Friday, March 9, 2007

Wrapping up all of the field work and heading to Safari

Hello everyone.

It is late Friday evening our time and we have had a full day. We were up early at the Treehouse to start our data analysis first thing this morning. When the alarm went off at 6:30 am I thought for a moment that someone was playing a joke on me. The past few days have been long and since the roads are rough, very sore.

We inputted all the data getting ready for our meeting with the CARE staff at 1:00 pm. Together we put together a powerpoint presentation which we will be presenting to the CARE offices in Dar es Salaan next week. There is so much information on each of the facility that it was a powerful working session getting everything compiled with input from everyone. It is fun to see the whole process work. After a year and a half in school, and all of the book knowledge in my head, it is powerful to see it all come alive.

When we were wrapping up the meeting we all excused ourselves before we all headed out to dinner. All of us ran to our rooms and changed into traditional conga dresses that we had made for us this week. We all put our traditional garb on with our head wraps on and walked into the living room to thank our CARE colleagues for all of there help the past few weeks. They were so appreciative that we valued there tradition and customs to dress for them in there native cloths. We all did a blessing and the women ended it with a rolling of the tongue sound. The rolling of the tongue sound is a symbol of being happy and having joy with the person or the moment. My American tongue just made a few small sounds similar to what I did when I was in the choir. I am smart enough to know that singing or voice is not my strong part and at the same time I want to participate in everything that is going on.

We leave for a few days to start a much needed rest and go on Safari. We have worked so hard and it will be a much needed break to enjoy this beautiful country. I will send everyone some pictures when I see my first monkey or giraffe. We will be back with internet communication sometime on Wednesday. Until then, Good night.

Thursday, March 8, 2007

I am back from the bush......

Hello everyone,

I am back after being out in the field for four days. Time flies but I am absolutely exhausted. I am so happy to be back at the tree house and have a warm shower and the confidence that the room is clean. Some of the rooms I have stayed in have been challenging to say the least.

Last night I slept in the Paris Suite at the Los Vegas Hotel located deep in the middle of nowhere in Kwimba. My room charge for an evening was 5000 shilling or $4.00 US. The reason my room cost so much is I did have a convenience bathroom attached with a western toilet and a shower that allowed me to fill buckets of water and dump them on my head. I forgot to mention that only cold water was available. I woke up very quickly this morning and I did not need a cup of coffee to get my day started. There is a small bar where soccer was playing last evening and Adam and I sat in a cement courtyard on a plastic chair drinking a few cocktails. Beers which we are charge 1,000 shillings or $.90 is a good value. We still have not mastered the shilling values but everything seems so inexpensive we are living like kings. The challenging part is they have these large amounts on the bills such as 5,000 or 10,000 shillings that you initially think is worth a lot of money and then you realize it is about a $5.00 or $10.00 bill.
(Please look at Adam's pictures he is documenting the toilets of Tanzania. They are porcelain pits in the ground. The picture will say it all.)

The land out in the bush is so incredibly beautiful. It is a land that is lush and green and breathtaking. The road situations which are mainly dirt roads are incredibly dangerous and treacherous. We are in a four wheel drive and yet some of the things we need to negotiate around stops our breath for a moment. Mostly after we pass a challenging part we give our driver, John, a big round of applause. I always try to motivate our driver to be careful especially when I know we are driving back on this road after we do our work at a health dispensary.

My night in Kwimba was considered staying at the Ritz in comparison to what Karen ChoCho and I experienced on Monday in Misungwi. We had a very successful day in the field getting our data from the health centers. We were invited for dinner at one of our colleagues from CARE house since she lived in the neighborhood. She was excited and waiting for us with 6 plastic containers with covers on them. Also the glasses had a piece of lace placed on them. I learned this is because of the flies to keep the food as fresh and sanitary as possible. The fact that Bernadetta has chickens running around her courtyard and that they come into her living room and every other room in her house is a whole other conversation. We had a delicious meal of rice, beans, bananas, tilapia with a fish stock and spinach. Before the meal starts you wash your hands with water being poured over your hands from a plastic pitcher spilling into a plastic bucket and soap. The food is place on a coffee table and you fill your plate up and sit on the couch or chair that is brought into the room. After plates are cleared away I was told that you leave money on the table to pay for the meal we just ate. Since people are poor this is an understandable tradition. The home cooked meal was wonderful and I am glad to pay the hostess money for the fresh items.

Karen ChoCho, Julianna and I now head to our luxurious accommodations. It is getting dark and Karen and I walk into our room which looks better in the dark than it did in daylight. We then proceed for 40 minutes repairing the mosquito netting in our room. We are getting stressed and sweating working quickly to get this done. The mosquitoes that have a greater chance to carry Malaria come out later in the evening. You can understand the intensity that the two of us are not only sharing a small room with two single beds but the netting is worse that Swiss cheese. I am so glad that I packed that duct tape. It was a godsend for repairs. Karen and I finally finish this task and need to take a quick shower to wipe off the adventures of the day. There is no air conditioning not even a little fan. As Karen is getting her items ready to head into the shower the electricity is cut off. Out comes our headlamps and Karen showers by the light of her lamp which has 3 AAA batteries.(not to much lighting). I am standing in the hallway since we are in total darkness except for the headlamps. I jump into the shower next for a quick military shower and then proceed to cover myself with layers of cutter insect repellent. Did I forget to mention the bugs that were flying around the room when we opened the door or the multiple little bodies lying in the corners of the room? This place is horrible. As Karen and I are lying in our little beds we cannot stop laughing that we are going to get all the services of going away to a spa and only have to pay $3.50. All of us are loosing weight either by limiting the food we eat and the room was so hot that it is similar to a sweat box where you can go in and clear your pores and system and loose inches. Even though we were getting so many beauty benefits from this we both were wishing that 7:00 am would come so quickly because we were both counting the minutes so we can bolt from this location.

That is all for now. I was on the road with my team this morning before 7:00 am and we did over 7 hours of driving not including the time we spent at the 3 health facilities we visited and did our data analysis at. The distance between all of these health centers is mind boggling. It really makes you realize that if you need a doctor or if you want to deliver a baby that distance and roads are a huge obstacle that needs to be added to the equation.

Sunday, March 4, 2007

Sunday, Day of rest....

Hello everyone,

I am sorry I have been out of pocket shortly, I was a little under the weather, but I am back on the road to recovery. I woke up with a fever Saturday morning and knew something was wrong. I stayed at home base for the day and decided not to go into the field until we knew what was going on. Dr Geiseker and the team were wonderful. They all monitored my temperature and kept me company. Fortunately it was only a case of traveler’s diarrhea which is common when landing in a new country. I am very lucky to have brought antibiotics specific for this condition before I arrived in Africa from CVS.

I learned a lot from the experience. We are so fortunate and take our medical system so for granted. The smart doctors that are educated in our medical schools and the research and development of the pharmaceutical companies are not really appreciated. The reason I say this is at one point it was briefly mentioned they would take me to a doctor. My first and clearly stated response was “NO WAY”. We spent the last 3 days at the best hospital in Mwanza, Missungwi Hospital. After viewing those conditions at the hospital, even though they were delivering the best possible care to the locals, I did not have any confidence that I would personally use them as a resource. In the birthing room at the Missungwi hospital there was an open can of pills of Amoxicillin sitting on the cart. No sanitary precautions were taken especially with all the flies in the air and the dust coming in off the dirt road since there was no glass in any of the windows.

I took a small excursion with Jamie and Adam on Sunday afternoon. This was technically our day off and I needed to walk around a little. We met our guide who was to show us the town and to make sure that we were safe when we were walking around. He was a student studying diplomatic relations in a school in the city. We walked to the village market to see what life was life for the locals and how they went shopping since Krogers and Whole Foods does not exist here. We start following our guide down one of the isles and start getting a feels for the setup. The first row has large burlap bags of rice, barley, beans, flour from 5 separate vendors trying to sell the same product. It is nice to know competition exists everywhere. They we travel to the vegetable section where the women have tomato piled on top of each other like small pyramids followed by peppers and garlic. We turn the corner and a lot of commotion is occurring. Before my eyes are 10 cages with approximately 40 chickens and roosters sitting on top of each other squawking. Feathers are flying and Jamie’s first response “lets gets out of here, I don’t want to catch avian flu.” We quickly turn the next corner and wind up in the fish section with multiple small mountains of sardines piled on top of each other. I cannot exactly do any justice to try to explain the smell. I can only ask you to close you eyes and imagine something fishy, hot and smelly. It was not pretty to say the least. We left the market and walked through the town some more. A lot of the shops are closed and Sunday which is a day of rest is taken by the local shop owners.

As you can well imagine, it was time for me to cut my adventure short. I took a cab to the Tree house bed and breakfast to enjoy the rest of the day. The countryside is so beautiful. I sat on the veranda with Karen ChoCho and Dr. Geiseker just feeling the cool breezes carrying across the land. There are so many animal noises from birds to the roosters and soft African music is being carried across the land. It is sad the country is so poor and yet the countryside and the people are so beautiful.

We are off to the field for the next few days. We are not sure if there will be electricity or internet. So if you don’t hear from us those could be the reasons.

Take care,

Dawn

Thursday, March 1, 2007

Misungwi Hospital Visit

Hello everyone,

We ended our day and are back in the Tree House Bed and Breakfast. It has been a long day working with the team and doing our first excursion into the field. We went to Misungwi Hospital which is only one of four hospitals in Mwanza. On the way to the hospital which is approximately one (1) hour of travel time we were slightly delayed since our jeep had a flat tire. Later on I will share how the roads are in this second largest city in Tanzania which is terrible to say the honest truth and yet I am told they are very good compared to the rest of the district. We happened to stop in front of a few huts and the woman who was looking at us from the back of her hut only spoke when one of the CARE workers spoke with her in Swahili. She told us that she has a small table and chairs set up so when people are walking on the road can stop for a glass of water or tea and relax before the rest of their journey. We were driving for miles before the tire had it’s flat and we drove for 5 – 6 more miles before we saw the next bit of civilization. This country walks as their main mode of transportation since it is what they can afford.

Misungwi Hospital is located off the main road and we drive down a narrow road until we get to our destination. The hospital is comprised of 5 -6 smaller building to make the complex. Families and mothers are sitting around under some tree’s waiting for a quarterly appointment. There are roosters running around the grounds and there seems to be more fly’s around the hospital than what we have experienced since we got to Tanzania. This is concerning since we are told that Misungwi Hospital is one of the better hospitals in the area and they have had success with lowering their maternal mortality rates. You do smell rubbing alcohol so you do know they are trying to keep in sanitary, and yet when we left at the end of the day we felt so dirty. We met with the main person of the hospital John Michael which was very knowledgeable about the facility. In our meeting we talked about changing the perception of the community and having the mothers trust delivering their babies in a hospital facility instead of home in their huts. The hospital presently has a total of 4 staff to take care of 19,500 women in the community. Since the hospital was one of the lucky ones that was fortunate to have a surgical theater in one of there rooms where cesarean sections are performed we asked John Michael if he did the surgeries. John Michael informed us that he was actually a dentist and they did not have a medical doctor on staff. (we did notice that John Michael had nice teeth but he would not be an asset if a woman was having an emergency). We were told that if a woman had a complication, they would put her in the ambulance that they owned if gas was available and drive her 1 hour back into the city of Mwanza for her to be treated.

Before we walked into the maternity ward we noticed a few huts 25 feet away where there were small children running around and older people were cooking food. We were informed that since some women live so far into the bush that their family travels with them to cook food and clean their cloths since none of these services are provided. We also figured out the reason roosters were running all over the grounds that the families brought them with them so they could be cooked for dinner. I guess a playmate cooler and ice are not available to them to travel with.

To deliver a baby at the facility it is free and the baby get’s a polio vaccination and another vaccination complementary before they leave the hospital. If she needed an IV drip it was 200 shillings (or $1.20 US) or a syringe which cost 300 shilling ($ 2.25 US), any other service would have to be paid a la carte.


The maternity ward was a room with 45 beds with mattress almost touching mattress that was filled with approximately 15 women. They were fortunate that mosquito netting was provided if they needed it at night. One woman was lying on her side and her husband was with her. I did notice that he had a shirt that was filled with mud. It is starting to become very clear that sanitary precautions and OSHEA regulations do not exist. As we were walking through the room one woman stands and is bending over in pain as her water just broke. Jane who was in our team is a nurse/midwife she stops and helps the woman. We call to a woman who was staffing the ward for help. The nurse walks over so slowly and helps the woman having her baby into a room that was bare beside a gurney and a metal table. We did not stay so we could give the woman privacy enabling her to maintain her dignity. She did not need our team sitting around her bed watching her delivery a child.

I think Misungwi hospital is a far cry off from Northside Hospital which is know as the baby factory in the country. We know Northside Hospital as the facility with the marble floors, the gift shop in the lobby and the beautifully decorated delivery rooms. These are two totally different ends of the spectrum.

The next room is where the mommy’s that just had there babies stay. They are not allowed to normally stay and most leave the next day and travel home. One woman had twins they were swaddled in her blankets lying on her bed with a sheet laying over them. Since cribs were not available this is how a mom protects her child until she leaves.

The building that housed the mothers had an old x-ray machine sitting on the porch. There were cobb webs on the knobs. We asked if this piece of equipment is functional. We were told that when they built another building they would put this equipment in it.

The last building comprised of men who were there for HIV/AIDS treatment and the room attached contained an outbreak of Cholera. We know this is a contagious disease and yet the nurse had on only one rubber glove, no gowns or masks and when she left the room she walked over to a bush where another man poured some bottled water on her hand with NO soap to sterilize her.

This was a day that impacted me. It is sad since this is one of the better facilities that exist and the ones we will be visiting over the next few days will be poor and worse. I will let you know what we experience.

Wednesday, February 28, 2007

We started working in Mwanza

Wednesday, February 28, 2007

Today we started working as a team and rolling up our sleeves and starting on our project. It has been a fun day even though it is long. As we start for breakfast we are investigating everything to see if we eat it. Going to Einstein Bagel store will be much appreciated when I get home. We have all decided that we will loose at least 10 pounds by the time we get back home.

We met with some of the CARE team that worked on the original data analysis. We presented some of our findings looking at spikes or irregularities on our data. These women were not only so warm, but they were very smart and knowledgeable. Julianna, Ellen, Jane, and Benedetta Bonkana were nurse/midwives and are well respected in the community. These women don’t have much in regards to possessions, but their sense of pride and helping the other women in the community came through. Jane traveled over two hours by bus this morning on roads that are terrible to say the least to attend this meeting. It is very much appreciated especially since it has been raining for 9 hours and all the roads are just mud. I am not sure but they started laughing when I told them I had never experienced a rooster crowing all day in my life. I think I am in trouble with what is ahead of me. The women also told me how good the roads are in Mwanza and that if I think that the roads are bad here, just wait until I experience a real rural village. (I will keep you posted on that adventure)

We are really enjoying this experience. I can say it is nothing like Atlanta. We did have the opportunity to go to the best restaurant on the island. Hotel Tilapia which is located on Lake Victoria is the closest thing to a white table cloth restaurant. We sat outside and watched the sun set. Jamie who ordered a whole tilapia fish for dinner decided to give herself a bet for 5,000 shilling to eat the eyeball of the fish. I personally thought it was pretty gross but told her I would happily give her the money if she went through with it. To my utter surprise she just popped it in her mouth and started chewing. (She told us it was crunchy and then just swallowed the rest). I am happy to pay her the cash which is equivalent to $3.50 US. I know she is getting married soon but I don’t think this amount will pay for an appetizer for one of her guests. We all had fun and if Jamie becomes a very good swimmer over the next few weeks, I will know why. One of the great things about these restaurants in Mwanza, that even though we are eating at the most exclusive place in the city, dinner only costs us all 15,000 shillings or $12.50 US. We could all live like kings if we live here, we would just need to hire our own personal security guard and driver to stay on the safe side.

I will keep you updated on my animal friends. When I see my next donkey, pig or rooster friends, I will send you all a picture. Take care and talk to you soon. Dawn

Tuesday, February 27, 2007

We Made it to Mwanza

Hello everyone,

Our internet connection was slow in Dar es Salaan. We spent the first few days getting over the jet lag. It is tough when you are changing your whole bodies’ time zone that you are awake when you really should be sleeping if you are still in Atlanta. The city of Dar es Salaan was beautiful. The area in which we traveled was in the heart of the city where the embassy’s and hotels were. You can tell the city is rich with culture and tradition. As women are walking through the streets with large baskets on their heads which looked to weigh 30 plus pounds walking in the hot sun when the average temperature was in the high 90’s filled with lots of humidity, you wonder where their strength and resilience comes from. I wonder in awe how strong the muscles must be in their necks and upper backs.

We made it to Bongoyo Island yesterday after our meeting at the CARE office. Meeting with the board of the organization was a wonderful opportunity. Helen Gail introduces us as guests at the event and made us feel welcome to be part of their meeting. The event was outside under large tents with 6 strategic presentation areas situated in their lawn. You appreciate the time before power point presentations when the effective color oak tag paper with pictures and key points scatter on the poster was displayed. As the temperature and humidity kept rising, you were dreaming of a cold winter day in Atlanta. We went inside to the one air conditioning unit which had the power of my blow dryer to cool the whole room off. Needless to say after the event we were excited to hit the beach and cool off in the water.

The boat ride to Bongoyo Island was in a wooden boat that was older than some of the antique furniture that I own. This vessel took us to our destination and that is all that mattered at that point. Jamie in our team was so hot that as we were anchoring closer to shore she jumped overboard to swim to the beach. Needless to say she made a big splash and everyone watched her swim as we sat in our dingy driving to the shoreline. The best part of our adventure was on this island the restaurant owner comes to ask us for our lunch order. With some key words like fish and small fish and some hand movements he shakes his head and heads to his boat to catch us our lunch. He comes back 30 minutes later with some fish that has just been grilled. Talk about FRESH….. I will never be satisfied with canned tuna fish again.

Now we cannot end our day without a little shopping and dinner. We all divide and conquer. Adam leaves to buy some native clothes, (he has only been in the country for a day and a half and he is getting some African dress. Jamie and Karen are sitting in the shade working on their Swahili testing each other. (they are not bilingual just yet, a little more work needs to be done) and Dr. Geiseker walks thru the stalls with the skills of a negotiator that would make everyone impressed.

Diner was the final event of the day. Of course the electricity is going on and off and we always say a little prayer that our entrĂ©e’s made it out of the oven before the lights go out for the final time. I am realizing the value of electricity and will be very happy to pay my Georgia Power bill next time it arrives. In all seriousness our flashlights and headlamps all become very valuable items to be treasured.

Tuesday, February 27, 2007

We are up early and start emptying our suitcases to carry as little weight as we can for our next destination to Mwanza. We are told not only is there a weight restriction, but sometimes the airline does not fly since they book to many flights with not enough planes in their fleet. I finally understand the term “African time”. Basically if it doesn’t get done today, you do it tomorrow. The plane ride was an adventure. We all said a little prayer that the wheels and landing gear we going to make it down as we hit the runway. It was a little interesting that there was no cock pit door (great security) and the pilots are served a meal during the flight. I was a little concerned on who was actually flying the plane at that point in time. The stewardess was wearing high heels and did serve us a beverage, but she forgot to tell us if there were any emergency exits or if the yellow mask was going to come down in case of emergency. We just decided that those little oxygen masks did not exist or the personal floatation devises were under our seat as well.

Driving to our accommodations you see that Mwanza, which is the second largest city in Tanzania, was a lot poorer than Dar es Salaan. The few roads we traveled were rocky with lots of pot holes. You do realize that the people walking on the street take their lives in their hands every time they journey on them. It is very clear that the driver has the right of way and a person has to either run out of the way of the front hood of the car and get hit or walk on the side of the most dangerous parts of the road where twisting your ankle could be done in a matter of seconds. Especially where most people that are walking in the road are bare foot or with a rubber flip flop as their shoe attire. They are not wearing a pair of timberland hiking boots that’s for sure.

The Tree House which is a bed and breakfast on the island. This is where we are staying most of the time while we are in this city. The rooms are equipped with our mosquito netting and we are told as the evening gets later the mosquitoes that eat the most and carry malaria come out. I am thinking I will be changing my time and become a morning person while I am here. The woman who runs it works with the street kids of Mwanza and the profits of the lodging goes to her work with these children. The accommodations have tight security with locked gates and a full time security guard. I am not sure the exact crime rate, but with the grave poverty in the country you need to have the security in place that a problem will not occur. Where we have been so far today has felt safe. It was interesting that during our drive there was a gathering of a hundred or more people gathered in the dirt in front of a church or business. We were told that it was a community meeting and they were gathering to discuss business. It was fascinating to realize that even though you were in a different country people still meeting to communicate and exchange ideas.

Now you need to realize that this is a whole new experience for all of us. As we are sitting and eating all of a sudden we hear a large noise and realize that it is from some animals (we are thinking it was either the pig or the donkey that is living next door) they just wanted to let us know they were there and to say hello. Now I am used to hearing a fire truck, car alarm, even a helicopter to pass. These are all tunes in my head that are familiar. Being a city girl the sounds of pigs, goats or donkeys will take a little getting used to. Well off to bed with the sound of my favorite animals ringing in my ear.

Thursday, February 22, 2007

Tomorrows the Big Day

Hello everyone,

It is after midnight and everything is finally packed. My computer is working with extra memory and any possible essentials that I could think of is added to my luggage. Who would have thought that duct tape, sewing kits, buttons, any possible over the counter drug that CVS carries was purchased and additional prescriptions were filled by the medical profession.

When we get there who knows what will be available. My motto is "It's better to be prepared than to realize when you are out in the bush that the safety pin you are looking for is sitting in a dish on my dresser."

I plan to keep you all posted on what we are experiencing during this trip to Tanzaniza. Well it is off to be to get a few hours of sleep before I rush to the airport.

Dawn