Pre-Mission Meeting

In preparing for our mission, we attended a Pre-Mission meeting here in Ottawa at the CACHA Office, Saturday Sept. 11 from 10:00am to 05:00pm. This meeting is setup for participants so they may ask outstanding questions, raise any concerns, and help with bin preparation. (Bins are the containers we use to ship the medical supplies)

The meeting started with an introduction to one of CACHA’s founders Dr. Don Kilby who was there to address the medical side of the mission with the doctors and nurses who were volunteering. Having no medical background ourselves, I still found this part of the meeting very interesting and helpful overall.

Dr. Kilby explained that this mission is actually an outreach program of the Kilema Hospital so we are in fact representatives of the hospital while we are there. He went on to describe the hierarchy of health care facilities in Tanzania. Apparently there are three levels that we could be interacting with:

• Dispensaries—located in the rural villages of Tanzania, these locations only provide basic care, observation for 48 hours, midwive service and dispense medication
• District hospitals (of which Kilema Hospital is one) provide limited surgeries and an out patient department
• Regional hospitals—the closest for us would be in Moshi which is the Kilimanjaro Christian Medical Centre (KCMC)

Cost for care in the district and regional hospitals is $3/day for hospitalization, yet most residents cannot afford this. If given the money directly, many will end up using it for more urgent things like food.

The most common problems we will see are:

• Musculoskeletal (MSK) problems
• Goiters
• Large tumors
• Low hemoglobin count (apparently a low count of 4-5 is common)
• Many incidents of osteomyelitis (particularly in children) which may lead to amputations
• Malaria, Pneumonia, Urinary Tract Infection (UTI), Diarrhea, Worms, Tuberculoses, HIV/AIDS
• C- Sections

Rapid testing kits will be available for syphilis and malaria. All people who come to the caravans will be invited to take an AIDS test. Many fear that if they accept the test in public, they will be ostracized by their peers. Because of this, we have been instructed to also ask the question in a moment of privacy so that each person has an option to reconsider.

Our caravans will dispense the same amount of medication in 2 weeks that the local district hospitals dispense in 3 months.

Next was an overview of what the logistics team will be doing, presented by the mission lead, Lise Turpin.
Logistics participants (that's us !) will be trained to perform triage (among other things).
First step in triage is to take temperature, heart rate, and blood pressure.
Questions that need to be asked are:

• Are you pregnant?
• How many children have you had? How many are still alive?
• What is their main concern for this visit (try to limit to one)
• Invite them to have an HIV test

Translators are hired to accompany us on the caravans so they will be asking the questions (whew).

There is a common misconception amongst the villages that Gynecological exams are performed on both sexes; anything below the waist is considered gynecological! The Gyne team was warned not to be surprised if men showed up wanting an exam…they should (obviously) direct the patient to another doctor.

The emphasis from both Don and Lise was teamwork across the board; it's what makes these missions work.

We all broke for lunch and dined at a nearby restaurant—another good opportunity to get to know the people we will be on the mission with.

After lunch, we headed to a storage unit where the bins of medical supplies were located. These bins were pre-packed by other volunteers. Some bins contained logistics supplies, some medical and some a bit of both. Seeing that we, as volunteers, are traveling with these bins (they are essentially our luggage), we should know what’s in them. This is why it is important to participate in this pre-mission task. We spent some time counting and verifying the supplies based on pre-made lists. We ensured that the bin numbers matched with the identified items within. Bins are labeled and weighed to ensure they were under the maximum allowed weight (23 kg). Later a hard copy manifest of each bin will be created for the volunteers to take with them during their flights.