Monday, March 26, 2007

Dar es Salaam

Hi everyone, I know it’s been awhile, but things have been fairly quiet since I got here to Dar es Salaam. I recently found out that Dar is not actually the capital of Tanzania, it’s Dodoma. And Dar is much much bigger than I originally thought, it took over an hour to drive through the whole city, it’s very spread out. Anyways, we some how arrived here two Sundays ago, I say some how because our plane left four hours early. They pretty much just fly when they want I guess. On the way to the airport Karen and my taxi driver drove off the road into a ditch, our car was completely sideways and I immediately jumped out because I thought it was going to tip over. A bunch of guys came over and were able to lift it out of the ditch, and afterwards they were yelling at Karen and me for money and I was yelling at them saying it wasn’t my fault it was the taxi driver’s fault. So, they eventually went over to the driver and he gave them some money. This past weekend I went to a town a few hours away for White Ribbon Day, promoting maternal and child health. Saturday night I went out to a club with two of the Tanzanian interns here which was really fun and interesting. I ordered a local liquor (Kunyagi) and they brought it to me in a small plastic bag! The event was on Sunday and it was interesting. We waited three hours for them to get organized and then we marched about three blocks. It was weird. And they gave out shirts but there weren't enough for everyone so people were chanting "shirts" in Swahili during the rally/march. Then we had to wait for the second guest of honor about another hour (the Vice-President of Tanzania) and we had to do the march all over again. The V.P came with about 20 cars following him! Then there were speeches, but of course I didn’t understand any of them because they were in Kiswahili. I saw two monkeys on the way there and a camel. At work here I'm supposed to be analyzing 150 surveys that they did with village health workers, it's all qualitative information and it's all in Swahili so I'm having a tough (impossible) time with it. There is not money in the budget for translating, so I am working with a Tanzanian intern to help me.
Karen and I are staying with our supervisor here from CARE. They weren’t able to find us housing, but she has welcomed us into her home. She has a three year old daughter who keeps me entertained. She also has someone that they call a “housemate” who takes care of her daughter, cooks, cleans, etc. and lives in the house. This is very common here, and I recently just found out from one of the Tanzanian interns that her housemate is paid $15,000shillings/month, that is about $13USD! I was so shocked. Apparently it’s a good deal for them because they also have food and somewhere to sleep. I can’t imagine paying $13 a month to have someone cook and clean for me and take care of my child. I could really get used to someone cooking for me everyday (and clearing the table and doing the dishes).
Jeremy comes in 9 days! We are both so excited. We finally booked our Safari, I know it is going to be absolutely amazing. We are spending 5 nights on the Safari and then flying to Zanzibar for 3 nights. Jeremy has arranged the accommodations for Zanzibar. Well, that’s about it from here. I am getting frequent updates about the Gators and of course am a bit disappointed to be miss seeing them in the Final Four. Oh well, Tanzania may only be once in a lifetime and I know there will many more Final Fours (as long as Billy doesn’t leave for Kentucky!). I miss everyone!

Saturday, March 17, 2007

More on Tanzania

I know it’s been awhile since I reported, but not a lot happened, then a lot. Last weekend was very quiet as I was here for the first time alone, and then Karen returned Tuesday and the rest of the group is back in the US (I’m a little jealous). I had grown quite frustrated with the way we chose which facilities we were going to visit, basically it wasn’t random, yet there wasn’t a good reason why we chose the ones we did. We just asked everyone their opinion of which facilities they thought we should visit, which is definitely not the most generalizable method of selection. In the process, we were driving 3 hours to the next dispensary and in the mean time passing by 3 others. Then, when Professor G. left she changed her rationale and said “just go to as many as you can.” So, with that in mind we were able to obtain a detailed map the from the regional planning office and I spent Monday marking on the map where each health facility is. Then, two CARE staff, assisted me in choosing ones that were near each other. I couldn’t have done it without their knowledge because sometimes two places looked near each other, but they informed me the road drawn on the map was not passable, so really it would take three hours to get from one to the other, even though on the map they were only 30km apart. Anyways, I’m happy to report that this past week we were able to get to 12 dipensaries! In the whole previous time we were here, working in two separate groups we only made it to 18.
Thursday was quite an eventful day for me. We (Karen, Victor, Driver, Myself) set off early on a two hour drive to Ngudu region where we would be working for the day, and as usual I was looking out the window of the vehicle taking everything in. We weren’t driving too fast as the road is dirt, and I noticed a man curled up on the side of the road covered in flies. It took me a few seconds to take in what I saw, which I quickly concluded was a dead man on the side of the road, but I yelled “stop” and asked the driver to please go back. Of course the driver and Victor (CARE staff) in the front seat had already seen the man and ignored it, but I made them go back because I had to see if the man was dead or not. I jumped out of the car and went over to him and he was covered in cuts, blood, and more flies than you could possibly imagine. I got closer and my heart nearly froze when I noticed he was in fact breathing. He was barely able to talk in a whisper, and I asked what happened (Victor translating) and he said he had been beaten for stealing a jug of water and left of the roadside to die. He had been on his way to the hospital which we were only about 2 km from, but he never made it. So, of course I knew we had to get him to the hospital immediately so we managed to get him into the back of the vehicle. On the way to the hospital I gave him as much water as he could swallow and was able to clean up his worst wounds in hopes to get some of the flies that were now covering our vehicle away ( I always carry my first aid kit and had gloves and supplies). We got him to the hospital, where we got him onto a “stretcher” and then to a bed, I left him with clean water and a towel. Later in the day after we had finished visiting our dispensaries I bought him new pants as his clothes were completely bloody and torn and he had been completely exposed. We went back to check on him, I gave him food, the pants, and a shirt I had of Jeremy’s that he had given before I left that I had been always been carrying with me here to sleep in. He seemed a little better, but it was also clear that the hospital hadn’t done much to help him. He pointed to his back where he had a huge thorn or wire or something protruding from his skin that looked very infected, I still cringe just thinking about it because it was sticking out almost two inches and he has been laying on his back the whole time! He had been in the hospital at least 5 hours and he still had this thing in his back. I slipped him a painkiller that Justin had given me before I left and I talked to him for a little while (with Victor translating) and then left. I think he will be ok, but I couldn’t stop thinking about how no one had helped him before…he had been on the side of the road for hours and there were definitely plenty of people that must have passed him. When I asked Victor and our driver about this they said that people must have left him because he was a thief. To this I said, “so they feel he deserves to die for stealing a jug of water?” To this they replied, “of course.”
To back up to a previous part of the day, we were visiting a dispensary to do our usual data collection. Karen began interview the in charge at the dispensary, while I was being nosy and looking around to examine the facility and take some pictures. There were only three rooms in the place and I turned the corner and right there, on the floor, was a woman giving birth at that moment. I stood there shocked as I was completely not expecting what I was seeing. I yelled for Karen to come see, and we both just looked for a moment in awe. The most amazing thing was how did we not know that there was a woman giving birth in this tiny building with no doors or windows? The answer is simple; she did not make a noise. Truly amazing!
Anyways, I have had a lot of memorable experiences here in Mwanza and am heading back to Dar Es Salaam tomorrow for the rest of my stay until Jeremy arrives. Speaking of Jeremy, I am happy to report that he has sold our house! We close April 3rd and they are letting us rent from then until early June. So we have to find a house pretty immediately when we get back. Jeremy is definitely missing me, when I talked to him the other day he said that he ate a bowl of soup with a ladle and ice cream with a fork because the dishwasher was full and we were out of dishwashing detergent! Needless to say, I am the one that does the grocery shopping. Last I talked to him, Russ was kind enough to bring over some beer and dish washing detergent.

Saturday, March 10, 2007

English...Oy Vey

Can I just tell you how funny it was when Adam refered to a clinical officer as one "bad dude" and then trying to explain to our Tanzanian collegues that he really meant that he was good. Being in a foreign language speaking country makes me realize how screwed up the English language can be.

Lost in Translation

Wednesday was all lost in translation. Somehow Dr. G and I ended up with the two CARE workers who have the weakest English skills, which resulted in a day of severe frustration. Needless to say, it is a CARE and CDC rule that we have to be off the road before dark, but instead we got home at nearly midnight. There are too many stories to tell from this day, but somehow no one was understanding one another and we ended up going to another health facility even two hours further than where we already were, when Dr. G and I thought we were heading home. We already had crossed one river where the bridge was washed out, we made our driver let us out of the car and we walked across as it was quite a dip down into the river bed and then of course having to forge the river. When we left the last health facility that we weren’t even supposed to go to it was already dark and we found out that the next bridge was impassable so we had to drive four hours back and cross the river again and this time the driver didn’t let us out of the car as no one understood English when Dr. G repeatedly said, “please let us out of the car now!”
Anyways, we weren’t able to go out Thursday as the other team was out in Kwimba where they had stayed overnight and Dr. G did not feel competent to let us go out again with the team that we were with the day before. Instead I ended up going with Bibi, who owns the house we are staying at, to read to street kids under a tree. It was great, and I took a lot of pictures for her and Dr. G took a lot of video footage to help Bibi make a documentary. Not only does she just read to the children under a tree, but she has a retired teacher who teaches them, someone who does first aid and bandages all their wounds, and she also counsels them and has extensive files on each child. She gradually learns about their life and the horrors they have been through mostly by the pictures they draw while with her. There were about 15 boys there when I was there, she doesn’t offer them food, as she says, only “emotional nourishment.” One of the kids stole my sunglasses, but I noticed before I left and asked one of the other boys who was still there if he knew what happened to them. He ran off, and ten minutes later came back with my sunglasses. It was very interesting.
The rest of the group left today to go on Safari, but i'm not going since Jeremy and I will go and it's too expensive to do twice. So, I'm saying goodbye to 3 people today because they are going back to the US after their Safari, but one other student (Karen) is coming back here Tuesday and will stay on will me the rest of the time. This weekend is my first weekend here alone, I don't really know what to do. It's been nice to be here in a group because I haven't been lonely and I always have someone to hangout with. I'm also getting tired of eating the same thing every single day, there is not a lot of variety of foods here. When we are working everyday out in the bush there isn't really food, so we haven't had lunch and we get home late, I've been really hungry during the days. It’s kind of a catch twenty-two; I try to eat a big breakfast, knowing i'm not going eat all day, but then I just get even more hungry. I wish I would have brought more snacks from home. Last night we had a nice dinner with the whole team, a good-bye dinner for the others, after working for over 10 hours yesterday on compiling all the data we have collected so far. We had a lot of laughs and I think the Tanzanians on our teams really appreciated us treating them to dinner. This weekend I will just hangout and relax and only try to imagine what Jeremy is up to right now at his Bachelor Party in Las Vegas.

Friday, March 9, 2007

Survivor

So, Karen’s boyfriend Munya says we sound like we are on Tanzania Survivor. We have unfortunately had our second illness of our 5-some, Dawn then Karen. Not to mention one person on our Tanzania team has malaria and another one now has a severe eye infection. I think I must have gotten immunity from eating the fish eye!
So, I have had a long few days. On Monday I set out to Kwimba district, where we had to stay overnight as it is quite a distance from Mwanza. The day actually went very smoothly despite all the bumps in the road. The roads are terrible, and I feel sore just from traveling in the car. We managed to get to 3 health dispensaries on Monday, which may not seem like a lot, but they are all so spread out. At one dispensary we were interviewing the Clinical Officer which is the person that runs the dispensaries (not a Doctor, but maybe something between a PA and nurse) and we asked what hours the facility was open. He said all the time, which I didn’t really believe, seeing that there was only two staff at the dispensary. Then he took us into the maternity room (a few beds in a building with no windows, water, or electricity) and there were 5 babies that he delivered in the past twenty four hours! One had been born less than an hour before we got there. I couldn’t believe my eyes. Then he showed us the labor room, a small room with a metal “bed” and the floor and bed were covered with blood and placenta and I don’t know what else. He apologized that he hadn’t had time to clean it yet…yes, he had to clean it himself and the nearest water was 1km away! The whole thing was unbelievable, this man works harder than I could ever imagine. And he had hardly any supplies, at night he delivers the babies by candlelight. Anyways, as you can guess from my pictures, I was excited to see and hold the five newborn babies! The “hotel” we stayed at was a once in a life time (hopefully) experience. It cost $5,000 shillings, which is about $3.50 USD and I must admit I wouldn’t have wanted to pay a penny more. At one point I thought I saw a scorpion in my room and I yelled for Dr. G and Adam and when I opened my door all three of us looked at each other and we all had headlamps on (no running water or electricity) and for some reason the sight was hysterical to all of us and at the same time we all started cracking up. Dr. G fumigated my room to kill the roaches and scorpion looking things with some bug spray that she came prepared with and after that I laid it bed and did some visualization exercises (I was visualizing being in the snow) to overcome the heat and I managed to eventually fall asleep with my pepper spray and knife at arms length away. Let’s just say the place was pretty sketchy.
I have to tell you about Jane, one of the village workers for CARE who has been working with us. She is an amazing woman who speaks very good English, she has recently retired as a midwife and she opened up a maternity nursing home. She showed us the facility which is exceptional by Tanzanian standards, and shared with us her vision and goals for the facility which really moved me. You can tell that she was passionate about her work; she really wants to provide quality care to women which you can’t readily find here. Her place is struggling as she does not charge women to deliver there, but she has individual rooms for each person around a courtyard planted with flowers. They don’t have individual rooms in hospitals, only one room with a bunch of cots a foot apart. I am definitely planning to help her financially to finish her maternal nursing home in the little way I am able to. Here is another story about Jane: I was telling her that Jeremy is having a Bachelor party this weekend and I explained what one was, and after she said, “oh, so when are you having your spinster party?” I started laughing hysterically and explained to her that it’s a Bachelorette party, not a spinster party. It was so cute though!
So on our second day in Kwimba, our vehicle got majorly stuck in the mud. We had to get out of the vehicle and were up to our knees in disgusting mud. People from the nearby village came to help, and after almost two hours of digging and trying everything our driver, Abas, finally got the car out. Poor Abas was covered from head to toe in mud. It was amusing at first, but after two hours I was really hot and tired and worried that we were going to be stuck there all night. Anyways, I have lots of more stories from this week but not enough time to finish them now. To be continued......

Sunday, March 4, 2007

The Babies are so Cute!

Hi all, tomorrow morning I am heading out to the bush, we are splitting into two teams for the next week and trying to get to as many health facilities as possible. I will be staying overnight in some village, as it’s too far to drive back in one day. I am getting to know Mwanza better and I still can’t believe it’s the second largest city in Tanzania…it’s just not big at all! We have had our first illness of the group, Dawn came down with a high fever and GI issues, but she seems to be recovering quickly with the help of her antibiotics that she came prepared with. We are being very careful about what we eat and drink, but sometimes there is only so much one can do.
I have to gush for a minute about how sweet Jeremy is, as I have unpacked my bags more and more or started new books, I continue to find sweet cards that Jeremy somehow managed to hide throughout my luggage. I think I have found three cards, all at separate times, and I it makes me so happy! My Tanzanian mother brought me to her home, as she wanted me to see it to see if Jeremy and I want to get married there. I also somehow ended up having to speak at a SDA church service in front of about 300 people. It was very uncomfortable, but amusing at the same time. Karen is SDA and we picked up one of our counterparts from her church on Saturday before heading out to the field and Karen wanted to see an SDA church here, and the next thing we knew the preacher had us up at the pulpit introducing ourselves to everyone. I am keeping my blog short tonight as we are heading out very early tomorrow and I have to get to bed, but today, being Sunday, we did finally have sometime for leisure. I think Adam and I managed to hit up every spot in town…we walked around everywhere with a Tanzanian man that Suzanne introduced us to, and we ended up taking a boat ride on Lake Victoria to a small Island. The Island was weird. Well, actually, it was beautiful. It was so scenic, but the weird part was the lion and the hyena in a cage. There were antelope running wild, and then the two caged animals. Of course their cages were sad and pathetic, I felt so badly for them. I think the island originally was meant to be a tourist attraction and from what I understood there used to be a lot of animals that were brought there, but apparently they all died. Apart from that sad part of the story, the island was great. The boat was a little subpar, but I don’t want to go into too much detail or else I might upset my mother…..come to think of it, probably my mother-in-law-to-be also!
Anyways, I like Tanzania so much better than Jamaica. I think I said that before, but I can’t stress it enough. I feel very safe here because the people are so poor that they don’t have weapons. Also, there aren’t very many cars, and there isn’t a lot of trash because people don’t have much to throw away. One thing I love is that almost every women has a baby tied to her back….the babies are so cute! You also see children with babies on their back, and they are hardly bigger than the babies themselves. I asked one of our counterparts at what age she let her children carry the next baby on their back and she said at age four! I am getting lessons in how to tie them on, but I still need a little practice. Also, the babies don’t have diapers here, so when they are on the mother’s back and the go to the bathroom, it basically just goes on the mom. That part makes me sad. I also found out that when a mother has a baby, the husband doesn’t sleep in the bed anymore, instead the baby does until it stops breastfeeding. I was told that this is basically done so the mom doesn’t get pregnant again right away!
Now that I learned how to say candy, the children love it. I love giving it to them because they get so excited! My parents got me so much stuff to bring to the children and I have only been here a week and I’ve pretty much given it all away already.
Anyways, I think Karen and I are going to stay on here in Mwanza an extra week or so, after the others leave, instead of going back to Dar. There is more to be done and we want to stay and finish it. Besides, it sounds a lot more appealing being out in the field than in the CARE office in Dar analyzing data. I guess this didn’t end up too short afterall, but there is always so much I want to try to share with everyone. I just got a text from Jeremy that the Gators beat Kentucky and are back on track! Yeah! Good night!

Thursday, March 1, 2007

Mwanza-the real beginning

We just finished day two in Mwanza and I am exhausted. Mwanza is the second largest city in Tanzania which is so hard to believe…it’s not big at all! I already saw someone I knew today who I met on the street yesterday! Our first morning here, Dawn, from midtown Atlanta via NYC and Long Island, awoke started by the sound of roosters crowing. Apparently it was her first time hearing it! Although it was hard for me to believe, you should have seen the Tanzanian’s reaction when she told them! Yesterday we met with the women that will be helping us with our research, they all previously were hired by CARE to work on this project and they are all retired midwives. They are extremely nice and seem to get a big kick out of us. They have been helping me with my Swahili and I have to brag and say that they told me I sound like an African and eat like an African! Speaking of eating like an African, last night we went to a restaurant on Lake Victoria and I had a whole steamed fish for dinner. I was then bet by the group $5,000 shillings to eat the fish’s eyeball, and all I had to do was think about Justin for one second and of course I did it. They were very amused and I made $5,000 shillings…don’t get too excited though, it’s about $3.50 US. Although we have been eating out a lot, it’s clearly not how the locals eat, as the women we work with said they eat chicken maybe once a month since it is so expensive. Tanzania is extremely poor; I can especially confirm this after our first site visit to the Musungwi hospital today. We have been working hard preparing to start our field visits, including choosing which health dispensaries, out of about 60, we will be visiting during our study. We clearly cannot go to all of them, as many of them take a whole day to reach by car. We started out at the hospital today, which was very depressing in ways, as the facilities are very bare, dirty, and minimal. If the hospital is the best line of care then I can hardly imagine what the health centers and dispensaries will be like. After meeting with the hospital doctor, they showed us around. The first stop was the maternity ward, which was about 15 cots in a room with no real windows. As we walked in a woman stood up moaning and her water broke. There was no hospital staff and one of the midwives in our group went to console her. She took her in the next room, the “delivery room.” They told me to follow, and after watching for a minute I felt bad just watching the women (still no hospital staff around) so I asked someone how to say “good luck” in Swahili and with saying that, I left the small room. The next stop was the post-natal room. Four beds. There was a newborn baby boy that I held..he was so cute but peed on me as they don’t have diapers and I noticed he had bad thrush in his mouth. Then I noticed that the one other woman in the room actually had a baby too. I didn’t see a baby when I walked into the room, only some bundles of cloth. Then I was told by our Tanzanian counterparts that she had twins! She opened up the cloth for us to see them, a boy and a girl. They were very premature; the girl couldn’t have been more than two pounds. I’ve never seen a baby so small in my life, it looked more like a fetus than a baby…but they were alive and I was very excited to see them. The last stop was the outbreak room. There was an outbreak from a village with about 10 people in the hospital that were very sick and had very bad dysentery. As I was excited about the babies, our professor was excited about the outbreak. She was an outbreak intelligence officer with the CDC and has worked on many outbreaks both internationally and abroad. I left the room fairly promptly as I wasn’t thrilled at the thought of being around whatever they had, but you could tell she was in her element. She stayed for awhile asking a million questions to the patients and health staff through our interpreters and determined it was from their pond in the village. Anyways, I could tell she was really in her element…I just waited outside and used a lot of hand sanitizer.
The land and scenery here is beautiful, it really reminds me of the Lion King. I keep thinking/hoping that I am going to see a wild animal, but nothing so far beside a humongous lizard or iguana.
I got my reputation for eating like a native after having lunch with the group today. You go into this place and sit wherever there are seats which for me was with other Tanzanians that I didn’t know, Dawn, and Bernedetta, a village worker in our group. My food was fish, ugali, and bananas and I just tried to eat how everyone else was eating. Ugali is basically a plain starch that is thick and very moldable, I can’t really think of a good analogy to describe the texture. Anyways, you take it in your right hand and make a ball with it, then pick up other food on your plate (with your hand) and eat it with the ugali. Well, everyone was making balls, which I was doing at first, but then I decided to mold a heart out of the ugali. I hadn’t really talked to the other people at the table as they didn’t speak English, but I showed them what I did and said, “ugali heart” and they all started cracking up. I guess no one had ever thought to make a different shape out of it instead of a ball. Anyways, I really liked the food and they were impressed that I cleaned my plate. I can’t say the same for the others in the group; Dawn definitely isn’t used to picking bones out of the fish.

Also, my parents and I bought a huge bag of Smarties candy before I left to pass out to the children here, but today I discovered a problem with them. On the way to the hospital when the car broke down (yes!) we were in front of a very small village so I walked in and said hi to the people. I tried to give the children the Smarties, but no one would take them. Then I tried to give them to the mother and she wouldn’t take them either. I tried saying it was candy, but they didn’t speak English…I also ate one, but they still wouldn’t take it. Then, a Tanzanian from our group came over, and translated. They thought the Smarties were medicine because they looked like pills! I had never even thought of that! I need to get a Swahili dictionary and find out how to say candy.
Anyways, as usual I am completely exhausted by the time we get home in the evening. Our days have been long, but we have a lot of work to do and nothing moves too quickly here. One of the women in our group has begun calling me her African daughter. We also determined that since I am her African daughter, if Jeremy expects to marry me, he will have to give her a dowry. She is excited about that…I hope it’s something good, because I’m worth a lot! She said it can be anything; it is really a token of appreciation for raising a daughter worthy of marriage (or something like that).
We are staying at an amazing woman’s house here.
She must be almost 80 years old and she is from Canada, but moved here two years ago and began a program where she goes out everyday and reads to the street children here. The money we pay to stay with her goes to her program, “Streetwise.” I really admire her, to move to the middle of Tanzania at this age (by herself) and to start this program is beyond my wildest imagination. She really amazes me and should be such an inspiration to everyone that anything is possible and it’s never too late to do anything.

You can find everyone else’s blog and pictures here: http://www.outbr8k.blogspot.com/
Again, please look at their pictures because I haven’t taken very many!