Tanzania

My time in Tanzania both flew and crawled by. I was so anxious to head home that at times it seemed the week would never finish, but now I can't believe it has gone by!  You may recall that my first week in Africa, I posted a snail that I saw so it seems reasonable to show you the huge snail that I saw in my final week in Africa.

Last Sunday we did something I haven't ever done in Tanzania before: we went to "city church." Usually we go out to one of the villages. Pastor Raymond (who has the biggest and most beautiful smile on earth) preached the sermon and a couple excellent choirs sang. The sermon was in Swahili, so I can't say what it was on, but the singing was delightful.

Afterward we ate lunch with the pastors and the bishop. My home church has helped to sponsor the education of several young men who are now leaders in the church. So many of them are familiar faces that I have seen again and again during my trips to Tanzania. Lunch also included a special treat. Apparently in the 2 years since my previous visit, Pepsi has moved into Tanzania (it used to have only Coke) and introduced the joys of Mt. Dew.

On Monday we began clinic by driving out at 7:15 in the morning to a village over two hours away on the far side of the mountains. The drive is beautiful, but jarring since very little of the way is paved. There were several times that I earnestly thought we were going to get stuck in the mud. But we arrived and set up our clinic in a school. School was let out especially so we could do this, and I think we doctors saw every student in addition to the many people from that village and surrounding villages. Many people were well. Some had malaria. Many had intestinal worms. Some had elephantiasis. I saw a woman who likely had advanced cervical cancer.

Our team included a pediatric nephrologist, an ER nurse/paramedic, several nurses, a dentist, a pharmacy student, an optometrist and several helpers of various backgrounds. This is the first trip where I have really felt like I was the most qualified physician, and that made it difficult as I still have plenty of questions and would have loved to have someone to go to with those questions. On the other hand, because I was feeling so anxious to get home, I almost wished I hadn't agreed to come to Tanzania, but I was definitely needed.

After my time in Zimbabwe, I am very aware of HIV. There was a Tanzanian nurse and HIV educator who joined our team and helped us do HIV testing. I think during the week we did around 600 tests. I didn't order them terribly often, but feel like God really led me to order them on a couple of patients. I tested a young girl pregnant with her first baby. She had not yet had any prenatal care and was around 15 weeks pregnant. Mostly I was checking for malaria, but since we were drawing blood, it seemed reasonable to do HIV testing also. As it turned out, she was positive. This puts her in a very difficult position. She has to somehow go home and convince her husband that they should both go for testing. If she reveals that she has been diagnosed, he will likely blame her. On the other hand, now that she knows her status, she may be able to prevent the baby from getting the disease. Please pray for Grace and her husband and baby.

Another patient that stood out was a 13 year old girl, Esther. She had a beautiful smile and alert, curious eyes. There is a special spark in her and when I saw her I thought she could grow up to be a doctor if she wanted. Her mom and little brother were there at the clinic with her. Much like my other patient, there was nothing that overtly suggested HIV, but I wanted to check them for malaria and so went ahead and did both tests. Esther and her mom got the surprising and difficult news that they have HIV. This poor 13 year old with so much potential, and such a difficult struggle ahead...

I saw several patients with infertility who I could pray for, but there was nothing medically that we were equipped to do for them.  It was hard to deal with being so limited in our diagnostic abilities and treatment capabilities.  After working in the hospital in Zimbabwe, this just felt like such inadequate care.  As the week progressed, I went from praying with a couple patients a day to praying with all my patients, because I recognized that my medical care was not going to be enough.  I also asked the patients if they had anything they wanted me to pray about and many said a good life, or success in business, or healthy animals.  A few women prayed that their children would come to church.  Please join me in praying that God will bless those I met this week with the life that is found in Jesus, and that he will multiply and complete our feeble attempts to bring healing.