Refugee Relief International After Action Reports

Tanzania, June 2013

Refugee Relief International, Inc. (RRII), Team 2013-2 deployed to the western region of Tanzania in the vicinity of Lake Tanganyika in June, 2013.  After a successful mission in 2012, RRI was asked by local health authorities to return. The shores and islands of Lake Tanganyika are home to refugees from the fighting in the Congo and the former genocide in Rwanda.

During four days of patient contact at in the mainland town of Kirondo, and the village of Kipili, and three days in the lake island villages of Ulwile, Karenge, and M’vuna, the RRII team treated from 560-570 patients.  The medical center staff at Kirondo was kind enough to loan us the use of three rooms in which to conduct patient care and pharmacy/lab operations while we were there. Inter-island boat transport was provided by Firelight Safaris, which has a base at Lupita Island in the lake. The great majority of our patients on the islands did not previously have access to care due to lack of transportation to the district medical center, and most did not have the money to pay for even basic medication.  A problem in the area where the team worked is that many medications, ideally in stock at the district hospital, are not available, leaving many patients with the option of travelling over 200 kilometers to a pharmacy, or going without treatment.  Having experience in the area, the RRII team brought with them such medications as finances and space allowed, and others were purchased in Dar Es Salaam and shipped.

The RRII team saw and treated many serious illnesses, to include malaria, filariasis, tuberculosis, leprosy, parasites, malnutrition, HIV/AIDS, and many others. Approximately half of the patients seen were children.  A generous donation from the Draper Foundation of Menlo Park, CA, and other donors helped us with transportation (our main expense) and medication that we dispensed to the patients. HIV, tuberculosis, and malaria diagnostics and medications are supplied to the medical center by the World Health Organization, but are unfortunately in short supply and not available outside the district center.

While there was no major surgical capability on this mission for such cases as hernias and trauma repair, minor surgeries and wound care were conducted. Commonplace things such as reading glasses, aspirin, or multivitamins were received with gratitude and changed lives.

The team observed several patients with deformities who had contracted polio as children. Vaccine-preventable illnesses such as mumps, with secondary orchitis, and pertussis were also in evidence. As far as we could determine when speaking with the local medical providers and village elders, there is no vaccination program in the center-west Lake Tanganyika area where we conducted our medical civic action. After insuring that a “cold chain” is possible for vaccines, RRII will work on securing grant funds for this purpose.

RRII Team 2013-2 in front of the Kirondo medical center; from left, translator Krispin, translator George, PA student Matt Padgett, PA Vicki Chan-Padgett, PA John Padgett, PA student Todd Phillips, medical student Florian Schmitzberger, and (squatting) PA student Fred Fombrun.

The team this year team included three physician assistant students from Touro University Nevada, and one 4th year medical student from Austria.  These students were given experience with patients and cases that they would otherwise never have gained. Experienced clinicians Vicki Chan-Padgett, MMS, PA-C, and John Padgett, PA-C, PhD supervised the students in collaboration with our Tanzanian physician counterparts. The two RRII clinicians were granted temporary medical licenses by the Tanzania Ministry of Health for their stay in the region.

As an additional benefit from this mission, local business owner and resident Tom Lithgow and team members met with local government and school officials to discuss the funding of a nutritional program for some 350 district school children. The idea is to provide lunch from local food sources for the children during school days. RRII will act as the conduit for funds donated in the US for this purpose.

Hospital Administrator Mr. Kinoni accepts an RRII gift of basic diagnostic equipment from PAs John Padgett, Vicki Chan-Padgett and medical student Florian Schmitzberger.
PA Vicki Chan-Padgett, "Mama Daktari", kneels to examine a child while surrounded by curious villagers.
PA Student Matt Padgett examines a young mother while translator George holds her newborn.
Under a tree on a Lake Tanganyika island, PA John Padgett receives the patient's medical history through a translator.
This patient had staples placed in his leg with a skin graft two years ago. He was unable to access care to have them removed. The staples were in so long that they caused him to walk with a limp, being unable to fully extend his leg. The team removed the staples and instructed his father on range of motion exercises to restore full function.