When I woke up this morning to the sounds of birds and bush babies, it felt like a homecoming. That is how profound my years of coming to Tanzania have been. The friends we’ve made and the feel and energy are the same but time marches on with the inevitable growth of Arusha as more people are moving to the city seeking better opportunities. In that regard the homecoming is bitter suite. However, the people and their medical needs remain the same if not more challenging. Time and progress marches on.