It was an exciting opportunity to be selected to join the SCL medical mission trip to Tanzania in November 2017. SCL visits our sister hospital, Arusha Lutheran Medical Center once or twice a year to assist with program development in various areas. In a prior needs assessment, physical therapy had been identified as a potential area for growth, particularly in treating outpatients with low back pain. Nicole Hopewell, Inpatient Rehabilitation Manager at Good Samaritan, partnered with me to take on this project. Twelve of us, including the CNO of Saint Joseph Hospital, respiratory therapists, nurses and a lab tech left the day after Thanksgiving for a 17-day journey. We flew to Minneapolis, then Amsterdam, then another 9 hours to Tanzania, filled with anticipation and curiosity about what we might find.
For the majority of our trip, we stayed in a lodge with bomas, small round buildings that had two bedrooms in each unit. Two of us stayed in each room that had twin beds covered by mosquito nets. We had power outages most nights and water that had to be preheated and used very sparingly to shower, but all of our needs were met. I woke up each morning to cows mooing, roosters crowing and church bells ringing in the distance. The lodge was pretty, with a pool, good food, and a balcony where we ate breakfast. Every morning we drove our Land Rovers through a gate that separated us from a very rutted, bumpy, narrow dirt road surrounded by shacks and rundown shops. Beyond the gate was noise, crowds, dirt and poverty; just one of the many contrasts I observed in Tanzania. As we drove down to the hospital, adorable kids in uniforms would trudge up the hill to school. They’d always wave and smile.
After attending morning chapel filled with beautiful singing in Swahili, we spent each morning in the PT department. Two PTs and one aide worked with a multitude of patients behind curtains in the hot and humid gym area. We had not expected to see the gym continually packed with patients and family members working independently on exercise equipment or helping each other walk around the room. Everyone was dressed impeccably in beautiful colors; otherwise it made me think of a packed fitness center right after New Year’s. Treatments were brief, as the PTs worked hard to meet the needs of as many patients as possible. We helped them develop treatment plans, establish goals with patients and teach appropriate exercise progressions. The PTs and all of the patients welcomed us and were very appreciative. On our last day, the PTs took us out for nyama choma, which turned out to be roasted goat that everyone ate with their hands.
We also contributed to various other programs affiliated with the hospital. The Plaster House, founded by an Australian OT, provides a place for children to live and rehabilitate after orthopedic surgeries or injuries. They have a school, house mothers and a loving atmosphere. We saw children casted for club foot, wearing braces to correct bone deformities due to fluorosis and recovering from severe burns due to cooking over open fires at home. Despite all of this, the children were laughing, singing, playing together and grabbing our hands so we could join them.
Another moving experience was teaching patient transfers and proper body mechanics to nursing students. They were so enthusiastic, eager to learn and grateful for our help. They all had cell phones and took many selfies with us! Then we went on a home health visit to a quadriplegic man outside the city. Though he had an accident seven years ago that left him paralyzed, his family and neighbors lift him out of bed to a chair every day. They built a standing frame with belts to secure him in an upright position. He had no bed sores and was clearly receiving decent care from dedicated people around him. They too were very appreciative of the few exercises and positioning techniques we were able to teach them. These people left me feeling surprisingly hopeful after witnessing a very sad situation.
Beyond healthcare, we also visited the Maasai Girls’ School, a boarding school that recruits girls and provides a high school education, encouraging economic independence. Typically Maasai girls attend school until age 12, then enter arranged marriages and care for cattle. The girls here were beyond inspiring. I toured the school with Miriam, a 15 year old who wants to be an accountant because she “likes math and money.”
Then we shifted gears and experienced breathtaking safaris at Arusha National Park, Tarangire National Park and Ngorongoro Crater, home to the largest concentration of wildlife in Africa. Words can’t describe the amazement of seeing giraffes, zebras, leopards, baboons, lions, rhinos, hippos and elephants in their beautiful natural habitat. I woke up one morning to eight elephants lined up right outside my tent. Apparently a lion had visited during the night too, but I slept through that. Monkeys invaded one of the tents, but otherwise the animals didn’t pay much attention to us. It was a very different world to witness.
I continue to think about Tanzania daily. The people I met and the group that I traveled with are unforgettable. Seeing the poverty mixed with natural beauty, the poor conditions yet the sense of community, the desperation intertwined with hope left a lasting impression on me. I am so grateful to have had this experience.
PVMC Physical Medicine Director