Care for Africa Online Journal

I wrote an epilogue in my Daily Diary while flying home from Tanzania. Here it is…

I’m halfway home, Leaving the unique culture of Africa, Heading to the Western multi-culture of Australia.

Sitting in a Bangkok lounge, Eating Pizza and drinking Chianti, Asians are eating Pasties and drinking Frappe’.

I stop and observe,The myriad nature of Human Identities, Skin color, dress, language and Religions.

I start to reflect upon, How our Identifying Culture is so often used, To separate, dominate and to justify abuse.

I listened on the plane, To a Christian Evangelist who preached his Brief, To build Churches in Africa and spread his Belief.

Then to an unassuming, Elderly woman in Muslim headdress, Wanting just to be accepted as she is, no less.

I’d come to Africa, With thoughts of only what I could give, I had no intention of changing the way they live.

What I discovered was, That in giving without judgement or expectation, We open the door to a deeper connection.

We create a path for, Two-way flow of love and appreciation, A shared culture without any Identity!

What an incredible 3 weeks – and already coming to an end. I could be on another planet – both medically and from every viewpoint.

Jane and I took a trek out to the point of a high cliff overlooking the breathtaking 75km long great Rift Valley – the cradle of human creation. Although the rest of the world has moved rapidly through the epochs of Civilisation, much of the Tarime district remains in the period of family communal living in mud brick huts with thatched rooves, subsistence farming, no power or sanitation. It is quality not quantity of water that is a problem here – yet water harvesting is not a priority.

Food is ample, the rich red volcanic soil very fertile, so most eat well. But the cost of accessing medical services is prohibitive to many, and many services we take for granted – like CT and MRI scans, histopathology, and bacterial culture, are not readily available.

On drafting this blog with a freebie pen, advertising Symbicort – a standard asthma puffer – yet noone here has heard of it, and i have seen enough asthma to suggest it is not an uncommon condition.

Presentations of medical conditions here are usually extreme, yet the response to treatment can be equally impressive, which suits the patients who are generally very eager for discharge at the earliest possible time.

In my short time here, I have learnt that the safest path to tread is that well trodden! Winani uses treatments that are 40 years old, and with good results. He is understandably quite resistant to change.

Despite his great appreciation for the support I have been able to give, I feel that I am coming away with a lot more than i have been able to give. At 72 yo, his calm energy, enduring love and passion for his work, his patients and community, as well as his vision for creating a better future, are a great inspiration.

Kwaheri Tarime!

Dr Joe Tempone

Having spent a day absorbing the incredible sights, sounds and smells of Tarime, I had my first taste of hospital work watchin Dr Winani pefoming procedures which he has carried out for over 40 years, D&C’s, tubal insufflations-injection of steroids & antiobiotics into the tube to clear chronic infection & scarring, the most common cause of infertility.

The theatre is threadbare, sterilisation happens over a parrifin burner, there is an acute lack of awareness around  hygiene and sharps.

I learnt the ropes with Isaac, a medical assistant in training, interpreting for me both the Swahili language and the foreign medical tapestry – malaria, parasite infestations, gonorrhoea, HIV. “Common conditions are common” takes on a whole new meaning.

The reality of high infant mortality hits me with two stillborn babes due to obstructed labour beyond the help of caesarian section and no available ventouse or forceps extraction.

Due to their inability to pay for transport or services, many presentations are quite late. I assisted Winani with an emergency laparotomy for acute small bowel obstruction which was 3 days old. The kidneys had shut down and despite an amazing surgical effort to remove 2 metres of dead bowel, the patient’s kidneys did not recover and she died 6 days later.

I later assisted a visiting urologist to operate on a 2 year old child with bowel obstruction from paralysed bowel due to peritonitis, with no suction, diathermy, and instruments suitable for a hippo. He was able to achieve a good result and the child is making excellent progress.

Medications we take for granted such as codeine, morphine, up to date medication for diabetes, asthma, and arthritis are not available here. However, the most potent antibiotics and antimalarials are readily available on street corners.

The enormity of the task can be very discouraging, but when the husband of our laparotomy patient who died, embraced me the next day, I felt only the deepest appreciation and knew that every effort is worthwhile.

Dr Joe Tempone

I’m on my way ( in 2 mins actually) a big stretch before me. All’s Good!

Ciao`

Joe