and swelling, we think ruptured 4 days ago. Her abdomen was completely full of pus—2 liters--and other nasty stuff. Had we not been able to do surgery until the following day, Doug thinks she may not have survived overnight. And this morning when we arrived for work and checked on her, she was awake and alert and smiling in bed. Praise God!

After our long day on Wednesday, we enjoyed dinner out under the stars at one of our favorite restaurants, The Arc Hotel.

Moving to today, the line of patients waiting on our arrival was substantially longer that the previous two days. And, again, Doug was booked in the OR with four procedures so his time in clinic would be minimal. It became clear very quickly that the patients waiting would be all that could be seen today—we could not take any additional that may come for services. That is always very hard for us, as Americans, to turn away people that are seeking help. And of the thirty-one patients that we registered, most had to wait five or six hours to see the doctor—some even longer. Our last patient was seen at 6:45 pm. But Tanzanians are willing to wait patiently for as long as it takes. Something we, as Americans, would never accept.