Return to Tanzania - 2011

So Many Things To Do

The time to departure is beginning to move quickly. I've been in touch with the people in Tanzania which in itself is not an easy process. Without making judgments I can report that the culture of East Africa is not really amenable to modern technology. Broadband web access is surprisingly available and relatively low cost computers are becoming ubiquitous in developed areas. In spite of that there is a cultural disconnect when it comes to reliably checking and answering email. The easy going, laid back lifestyle simply refuses to generate the sense of urgency necessary for instant communication to work. Though that is probably a good thing  for them it poses some challenges for me.

After some phone calls to Sumbawanga I managed to confirm that my presence there is anticipated. I continue to accumulate supplies. The Ethicon corporation, a subsidiary of Johnson and Johnson, filled an order for sutures that are unavailable in Africa. The $4000 order was custom assembled for free. Kudos to them. Now I have to get it there. Fortunately I can ship some of it to one of our team members to hand- carry.  I cannot ship anything. Even if it got there unmolested it would take weeks to negotiate it out of customs. I also have an assortment of disposable surgical staplers donated by the Autosuture company. These, also worth thousands, will need to be hand carried. Using such devices advances the level of intestinal surgery by 75 years.

Meanwhile I am faithfully attending my physical therapy sessions 3 times a week and working the shoulder at home. It won't be fully functional by the time I leave but if the present level of progress continues I should be able to do what needs to be done with minimal discomfort.

Now it's about paying attention to the details of being away for 6 weeks.  Getting bills paid, arranging home maintenance, arranging coverage for business obligations, assembling a meager travel wardrobe and a generous photographic toolbox, updating immunizations and the list just goes on. Yeah, I am beginning to get excited about this.   

Getting Ready

   

I'm returning to lead a surgical team in western Tanzania this summer. I'll be using this blog to keep in touch so if you want to keep up with my craziness go to the site and I'll do my best to paint an accurate picture. Now it's just four weeks to go. My trip back to Tanzania is motivated somewhat differently than last year. Then it was about fascination with the unknown, the chance to do some remarkable photography and the probability that I would be able to do some good. Now the unknown part is over - I know what to expect and am much better prepared mentally for the arduous journey with its strange sights and smells. I also know how to find accommodations in transit that provide enough security to let me close my eyes and survive the night.. The photography part has narrowed. Instead of trying to paint a hodge-podge panorama with my camera my focus will be limited. I've been given an assignment by Emirates Airline, which is sponsoring my trip, to do a piece on the children of Africa. That's still a huge subject but having been there I know where the stories are and intend to capture them.
    The medical part, however, has taken front position. When I left Sumbawanga and it's large, under-supplied hospital last summer I was devastated by my inability to provide even the simplest care that could have been lifesaving.  Severe burns and  serious infections went untreated or inadequately managed simply because the means to treat them were not there. I performed major surgery using only the barest of essential equipment and got surprisingly good but not acceptable (to me) results. I am taking a good supply of sutures and other equipment, as well as some medications with me and have been successful in getting others to donate items. However, I have no illusions about being able to solve all the problems. My focus this trip will be to provide training for the many people who, thought barely educated, make up the bulk of the hospital staff and provide care on a daily basis. This will not be easy. They are a proud group and jealously guard their positions. However, as a returning physician and not a one-time interloper, I believe I will have their trust.
    The main challenge right now is to get ready physically. A dumb skiing accident in March resulted in complicated shoulder surgery April 1. With intensive physical therapy the goal is to get the shoulder at least pain free if not fully functional by the time I have to leave. I'm working hard at it and it's not fun. Other tasks include stuffing as much equipment as possible into a duffel bag, getting politicians in Tanzania to grease the customs wheels for me so I don't get hung up on my way in and contacting the doctors and other personnel with whom I will be working. There's lots to do. Stay tuned.