Twenty hours and seven time zones after entering terminal E at Logan airport, I walked out of the only terminal at Kilimanjaro International Airport, sluggish and tired since I tried to sleep as little as possible during the flights. Had my plane arrived with the sun still up, I would have been welcomed into Tanzania by a stunning view of Mt. Kilimanjaro, but as my flight landed (exactly on time, I might add) at 10:30pm, the only thing I could see was a bright full moon breaking out of evening clouds over what can only be described as an airport in the middle of an Arizona desert. All in all, I didn’t lose any baggage, all my flights arrived early or on time, and I managed to stay awake for most of the trip; No complaints here.
MIT's iLab waits in Amsterdam
Randomly, during my three hour layover in Amsterdam, I decided to walk around the airport for a bit and suddenly heard my name being called out. Now, my name, for those of you who don’t know, is pronounced like the letter “K.” To the untrained ear, people who shout “OK” without emphasizing the “O” sounds just like as if they are shouting my name. I have gotten good at making the distinction over the years, but occasionally I still get turned around because I thought I heard my name. So as I was walking in Amsterdam International and heard a vague “K,” I was sure that it was nothing. Well, it turned out that I was being summoned, by three other MIT students. I turned around to see Bryant, Adnaan, and a third member of MIT’s ILab project. They had just returned from a three week expedition to Tanzania and Uganda and was stuck in Amsterdam with a long layover. Bryant and Adnaan traveled with my D-Lab team this past January and got to know each other pretty well. It was extremely serendipitous for us to run into each other again, and during a layover in Amsterdam of all places.
Pit Stop: Beautiful Lake Manyara
Since the Kilimanjaro Airport is still a good three hour drive away from Dr. Frank’s dispensary and my plane arrived late at night, we decided to crash at a place between the airport and Arusha for the evening and make the drive next day. Today, we made a few errands in Arusha and then drove South to Dr. Frank’s house, which is a mile down the road from the FAME dispensary. I’ll spare you the boring details of errands and travel, but the whole time Dr. Frank and I talked about life in Africa and he told me quite a few stories that were fascinating.
The “Heartbreak of Africa.”
In the midst of driving down to Karatu, on a road that makes driving in Boston or the Jamaica Way seem ridiculously easy (cars go over 70 MPH on an one-lane street riddled with potholes), Dr. Frank was sporadically on his cell phone talking to Dr. Ivan, a Tanzanian colleague who also works at the dispensary. In the course of the three hour drive, two phone calls changed the way I see healthcare in Africa forever. The first was about a neo-natal infant brought to Dr. Frank by a local “Mama” who runs an orphanage down the street from the clinic. A two month old baby was abandoned at the doorsteps of the orphanage and was immediately brought to Dr. Frank’s attention. The baby was severely malnourished and weighed less than five pounds. In two months of life, the baby actually LOST weight. What she desperately needed was an intensive neonatal clinic and a feeding tube pumping vital nutrients. Dr. Frank and Dr. Ivan took in the orphan and did everything they could to try and stabilize the child and help her gain some weight. However, early on in our car ride, a text message informed Dr. Frank and their efforts had failed. The baby was just too frail.
As we drove further, Dr. Ivan again gave Dr. Frank a call, this time seeking consultation on a 16-year-old girl who presented with a severe murmur. A murmur is a failure of a heart valve that is characterized by the long drawn-out sound produced by the heart at each beat. Properly identifying a murmur without an EKG (Electrocardiogram) is difficult, even for a skilled cardiologist. However, it just so happens that an American doctor who specializes in cardiology and has extensive EKG experience will be in a nearby town starting this Friday. However, Dr. Ivan called to inform us that the girl is now so sick that she was unable to walk. Dr. Frank explained that the chances of the girl making it to the EKG is very low, and she is most likely going to die. However, African customs stipulate that a physician cannot tell a patient that she is going to die, because doing so would put blame on the doctor for cursing the patient. What the girl desperately needs, is a valve replacement surgery for her heart, but that cannot be done without an EKG. It’s a frustrating double-dagger of not being able to give a patient the immediate treatment that she needs and then not being able to tell her that she’s most likely not going to survive to the end of the week. For doctors in this country, determining the correct diagnosis for a patients is not the tiring part. The hard part is when the diagnosis is extremely simple, but requires a medication or procedure that may be readily available in the US, but is just not obtainable in Africa. The emotionally draining part is sending the patient home knowing full well that she is most likely going to die by the end of the week.
In my first day here, I am beginning to understand the heartbreak of Africa.
