Thursday, July 28, 2011

Visiting the hospital for poor families

Today Shirley and I had our turn to accompany Dr. James Lace on his rounds at the pediatric clinic that the government runs here in Arusha.  There are private hospitals here that look very fancy on the outside, but the only one accesible to poor families is the government hospital.  The hospital is having some renovations, so the pediatric section has been moved to a health clinic in a neighborhood called Levolosi.  The first issue they had in their new location is that there was no electricity there until last week, when Dr. Lace made a donation that enabled them to run the generator.  (The general electricity here is very unreliable).  When a child comes to the hospital, they are generally accompanied by their mother.  The mother stays with the child in a bed (or sometime 2 or 3 mother and child pairs share a bed) and they must provide their own food and clothes or bedding. 

There are four "sections" in the pediatric ward.  The first is "Intensive care" which consists of three beds separated from the rest in a large room by screens.  There are no special machines there; they are just located closer to the table where the doctor and interns sit to write their notes.  This area is for the children who are the sickest.  The rest of the beds in that large room are the section called "P1"  This is for the kid's who are a little better than the ones in Intensive Care.  The most common diagnosis is malaria and pneumonia.  Dr. Lace told us that malaria is the number one killer of children under age 5 in Tanzania.  It presents as fever, vomiting, diarrhea, as well as other symptoms.  That, of course, could be other things, but they have very few diagnostic tools and malaria is so common that they just generally treat for it.  There were also cases of kidney disease in which protien is shed in the urine, a mystery case of headache and dizziness, and a probable skull fracture that was a week old.  It was very interesting to watch Dr. Lace interact with the interns, both of whom are Tanzanian medical students.  Because there is so little in the way of technology, Dr. Lace emphasizes listening the patient's story, the physical exam, and informed reasoning about what is likely going on.  He has shared with us earlier the challenges of bringing in technology that is appropriate to the setting, and his finding over the years that the most helpful thing is conversations with the doctors about specific cases, sharing information and expanding their knowledge base.  We had one case of an umbilical hernia with a granuloma (a part of the umbilical cord that had not died) in a month old baby.  The intern had thought it was an infection, because she had never seen this before.  But Dr. Lace recognized it immediately -- and now the intern will know about this possibility for the future as well.

A third section is "P2" where the kids from "P1" go when they are a bit better but not yet ready to go home.  The fourth section is the "Malnutrition Room"  There were three patients in there today.  One is an HIV positive baby who was left with his grandparents for 10 months while his mother looked for work.  While there the grandparents stopped giving him his medicine and he stopped eating.  He is responding to the care at the hospital and the intern was considering releasing him, but Dr. Lace said keep him here for at least a week, "We need to fatten him up!"  Another was a baby who is 12 months old, but is the same size as a newborn.  He has been vomiting all his life, can't keep any food down.  It is a mystery how he has survived!  Dr. Lace is hoping that they can get some more "investigations" (tests) done to discover the why of his ailment.

From there we went to the actual hospital.  We were able to tour the renovations which will be quite an improvement.  Instead of open windows, there will be sliding windows with screens.  Instead of concrete slab floors there will be tile floors.  There are lovely rooms with glass doors and walls.  We went to the nursery for the newborns and preemies.  There were some amazing sights there.  A few babies look healthy and responsive and will go home today probably.  There was a set of twins with Cerebral Palsy, and some tiny ones who need oxygen.  Many have nasal gastric feeding tubes because they can't suck, and some can't swallow.  There was one baby I kept watching closely to see if he was going to get that next breath.  It came seldom and was the only sign that he was still alive.  But they said he was better than the day before!  The cribs have 2-3 babies in them.  There is no bedding, so each baby is wrapped in or resting on a cotton cloth, called kanga here. 

We also saw the women in the breast feeding class.  That is good!

We met the only local pediatrician (for an area of 1 1/2 million people).  She said to us "This is how it is here.  It is hard to be born in Africa.  But if you survive your birth, you will be strong!"

-- Linda

Bartering or Not..................

The first shopping trip I was told to barter.  I really didn"t want to because I told them it was too
expensive.   The shop person would say "Give me a price."  I wasn't very successful the first time but
the next time I went shopping I saw a carved wooden bowl I really liked.  I asked, "How much?"
He said, "One hundred dollars".  I said that is too much.  He asked how much I would pay and I
said $30.  Of course he said 'NO".

I went out of that shop empty-handed and the other shop keepers saw that.  After that whatever price they
said, I said that was too much.  Again, they wanted me to give a price and I did.  I got seven gifts that day
for the prices I wanted.

So bartering does work.

Shirley Garrison

Teaching Computer Literacy

One of the challenges of computer training is the lack of consistent electricity. Dr. Lace says this is worse than he has seen before. We may have electric a few hours in the middle of the night but then it's gone during the day. So we have a generator that has worked some days.

The students that we have in the computer class are from a shelter for homeless youth. The agency works hard to get the students off the streets and into their safe environment. One of the goals is to help the individual gain job skills and computer literacy is one of those. Some of these young people are also in tailoring or cooking classes in the afternoons.

Many of the students were shy to start with but have opened up and have gotten quite engaged. Some of the young people have a small amount of English but the language barrier has been another challenge. It is a wonderful feeling to be helping someone through an experience and then for them to share that with another student who hasn't quite understood yet. It may have only been a few days but the students are certainly gaining their skills. And now really enjoying their facebook and emails!!

The Orphans Foundation Fund organization has great hopes for this computer lab to help individuals gain job skills and in the future to also be available for others in the community to pay for their classes. This will then become an income source for some of the programs as well.

Our group felt very close to those individuals in the village last week and were sad to leave them but this week has developed into a whole new group of relationships and just as meaningful. It's a wonder what can happen in a week's time.

Shanga Sign Language

Our group went to Shanga, a place where people who live in Arusha and are disabled can work. Shanga is Swahili for bead, and this place was a bead/craft making workshop and gift shop. There were quite a few people who worked there and we were able to see people making and sanding beads and making other crafts. One of the bead makers was going very fast it was very cool to see his technique. While we were watching him, we saw the group of people in that area all using Tanzanian Sign Language. I myself use American Sign Language so I was fascinated watching them.

The director came over and he knows how to speak Swahili, English, and Tanzanian Sign Language, very impressive. He would interpret for us what the deaf people were saying and our responses or questions to them. We all introduced our names then the director said we could go to the sitting area and one of the girls would come over and teach us some Tanzanian Sign Language. There was a board that had words in Swahili and English and she showed us the signs for them. Our whole group was signing and I was very excited to learn and enjoyed watching the rest of my group sign also. There is a person at the place we are staying who uses Tanzanian Sign Language so I wanted to be able to communicate with him.

Once we learned Tanzanian Sign Language I was asked to go up and show the same words in American Sign Language. I really enjoyed showing them my signs and they loved learning it. All of the deaf workers there came over to watch and they asked me a whole bunch of words to show them and they usually laughed when they saw the difference. It was a fun, interactive experience. This went on for about a half hour and then one of our group leaders asked for a picture with everyone so we all got in a picture. That is a picture I will always cherish.

~Katharine Choate

Traveling the Roads of Tanzania

One of our main activities on this trip has been driving in vans and cars trying to get from place to place- the village to Arusha,  the orphanages and resource centers to home. There are many sayings about how one must enjoy the journey as well as the destination, and in this case, we truly are. The roads here are so bumpy, hilly and rough that each voyage feels like a carnival ride. And if the state of the roads are not bad enough, they have added speed bumps at close intervals to make things even more interesting. Even this would not be so bad, is we were riding in vehicles with good shocks and planty of space for each passenger to have a padded spot for their rear. But, alas, this is not the case. Our vehicle is generally a land rover with hard seats that barely fit all of us inside. On the occasions that we drive through the unpaved areas (this happens frequently) it feels as though the walls are going to fall off the car and that we will be thrown out the windows. Needless to say, after these rides our butts complain profusely with all our other joints providing supporting complaints. But as in all aspects of this trip, our group makes the best of this situation. We laugh at the big bumps and try to make sure no one seriously injures themselves by hitting their heads on the ceiling and that no one ends up too car sick. I think that smooth road and comfortable, spacious vehicles are some of the things our group is most looking forward to reclaiming in the US. As with any carnival ride, it gets old. We have fun, but no one will complain when we leave it behind.

Teaching health in the village

So one of my favorite memories that I would like to reflect on is when our team taught health to the women in the lengasti village. We had just arrived in the village the day before and we were all eager to get to know people and get started on all of our projects. We were asked to teach health the next day to the women in the village. We had a brief meeting the night before. All of us weren't quite sure how it was going to turn out and we all tried to prepare ourselves for whatever would happen. We all sat around a table and just started out with asking the women questions about the village and what they do to take care of themselves. Our conversation very quickly transitioned from malaria to HIV/STD's/AIDS and it wasn't until that moment that I realized how much previous knowledge I had on something so simple. It is definitely easy to assume that everyone should know what I know, but unfortunately they were not given this sort of information. We had a translator there helping with the language barrier but although we could not fully understand one another our emotions were clear that when something was serious the tension was serious but when we practiced putting condoms on the models then the tension became more comfortable and it was clear that we all felt the same giddiness. the women made it clear that they were grateful for what we taught them and to make it understood it is not that the people were unintelligent for not knowing this information. If no one teaches you these things then how can they be retained. The women left confident and secure in what was taught to them and through prayer and the new knowledge they have retained I myself am confident and secure that they will teach others in the village the importance of their health.

Guests of Honor

Tonight we went to a house warming party for a new home in the village of Lengasti. After a bumpy ride standing in the back of a truck, we arrived at our destination. As we got out, the Maasai women handed us chairs and instructed us to put them in a semi-circle. As we sat down, I noticed every single Maasai face was turned towards us (about 250 villagers). I asked our Tanzanian friends Stanley, James, and Evelyn about it and they told me to just stare back--it's just what they do when they see strangers. Feeling awkward, I attempted to do so, but could hardly help but smile and laugh when their faces remained blank for over 15 minutes. I'd be surprised if they even blinked.

 After this, we were moved to another area where a Maasai man brought over a huge slab of meat on a stick and began handing us chunks of it. At this point, Gladness told us we were the guests of honor at this party. This meant that we had to eat the meat or it would be very disrespectful. Not normally eating much meat myself, I reluctantly accepted the pieces they handed me. It was not appetizing, but as soon as I got a piece down they promptly handed me another. I quickly learned to eat a bit slower to prohibit them giving me too much.

When the entire slab of meat had been eaten, I let out a sigh of relief. They quickly brought more though, howver this time they brought goat ribs. I politely declined their generous offer this time, as did most of our group. When the Maasai were done eating, I noticed them rubbing their meaty and juicy hands all over their bodies. I asked Gladness about this and she told me that it is because they enjoy the smell of it so much and it also moisturizes their skin.

A few of us then went for a walk around the village and down a small path. After 10 minutes we noticed about 30 children running towards us. We stopped to see what they were doing. It turns out they were just following us so they could stare at us some more! After walking through our paparazzi back to the party, we were invited to dance with the Maasai women. They graciously motioned us to join their circle and taught us their traditional dance moves ( a lot of shaking of the shoulders and chest as well as jumping).

I feel blessed to have had an opportunity such as this and to experience the Maasai lifestyle for the 5 days we stayed in Lengasti. Tonight was truly one to remember.

-Stephanie LeVine

Building the playground

When we were told that we would be building a playground, I am not sure what I expected. I envisioned power tools and precise measuring devices; this was a gross overestimation on my part. What really happened , is that Denvy and Gladness went in to town and bought the materials, and for the next two mornings we put together the whole thing. I personally worked with a few other people on garden boxes and the climbing apparatus. This entailed tying evenly placed knots, over and over again. Keep in mind that this was using 100 meters of rough hemp rope! It was a rough process, let me tell you! after considerable teamwork and frustration, we finally managed to tie the rope into a net of sorts that we would later put up on a wooden frame. This was very tiring work, but ultimately was worth it. The others worked on building garden boxes and the swing set. Men helped immensely by digging three foot deep holes (through rock!) to put the posts for the swing and the climbing thingy, which were then filled with concrete. Unbelievably, it only took two mornings to put all of these things together; proving just how much can be accomplished with teamwork!

Finally We're On

It seems redundant now that we're near the end of our trip we would report in that we arrived OK, but this is the first opportunity and time to access the Internet. We have been busy the entire 14 days and are looking forward to one more computer literacy session tomorrow in the midst of ice cream this afternoon, disco tonight, safari tomorrow, church and flying the next day, touring DC on Monday just before we arrive home.

Chronologically the story may be endless so you may receive several blog entries on different topics. Happy reading and we look forward to seeing you.

Thursday, July 14, 2011

First Step

The bags are checked and we're nibbling on breakfast snacks, purchased fruit, coffee and Gail's homemade scones. Security checks were routine except Shirley took the wheelchair lane and Denvy was randomly selected for a special search as well as a rerun through the bag scanner. If there was a turning around point, it was sometime in the past. The machine is set in motion and for the next 18 days our fate is not self determined. Bon voyage.

Sunday, July 10, 2011

Dedication Sunday

Support for this trip to Tanzania has been overwhelming particularly from the church, and so today during the worship service Pastor James is taking some time to bless, dedicate, consecrate or just acknowledge the trip and its efforts. Then in four days we board the plan and turning is no longer an option.

We're packed, or at least far along enough in the packing process to know that all but one has hone their personal stuff down to one carry-on and one personal bag, except one traveler, and that we think we have about six team bags to check with stuff for the villages. Quite remarkable in the list for the villages are 3000 condoms and 6 laptops. There are also volleyballs, jump ropes, glasses, clothes, dental hygiene supplies, woodworking tools and several other odds and ends. All the tickets and itineraries are in a three-ring notebook and the crisp new $100 bills for buying visas are securely packaged.

One last walk through with the team and then with empty SD cards and full batteries, the adventure begins. It's about now that I wonder where all the adrenaline has gone as we compare the comfort of an Oregon summer in the comfort of our home against the unknowns and challenges of living and working in a country and lifestyle we have never experienced. Hindsight tells me that all will be great throughout the trip and especially when we return.

Sunday, July 3, 2011

Wedding Day

As I awoke this morning I sensed a tension unique to Alaska. Alaska, particularly remote Alaska, is populated by independent individualized people. This uniqueness sometimes goes beyond logic and far enough from the normal range that it becomes a challenge to accept or understand. While these individuals will claim that keeping up with the neighbors is not important, it almost seems like there's a type of "keeping down" with the neighbors. No one wants to be known for their big house or neat yard and advanced education is not a virtue. Of course, because of the unique nature of Alaskans, the above statement certainly does not apply to everyone, or even a majority.

The wedding day started with wet grass and a heavy cloud cover. Arriving a couple hours before the ceremony we again helped with some details like setting up the electronic slideshow at the guest book and carrying the cakes from the house to the tent. At the time of the wedding the rain held its breath and so the microphone and handful of chairs were moved to the bottom of the ridge making a grand amphitheater and a great view of the brief ceremony. The couple arrived together in the back of a '56 red and white classic Chevy from the far end of the open field. The bride and groom each read prepared statements avowing their love and exchanging rings. The minister who said very little announced them as lifetime tentmates and the chatter began after the kiss.

For the next couple hours some hundred or more old acquaintances and strangers shared stories, ate and drank. Around the time the sun would set by most people's standards, a bonfire was started, the older generation went home and the canoe filled with beer kegs was pulled down the hill to the fire. The rain showed its moist head and gently showered the ongoing party.