Moipei

Moipei* is a 54-year-old pastoralist from Loliondo, an area traditionally Maasai with pastoralism as the primary land use. He has spent his entire life tending to his cows and takes great pride in his ability to care for them. That's why when he had a herding accident, the thought of leaving his cows alone in the fields devastated him. 

“Because of the drought, there is no more grass for my cows to feed on, so I usually climb trees and cut some green leaf branches. As I was up there a week ago, I slipped and fell to the ground, falling on a huge stick that pierced my stomach. I tried to stand up, but the pain was too much. I was alone with the cows and was in too much pain to shout for help. Luckily I had a mobile phone, so I called my younger brother at the homestead and asked for help.”

— Moipei

Moipei was seriously injured, but he believed traditional herbs and oils would cure him, as they had many times before.

“With the nearest hospital miles away, my family and I don’t go to hospitals. We often rely on sheep oil, which works every time! After my accident, I drank a big cup of sheep oil three times a day, sometimes even more! But it didn’t help; if anything, the pain got worse and I could barely stand. After three days, I visited the local dispensary. They gave me medicine, sent me home and asked me to return in a few days if the medicine did not work.”

— Moipei

Moipei took the medicine for four days, but he got worse. While he could take small steps before, he now could not move. His brother decided to bring him to FAME. He hired a private car as Moipei was in so much pain that he couldn't sit up on a bus and had to lie down during the drive.

Once at FAME, the doctors and nurses were shocked by his injury's severity and knew they had to act quickly. He was admitted to Ward 1 and an X-Ray was performed. It was determined that he needed urgent surgery.

Moipei poses with his brother.

“After I woke up from surgery, I was still in pain, but the doctors have been giving me injections and pills and now I can even sit up, almost! Look! The nurses have monitored me closely and have taken care of me, so much so the pain is gone! The doctor says I might be going home tomorrow. I’m looking forward to going back to my cows! Thank you, FAME doctors and nurses, for helping me. God bless you.”

— Moipei

“When Moipei got very sick, I was scared and knew I had to bring him to FAME, even though it’s miles away from home. The journey was long and difficult, but we made it and received urgent care. The doctors and nurses have been kind and gentle with my brother and this comforted him, which I believe helped his healing. Thank you, FAME, for saving my brother’s life.”

— Moipei's Brother

FAME’s Social Worker, Kitashu Ngananga, a Maasai from Ngorongoro, has something to say about the sheep oil. 

“We [Maasai’s] use sheep oil as a local herb treatment. It’s very common. When someone gets sick, they slaughter a fat sheep. We believe that sheep are blessed animals and therefore cure illnesses. Even I drink sheep oil! [chuckles]. However, we are teaching our people that traditional medicine has its limits and they should combine it with modern healthcare to ensure everyone has access to the best possible care.”

— Kitashu

*The patient’s name has been changed to protect his privacy and permission was secured to share his story. The quotes have been translated from Swahili to English.

Sankale (middle) poses with his dad (left) and FAME’s Operating Theater Supervisor, Moses Kikonya (right).

Sankale (left) and his father.

FAME, located in rural Tanzania, was established to provide quality healthcare services to the people living in its surrounding areas. Despite its remote location and limited resources, FAME has served its catchment area effectively by employing local people. This creates job opportunities for the villagers and a sense of ownership and responsibility towards the hospital. For this reason, FAME has prioritized recruiting staff from the local community whenever possible. As a result, FAME has a dedicated team of doctors, nurses and other healthcare workers committed to providing the best possible care to their neighbors, friends and family.

FAME staff from the local community deeply understand the local culture, traditions and language. This has made it easier for them to communicate with the patients and understand their healthcare needs. They also have a good rapport with the community and have built trust and confidence among the people. 

FAME staff shares their positive experiences about the hospital with friends and family, encouraging them to seek medical care at FAME. Despite its growth, FAME never forgets its roots and 40 percent of its workforce comes from the community where we are based.

This week, we ran into a father and son duo at FAME's Outpatient Clinic (OPD). The son, Sankale*, was bringing his father for a three-week review after successful surgery and treatment at FAME.

“When Mzee [father] started getting sick, we were all very worried. We went to a local hospital that advised us to take him to Arusha, more than 220 miles away, as they claimed his condition was serious. That’s when I called Kikonya. He comes from our village and works at FAME. We trust him with our lives. He is our brother and son; we know he always tells us the truth as he is one of us! He asked me to bring Mzee to FAME for additional tests before deciding on the next action.”

— Sankale

The "Kikonya" Sankale referred to is Nurse Moses Kikonya, FAME's Operating Theater Supervisor, who has worked at FAME for three years.

“Sankale and I come from the same village in Loliondo, which borders Kenya to the north. He called me immediately after visiting a local clinic that referred them to Arusha and explained to me in detail the diagnosis they had been given. I advised them to come to FAME to run some tests before making the long trip. After investigations at FAME, we discovered that the original diagnosis was incorrect. We diagnosed Mzee with a condition easily fixable by surgery at FAME. After a successful surgery, Mzee is now fully recovered. Many people from Loliondo, not just from my village, know me well and about my work [Loliondo contains more than 40 villages]. They always call me to seek advice on health issues that need intervention. Today I received another call from home and directed the patient to FAME. People in my community are more likely to trust one of their own who works at a hospital than an outsider. The fact that I work at FAME creates a sense of familiarity and comfort, making them likely to trust my advice. I feel very honored to be in a position to help my community.”

— Kikonya

Mzee (left) explains to Kikonya (right) how he is no longer in pain and his hands work just as they did before!

FAME hires staff from all different tribes in our catchment area. The Maasai are our largest growing patient population and it has been important that we ensure we have staff that represents our entire patient population. As a historically underrepresented group in Tanzania, many Maasai patients have expressed an appreciation for how FAME treats all its patients equally, no matter where they come from.

Overall, the benefits of employing people from the local community in healthcare cannot be overstated. FAME's success is a testament to the fact that by investing in local communities, it's possible to build sustainable healthcare systems that cater to the needs of the people. FAME remains a symbol of hope and progress for the people in our catchment area and a shining example of how a small rural hospital can make a big difference in people's lives.

*The patients’ names have been changed to protect their privacy and permission was secured to share their story. The quotes have been translated from Swahili to English.

Agnes

At FAME’s Outpatient Clinic (OPD), we meet a very upbeat Agnes*. This is her third time at FAME, having discovered it last year when she had recurrent infections that wouldn't go away. Since her first visit, Agnes has been impressed with the care she received at FAME and keeps coming back. Today, she is here on a very special mission:

“I’m here to talk to the doctor about trying for a baby at 47!”

— Agnes

Agnes already has four adult children with her ex-husband. However, she remarried recently, and her current husband is yearning for kids, as he does not have any of his own. 

“My husband is very good to me. He treats me well. He loves me very much. But I am scared he will leave me if I don’t give him a child. He says he will be okay if we can’t have children, but I don’t believe him.”

— Agnes

Agnes confesses that she has been trying for a baby for a year without success. She has taken traditional herbs and medicines, but this has not worked, and she has now come to FAME to talk to the doctor and run some tests to understand the problem. She is hopeful that with FAME’s help, she can get pregnant.

“When I had my second baby in 1996, I was only 20 years old and gave birth in the village. The baby was very big, but the nurses forced me to deliver anyway. Immediately leaving the hospital, I received no aftercare and was back to doing hard manual work. My back and stomach have had on-and-off pain since then. I did go on to carry two more children, but I still wonder if this problem could be what’s stopping me from conceiving.”

— Agnes

Agnes meets with FAME’s Dr. Omary Mvano for a consultation.

Advanced maternal-age pregnancies, or pregnancies in women over 35, are associated with increased risks of pregnancy complications for the mother and chromosomal abnormalities for the baby (WHO). However, with proper medical care and monitoring, many advanced maternal-age pregnancies can be handled well, resulting in healthy outcomes for both the mother and baby.

“I know I am old, but I firmly believe I can have a baby despite my age. My neighbors at home are Maasais, and the women give birth at very advanced ages, sometimes even older than me, and they have healthy children! I’m praying I am blessed the same way.”

— Agnes

FAME’s Head Doctor, Gabriel Kissima, explains how FAME handles fertility issues. In 2022, FAME’s maternity center saw 847 deliveries; the average age of mothers was 29. Still, FAME also encounters infertility in young women too.  

“We run tests when a woman comes to FAME with fertility issues. Some of our tests include a hysterosalpingogram (HSG), an X-ray procedure used to check whether the fallopian tubes are open and if the uterus is normal. A pelvic ultrasound is done to rule out tumors or cysts. We check thyroid functions and other infections. If this is all clear, we check the partner’s quality of sperm, which is essential in maintaining male fertility. We test for other hormones such as testosterone, estrogen and progesterone, but for this, we send the lab samples to Arusha. If a patient needs in vitro fertilization (IVF), we refer them to a specialized clinic in Arusha.”

— Dr. Gabriel

On why she is so happy:

“I love everything about FAME. The nurses are very cheerful, and their demeanor is comforting. When I come here, I already feel better even before seeing the doctor because of the wonderful reception I receive!”

— Agnes

*The patient’s name has been changed to protect their privacy and permission was secured to share her story. The quotes have been translated from Swahili to English.

Mzee Tajiri

78-year-old Mzee Tajiri* has never had surgery in his life before. He has managed to stay, in his words, “very healthy” and has needed little to no medical intervention over the years. Sadly, he recently suffered a traumatic illness that almost left him dead and surgery was the only way to save his life.

“My stomach was very big, painful and I could not pass any stool. I asked my family to take me to the hospital. They carried me four miles to the local village clinic, where I was admitted for three days, but my condition worsened. I quickly resigned to my fate, that I was going to die. My time had come.”

— Mzee Tajiri

As Mzee Tajiri’s condition quickly deteriorated, his family wanted to take him to a bigger hospital, hoping he would access better healthcare. But Mzee Tajiri was not having it.

“I knew I would die and wanted everyone to leave me in peace. Finally, my family called my brother, who works in a big town. He came and forcibly discharged me from the clinic, put me in his car and drove me to FAME. He said FAME was a good hospital that saved lives and that I should give it a chance. Since I was too weak to fight him, we drove to FAME.”

— Mzee Tajiri

Mzee Tajiri and his brother arrived at FAME at 3 am. He was coherent and conscious and knew what was happening, but he was in severe pain and begging for help.

“When we received him at FAME, it was clear that this was a fight against the clock. He was very sick and we reckoned we had little time to save him. We quickly summoned FAME’s surgeon, Dr. Emmanuel Erick Manjira, to consult on the case and he determined that Mzee Tajiri needed an emergency laparotomy to save his life.”

— Nurse Joram Sumawe

Mzee Tajiri presented with an abnormally swollen outward abdomen. Dr. Manjira ordered an abdominal X-ray which revealed he had intestinal obstruction, which occurs when a loop of the intestine twists around itself, causing bowel obstruction. The team had to perform a laparotomy to repair this as it was impairing blood flow, causing him much pain. 

The operation was a success and Mzee Tajiri was discharged after four days. He was asked to continue dressing the wound in a hospital closer to his home and to return for a check-up after four weeks.

“This condition can occur to anybody but mostly people with excess redundancy in the sigmoid colon [a redundant colon is an abnormally long colon that cannot fit inside the body without looping or twisting]. Another possible cause is a tumor; however, in Mzee Tajiri’s case, it was just the redundancy of the colon.”

— Dr. Manjira

Mzee Tajiri poses with his son in FAME’s Ward 1.

“When the doctors told me that I had to have surgery, I was not scared, even though this was the first surgery ever in my life. I just needed the pain to stop. This surgery saved my life and took the pain away. This has been my first time at FAME and I’m so glad my brother insisted on bringing me here. I have received good care. I’m looking forward to going back home and starting my healing journey. I feel like a young man!”

— Mzee Tajiri

“When Mzee Tajiri woke up from surgery, he immediately looked at his abdomen and exclaimed, ‘Where is my stomach?!’ in response to the fact that his big stomach when he came to FAME was now flat. We had to explain it was part of his healing process!”

— Nurse Joram Sumawe

*The patient’s name has been changed to protect their privacy and permission was secured to share her story. The quotes have been translated from Maasai to English.

Joyce (left) poses with Monica (right) and their babies at FAME's Special Care Nursery.

"The babies are already friends!" says Monica

Hospitals the world over can be difficult and overwhelming for parents with premature babies. However, for two mothers, FAME’s Special Care Nursery (SCN) became the place where they found a lifelong friendship. Monica* and Joyce* met in FAME’s SCN because their babies had been born prematurely. Monica's baby was born at 27 weeks and Joyce’s at 28 weeks. Together, they have been navigating the ups and downs of having premature babies and have offered each other support and strength through this tough time.

While Joyce’s baby was born at FAME, Monica gave birth to her daughter in a local hospital that did not have the resources to care for her premature baby.

“After giving birth at 27 weeks, the baby was put in an incubator for a few days. Then the doctor asked me to stay with the baby in the ward, as many children needed the incubator. I stayed with the baby for 17 days in the ward until we were discharged to go home. The baby, born at 3.3 lbs, was now 2.2 lbs and looked very sick, so instead of going home, I came to FAME.”

— Monica

Monica’s and Joyce’s babies required extensive medical care and support in the SCN and the mothers shared a room. 

“This is my third baby. The other two were born full-term, which made having a preemie new to me. I was scared when they told me I would have to deliver the baby at 28 weeks because of my high blood pressure. Luckily, the FAME team is experienced in caring for these tiny babies.”

— Joyce

As Monica and Joyce spent more time together, they began to open up to each other and share their experiences, realizing they were not alone in their struggles. They found that they had a lot in common and bonded over their shared experiences of having premature babies. They shared tips and advice on coping with the stress of having a baby in the SCN and offered each other emotional support during the ups and downs of their babies' medical journeys. They continue to support each other as they navigate the challenges of parenthood.

““We have formed a powerful friendship! We are sisters! We have a strong bond that will continue long after we leave FAME. Monica lives 30 minutes from home, but I plan to visit her often. I am very grateful for this friendship. It has helped me through a difficult time. As much as FAME doctors have provided me with reassurance and guidance, I found more hope and comfort from Monica as we share a similar experience. The encouragement from this friendship has been very uplifting. I am happy that FAME recognizes the value of peer support in patient care and they have encouraged our friendship where we have found hope and strength to keep pushing forward.”

— Joyce

*The patients’ names have been changed to protect their privacy and permission was secured to share their stories. The quotes have been translated from Swahili to English.