Doctors Wanted! Making a difference in rural Tanzanian health care

Dr. Will Metcalfe and Vikki Milne with an NGO Home Based Care Volunteer visiting a patient in the village of Isipii in Mufindi District, Tanzania

Week three of June was action packed as well, and had a distinctly health-centered focus.

On Monday (17^th) Charles Mwagala from the Children’s Village attended a meeting at the Luhunga ward office that discussed issues with AIDS, and what issues to bring up when upcoming district guests visit the village the following day. We are being invited to all of these Ward meetings these days held by the government, and we take it as a great sign that the local government wants to include us whenever they can.

Children’s Village/Community Outreach manager Jenny Peck held a meeting with the sewing school leaders (teacher and top students) and discussed a future plan to generate steady income for the school. Things have really taken off since volunteer Annelies Vermeij visited and gave the program a shot in the arm. Jenny then gave a small seminar on HIV education to the guardians at the Children’s Village, and announced the visiting doctors Will and Vikki would be giving a full seminar before they leave. We have a goal that everyone working with our NGO will become a local expert in HIV, so there will be even more education about the disease spread to the community at large.

Will and Vikki then did a round-up around the Children’s Village, and made a check-up on all the children with health issues.

Tuesday brought a trip to town as Nache, an 11 year old HIV+ boy at the Children’s Village, needed an x-ray (available only at the district hospital for now), to diagnose whether or not he had tuberculosis. He tested negative, but a complicated treatment plan was put in place to treat him for Pneumonia. The Mufindi District HIV team came later in the day to visit the Children’s Village. We are located quite a distance from the district capitol, so again it was great to see this inclusion by district leaders. We were able to bring up all of our concerns such as CD4 reagents for the Mdabulo Care and Treatment Clinic for HIV, broad-spectrum anti-biotics for HIV patients, line 2 ARVs, and infant tests for HIV. It was useful to get a voice with the stakeholders at the district level on HIV treatment. We continue to voice our concern that our area is underserved in relation to the high prevalence of HIV in such a rural place.

Wednesday the 19^th featured more health focus, as the NGO health department called a special meeting to discuss the developments of two children at the Children’s Village (Nache and Meshack) who were starting the second line of Anti-Retroviral treatment. This begins when the body builds immunity to the first line, and it is very dangerous as in Tanzania there is no third line. This means that proper health practices such as diet, and strict medication adherence are literally vital concerns now for both of these children.

Jenny and Peace Corps/Foxes’ NGO volunteer Stacey Droll discussed and planned the schedule for remaining week that Doctors Will Metcale and Vikki Milne would be present. They themselves spent the day visiting areas in and around Luhunga village including Mwefu, Kipendaroho, and Igoda, seeing patients. They saw many patients affected by HIV, and who were afflicted with opportunistic diseases such as tuberculosis.

The next day physiotherapist Sigi Steiner arrived and she immediately worked with Hezron, an 18 year old boy living at the Children’s Village who is HIV+ and physically disabled due to severe cerebral palsy. Sigi has been teaching guardians some exercises that will help Hezron feel more comfortable and be more independent in his life.

Stacey brought Doctors Will and Vikki off to Kidete village in the morning as we were fortunate to have a visit from Dr. Schuyler Wood, and his wife Kavisa. Having Schuyler present meant that he could help with Nache’s complicated pneumonia treatment (which included daily injections and refilling of an implanted IV). This allowed Will and Vikki to see more patients. The next day doctors Will and Vikki visited the Mdabulo CTC. It was clinic day, and they were able to help with the abundance of patients (over 100) that arrived on the one day. Sigi came as well so that Stacey could take her on home visits where family members were taught how to help their disabled relatives.

Dr. Metcalfe with Zakayo (in the Dr.'s right arm) and Vasco (on his right) with their family members. The children successfully re-patriated back with their families earlier this year after spending the past four years at Igoda Children's Village

Saturday the 22^nd featured a long day of travel as we checked up on Zakayo and Vasco who had left the Children’s Village and gone home to their far away village of Kilosa to leave with their respective families again. We were overjoyed to see that they are doing very well. This is something that we all love to see as our main goal is to have every child live in the village with his or her family, and successful ‘re-patriation’ back into the village is our goal for every child at some point. We see this as an overall good sign of development for the surrounding community as more and more families are becoming able to take their children back to their village homes. They are gaining the ability to care for their own children as positive development improves their lives. Doctors Will and Vikki made the trip, along with Sigi, and they all saw patients in Lulanda, and Isipii villages.

On Sunday the 23^rd, Will and Vikki gave Nache his last injection/IV refill, and he had shown signs of improvement. We hope for the best for Nache, but he is in a very fragile condition. Just as his cough and pneumonia symptoms were improving, he was diagnosed with shingles. He has medication (left by Dr. Leena Pasanen from her previous visit) and his condition will continue to be monitored very closely.

The week really showed us what kind of impact medical volunteers really can have. Under the right local guidance, medical volunteers can help overall health on a case-by-case basis, but also through educating the masses about better health practices. Our NGO has been blessed with some great medical volunteers in the past, and as the Mdabulo Hospital is ready for its grand opening, we will have the capacity for medical volunteers of all kinds including dentists, surgeons, nursing professionals, physiotherapists, and others. We welcome anyone who would like to make a difference in a very underserved rural population that is on the road to recovery.

Children of Africa Day / Medical Volunteers Making an Impact

The Igoda Community Hall was packed for the big event on Sunday! This is the forth year in a row that the Hall has hosted an event to commemorate the day.

Another busy week in the books here in Mufindi. Sunday was spent organizing the schedule of volunteers for the rest of the month as we will have a full-set of volunteers with over 30 volunteers expected in the last quarter of 2013! Word is getting out about the NGO, and we're happy that these volunteers have something to contribute to the projects here in Mufindi. 

Monday we welcomed Elida Mkolefu back to the Children's Village. She has been studying in the southern area of Songea, where she will be getting her certificate to be a professional child-care giver. Once she has completed her course (end of October) she will be the third certified member of our Children's Village team. She brought her grades home with us, and she urgently sits at the top of her class! She's making us all very proud!

Tuesday, Dr. Will Metcalfe went to Mafinga where he helped two HIV positive children get medication at the district Hospital as well as an x-ray for Meshack who had severe swelling in his elbow. There was no break, so Will will be supervising physio for the next month while he's here. Dr. Vikki Milne assisted Dr. Ndenga at Mdabulo as it was 'CTC' day and hundreds of patients crowded the facility. The extra doctor helped get more people treated and allowed for more health service to the community.

The sewing school, named 'Threads of Hope' held its first meeting since volunteer designer/sewing master Annelies finished her stay with us. She brought some great fresh ideas to the classroom, and she will be back again in October. She has committed to a long-term partnership with the school in hopes of bolstering the school into a profitable entity and thus creating more sustainable growth for the area.

On Wednesday, several guardians met with Boniface, a 15 year old boy who is living with his Mother in the Care Homes Complex while she re-builds her home. Boniface left the Children's Village earlier this year, but is having trouble with the challenges of school. We are happy to have many invested parties in his success, including neighbors and a caring Mother who all want to see him succeed in school. We hope that with continual follow-up meetings his progress in school will improve and we are all putting forth the efforts to help him succeed and become a productive member of society. We are happy that the guardians show such care for the children they've cared for even after they have moved from the Children's Village.

Dr. Will Metcalfe and Dr. Milne then had a busy Thursday and Friday as they visited several villages in the area (Luhunga, Ikaning'ombe, Mkonge) and saw patients in their homes. There were many affected by HIV, and therefore several opportunistic diseases that came about and were treated. Because our community is still recovering from the high prevalence of the HIV pandemic, overall health is gravely affected. Having these medical volunteers come and add their services to the health care system that is lacking in resources will ultimately improve health in the area, and enable the community to care for all of its children.

On Saturday, the Doctors gave Amani, 12, a check up, looking at his hand and seeing how he has progressed since his surgery last month. Amani suffered a bad burn as a small child, and his hand has become enclosed, with fingers infused. He has had surgery to fix his hand, and now he has more grasping capability, and a working thumb. 

Logistics were also organized for Bennett Mwagala to get treatment on his foot. Bennett is an HIV positive man who has worked to get his family's lives back on track. Four of his children lived at the Children's Village for a few years while he worked to get money to build a new house. The children are back with him in the village, they are attending Mwefu Primary School, and their progress is going well by all accounts. Unfortunately, Bennett has recently contracted Kaposi Sarcoma, an AIDS-defining illness, and he has received counsel from the NGO on how to get to Dar es Salaam, who to see for treatment, and how to maintain health after treatment.

June 16th marks Children of Africa Day, and for the 4th straight year an event was held at our Igoda Community Hall to commemorate the event. This event recognizes the importance of Children's rights, and highlights what can be done to improve the lives of the community's youth.

This year we were proud to host the official event for the entire Region of Iringa! Regional officials along with the district commissioner of Mufindi, and other important stake holders in children's rights attended, and it was arguably one of the biggest ceremonies we've had at the Community Hall. It was an honour host so many crucial players in childhood development, and even humbling as many specifically mentioned our NGO as an organization 'worthy of imitation!'

It is not for the thanks and appreciation that we do this work of serving the community of Mufindi, but the recognition is greatly appreciated. We feel the local leadership within the organization stepping up more and more is perhaps the leading cause for this extra attention.

This makes us all very excited for the remainder of the year as we look forward to continued successful cooperation with all members of local and regional government, as well as everyone in the community at large. The event at the Community Hall was a big hit, and we look forward to many more to come!

Life, Death, and Development

Isaya Mwila (front right) Longi (left) and Yusto (background) helped explain the projects in Mufindi to the big crowd at the goat races charity event on June 1st, 2013.

This was certainly one of the more memorable beginnings to any month we've had in a long time. June 1st marked a charity event where 4 members of the NGO came to Dar es Salaam to celebrate the developments of our income generating projects that have helped members of our community stand on their own, and lift themselves out of poverty. 

Isaya Mwila from the Children's Village; Yusto Chumi from Igoda Primary School library; and Longi and Maria from the sewing school named 'Threads of Hope'; all came to talk about the projects in Mufindi. The event was a smash hit as there were many sales, and the word was spread about the NGO!

Sunday, everyone was happy to be back in Mufindi after a long day of travel, and ready for work again the following day. The 3rd started with a round-up of all projects, with a progress report of every building project. At the Children's Village, a small clinic is being built, along with a house for Dr. Leena Pasanen who is moving here full-time, a nursery school is being built to open next year, and an administrative office is under construction. In the afternoon, the guardians all met for their weekly guardians meeting, to discuss issues and make announcements. That night, a baby boy was born at Mdabulo. His Father is a former child from the Children's Village who has started an independent life for himself in the village. He has entered Fatherhood perhaps earlier than we would have liked (20 years old) but is ready to accept the responsibility as an adult.

Tuesday was CTC day (Care and Treatment) at Mdabulo and so, returned volunteers Dr. Will Metcalfe and Dr. Vikki Milne with Jenny Peck visited, and also said hello to the new arrival. Just as they all arrived, another Mother had gone into labour, and the Doctors and Jenny gave a helping hand in that delivery! There was a lot of new life happening in Mufindi!

Doctors Metcalfe and Milne took a tour of the Children's Village on Wednesday the 5th, and paid special attention to two children Nache and Meshack who need to be started on line 2 medication of Anti-Retroviral Treatment, as they have grown immune to the first line. Stacey Droll was supposed to have returned with Zainabu and care-giver Sijali this day, but news from Dar came that Zainabu had contracted Malaria. Zainabu has been at the children's Village for about 18 months. she is 17 years old, is blind, and suffers from epilepsy. The following day brought the news that would shape the rest of the week.

At around 10am Thursday the 6th, Zainabu passed away. She had gone to Dar seeking treatment for her broken leg brought on by Osteoporosis, and had received very poor treatment from various health centers.

The body came back to Mufindi on Friday, and the funeral was set for Saturday. All of us had been less than a week removed from the joy and fun of the developments from the charity event, and the new life in the form of the newborns, and now we had to work through the passing of a child.

The funeral actually had a beautiful service, as led by a Catholic priest with time given to Isaya, Charles, Rehema, and others from the Children's Village to say a few words. Everything said by members of the Children's Village was well received by everyone in attendance. It was great to see the service led with such poise and grace, as delicate issues were directly addressed such as the improvement of treatment of people with disabilities in this rural community. Equally as important as the good work from the speeches of the members of the Children's Village, perhaps was the manner in which the ideas were received by the community. Everyone is invested in the betterment of their own community, and all ideas are welcomed. Zainabu was remembered respectfully. Her service also featured sentiments from the community itself, as several people suggested we try harder to contribute as a community to someone's health while they are still alive rather than just contributing to funeral costs. It was nice to hear this coming from the community. It seems the community is trying to lead itself into more positive development.

Indeed there are some great developments on the horizon here in Mufindi, with some work left to be done for sure. Now is the time however, that it's own people need to stand and affect change for themselves. It is great to see that local leadership is stepping into the fore.