Cecilia

Cecilia* is a 38-year-old woman at FAME’s Outpatient Clinic (OPD), here for her post-surgery consultation. This post-operative check-up will assess her progress after the surgical procedure, address any concerns or complications that may have arisen and ensure that she is on track to a successful recovery. Nine days ago, Cecilia underwent a laparotomy, a surgical procedure to remove a large mass from her uterus.

“My lower abdomen had been hurting for over three months before my sister brought me to FAME. I was in pain all the time and my back hurt so much that I could not do my house chores anymore. I also had a fever and was warm to the touch. I visited a local clinic that could not diagnose the problem, but they prescribed a broad-spectrum antibiotic that they said was effective against a wide range of bacteria. Sadly, this did not work. When we arrived at FAME, the doctor performed a pelvic exam and ultrasound and said I needed emergency surgery to remove a growth in my uterus.”

— Cecilia

After a successful operation without significant complications or adverse effects, Cecilia’s pain is mostly gone and she is finally starting to feel better. She reports feeling weak and fatigued nine days post-op, but this is normal as the body recovers from the physical stress of the procedure. Her older sister, who accompanied her on this check-up, is nursing her back to health. 

“My sister makes sure that I follow all the doctor’s instructions, including attending all doctor follow-up appointments despite us living 86 miles from FAME! She provides me with proper post-operative care to promote healing and prevent complications by ensuring I eat a balanced diet. At the same time, she helps with all my chores at home to prevent me from doing strenuous activities. She has truly been godsent!”

— Cecilia

Cecilia poses with her sister at FAME’s Outpatient Clinic (OPD).

Cecilia is grateful to FAME for all the care she has received. 

“Without FAME, I would probably be dead by now! I am happy that my sister brought me here. From the moment I arrived, I was impressed by the professionalism and kindness of everyone I encountered, from the reception staff to the medical staff who provided my care. FAME’s facilities were clean and well-equipped and your commitment to providing top-notch medical services was evident in everything you did. This place has been a blessing to my family and me.”

— Cecilia

Since being designated a Level 1 District Hospital in 2020, FAME is seeing more and more complex cases requiring surgical intervention. Given the limited number of practicing surgeons in Tanzania, death rates in Tanzania remain high for common, easily treatable conditions like appendicitis, hernia, obstructed labor, bowel obstruction, and burns for lack of surgical capability. Access to safe and timely local surgical services remains critical for those in our catchment area. FAME is investing heavily in growing its surgical capabilities over the next five years to meet this need.

*While the patient’s name has been changed to protect privacy, permission was secured to share her photos and story with FAME supporters and to raise awareness of available medical care at FAME Medical.

Mary smiles as she is being discharged from FAME’s inpatient ward.

In rural Tanzania, families play a significant role in caring for their loved ones when they are sick. This role can be demanding and require substantial time, energy and resources. Families take on additional responsibilities in many hospital settings, such as providing basic care and supplies to their sick family members. This can be emotionally and financially challenging.

At FAME, we provide all patients admitted to the hospital with food assistance, which reduces the financial burden on families and ensures that patients have access to nutritious meals, which can improve their health outcomes. 

This was especially useful this week when we had a patient from Tanga, a region in northeastern Tanzania 375 miles from FAME. She was admitted to the inpatient ward and was worried that she did not have family nearby to bring her food. This is her story. 

Mary* is a 57-year-old maize farmer who had traveled from Tanga to Karatu just before Christmas to visit her 79-year-old mother, who was sickly and lived alone. 

“Almost immediately after I arrived, I could feel I was not well. I had headaches, extreme fatigue and sometimes shortness of breath. I didn’t feel like myself at all. I visited a local clinic that diagnosed me with typhoid and gave me some medicine, but this did not work. My condition continued to worsen. I started becoming dizzy and feeling faint all the time. I had come to Karatu to help my sickly mother, but now she was taking care of me. She suggested I come to FAME, a hospital she had been to many times with good outcomes. However, she was too weak to bring me, so with the little money I had, I called a taxi that brought me to FAME.”

— Mary

Once at FAME, Mary had blood and urine tests done. She was diagnosed with iron deficiency anemia. Anemia is a common health problem in Tanzania, particularly among women and children. The leading causes are an iron-deficient diet and malaria (WHO). At FAME, we saw 390 cases of anemia in 2021 and 318 cases in 2022. The Tanzanian government has implemented programs to address anemia in Tanzania, including distributing iron supplements, promoting malaria prevention and treatment and providing nutrition education. 

In Mary’s case, the anemia was caused by repeated malaria infections. Some of the most common symptoms of anemia are fatigue and weakness. Long-term anemia can lead to cardiac problems such as heart failure and high blood pressure; in severe cases, anemia can lead to death. Mary’s condition required prompt treatment and was admitted to FAME’s inpatient ward.

“Tanga, where I live, is known to have a high incidence of malaria because its tropical climate is conducive to transmitting the malaria-causing parasite. I have had malaria several times; I didn’t know it could cause other problems like this.””

— Mary

Mary had to call her mother and let her know that she would be admitted at FAME for a couple of days and would not be going back home right away.  

Pendo, delivering food to patients at FAME’s inpatient ward.

“She was very concerned about me, not only because I was much sicker than we had thought, but because she was not strong enough to cook and bring food to me at FAME every day. The hospitals we have been to in the past don’t always provide regular meals for patients, so it’s up to the patient’s family to provide food for them while they are in the hospital.”

— Mary

Providing food for patients is important, as proper nutrition is essential for a patient's recovery and can significantly impact patient outcomes and overall health. At FAME, patients are provided with breakfast, lunch and dinner, as well as 10 am and 4 pm snacks such as porridge and fruits. Hospitals in underserved areas, such as where we work, may not always have the resources to provide regular meals for patients. Additionally, patients from these areas are more likely to experience poverty and food insecurity, making it challenging for families to bring food to the hospital regularly. 

“It was a huge relief to learn that FAME would provide all meals for me. With my family so far away and my mother unable to do much, I was worried about how I would survive my hospital stay without my family’s support. However, it turned out that I didn’t need any additional support! FAME became my family and helped me in everything. FAME is home away from home! Being here, I have noticed that patients who do not have families visit them do not lack anything, as the food is provided and the nursing staff provides attentive care. Asante Sana [Thank You] FAME!”

— Mary

After three days, Mary was discharged to go home. She was given iron supplements to increase the iron in her body and a diet plan to increase iron intake by adding foods such as meat, beans and leafy vegetables to her diet. She was also advised to take preventative measures against malaria, including using bed nets treated with insecticide. 

“I feel better and excited to return to my maize farm in Tanga. What was supposed to be a short visit to Karatu turned out to be a month-long adventure! Thank you, FAME, for everything.”

— Mary

Editors note: FAME is familiar with patients from faraway places; just last year, we had a patient come from Zanzibar! You can read that story here. 

*While the patient’s name has been changed to protect privacy, permission was secured to share his photos and story with FAME supporters and to raise awareness of available medical care at FAME Medical.

At the Foundation for African Medicine and Education (FAME), we place the same value on education as healthcare. Because at FAME, we know that to provide high-quality, patient-centered care, we must be completely committed to learning, growing and transforming as individuals and as a team. On this International Day of Education, FAME is proud to highlight its investment in education and the life-long learning of our staff. 

At FAME, we recognize that positive outcomes for our patients rely on the strength of our team. Therefore, FAME views capacity-building as a long-term investment in our Tanzanian staff’s ability to treat patients by creating new structures and approaches to deal with complex cases, supporting patients and their families and working to effect necessary systemic change as a model institution for patient-centered care. By continuously educating our staff, FAME ensures that we are best positioned to have an even more significant impact on the populations we serve for generations to come. 

Here’s a look at what's in store for education and capacity-building at FAME in 2023:

Mental Health Course for all FAME staff

FAME’s Housekeeping Team, at the mental health training.

FAME’s Social Worker, Angel Obeid, educates the housekeeping team on the importance of mental health.

This year, FAME has introduced an in-house mental health course training to support the prevention and alleviation of staff stress and anxiety. 

Mental health conditions are increasing worldwide (WHO) and mental health stigma remains strong in northern Tanzania. Mental health problems are believed by many to be a myth and those who struggle with mental health have nowhere to turn.

In light of this, last year, FAME sponsored its Social Worker, Angel Obeid, to attend a Mental Health for Organizational Success course at the Institute of Social Work in Dar es Salaam. This course brought together government and private organizations to learn and discuss mental health conditions. The training equipped Angel with information and skills to train her fellow employees at FAME. 

“I’ve started training FAME staff on stress management in an occupational area. In today’s world, there is so much going on that can affect people’s mental health and FAME wants to ensure that our staff feels supported. This course seeks to increase mental health awareness amongst our staff to create more understanding and less stigma and to offer details on the access to quality mental health care and treatments available. I’ve already trained the housekeeping department and they have been very receptive and asked many questions. I intend to do this with every department at FAME. Everyone must know that mental health conditions are indiscriminate and can affect anyone.”

— Angel

Diane Returns!

FAME’s long-term volunteer, the amazing Diane Berthel.

Long-term volunteer, Diane Berthel, has returned to FAME for three months to spearhead our intensive management training across departments. 

Last year, Diane led a three-month process to develop FAME’s current Strategic Plan. She met with all department heads to discuss the strategic priorities identified and the resources needed to support them through their work. 

This year, Diane plans to meet with department heads to discuss the progress made on the strategic priorities and the next steps they need to take to ensure that FAME continues to see growth and success in these areas. 

“There will be individual and team coaching to establish initial goals regarding the strategic priorities during my three-month stay. I will pay particular attention to resource management in three general areas; employee capacity, data analysis and use and internal and external collaborations. The overall focus will be to offer support to achieve interim and long-term strategic priority goals.”

— Diane

Welcome back, Diane!

Doctor and Nurse Training continues

A past doctors training session. FAME doctors were joined by FAME Co-Founder and Co-Director, Susan Gustafson (third left) and volunteer Emergency Medicine Doctor, Natalie Strokes (right, in scrubs).

FAME’s Head Nurse, Kizito Koinet (left) leads a nurses training session.

In 2023, FAME will continue providing educational opportunities for its medical staff.

In 2022, FAME staff received over 100 trainings and lectures from specialists from around the world. This year, on-campus trainings, online consultations via zoom and western-trained medical specialists from overseas medical communities coming to FAME as on-site volunteers will take center stage. 

Some educational opportunities offered to FAME staff in 2022 included epilepsy case management, electronic fetal monitoring, rabies awareness, emergency care, cervical cancer screening, malnutrition education and postnatal care, among many others. 

“Capacity development is critical to achieving results and sustaining what we have already built. It is a process of learning new skills, which in FAME’s case, has fostered a great sense of ownership. A big thank you to all our supporters; we are so grateful for the support and look forward to another year of collaboration.”

— Dr. Ken Karanja, FAME’s Clinical Education Coordinator.

Malaria is a serious and sometimes fatal disease caused by a parasite that commonly infects a certain type of mosquito that feeds on humans. In the United States, about 2,000 cases of malaria are diagnosed each year, with the majority of cases in travelers and immigrants returning from countries where malaria transmission occurs (CDC). This is a stark difference from Tanzania, where over 45 million people are at risk of malaria because of the climate and topography (USAID). The Tanzania Ministry of Health reported 4.4 million malaria cases in 2021, resulting in 1,905 deaths. 

FAME is located in northern Tanzania, near the Ngorongoro Crater, at a relatively high altitude of 5,900 feet above sea level. While malaria is a concern in all areas of Tanzania below 5,000 feet, given the altitude of our catchment area, malaria cases are minimal. Malaria thrives in low-altitude regions and is much more unlikely in higher altitudes. 

That's why our team was surprised when Daniel*, a 19-year-old boy who resides in the Ngorongoro area, was admitted to FAME’s inpatient ward with Malaria. 

We learned that Daniel had just returned from a trip to the southern highlands of Tanzania. He had traveled to Songea, a region in southwestern Tanzania, to see his mother for a month. Songea is at an elevation of 3,600 feet above sea level. The altitude, among other factors, makes it a high-risk area for malaria. 

It was on his way back to Karatu from Songea that Daniel started experiencing symptoms: fever, headache, chills, and nausea. The journey was long and traveling 690 miles on a bus is not the most comfortable. Daniel wondered if he could make it home to Karatu. He spoke to the man who sat next to him on the bus, told him that he was unwell and asked him to watch his belongings if he lost consciousness.

More than 17 hours later. Daniel arrived in Karatu. 

“I was nauseous and in pain when we arrived in Karatu at almost midnight. I thought of coming to FAME but then had second thoughts on whether I was really sick or the long grueling journey had taken a toll on me. So I went home, took paracetamol and tried to sleep.”

— Daniel

After a night of restless sleep, tossing and turning and waking up several times, Daniel came to FAME the next morning. 

“I was lucky that my father was in Karatu. I called him and asked him to bring me to FAME. He came on a Boda Boda (motorcycle) to pick me up. I was so sick I couldn’t sit upright; he had to support me.”

— Daniel

Dr. Lingato Olekotoy (right) consults with Dr. Joselina about Daniel’s case.

Once at FAME, Daniel was received by a doctor and sent to the lab for tests. 

“After doing tests at the FAME laboratory, I was diagnosed with malaria and was admitted to the inpatient ward. This is the second time I have gotten malaria, the first time being when I lived in Dar es Salaam [elevation: 187 feet above sea level] seven years ago, but the symptoms this time were different! I don’t remember being this sick!”

— Daniel

After two nights at the inpatient ward, Daniel is ready to go home.

“The care at FAME has been exceptional. The food was delicious; I’m extremely sad that malaria took my appetite away and I couldn’t eat much. I might return for the food alone; this was a missed opportunity! I’m happy with the treatment and thanks to FAME, I’m starting to feel back to my old self again.”

— Daniel

Drs Joselina (left) and Lingato (right) are joined by Dr. Emmanuel Mbilinyi (second right) and Nurse Iluminata Sanka (second left).

Through the National Malaria Control Program (NMCP) and in collaboration with its partners, the Government of Tanzania has made significant strides in the fight against malaria, resulting in a remarkable reduction in malaria cases. This is reflected in the number of malaria patients at FAME: in 2021, we saw 53 malaria cases; this dropped to 38 cases in 2022. 

FAME’s Head Doctor, Gabriel Kissima, explains the malaria cases we receive at FAME: 

“Because of Karatu’s high altitude, we don’t usually get many malaria cases from around here. Often, the patients have traveled outside Karatu or live outside our catchment area. At FAME, close attention is paid to the differential diagnosis of febrile illnesses [fever], as early recognition of symptoms and signs perceived as malaria are vital for effective case management.”

— Dr. Gabriel

*While the patient’s name has been changed to protect privacy, permission was secured to share his photos and story with FAME supporters and to raise awareness of available medical care at FAME Medical.

Lugongo poses at FAME’s inpatient ward.

Three months ago, we covered the human-wildlife conflict in our catchment area, where a young boy was attacked by a leopard while herding goats in the Serengeti and was quickly rushed to FAME for treatment, saving his life. You can read his story here.

This week, we encountered a similar case, only this time, it was a buffalo attacking a 59-year-old man, Lugongo*, as he picked some native wild vegetables.

Since the death of his wife a year ago, Lugongo has had to take up her chores, including picking wild vegetables for food from the forest. His home borders the Ngorongoro Conservation Area (NCA), sharing the same ecosystem as the wildlife. Due to this, human-wildlife conflicts are not unusual. 

On this fateful day, Lugongo and his friend ventured deep into the forest, searching for wild vegetables, as they often did. Suddenly, he was attacked from behind and thrown in the air.

“I didn’t understand what was going on. One minute I was laughing hysterically with my friend; the next, I was high in the air. When I fell, I saw that a buffalo was attacking me. Terror, shock and fear engulfed me. I know about the buffalo. It’s a very dangerous animal. Its horns would shred me to pieces; if that didn’t work, it could easily trample on me. It’s a very heavy animal.”

— Lugongo

The African buffalo is a member of the Big Five wildlife animals. It weighs 660 to 1,840 pounds, is 4 to 5 feet tall and is extremely strong (National Geographic). It is herbivorous and favors dense forests and open plains for food. It is easily seen in protected areas and national parks such as the Ngorongoro Crater and the Serengeti.

Lugongo’s friend started screaming and throwing sticks and stones at the buffalo to chase it away. This alerted other people in the village, who ran to help scare the buffalo off. When it finally ran off, Lugongo was in bad shape. The villagers put him in a car and quickly rushed him to FAME. Time was of the essence if he was going to survive. 

Here, FAME’s Head Doctor, Gabriel Kissima, describes Lugongo’s condition when he arrived. 

“Lugongo had suffered a traumatic chest injury from the attack. He had a cut on his chest that was 3.9 inches long and 1.5 inches wide, with many rib fractures and extensive damage to his lungs and internal organs. He had lost a lot of blood and needed emergency surgical intervention. He was sent to the operating room (OR) for trauma assessment and a thoracotomy [a surgical procedure that goes into the chest] was performed. This enabled the surgeon to see through the damaged lung and internal organs. The left lower lobe [lung] was repaired.”

— Dr. Gabriel

African Buffalo, photographed in Ngorongoro by FAME’s Board Chair, Dr. Michael Rubenstein.

At FAME, surgery is increasingly becoming integral to the healthcare we provide. Once it was discovered that the patient required immediate surgical intervention for his life-threatening injuries, FAME’s surgical team moved swiftly and coordinated their work with each other to have a successful operation and save his life. With FAME’s catchment area including national parks, FAME often deals with injuries related to human-wildlife interactions that may not be as common elsewhere, such as Lugongo’s case. FAME’s surgical team is crucial for treating complex cases and saving lives in time-sensitive situations, even as essential surgery remains inadequate and poses significant challenges in rural Tanzania.  

It has been four days since the surgery and Lugongo is awake and fully alert. The doctors expect a full recovery. 

“FAME saved my life. My family confided in me that they were sure I would die since the injuries were so severe. After four days here, I feel much better. I’m still in a little pain, but I can sit up and talk to the doctors and nurses when they come around. I am telling my story to warn people of wild animals’ danger and ask them to be careful. And if they are ever attacked, FAME will save them!”

— Lugongo

*While the patient’s name has been changed to protect privacy, permission was secured to share his photos and story with FAME supporters and to raise awareness of available medical care at FAME Medical.