Foundation for African Medicine and Education (FAME) is a non-profit medical clinic based in Northern Tanzania with a focus on providing patient-centered medical care in their outpatient clinic and inpatient hospital. They aim to provide high-quality services in surgery, maternal and child health care, diagnostics, community outreach, and education. In 2021 alone, FAME had over 27,000 patient visits, admitted almost 600 patients to the general ward, and completed 428 major surgical procedures.
Dr. Michael Rubenstein is an Associate Professor of Clinical Neurology and the Director of Health Equities and Global Health for the Department of Neurology at the University of Pennsylvania. He has been involved with FAME since 2009 and currently serves as the Board Chair, traveling to Northern Tanzania biannually with residents and medical students from the Hospital of the University of Pennsylvania and the Children’s Hospital of Philadelphia.
Q: How did you become involved with FAME?
I was traveling in Africa with my two children because my daughter was interested in wildlife management and I asked our safari driver to take us to a Tanzanian medical facility nearby. I started working there for about three years on my own and I was teaching doctors there how to do neurology evaluations and exams. One of the residents I was teaching mentioned that this would be an amazing opportunity for residents to go and teach doctors in Tanzania.
Now, each year I travel to Tanzania twice a year for a month each, and I bring four residents and a medical student on each visit. We run a big neurology clinic where we see up to 400 patients in the month that we are there. While we’re doing this, we’re also teaching the doctors that are there so we may have some medical students from Tanzania that work with us and/or we have the doctors from FAME work with us in order to care for the patients in between our visits.
Image courtesy: Dr. Michael Rubenstein
Q: What is the Foundation’s main mission?
The Foundation is called the Foundation for African Medicine and Education because its mission is two-fold. First and foremost, it is creating a patient-centered clinic or care center in Northern Tanzania where access to healthcare is very limited. But it also provides educational opportunities from a standpoint of having Western volunteers come and work side-by-side with Tanzanian doctors, and it also sponsors some nurses and doctors to go back to school if they want other educational opportunities. We also sponsor clinical officers to go off and get their medical assistant degrees.
Q: What impact has the Foundation made in the region of Northern Tanzania?
FAME has made an incredible impact because they have a catchment area of about 2.9 million people in Northern Tanzania, and they provide probably the best medical care among all the institutions in Northern Tanzania right now. Since the beginning of my involvement in 2009, we’ve grown to where FAME now has two operating suites, radiology, laboratory, a small hospital with two 12-bed wards, and a 25-bed maternity ward. So from a standpoint, FAME has clearly impacted the general care of Tanzanians in that community and a lot of people from very under-resourced areas travel to FAME for their medical care.
We have also been keeping data on our patients for the last six years, and one of the big things we treat there is epilepsy because 90% of epilepsy exists in low- to middle-income countries. We’ve made a huge impact in the epilepsy world, and we demonstrated that because epilepsy patients continue to come back for follow-ups so we have a high retention rate for epilepsy patients. We’ve also kept data on seizure control, and we know that epilepsy patients that have come to see us have improved seizure control – better than what they had before they came to see us.
Q: What does the Foundation have planned for the future?
We’ve now partnered with some researchers at Muhimbili University in Dar es Salaam, and we now have an IRB in Tanzania so that we can begin looking at the data that we have. Not only can we begin looking at the data, we can begin accumulating new data with questionnaires looking at the health of patients. Our hope is to continue to improve the health of the people in Northern Tanzania and continue to provide them with the care that they need. We just made our new 5-year strategic plan, and it is focused on pediatrics, maternal health, and surgery.
Q: What is your fondest memory from working with the Foundation?
I met a woman who was unfortunately attacked and had acid thrown in her face and was blind, disfigured from the acid, and had multiple surgeries. She came to see us because she was having headaches. It was her resilience and her strength that resonated with me and the residents when we saw her. We sat at a table with her as we were interviewing her, and at the end of the interview, she asked if she could take a photograph with us. Even though she was blind and would never see it, she wanted to take a picture with us so that she could remember it and have other people describe it to her. That was something that was incredibly powerful.
In general though, a continuous memory I have is the resilience of the people in Northern Tanzania and the beauty that the people there aren’t unhappy. They don’t wake up every morning thinking that they want to be in the United States and want to be Americans. They’re happy where they are – this is their life. We see many different types of tribes and different cultures and the people there are very happy. You can’t help but want to do what you can for them and, in turn, they treat us very well and treat us like they can’t believe we traveled all that way to care for them. There is a big difference when you’re volunteering somewhere and the people know that this is not your job and that you’re there because you want to be there and you’re seeing them because you want to see them. There’s just something different about the relationship you have with the patient when they know that you’re there because you care.
Image courtesy: Dr. Michael Rubenstein
Q: What sparked your interest in global neurology?
My first visit to Africa. When I went to Africa and saw the warmth in the people and the beauty there, I just wanted to go back. Every time I go back, it’s more and more rewarding. What drives me now though are the residents and medical students that I introduce to global health.
We also run a program called Global Health at Home where we actually go see neurology patients at several local community clinics on a voluntary basis. Essentially, if we’re going to travel halfway around the world to treat patients in another country, we should, at the very least, treat patients who have poor access in the United States the same way.
Learn more about Dr. Rubenstein’s work with FAME here at: https://michaelintanzania.com/
If you are interested in supporting FAME, please consider donating to their cause at https://fameafrica.org/support.