Sunday we were privileged to join our fellow Christians in the Masai village of Parakuyo for worship. Two Land Rovers departed LJS with our team and the Washington team for the 1 ½ hour drive, which veered off the highway shortly out of Morogoro and continued down a dirt road through the Masai range land. The scenery was very much as most of us picture Africa, with grasses interspersed with vegetation and trees.
We were greeted with wide smiles and warm handshakes as we were ushered in to tea. Services began once all the villagers had finished tending their cows and completed the trek to the church. Pastor Martin Geisler, who is German and has been serving in the area since 2001, presided over worship and was assisted by a local minister, Pastor Daniel. We were overwhelmed by the beauty of the music, which featured congregational hymns along with an adult choir and a children’s choir. When the choirs sing, they also perform choreographed dancing that further expresses their joy, which brought a smile to all our faces. In the middle of the service, Pastor Martin invited all to bring their children forward that wanted them baptized. Women with babies in slings on their back surged forward and, as the baptisms began, the crowd of people waiting for their turn increased as both children and adults came forward. More than 20 were welcomed into the body of Christ yesterday and their friends rejoiced with them at this momentous change in their lives.
By 3 pm we were on our way back to Morogoro; Doug, Cindy and Pati returned to St. Mary’s to join Dr. Makao and Mr. Wazuri for two more procedures and the rest of the team continued on to LJS. The second procedure was challenging for the team. Dr. Doug removed a gall bladder from a patient that was anesthetized with only a local anesthetic and IV sedation. This is normally done in the States under general anesthesia, which requires a breathing tube with oxygen, something that St. Mary’s does not have available. Since oxygen is not possible, all sedation requires that the patient continue to breathe independently. This also means that there is no relaxation of the abdominal muscles, so keeping the incision open wide enough to allow Doug access was very difficult. Mr. Waziri and Pati applied all their strength using retractors to manually keep the incision open. Doug had to call rest breaks several times to allow tired and shaking biceps to relax.
Many of our friends and family back home have wondered at our individual roles during this trip. Doug, as the general surgeon, performed all procedures. Cindy, our registered nurse, circulated in the operating room to bring anything Doug needed during the surgery. Mike, our family and sports medicine doctor, saw patients in clinic each day. After our first day, when it became clear that we would have to work without Arleigh, Mike pointed out that he has a person assigned "to his hip" at his office in Alaska. So Pati became Dr. Mike’s "hip", making notes in patient’s records during his exam and writing prescriptions as directed. This also allowed Mike to economize on time and help more patients each day. Dana and Glynnis worked in our pharmacy, dispensing and interpreting the meds for patients. Glynnis also managed our main records and directed the flow of patients. All of the team worked as an integrated unit and supported each other throughout each day. As we reflect back on these days in Tanzania, we all feel that this team “clicked” and we were all a blessing to each other.
Today we completed our last five surgeries and our last clinic. We said our goodbyes and were thanked over and over again by each of the fourteen staff at St. Mary’s and urged to return again next year. Dr. Nkya gifted each of the team with a unique Tanzanian kanga to express her thanks.
In all we estimate that we were able to see almost 220 people in clinic and we performed 24 surgeries. As we pack and prepare for the return to our families tomorrow, we know that this mission has been inspired by Christ, as He has allowed His love to equip us for this work. We bid all our friends in Tanzania “Kwa Heri” (goodbye) until we see them again and wish them God’s richest blessings.
Monday, July 6, 2009
Saturday, July 4, 2009
We Say Goodbye to Dr. Arleigh
Yesterday Dr. Arleigh made the wrenchingly sad decision to return to the states. Her health had been worrying her for several days and became enough of a concern that, after her consultation with Dr. Doug and Dr. Mike, arrangements were made to change her flight. Words cannot express Arleigh’s distress about being unable to continue as a part of the medical team, but, as an emergency medicine physician, she knew the importance of being close to her own medical facilities and physicians.
The operating room saw constant use as Dr. Doug and Cindy worked with Mr. Wazeri, the scrub tech, and Dr. Makao, the anesthesiologist. One of the surgeries was a hysterectomy and Pati was taught to scrub and assist with the procedure. Dr. Mike saw patients all day with the rest of the team assisting him in his exams and dispensing his prescriptions. After working at such a fast pace all week, the energy level on the team was not as high as it had been the previous several days, so work stopped at 5:30. As we left the clinic, we decided to play tourist for an hour or two. Barbara asked for votes, and the top two were fabric and BEER. Unfortunately, it was 5:50 by the time we were in downtown Morogoro and the grocery store where beer can be bought closes at 6. Therefore, obviously, we had to shop for fabric and then eat dinner at a restaurant where the second need could be met.
Barbara took us to her favorite fabric shop, which was a very narrow store front that revealed walls 12 feet tall proudly displaying every array of native fabric. Glynnis (the sewer) and Mike (the world class shopper) traded elbows back and forth as they pointed their choices to the shopkeeper. Barbara was kept busy translating the Swahili phrases on all the “kangas”, which are the Tanzanian bordered fabric.
Dinner was another visit to the Acropol and the team enjoyed a relaxing evening with conversation covering the gamut from Tanzanian culture and traditions to theological debates. By the time we returned to the LJS at bedtime, we were tired but content.
Before today, we had been working with four translators--two local pastors, Pastor William and Pastor Peter; our main translator from last year, Emanuel; and Barbara. Because tomorrow is Sunday, both pastors had to turn their attentions to preparation for services so we had only two translators to help us today. Four surgeries were performed and, again, Pati assisted with a hysterectomy. We were joined in mid-afternoon by Sue and Michelle, two members of the team from Washington State that arrived yesterday. Sue is an RN who works as a school nurse and was eager to see what our mission entails. We were eager for the extra help and immediately put them to work.
Dr. Mike was able to see and treat more than 20 patients with Dr. Doug seeing several surgical candidates during times when the operating room was being cleaned and prepped for the next patient. Our day did not end until 7:30 tonight and Barbara joined us for a late dinner at LJS. Diane Johnson, the leader of the Washington team, and Jill, another Washington team member, joined us in the dining hall to hear about Sue and Michelle’s time at St. Mary’s.
Tomorrow we will worship at a Masai village with the Washington team, after which Dr. Doug, Cindy and Pati will go to St. Mary’s to work on two more surgeries.
The operating room saw constant use as Dr. Doug and Cindy worked with Mr. Wazeri, the scrub tech, and Dr. Makao, the anesthesiologist. One of the surgeries was a hysterectomy and Pati was taught to scrub and assist with the procedure. Dr. Mike saw patients all day with the rest of the team assisting him in his exams and dispensing his prescriptions. After working at such a fast pace all week, the energy level on the team was not as high as it had been the previous several days, so work stopped at 5:30. As we left the clinic, we decided to play tourist for an hour or two. Barbara asked for votes, and the top two were fabric and BEER. Unfortunately, it was 5:50 by the time we were in downtown Morogoro and the grocery store where beer can be bought closes at 6. Therefore, obviously, we had to shop for fabric and then eat dinner at a restaurant where the second need could be met.
Barbara took us to her favorite fabric shop, which was a very narrow store front that revealed walls 12 feet tall proudly displaying every array of native fabric. Glynnis (the sewer) and Mike (the world class shopper) traded elbows back and forth as they pointed their choices to the shopkeeper. Barbara was kept busy translating the Swahili phrases on all the “kangas”, which are the Tanzanian bordered fabric.
Dinner was another visit to the Acropol and the team enjoyed a relaxing evening with conversation covering the gamut from Tanzanian culture and traditions to theological debates. By the time we returned to the LJS at bedtime, we were tired but content.
Before today, we had been working with four translators--two local pastors, Pastor William and Pastor Peter; our main translator from last year, Emanuel; and Barbara. Because tomorrow is Sunday, both pastors had to turn their attentions to preparation for services so we had only two translators to help us today. Four surgeries were performed and, again, Pati assisted with a hysterectomy. We were joined in mid-afternoon by Sue and Michelle, two members of the team from Washington State that arrived yesterday. Sue is an RN who works as a school nurse and was eager to see what our mission entails. We were eager for the extra help and immediately put them to work.
Dr. Mike was able to see and treat more than 20 patients with Dr. Doug seeing several surgical candidates during times when the operating room was being cleaned and prepped for the next patient. Our day did not end until 7:30 tonight and Barbara joined us for a late dinner at LJS. Diane Johnson, the leader of the Washington team, and Jill, another Washington team member, joined us in the dining hall to hear about Sue and Michelle’s time at St. Mary’s.
Tomorrow we will worship at a Masai village with the Washington team, after which Dr. Doug, Cindy and Pati will go to St. Mary’s to work on two more surgeries.
Thursday, July 2, 2009
Wednesday and Thursday at St. Mary's
Peri had been living with pain from fibroid tumors for many years. She is a fragile, ethereal young woman and her increasing pain had been interfering with her ability to do even the most basic chores, including caring for her children. Dr. Doug performed a hysterectomy yesterday and we know that she will return to her family in several days with renewed vigor.
Joti is a 4 year old boy from a remote village with solemn black eyes that gaze stoically out of his beautiful face. His parents waited with him more than nine hours before meeting with Dr. Arleigh. Joti has a birth complication that will result in cancer if not corrected surgically. Although this surgery is not a good fit with our doctors, we have consulted with the Tanzanian pediatric surgeon and have arranged for the procedure to be done Sunday. His parents repeated echoes of “Asanti, sana” (thank you very much) showed their relief and their renewed hope.
Yesterday we saw Peri and Joti and more than 40 other patients. Our list had more than 60 names before 9:30. Tanzanians will wait endlessly without complaint to see us. As the sky darkened, we reluctantly sent the last 20 patients home for the day at 7:15 and told them to return early the next day. With any mission trip, the unexpected can trigger changes and inventive adaptation is required to meet these challenges. Our anesthesiologist was detained and did not arrive until two hours later than expected. And we discovered the gasket to the sterilizer at St. Mary’s was broken so we did not have the ability to sterilize instruments between procedures. Working through these problems cost us precious time, which slowed our ability to see patients. We also lost Barbara as a translator around 1 pm, because she had to leave to drive to Dar es Salaam to pick up another mission team arriving from the States.
After Dr. Arleigh and Dr. Mike had met with patients, any candidates for surgery were directed to a different area to wait for Dr. Doug to examine them during his breaks from surgery. We asked the head nurse at the hospital, Mama Ana Msumari, if she could find a room for Dr. Doug to use that was separate from the two being used for clinic. She pondered the problem and applied amazing Tanzanian ingenuity and arrived at a wondrous solution. There is an outside area where we had taken our lunch breaks that resembles a large open courtyard with a small covered area on the side. A tattered sofa and two arm chairs were stored underneath the slanted roof. She directed the staff to clean the furniture and carry a desk out, which was covered with a sheet. More sheets were suspended from the eave of the covered area to create a long curtain that concealed this seating arrangement from casual view. And so Dr. Doug’s office was created!
Today we were greeted with warm smiles by the 20 patients from the day before who were sent home. Although we were delayed by a complication that required the doctor’s time to start an IV, Mama Ana was ready to help us and the patients were quickly organized and happy to see the doctors. We also began the day with an additional 13 patients that had arrived from the village and were referred to us by the Asbury medical team. Throughout the day people continued to arrive and were added to the list.
Barbara arrived back from Dar mid-afternoon and brought with her a new gasket for the sterilizer. This will make such a difference in our ability to do more surgeries in subsequent days.
Unfortunately, we met with a bit of government red tape that pulled our doctors away from clinic for more than an hour. Somehow, our mission hit the radar of an agency that decided that the proper paperwork had not been filed. If we did not remedy the problem before Friday, we were told that we would be shut down and subject to repercussions for the work already done. We suspended clinic and surgery while forms were completed and the doctors travelled to a shop to have their photos taken. We were due at Faraja Trust, a home-based heath care that works with families with HIV and Aids, at 4 pm to see patients. Because the doctors were not back at St. Mary’s until after 5, we again did not have enough time to see everyone on the list and an additional 11 people were told to return tomorrow.
Dr. Doug and Cindy stayed at St. Mary’s to continue surgeries. The other four team members arrived at Faraja Trust, only to be told that everyone had given up hope of our arrival and gone home. However, they agreed to come to St. Mary’s tomorrow and we will be sure that we are able to see them. All was not lost, though, because we left many Tanzanian shillings at Faraja Trust in exchange for the beautiful hand-dyed batik cloth that they produce, which is their main source of funds.
Afterwards, a stop was made at a local grocery store and we browsed the shelves wondering at the different foods. The owner of the Acropol hotel happened in to the store while we were there and helped us spend even more shillings as we eagerly accepted her recommendations for snacks and goodies.
Joti is a 4 year old boy from a remote village with solemn black eyes that gaze stoically out of his beautiful face. His parents waited with him more than nine hours before meeting with Dr. Arleigh. Joti has a birth complication that will result in cancer if not corrected surgically. Although this surgery is not a good fit with our doctors, we have consulted with the Tanzanian pediatric surgeon and have arranged for the procedure to be done Sunday. His parents repeated echoes of “Asanti, sana” (thank you very much) showed their relief and their renewed hope.
Yesterday we saw Peri and Joti and more than 40 other patients. Our list had more than 60 names before 9:30. Tanzanians will wait endlessly without complaint to see us. As the sky darkened, we reluctantly sent the last 20 patients home for the day at 7:15 and told them to return early the next day. With any mission trip, the unexpected can trigger changes and inventive adaptation is required to meet these challenges. Our anesthesiologist was detained and did not arrive until two hours later than expected. And we discovered the gasket to the sterilizer at St. Mary’s was broken so we did not have the ability to sterilize instruments between procedures. Working through these problems cost us precious time, which slowed our ability to see patients. We also lost Barbara as a translator around 1 pm, because she had to leave to drive to Dar es Salaam to pick up another mission team arriving from the States.
After Dr. Arleigh and Dr. Mike had met with patients, any candidates for surgery were directed to a different area to wait for Dr. Doug to examine them during his breaks from surgery. We asked the head nurse at the hospital, Mama Ana Msumari, if she could find a room for Dr. Doug to use that was separate from the two being used for clinic. She pondered the problem and applied amazing Tanzanian ingenuity and arrived at a wondrous solution. There is an outside area where we had taken our lunch breaks that resembles a large open courtyard with a small covered area on the side. A tattered sofa and two arm chairs were stored underneath the slanted roof. She directed the staff to clean the furniture and carry a desk out, which was covered with a sheet. More sheets were suspended from the eave of the covered area to create a long curtain that concealed this seating arrangement from casual view. And so Dr. Doug’s office was created!
Today we were greeted with warm smiles by the 20 patients from the day before who were sent home. Although we were delayed by a complication that required the doctor’s time to start an IV, Mama Ana was ready to help us and the patients were quickly organized and happy to see the doctors. We also began the day with an additional 13 patients that had arrived from the village and were referred to us by the Asbury medical team. Throughout the day people continued to arrive and were added to the list.
Barbara arrived back from Dar mid-afternoon and brought with her a new gasket for the sterilizer. This will make such a difference in our ability to do more surgeries in subsequent days.
Unfortunately, we met with a bit of government red tape that pulled our doctors away from clinic for more than an hour. Somehow, our mission hit the radar of an agency that decided that the proper paperwork had not been filed. If we did not remedy the problem before Friday, we were told that we would be shut down and subject to repercussions for the work already done. We suspended clinic and surgery while forms were completed and the doctors travelled to a shop to have their photos taken. We were due at Faraja Trust, a home-based heath care that works with families with HIV and Aids, at 4 pm to see patients. Because the doctors were not back at St. Mary’s until after 5, we again did not have enough time to see everyone on the list and an additional 11 people were told to return tomorrow.
Dr. Doug and Cindy stayed at St. Mary’s to continue surgeries. The other four team members arrived at Faraja Trust, only to be told that everyone had given up hope of our arrival and gone home. However, they agreed to come to St. Mary’s tomorrow and we will be sure that we are able to see them. All was not lost, though, because we left many Tanzanian shillings at Faraja Trust in exchange for the beautiful hand-dyed batik cloth that they produce, which is their main source of funds.
Afterwards, a stop was made at a local grocery store and we browsed the shelves wondering at the different foods. The owner of the Acropol hotel happened in to the store while we were there and helped us spend even more shillings as we eagerly accepted her recommendations for snacks and goodies.
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