|Students playing at recess|
Currently, I have been spending some busy days in clinic. On Mondays, Tuesdays, and Fridays, I work in Moshi at a cardiology clinic and medical dispensary, seeing patients with a translator present, or helping with physical exams, EKGs, and echocardiograms. On Thursdays, I travel about 20 km up the side of Mount Kilimanjaro to volunteer at Kibosho Hospital, a fantastic rural hospital that many people from the Mailisita Foundation have visited. I have been working in the pediatrics ward and also in the minor surgery clinic assisting with suturing wounds and draining abscesses among other random doctor-ish things.
While my clinical experiences have been fantastic and extremely beneficial to my education as a young physician, my favorite day of the work-week comes when I’m not at clinic. On Wednesdays, I spend the day at Stella Maris working with Mr. Terry, Agnes (a teacher’s aide), and the watoto of Stella Maris. With the help of an epidemiologist at Loyola and my medical school’s Global Health department, I’ve designed a nutritional survey and health-screening program for the students. The basis for the project comes from my past experiences at Stella Maris and in the Mailisita community. Aside from when they are very sick, children here do not go to dispensaries or to see a physician. It is simply too expensive for our children to seek out consistent health care. Also, the lives of our children outside of their school day can be pretty hectic. The past two years have seen droughts grip the Kilimanjaro area, and farming crops have not been as plentiful as in years past. This puts the poorer families in the area, many of which have children that go to Stella Maris, in a difficult situation of not being able to provide enough food for their families.
Our exam for the children is fairly simple. It involves taking height and weight, blood pressure, pulse, temperature, and looking for vitamin and iron deficiencies, as well as ring worm and scabies. We also take time to interview each student and ask about their home lives and how much they are eating when they’re not at school. We want to be sure if kids are only having tea for breakfast or have to skip meals due to inadequate food at home that we can ensure they are eating enough when they are at school. For lunch, Stella Maris serves a delicious Tanzanian meal called makande, which is a medley of corn meal and beans and the kids get plenty of it. During our screening, we identified some students that have families that cannot afford to feed them on the weekend. Mr. Terry and I are working on a plan to provide them meals on the weekend from the guesthouse and also work in some tutoring too!
|Dr. Matt checking Alicia's blood pressure|
I haven’t crunched the numbers on the data we have already collected, as I have three more weeks here to survey and screen the children. However, I have hope that this project will allow us to identify students that need more food in their diet and also tailor our meals here at Stella Maris to optimally provide for our students. It will be especially important to do so in the coming years as our older students start to enter puberty.
One theme that keeps permeating my time here in Tanzania is that of vulnerability. I see it constantly in the clinic and in the hospital. People come in wounded, hurting, and sick and they turn to the people in white coats looking for assistance and answers for their illness. I’ve found myself in difficult situations that have overwhelmed me. This past week, I held hands with a 14-year-old boy moments before cutting open and draining a swollen hematoma on his leg. During the procedure as he wailed in pain (since we didn’t have adequate pain medication for him), I could hear him screaming “asante” (thank you in Swahili), over and over between sobs. I walked out of the minor surgical theater both frustrated and shaken to my core. It is frustrating to put someone so young through that much trauma when elsewhere with different medications, he might not have suffered as much. Yet he showed so much courage and trust in me to be able to sit on the operating table and let me clean and care for his injury. In moments like that, I feel the responsibility of the coat I am privileged to wear and weight of all things.
|P3 students enjoying their makande!|
In the same vein (pun intended), the children of Stella Maris show similar vulnerability. They have shown such a willingness to speak English at school to each other and to the teachers, even though it is not their native language. When they speak incorrectly, they are so open to being corrected. Each child here wants affirmation that they are learning. I have seen such a growth in the P3 class since I last saw them in P1 two years ago. Their fluency and confidence in their English has grown tremendously and I can’t help but be proud of them, proud of their teachers, and proud of Stella Maris.