Dr. Druffner’s Mission Trip to East Africa: Written by Dr. Druffner
Each year for the past eight years, I have traveled with my family to St. Luke’s hospital in a village within the South Pare mountains of Tanzania, in East Africa. For five weeks each year, my mission has been to train and support the medical staff there. This small hospital serves an area of 40,000 people. It is the only health facility in that region.
Since we started our work in 2009, we’ve only had a simple dipstick urine, hemoglobin test, and HIV test. When faced with sick patients, this has been a complicated diagnostics situation. Every day patients come to the emergency room area, and we try to diagnose and treat trauma, severe dehydration, hemorrhage, sepsis and cardiopulmonary disease without basic lab equipment: No CBC, BMP, Urinalysis, Liver Profiles. As you can imagine, it was a frustrating and often a losing battle.
Most significantly, we had a nine-year-old girl who presented with DKA, severe dehydration and coma. We had to blindly give her fluids without knowing her electrolytes status CBC or liver function.
The good news is that last year we were able to raise money for a basic hemoglobin machine as well a fridge to hold blood for up to 30 days. This has been life-saving for patients who come in hemorrhaging from trauma, but more specifically for mothers with severe postpartum hemorrhage and who often die without blood transfusion.
My daily duties include seeing patients in the hospital first each morning. Usually, this means going up to the labor and delivery area and doing postpartum rounds with women who have just delivered, and checking newborns, their vital signs and overall health. These rounds are done with two nurses from the hospital in addition to Dr. Beda and Dr. Josephat who are Tanzanian physicians. Dr. Josephat is a new physician that has just finished his training and needs additional guidance to do daily rounds. We also examine mothers who are currently in labor and make decisions on their labor management. In this part of Tanzania, nurses and doctors have never seen or been trained on a fetal monitor. Last year, for the first time, we were able to raise money for a fetal monitor.
Next, we proceed to the pediatric ward to see children with pneumonia, malaria, burns or cellulitis. And finally, we see adult patients with various medical problems such as pneumonia, heart failure, stroke, skin infections or malaria. Most of my time during these rounds are spent examining the patient and discussing the differential diagnoses and treatment with my fellow Tanzanian physicians. Teaching is my main goal on this annual mission trip, so they are better able to care for their patients when I’m not there.
At approximately 11am, we are done with hospital rounds and we walk down to the clinic, and among the three physicians, we see about 50 patients a day. During this time we might be interru
pted with emergencies such as motorcycle accidents, patients with sepsis pneumonia or shock. At our facility, we have simple lab tests such as CBC and urine test. There is no ultrasound tech or radiologist. We can take simple x-rays and perform ultrasounds ourselves. I spend a lot of time teaching obstetrical ultrasound to the doctors.This year, I started a WhatsApp group of more than 20 doctors from the United States who can look online at posted x-rays, ultrasound pictures or case descriptions of patients we’re seeing in Tanzania, and help answer important clinical questions in real time. It’s been very successful, and we’ve received a lot of help and support during serious medical cases.
Other duties during the day include getting called to help with a labor and delivery problems which might consist of standard delivery or a C-section. Typically we work until about 1 PM and then break for lunch. Lunch usually consists of rice with stir fry vegetables and sometimes chicken. Other times we eat Ugali served with fish or meat, which is essentially cornmeal cooked until it’s in a very thick paste.
This year my two youngest children, Francis in eighth grade and Rose in fifth grade, came with us to Tanzania. One of my duties at lunchtime was to teach Francis algebra. After teaching, I would go back to the hospital and check on any sick patients or check in on the labor and delivery unit. I would then walk back to our home for dinner and relaxation. The evenings were spent with the kids, playing board games or card games. However, I would often get called back to the hospital for an emergency or labor and delivery case.
We’ve been coming yearly to the same hospital in Tanzania for ten years. I love my work there because I feel like I am making a big difference in the lives of every patient that I see. I am sharing and teaching all the knowledge from my education which is the greatest gift I can give. Education is the best way to deliver good healthcare and ultimately a way out of poverty and illness.
Mark R. Druffner M.D