Refugee Relief International After Action Reports

Tanzania - June, 2012

The Refugee Relief International, Inc. (RRII) Mission 2012-2 was a mission to the border areas of Tanzania, The Democratic Republic of the Congo, and Burundi. The mission was to provide medical and surgical services to the refugee and underserved population in that area. Graciously hosted by Tom and Belinda Lithgow of Firelight Safaris, and supported by a grant from the Draper Foundation, the team was based on Lupita Island in Lake Tanganyika, and was transported to various villages and the local city hospital by boat and Land Cruiser. The team registered with Tanzanian Public Health prior to departure, and the clinicians were granted temporary licenses.

PA Vicki Chan-Padgett examines a pediatric patient at an island refugee village. She became known as “Mama Dakitari Vicki.”

The team consisted of surgeon David Mohler, MD, student doctors Florian Smitzberger and Lauren Mamer, physician assistants Vicki Chan-Padgett, PA-C and John Padgett, PA-C, and volunteer Marleyna Mohler. The team performed surgical treatments and medical services, often at the same time. While part of the team was operating, others were seeing medical patients. The surgical cases consisted of hernias, a large hydrocele, fractures and dislocations. Medical cases included such tropical medicine diseases as leprosy, tuberculosis, schistosomiasis, malaria and parasites, together with some of the medical conditions encountered more commonly in developed countries.

The team had pre-positioned some medicines for use through local contacts. Some medicines which would have been useful did not arrive, but the tem was able to successfully treat most cases with what was available. We brought our surgical equipment and a limited amount of medicine.

PA John Padgett takes a medical history from a refugee patient.

Our Tanzanian counterparts were not available to go into the villages and islands distant from the local hospital, so the team functioned with volunteer interpreters who spoke Swahili and English. This served for most of the population, with the exception of some refugees from deep in the Congo. In those cases, a combination of French and limited Swahili served to help us to serve those patients.

Conditions in the villages were austere, but the villagers did their best to cope with limited resources. The islanders seemed more at risk for poor outcomes from serious medical conditions, as transportation was limited to a small number of boats, and bad weather sometimes makes the lake impassable.

Team surgeon David Mohler, MD, prepares the austere town hospital surgical suite for
RRII surgeries.

Problems identified included difficulty in evacuation to a more developed level of care by patients needing imaging, more than basic laboratory studies, or advanced medical or surgical treatment. We learned of some patients who had no money for transportation to a more advanced level of care, nor family to provide care. These patients could not receive sufficient care from the basic services offered at the city hospital and were very likely to not survive.

The Kirando hospital where we saw surgical and medical patients presented challenges on multiple levels, as even basic equipment such as thermometers, scales and blood pressure cuffs were not present. Only the most rudimentary laboratory services were available, and there was no imaging capability. Staff physicians did he best that they could with little support, often relying on what little medical history was available from the patients to reach a diagnosis.

Rush hour in Tanzania. The RRII team was fortunate enough to observe some of the wonderful African wildlife.

RRII has resolved to bring in basic diagnostic equipment for the hospital and physicians on our next visit. Training programs to upgrade the skills of local clinicians are also being planned.

RRII has discovered a refugee and underserved population that needs help. With the assistance of our donors, we will strive to provide help and upgrade available services.

Respectfully submitted,
John Padgett, PA-C, PhD
Vice President & Director of Operations