October 08

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Regional Dermatology Training Centre (RDTC) and Outreach clinics in the Kilmanjaro Region

Friday will mark my first month in Moshi Tanzania with the Regional Dermatology Training Centre (RDTC) at Kilimanjaro Christian Medical Centre (KCMC). The picture (yes, my camera is working! thank goodness for HDMI cords) is the building where I work, on the second floor. It’s about a 10 minute walk each day, depending on my speed and the weather. Mostly the weather has been good, but I experienced my first all day rain yesterday. (My rainboots were noticed by some and I even had an offer to have them taken them off my hands when I leave) Apparently it is now the light rainy season. It should be interesting!!!

Over the past month, I’ve been working with the faculty, staff and medical residents on my project. I’ve been tasked to help the group put together a complete database of all PWA (persons with albinism) data that has been collected since 1993. Our first step has been to update the patient questionnaire that the group completes for each PWA they see either at an outreach clinic or a visit to the RDTC. From these questionnaires, the data is captured and then input into a database. The questionnaire has not been updated since 1993 when it was put into place and the data entry was stopped in 2005, but the data has been collected. I was lucky enough to meet the person responsible for putting this program into place back in 1993, as Barbara Leopard stopped in for a visit to RDTC last week, by chance. Last week, I co-developed a presentation for the group, including my purpose for being here, why the data is so important to the RDTC and patients and the updated questionnaire which was presented to the faculty and medical residents. There was a hearty 2 hour discussion with great input and feedback. I’m hoping for a finalized questionnaire next week, so the database development can begin.

In the meantime, I’ve been very fortunate to attend two outreach clinic days. On Sept 25, we were at Kilema Hospital (8 patients seen) and Mwanga heath centre (12 patients seen). All of the subjects at Mwanga were children. We were extremely late (2 hours) but all the patients stayed and waited for their appointment along with education and distribution of Kilisun sunscreen (specific formulation for PWA). What most stood out to me that day, was at Kilema Hospital. There were 2 young brothers, 4 and 8. They were both albino, while their father, mother and 2 older siblings were not. While we all understand genetics, it’s still very hard to wrap one’s head around. it is evident that most of the patients are trying to take the appropriate precautions, hat, long-sleeved shirt, long pants, staying out of the sun, wearing the sunscreen, but it’s hard, especially for children.

Yesterday, Oct 7th, was the second outreach day. We left in the pouring rain. We first stopped at Machame Lutheran Hospital, on the west side of Mt. Kilimanjaro. The group did not expect many patients to attend due to the rain. When we arrived, there were 2 boys waiting (not related). The younger boy, maybe 10 with his grandfather, was very much taking care of himself. After he was checked and the questionnaire reviewed, he brought up to the doctor, that he was starting to have vision problems (due to the albinism) and a referral was given to him to go to KCMC – the ophthalmology department for vision screening. During his check up, 3 additional patients arrived, even a new one to the outreach program. Jenifer (yes :)) was 3 years old and this was her first visit. Another mind-boggling moment, as the only other albino in the family of her mother or father, was a cousin on the mother’s side. All 4 of the patients seen at this clinic, have been very diligent with their care. They have all been seen for quite some time, as 2 of the patients started with the clinic back in 1993 when it started.

We then left for the next clinic Masama Heath Centre. The drive to this centre was a bit difficult. Apparently when they normally attend this clinic it is dry and not wet and raining. The road was complete mud and we had to go up the mountain. Our driver, Freddy, was incredible. Obviously he has the experience of driving here year round. We arrived at the centre and there were 5 patients waiting for us. All of these patients were adults, at least 30’s if not older. It was also apparent that they were all taking very good precautions for themselves. They were all seen, sunscreen dispensed and we were on our way.

The third and final clinic for the day. Luckily we were going downhill and it wasn’t raining. But by the time we got to the turn off, it started raining again. The road had turned to mud completely. The drive was through a small village, near a large catholic church, thus, the outreach centre name – Narumu Roman Catholic Dispensary. It was absolutely beautiful tucked behind the banana trees. Upon our arrival, there were 5 men waiting. We rushed in hurriedly, as I was told we needed to complete quickly so we did not get stuck with the continuing rain and road conditions. At this clinic, I was told and could also see that these men were not taking as good care of their skin as the previous two clinics. They were re-educated on the reasons why they needed to cover up, given new hats and how to apply the sunscreen and we were on our way.

As most of us are creatures of habit, I’m starting to get into somewhat of a routine. I think at this time, my biggest frustration is that I do not speak or understand the language. I’m hoping to start Swahili lessons tomorrow. As we all know, the only way to change something is to take one step forward and try.

Thank you very much for all of your support and emails!!! Please keep them coming.

Jennifer