Jasper

The key to my effectiveness here in Tanzania is Dr. Jasper Nduosindi. He is the senior of four or five physicians assigned by the government to staff Rukwa Regional Hospital. It is a daunting task particularly as one or more of the junior docs seems to be away at a meeting most of the time. I have not been impressed with any of them except Jasper. He has had surgical training, how much I’m not sure. Nevertheless, he has been responsible for all surgery, crossing all specialty lines, for several years. He does it all, OBGYN, urology, orthopedics and general surgery. As I’ve indicated, he has very little to work with in terms of equipment and supplies. There are almost no x-ray or laboratory diagnostic methods available. His diagnoses are always strictly clinical, arrived at by physical examination supported by experience. He must act on them every day knowing that he might be wrong. Under these circumstances the most important things he needs to avoid are exceeding his limits and getting into situations where he runs out of options.

Jasper is a bright guy. He attends postgraduate seminars often in Nairobi or Dar. He can put little new knowledge to use here because of equipment limitations. WE sit for hours sometimes talking surgery and as I describe the developments of the last 20 years he is incredulous. I brought intestinal stapling devices with me. Although they have been in use in the US for 40 years he had never heard of them. I can show him how to use them and leave my stock. It will be up to him to cajole the government into getting him some more. I’m not real hopeful about that.

We have a neat relationship. Going about the day with him I get to help set bones, treat malaria and do other things that I’ve either never done or long forgotten. He gets to assist me in surgery doing the things that I know well thereby upgrading his own technique and decision making. Where Jasper is rapidly becoming a formidable expert is in the area of repairing fistulas caused by obstetrical damage which is a huge problem here. Each year he works with a dedicated team from Nairobi that comes for two weeks to work and teach. He’s getting really good at it and may be forming a team of his own.

Doing medicine for the government doesn’t pay much here – perhaps ten to twelve thousand dollars a year. The good news is that things are very inexpensive here outside Dar and the northern tourist areas. Jasper has managed to raise a beautiful family and acquire a few houses and a sizable piece of ranch property not far from town. His wife is currently away working on a nursing administration degree in Dar. He sees himself getting out of government medicine before too long and settling down as a gentleman rancher and perhaps running a small private clinic somewhere. Those are positions in life that he will have rightfuly earned

Comments

[Kim H]

Wow! As I sit here reading your blog on Sunday morning at 6:40am a new post suddenly appears. The miracles of the Internet never cease to amaze me. I have met a young lady here in Scottsdale who will be going to Tanzania in August to teach AIDS/HIV awareness to children there. I have given her your blog address so she may be in touch. I'm not sure what part of Tanzania she is going to and I know it is an enormous area. But you never know. Keep up all the good you are doing Skip. You have a very kind and generous heart!