Noon, the Tanzanian sun settled directly overhead. A great Baobab tree offered refuge as women in bright traditional kangas sold withered tomatoes and village elders gathered, contemplating the recent drought. A scattering of rusted bicycles waited, there were no cars. School boys in tattered uniforms kicked a soccer ball made of tightly woven plastic bags.
Leaving Portland, Oregon’s winter behind, I found myself volunteering in central Tanzania for Mwangaza, an international organization focusing on children’s rehabilitation. On this occasion, we had set out to identify infants and children with birth deformities and burn contractures from the remotest of African villages offering them surgery and hope.
Heads turned as our Land Rover exploded through a cloud of dust. Circling the car, villagers were curious of our arrival. Our driver and assistant Amiri, a Muslim from coastal Tanzania, addressed the locals first. With a passion for his people and a disarming, quick wit he eased the crowd and summoned welcome for the rest of our team.
Formal greetings in East Africa are crucial and last several minutes, anything short is disrespectful. ‘Mambo, Jambo’ pass as ‘Hello,’ while ‘Shikamo’ ‘I bow down to your feet’ is reserved for elders. An inquiry into family members and health, followed by head nods and handshakes, finally we were invited under the Baobab tree.
At each village, Amiri explained our efforts again and again: to evaluate childhood deformities and coordinate surgery at Arusha Lutheran Medical Center (ALMC). There, a group of plastic surgeon volunteers would provide intensive reconstructive surgery. Initially, many villagers were skeptical, doubtful and afraid to hand their children over, who could blame them; but as word spread and prior patients stepped forward with beautiful smiles, fears were alleviated and hope restored. Three live chickens joined our ride as families made offerings of thanks.
With poor roads to these distant villages, children are delivered at home in mud thatched huts without running water or electricity. Many newborns with facial disfigurements die, while the living few are hidden away in shame, often malnourished and kept from school. Without electricity, cooking pits smolder and scalding spills are frequent, leaving life long deformities and burn contractures.
We traversed hundreds of miles in one week, stopping when rows of huts resembling a village appeared, looking for these children. Without maps or road signs, we were lucky to occasionally find cement stubs etched with town names like Katesh, Gogo or Bereko.
The absent rains left cattle emaciated, heat slowed all progress. Under the merciless sun, dry river beds cracked and women dug deep into the sand, drawing from pools of murky silt. Such resilience as they carried buckets of drinking water weighted with sediment back to the thirsty village. We drove on in silence.
Swerving right to avoid a massive herd of goats, we stopped short of colliding with a farmer. Running at the car, waving his arms, he shouted for us to stop. Breathless, he described a son and daughter who could benefit from our help. Asha, fifteen, has a deformity of her right leg, while Ramisi, five, has a severe cleft palate, affecting his entire nose and mouth. I examined the boy and without hesitation, he was placed on the surgery schedule, unfortunately Asha’s childhood knee injury was beyond surgical repair. Next to the hospital was an eighteen month rehabilitation program, there she might at least become a seamstress.
The next morning we returned to the father’s hut, he tearfully handed his children into our care. Without fear or resentment, Ramisi, his sister and one small bag of belongings were piled into the Land Rover. For nine hours we sat together in the back, smiling and gesturing, his local dialect, my broken Swahili. We drove them to the children’s hospital where they joined other families in preparation for surgery.
The pediatrics ward swarmed with nervous families and children. I found him sitting, staring out the window while his sister stood guard; seeing me, he smiled and took the toy bus from my hand. Escorting him into the operating room, I held the oxygen mask in place and watched his eyes, calm and contented, drift easily to sleep. Over several hours his frightful deformity transformed into a distinct nose and beautiful full, round lips.
Several weeks later, fully recovered, Ramisi returned to his village a new boy, his sister continued her studies near the hospital with plans to return upon completion of her diploma. Their father forever grateful that his children can lead normal lives- perhaps Asha will find a husband and Ramisi attend primary school. No longer hidden away, ashamed, he will be free to run with other boys, laughing as he dreams of becoming a soccer star, a pilot or a farmer like his father.