Outreach patients travel for miles to reach Dr Mengiste's team. Dr Mengiste insists: "The operations make a big difference to the lives of my patients. Most of them have suffered for a long time, often since birth. It may be a cleft palate so that one is unable to talk, eat or go to school. It may be a burn that has left one unable to walk or to hold things."
More than 60% of the patients waiting in line are children. Amongst those awaiting surgery is four-month-old Angelina, whose mouth and nostrils are badly disfigured due to a cleft lip and palate. Angelina's mother carried her for six hours to the nearest bus stop in order to bring her to the AMREF team in Moshi. Angelina cannot be breastfed because of her disfigurement - her mother has to feed her milk andporridge drop by drop.
Angelina is first on the operating table. Like with all his operations, Dr. Mengiste explains to observing medical students what has caused the condition, answers their questions, talks them through the surgery, and discusses aftercare.
This simple operation will transform Angelina's life and her mother is overjoyed by the results: "Before the operation I had so many worries, that she would not survive, have friends or find a husband, now I am sure she will survive and live a normal, happy life".
Next in line is a boy who injured his hand by falling into an open cooking fire. His little fingers were badly burned and have not healed well; his forefinger is now attached to his thumb by scar tissue. Nearly 99% of Tanzanians cook on open fires. Too often children fall into fires or scald themselves with boiling liquid. If the burns are not treated they form thick cobwebs of scar tissue, causing crippling deformities, making the simplest of tasks such as dressing or eating impossible.
During surgery Dr Mengiste separates the boys thumb and finger so they move independently again. Such a small operation will make an enormous difference to this little boy's life. While recovering from surgery the boy tells Dr. Mengiste he is looking forward to going back to school and being able to write like the other children in his class.
Dr Mengiste and his team spend their lives travelling to remote rural hospitals. The challenges of performing surgery in these hospitals are immense. Water supplies are often scarce, surgical facilities and basic medical equipment are poor or non existent, and power cuts happen every day.
Despite these challenges, Dr Mengiste has carried out 1,702 consultations and 801 operations during 80 outreach trips in the last twelve months. "The fact that we are able to make a difference in the lives of many desperate people in our region makes me proud."