Another record breaking day at FAME - 34 patients all seen via a language interpreter. A few of the patients I saw today were followups from prior visits. These patients always bring me the most joy because they often have had a good experience with the past visiting neurologist and are starting to see the benefits of their treatment. In fact, most of the follow-up epilepsy patients have seen at least some improvement in their seizure frequency since our last visit. A testament to the amazing work Mike Rubenstein is doing here.
It is very interesting to practice medicine in a culture so different from your own. In fact, there are many different cultures and subcultures here in Northern Tanzania given the fact that Tanzania use to be a conglomeration of 280 separate tribes. By far the most well-known group is the Maasai population. The Maasai are a Nilotic group. They inhabit the African Great Lakes region and speak their own distinct language. The Maasai are famous for their fearsome reputations as warriors and cattle-rustlers. They believe that God gave them rights to all the cattle in the world and in the past have used this divine right as a means to steal cows from other tribes. Maasai's weapon of choice is a long spear, and they are known for their fierce determination to fight their opponents to their deaths. Many companies have hired Maasai as bodyguards in safari areas as guns and ammunition are prohibited.
Maasai are incredibly paternalistic. They are a polygamous group with the head male independently making all family decisions. In fact, in the presence of male Maasai members, females are not allowed to speak. You can imagine that this makes getting the history on a female Maasai patient very difficult. In fact, for one of our patients, our history required two different translators each one interpreting her events through her husband's eyes - so of course we got the wrong history. Finally, after attempting to navigate this situation for a half hour, we were able to encourage the husband to allow his very young wife to speak to our female Maasai receptionist. That simplified things tremendously and empowered our patient to take ownership of her own health - not to mention saved me from treating the wrong diagnosis! It is incredibly complex and yet rewarding to work in such a unique environment. You feel blessed to be able to interact with people in such an intimate way and witness the intricacies of their culture.
Just the fact that Maasai are willing to come to FAME is huge as the Maasai are very very traditional. Infant mortality is so high amongst the Maasai that they don't give their children names until they are 3 months old. FAME has done a tremendous amount of outreach and maintained cultural sensitivity in their clinics, which has resulted in good patient experiences. So, as they have recently opened a new labor and delivery unit, hopefully FAME's reputation as a respectful and trustworthy place will do wonders for everyone in this community. I'm excited to see how FAME will grow over the following years and am happy to be a part of the journey.
It is very interesting to practice medicine in a culture so different from your own. In fact, there are many different cultures and subcultures here in Northern Tanzania given the fact that Tanzania use to be a conglomeration of 280 separate tribes. By far the most well-known group is the Maasai population. The Maasai are a Nilotic group. They inhabit the African Great Lakes region and speak their own distinct language. The Maasai are famous for their fearsome reputations as warriors and cattle-rustlers. They believe that God gave them rights to all the cattle in the world and in the past have used this divine right as a means to steal cows from other tribes. Maasai's weapon of choice is a long spear, and they are known for their fierce determination to fight their opponents to their deaths. Many companies have hired Maasai as bodyguards in safari areas as guns and ammunition are prohibited.
Maasai are incredibly paternalistic. They are a polygamous group with the head male independently making all family decisions. In fact, in the presence of male Maasai members, females are not allowed to speak. You can imagine that this makes getting the history on a female Maasai patient very difficult. In fact, for one of our patients, our history required two different translators each one interpreting her events through her husband's eyes - so of course we got the wrong history. Finally, after attempting to navigate this situation for a half hour, we were able to encourage the husband to allow his very young wife to speak to our female Maasai receptionist. That simplified things tremendously and empowered our patient to take ownership of her own health - not to mention saved me from treating the wrong diagnosis! It is incredibly complex and yet rewarding to work in such a unique environment. You feel blessed to be able to interact with people in such an intimate way and witness the intricacies of their culture.
Just the fact that Maasai are willing to come to FAME is huge as the Maasai are very very traditional. Infant mortality is so high amongst the Maasai that they don't give their children names until they are 3 months old. FAME has done a tremendous amount of outreach and maintained cultural sensitivity in their clinics, which has resulted in good patient experiences. So, as they have recently opened a new labor and delivery unit, hopefully FAME's reputation as a respectful and trustworthy place will do wonders for everyone in this community. I'm excited to see how FAME will grow over the following years and am happy to be a part of the journey.
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