Flying Medicine

From the windows of the Cessna single-engine plane, the grasslands of Maasailand spread out below. Circular villages or "bomas" dot the hillsides, and herds of animals run between--cattle, goats, zebra, wildebeests, giraffes, and even ostriches. In the midst of savanna and farmland, a line of dirt appears--the airstrip. We do a low fly-by to ensure that the herds have cleared the field and to notify the people that we have arrived. Then we land.

Standing on the airstrip, there is a not a village or a building in sight, except for the mud hut maintained for the clinic. Through the brush and acacia trees, Maasai men and women emerge in their red, purple, and plaid cloths. Babies are hidden under their mother’s wraps. The villagers gather around the plane and help to carry our gear to the hut. We set up and get started with the clinic routine.

Babies are weighed and vaccinated---BCG, polio, and DTAP for the infants, measles and vitamin A for the toddlers. Medical patients wait in line for the local clinical officer, who speaks Swahili and some Kimaasai. Pregnant women crowd the hut waiting for prenatal care. After helping with vaccines, I become the OB provider. For each woman, I ask how many pregnancies she has had and how far along she thinks she is. Often this takes two- or three-way translation from Kimaasai to Swahili to English. I take her blood pressure, check her eyes for anemia, and press on her ankles looking for edema. She lays down on the bed made of branches in the hut, and I feel her abdomen, assessing her gestational age with my hands. We have no measuring tape, so I recall that the width of my hand is approximately 10cm. We have a Doppler, so when it is functioning properly, I am able to hear the fetal heart tones. I record all of this on the woman’s antenatal card, which she keeps in her possession tucked under her cloth. Then I give her iron and folic acid tablets for the month, malaria treatment, de-worming treatment, and a tetanus shot if she needs one. She is finished and the next woman sits down on the bed.

Once all the steps of the clinic have been completed, we pack up the plane and say our good-byes. Another group will arrive for the same clinic in two weeks. Some of the Maasai wait to see the plane take off, but most of them do not wait. As quickly as they came, they disappear back into the bush.

Over three days, we did seven rural clinics at Loongong, Narakawo, Arkasupai, Ilkiushi Oibor, Lowsaki, and Oiborkishu. We vaccinated over 300 babies, and I did 90 prenatal visits.

Do your ears hang low?

The Maasai people have a variety of styles of earlobes. You may have seen them in magazines. They pierce their ears with hot metal sticks and stretch the skin of their ears with pegs, then use jewelry to weigh them down. Unfortunately, a high number of them end up with tetanus from this procedure. I have seen younger Maasai women with beaded earrings that are connected under the chin by several beaded strands. Many older Maasai have quite lengthy earlobes and have long forgone decoration to embellish them.

While on my second night of call last Wednesday, the intern Sanaa and I admitted a sick older woman who was accompanied by her son. They only spoke Maasai, so we had three-way translation--Maasai to Swahili to English. As we took her history, I noticed that her son’s ears were unusually shaped. They were misshapen at the bottom, almost like the earlobe was missing, and there was a large slug of skin hanging in front of his ear. I glanced at Sanaa and mouthed, “What’s with his ears?!?” She mouthed back, “They’re flipped around from back to front. He knows we’re talking about his ears!” The man and I then made eye contact, and he gave me a knowing look.

While we examined the patient, her son stepped out in the hallway to give her privacy. While checking her over, I realized that I needed the pulse oximeter from the intensive care unit next door. I ran out into the hallway, and there was her son leaning against the wall. He had unhooked his long earlobe which draped down almost to his shoulder. He fondled the lobe and smirked at me. Recognizing the face of a man who had an agenda, I hurried down the hallway.

“Do your ears hang low? Do they wobble to and fro? Can you tie ‘em in a knot? Can you tie ‘em in a bow? Can you throw ‘em over your shoulder like a continental soldier? Do your ears hang low?”

This song now has new meaning for me.

safari means "journey"

No one can come to Tanzania without going on safari. Within two hours by road from Arusha are two incredible parks, where animals roam free within their natural habitat. In Swahili, the word safari means "journey." Although Jason and I are on our own journey here in Tanzania, last week we had the opportunity to take a break from writing and hospital work and join a group of American volunteers on a two-day safari. Seeing such abundant wonders of nature up close reminded me again and again of the phenomenal creation on this earth. How can all of this magnificence be random?

Our first stop was Tarangire National Park--a grassland filled with Baobab trees and all the animals and birds that benefit from them. Animals roam in Tarangire year-round because the area has a permanent river. During the dry season, they migrate to the park for water. The rains have been early and heavy this year, so we are well into the lush, green season.




I never tired of watching the elephants. I wrote my first research paper on elephants in 5th grade! My resource was a 1960 National Geographic that I found at the Akron Public Library. Perhaps I love elephants because they have a matriarchal society. Maybe I'll join them.












My second cousins, baboons, were everywhere. This baby is smart to catch a ride.









Impalas and baboons live well together in the same space.











Giraffes are the most graceful animals I have seen. Did you know that they have 7 vertebrae in their necks just like humans?












The well-kept nests of the weaver birds.











These ostriches were constantly moving--heads up, heads down, shake the backside, repeat!









Jason and I at our picnic lunch spot overlooking the river.





After a night at a pleasant lodge in Karatu, we traveled the Ngorongoro Crater. This 3-million-year-old crater was formed by a volcano. 2000-foot-high walls surround the entire depression, creating a natural enclosure which keeps the migrating herds within. The local Maasai people have maintained their right to graze cattle in the crater, so the park is a conservation area as opposed to a national park. With herds of wildebeest and zebras come many predators such as lions and hyenas. If I were a cattle herder, I would stay far away from here!




















Jason and I perched at the rim of the crater.










On the drive in, a friendly roadblock halted traffic. I particularly enjoyed the baboon in the middle of the road picking his belly-button lint. I can relate.






Taking the scenic route down into the crater, we encountered a family of lions on the edge of the road. I wondered if the animals ever came out of the crater and into the surrounding area. This was my answer. Good thing we didn't take a "coffee break" (ie, pit stop) anywhere near these guys!








This lion cub was not impressed by us. I think he had just been fed his breakfast.












The crested crane is on the Ugandan flag. My friend Freda from Uganda had the flag hanging in her apartment in Montreal. Right next to her roommate's home-state flag of Texas. Quite a contrast.













Thompson and Grant gazelles were seen throughout the crater. Flamingos are lining the water's edge in the background.











Zebras are fascinating to watch. Believe it or not, their stripes make them difficult to spot from afar.







Rubbing themselves in the dust helps camouflage them even more. This one reminded us of our dog Nellie--but a striped belly instead of a spotted one!










The crater rim is lined with canopies of Acacia trees.









This was my prize photo of the day--one of two hippos in a fierce battle.










Hmmm.....







And the most incredible creature of them all...the khaki-clothed tourist!