This is truly the 'last mile' as they call it. Here is a note from a recent trip to Northern Tanzania:
"Our (a M. D. and myself) work in Northern Tanzania was difficult but fulfilling. We were providing services in a Maasai area that people have to walk more than 10 miles to get medical services. Even in a car it takes 45 minutes because the roads are so bad. The government has set up a clinic out in this area, but besides building the building, they don’t really keep it stocked or staffed. Most people don’t even go because they can’t do anything. We had people walking over ten miles from up in the hills to come to our temporary clinic.
We saw many sick children, older adults with chronic achy joints and upper-respiratory problems, malaria, malnourished children, dehydrated children, screened the school children and de-wormed them, and screened the pregnant women and gave out clean birth kits. Unfortunately, during the 2 weeks we were there, there were no births we could assist with. We never were able to see all the people who came to the clinic to be seen. We had to triage the most severe cases to be seen first, others had to come back another day to see if they could be seen. It was very difficult to send people away, but our hosts felt it was important to try to get out of there by dark.
The attached picture shows me using the hemoglobin test strip and you can see the scale sitting on the table to my left. We screened around 50 pregnant women with the hemoglobin strips and started treatment with pre-natal vitamins with iron appropriately. We also tested a few of our children who were so sick or malnourished. It worked well for us, and it was so nice to have the capability to test for anemia in a rural setting without lab capabilities.
The other item we used quite a bit was the visor headlight. There was no electricity at all in the village where we were working, so besides using it for a spot light for medical exams or treatment, we also used it to see what we were doing as we never were able to see all the people who came to our clinic, and sometimes we worked past dark. Then we got to our hotel back in the closest town where there was accommodations, the electricity was off almost daily for periods of times. The visor headlight was very useful.
We ended up leaving the rotary cell phone charger at the village where we were working since so many of the people have cell phones, but with no electricity they have a difficult time keeping them charged. They were thrilled to have the rotary charger to use when needed.
Thank you for your help by providing resources for us to use on our first medical mission to the rural Maasai people of Northern Tanzania."