Last week was my first week of FAME’s mobile clinic. On Monday morning, we packed up a bus that carried the lab, the pharmacy, and the FAME staff to a little town called Gidamilanda. The drive takes about five hours and is rather bumpy. There’s no use trying to read, so driving there, I mostly listened to music, enjoyed the sun on my face, the warm breeze, and my butt bouncing up and down the entire way.
“Karibu to the bush,” my butt said.
The cooking staff arrived to Gidamilanda first, and shortly after we arrived, we enjoyed a delicious meal. Chapati were very popular for dinner and breakfast. Chapati are very similar to flour tortillas but are made with fine corn meal and are basically deep fried. For breakfast, I would load my chapati with a hard-boiled egg, sweet potatoes, and beans. I mentioned that I was told I would lose 20 pounds in Africa. Scratch that. Gain 10 pounds in Africa.
At night we slept in an uninhabited schoolhouse with mattresses on the floor and mosquito nets overhead. Surprisingly, the beds are no less comfortable than an IKEA futon, and if it weren’t for the still air and 80-degree heat, I would have slept like a baby. Instead, I read most nights until midnight, thinking about the creepy, crawly things around me and my nagging constipation. Too many bananas I’ve been told.
The first day, we drove to the small village of Endesh, which was about an hour away. We hosted our first day of clinic there and the second two days back at Gidamilanda. Since I have no true clinical skills yet, I was charged with recording new patients in the lab book, labeling the receptacles for their stool, urine, and blood, and passing them off to the other lab person Julius, who would draw blood and check for malaria and other parasites under the microscope. Malaria and ringworm are the most common parasitic infections. STDs however are just as common.
In the Datoga culture, men are allowed to have several wives, which makes it difficult to stop the spread of disease, unless all of the wives and the husband come to the clinic to be treated together. The other problem is that the sharing of wives is socially acceptable. If you’re lucky enough to stop the spread of disease with the current wives, a new wife or shared wife can reintroduce a sexually transmitted disease. Quite the dilemma. Condoms could help but those are far less socially acceptable than multiple partners.
In addition to recording lab results, I was promoted to urine testing by our resident lab guru, Joyce. She’s a professor and PhD from the east coast who has given up a year of teaching to instill lab processes into the hearts and minds of the Tanzanian staff.
Some patients would fill their entire container with urine, so much so that upon opening the lid, the urine would spill out and take up residence all over my hands. Other times, our translator would forget to show the patients how to open the container, and instead of peeing in the cup, they would pee on the lid. For many patients, this is their first time seeing a doctor, so I’m sure I would have thought “WTF”, too, when handed a container I had never seen and asked for pee.
After the first long day (it was exhausting), we drove back to Gitamilanda and again enjoyed something delicious at night. I can’t quite remember all the meals (I’m no Pat Coulter), but I won’t forget the delicious fruit salad and the warm beer. After touching urine all day, I felt like I was drinking it.
At bedtime, we’d sit outside and chat. One woman with her box-o-wine and pack of camels. We’d eventually make it to bed and attempt to sleep through the stifling heat. When we awoke at 6:30 am, it was bucket-shower time. I truly can’t complain too much, because I feel like the majority of volunteers in Tanzania don’t have their bucket shower piping hot and served shower-side.
After the shower, I’d walk next door to the squat toilet and attempt to avoid peeing on my shoes. By the third day, I had perfected the art of squatting and peeing but it certainly takes practice. I also said a little thank you to the man in the sky for granting me constipation last week.
Wednesday and Thursday clinics at Gitamilanda were a little slower than Endesh. They were at the same location as the schoolhouse, our squat toilet came with toilet paper, unlike the squat toilets at Endesh, and we could run back and forth to wash our hands. There wasn’t a lot of hand washing at Endesh, so it was lucky I got promoted to urine on the second day of clinic.
On Friday, we returned in the early afternoon. After a long nap, the FAME staff and volunteers went to the most amazing place called Octagon. It’s beautiful, covered in foliage and flowers, an open building with the night breeze blowing. And what they serve is equally magnificent. My father’s dream – a meat buffet: pork, chicken, goat, beef. After being a vegetarian for over two years, this was pretty delicious. We didn’t realize that they had a non-meat buffet with vegetables and sides until we had already filled our plates with barbeque. We shared stories and wine, talked about lower back tattoos, and ended the meal with rhubarb and ginger pie. Such a good ending to a warm, dusty, dirty and fulfilling week out on mobile.
