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May. 7th, 2007

06:17 pm - 4 May -- Tanzania, Part 9

I fly back to Europe today. This is my last entry. I cannot believe the trip is over with. While I can’t say that it flew by, because at points it seemed to be endless, I can say that the time here has truly changed me. I am more independent now. I’ve learned I can coordinate things and travel to faraway places alone. I also think my point of view has changed on many subjects. I look at poverty differently now. I know I hold a changed opinion about the structure of the American and other government systems. I certainly have an appreciation for simple things like clean water, healthy food, functioning roadways, an infrastructure that works...

It’s hard to think that really, by a stroke of fate, I was born into a privileged lifestyle when I could have been born in Africa. That’s not to say life is awful for an African. They seem to be happier overall than people in the US or Europe. I have been reflecting on this a great deal, and I think that it’s possibly because of the simplicity of life. The fact is, when you are not educated, and you are not exposed to things like ipods, TVs, fancy cars, snazzy buildings, etc., you don’t want for them. The people I have met have been happy, even though they live without electricity and running water. They sing and dance, because that is their form of entertainment. They take care of one another, something I don’t think my culture does that much of anymore. They are brave, even though sometimes they do not fully understand what they are up against. They are friendly and welcoming to a stranger that really has nothing to give them. They are trying, despite no resources or education, to learn things and survive. They care for their kids. They live every day. They survive.

It’s amazing, really, to think about how many people are alive on the continent of Africa, despite all of the disease, sickness, and hunger. And while there are times and places where people were just looking for a handout, there are many things that I have seen that contradict that generic stereotype. The WORTH groups want a handout, but not of money or food. They just want knowledge, and they will work to change their lives themselves. The development programs I have observed are amazing and really inspirational. But after my time in Africa, I can say that charity groups cannot do this alone. Donors, also, cannot make a difference alone. And the Africans themselves, cannot make it by themselves. The government needs to step up and do more. Everyone needs to work together for change to happen. Infrastructure is needed, plain and simple. Basic, crucial services like water, electricity and roads are needed before Africa can move forward. It’s not going to happen overnight. And frankly, I don’t see it happening unless education is severely overhauled. The majority of today’s Tanzanian adults are not educated enough to know how to change things and how to make things happen. Most Tanzanians have a primary-school level of education. Their children need to surpass them in that. The schools need to put kids through all 12 grades as a mandatory and not a privileged path, and the kids need to learn English early on, in tandem with Swahili. I’ve talked with leaders about this in Africa, and most agree. The only real substantial change can happen when the next generation of educated-Africans take charge. I hope I am living to see that day. I would like to return and see what happens to the WORTH women. I would like to see what becomes of the kids attending the kids clubs. And I would like to see a government that is looking out for everyone, even those in the remote, now-forgotten villages, that are an hours-drive and a lifetime away from civilization. I guess what I learned during this visit is that change is possible. But patience and a lot of work is required for it to happen. Kwaherini, as the Tanzanians say. It’s a beautiful saying because it means “Goodbye with Many Blessings.”

Current Location: Kilimanjaro, Tanzania

06:15 pm - 3 May -- Tanzania, Part 8

I flew back to Kilimanjaro today, to do my interview with Erica. I flew Precision Air back, another budget carrier, and ended up talking to a young woman named Kayla on the plane who had been in Dar Es Salaam for research. She is an American doctoral student from Denver, and she is in Africa doing research on some rare species of monkeys for her thesis paper. She spent a lot of the time complaining about the lack of organization in Tanzania and how frustrating it is to travel alone in Africa, something I could now sympathize with. Apparently, she had planned a lot of her trip from the States, and had lined up interviews and guides which then fell through when she arrived. Her experience made me feel grateful that so many of my interviews went off without a hitch. (Really, that is a credit to the WORTH staff for making it all happen so easily.) Kayla, I think, was encountering the African time phenomenon. She also mentioned that the cost to get permits for research from the Tanzanian government were outrageous. This, also, did not surprise me. (I had decided to bypass the journalist permit requirements and get a tourist VISA instead when I entered Tanzania. Though I was a bit nervous that I would be discovered, I too had found the permit application process daunting when I looked into it. They wanted $1000 USD for me to bring recording equipment into the country, plus a detailed itinerary of dates, interview subjects and questions being asked. They also wanted to see proof of my status as a journalist and they wanted a copy of my college transcript proving I studied journalism! All of this, for just 2 weeks of interviews. Certain colleagues and people I contacted told me just to play dumb and not mention all of the recording equipment in my bag. It worked.) Kayla’s story made me realize I had made the right choice there too. Clearly Tanzania has figured out a way to exploit any foreigner with money entering their country, by levying permit taxes on whatever profession they are coming in to work for. Taxes at the airport (because people have enough money to fly), fees for a journalist permit (because a company has enough money to send an employee), fees for researchers (because they will get money from publishing.) The list goes on and on.... One has to wonder if the government really even wants the help, since they make it a challenge for people to come in and do work!

At the airport while we were waiting for our bags, a white guy approached us and offered to give us a ride to Arusha. This, I think would only happen in Africa. First of all, you pretty much know someone is not African, just by looking at them. They are either a tourist or with some-type of non-profit group. This guy was Australian and was working for an NGO. Kayla, the research student, agreed to the ride, but I was not travelling to Arusha, so I declined.

I met up with Erica later that evening in Kili, and we went out for dinner at El Rancho, my favorite (and in my opinion, the really only safe) dining spot in Moshi. By chance, I ran into some of the nurses from the American volunteer contingent. Clearly, from the number of tourists dining at El Rancho, the secret of their food was spreading. The nurses had just finished up their last surgery and were preparing to go on a safari in Ngorongoro before they fly back to the States. They told me they had been able to perform 11 surgeries this time. There had been 25 people on the list. So, not everyone was going to get new heart valves this time. The nurses told me that it was hard work, that the pace at KCMC is slow, and while they have done more operations in the past, sometimes patients have died. They said, with fewer surgeries there are fewer complications. I guess the people who did not get the surgery will remain on the list and can hopefully wait another 6 months when the doctor team returns.

Erica and I had a great time talking, and I learned all about her life path and experiences in Africa. She is married, and she lives with her husband in Nairobi, Kenya. He works for an NGO. She has been in Africa for 2 years. Before that, she had lived in Russia and Germany for several years. She is an American, from California. Our interview lasted 45 minutes, with her talking at length about the program, it’s progress, and what the future holds.

Erica had just gotten the news earlier today that First Lady Laura Bush is going to visit a WORTH village! Apparently, the president’s wife is interested in the program and requested to make a visit sometime in June. Erica said she will probably come to either Zambia or Kenya, because that is where the program is working best. There are also some travel restictions, in that the First Lady has to be able to land at a nearby airport. Given my experience in visiting Tanzania, I know this can be a difficult bill to fit, given that most of the WORTH programs are in very remote, faraway villages. That is where the program works best. It’s not designed for a city or bigger village environment. Erica is hopeful that Laura Bush’s visit will spur more public and private donations to the WORTH program, making it possible to bring the program into other areas of Africa.

Current Location: Moshi, Tanzania

06:14 pm - 30 April -- Tanzania, Part 7

I have mostly wrapped up my visits to the WORTH groups and kid’s clubs and I only really now need the big interview with Erica, who is the program coordinator for WORTH/PACT International. I was hoping this major interview, in English, would be the centerpiece, tying together a lot of the holes left by the other interviews. She was supposed to fly in this morning, but she was delayed in Zambia for a few days and rather than wait here for her, or go there, I decided to go to the coast. I had heard so much about Zanzibar, that I had visions of an aging gilded city, that was reminiscent of the days of the sultan.

What I found was a city that looked like Beirut after the war. A lot of rubble. Blackened buildings. No gilt or glory. In short, Africa with a beach.

I had to take a budget African carrier to get to Zanzibar, so I flew Air Tanzania, which was an experience. When you fly domestically in Africa, you have to deal with a lot of stuff that doesn’t happen on an international flight. I am assuming KLM has their own employees that handle ticketing, boarding, and departure. This leaves no hassle for the passengers. I don’t think that is the case for the African airlines. For instance, I had to pay arbitrary “taxes” at different points along the way, by someone in uniform telling me I couldn’t get my luggage or board the plane until it was paid. Really, the whole thing felt corrupt!

I had found a beach resort online that looked good. It was a Mövenpick resort, which I figured, had a good standard because of it’s German ownership. It turns out, as it so often does for me in Africa, that there are 2 resorts named “Zanzibar Beach and Hotel Resort,” with just one word interchanged, and so I was taken to the other one where I had no reservation. I decided to stay there because it looked nice. I did though, demand to see a room first, before handing over my credit card. I splurged and decided to stay at a 5-star resort. I mean, it was the low-season, it’s Africa so everything is cheaper, and I hadn’t had a hot shower in days. 130 American dollars a night secured me a deluxe room with all inclusive meals. I had a feeling my father, a fan of luxury travel, would have been proud. My room had A/C, which was an amazing experience, and a bed with a canopy. When I stopped out onto the patio, I had a clear view of the Indian Ocean, only 100 paces away. There was a hammock swaying in front of my door, so I spent two nights lounging there watching the sunset.

All of this time was, of course, alone, but still lovely. The Tanzanians, however, seemed to have different views about me travelling solo. At least 5 different people asked me why I was alone. I realize, often times, it was out of concern for me. Perhaps it is strange for them to see a woman alone. Perhaps it is strange that a white woman is travelling alone. But still, as I had so many times in Africa, I felt like my privacy was being invaded. This is the conversation I had when I bought my return flight on Precision Air in their Stone Town offices. The female ticket agent, I had to assume, was Muslim because of her headscarf. (Please imagine this repartee with an African accent):
JR: I would like a one-way ticket to Kilimanjaro.
Ticket agent: You are alone?
JR: Just for me, please.
Ticket agent: You have no partner?
JR: No, I have no partner, just one ticket.
Ticket agent: So you are not married?
JR: No.
Ticket agent: And you have no partner where you are from?
JR: No.
Ticket agent: So why are you travelling alone?
This conversation, though funny, repeated itself several times in various forms when I dined alone and was asked by the waiters why I am always reading.

On Tuesday though, I did meet someone. I was wandering around Stone Town, getting lost amid the narrow alleyways, and trying to re-route myself back to the Ocean so I could get my bearings. It was raining, so I had my FOX rainjacket on, and a white person passed by me, also wearing a hooded rainjacket. The form turned, and I was looking into the face of a smiling young woman. She asked me if I knew where the bank was? I told her no, and we stood under an overhang chatting, waiting for the monsoon-like summer storm to stop raining. After a few minutes of chatting, I agreed to find a bank with her and she then said she’d like to go shopping with me. We ended up walking around all afternoon together.

Her name is Siobahn (pronounced Sch-vaughn) and she is a 23-year-old from Ireland. She is living in Mumbai, Kenya, for 6 weeks while volunteering with a program at an orphanage for children with AIDS. She decided, just like me, to take a quick trip out to Zanzibar, because so many people talk it up. We ended up having lunch at The Africa House, which is a luxury hotel now housed in a historic building. It used to be the Englishmen’s Clubhouse, during the years when the British occupied the East African coastline.

After lunch, we headed over to the old Anglican Church, which was built on the site of the former slave market. Zanzibar, back in it’s heyday during the sultan’s rule, was a huge port city. It exported slaves, spices and coffee, and the sultan made a fortune doing it. That is probably why the island is so well-known in old fables and stories. The former slave market, was mostly destroyed, but the church kept up two of the cells for people to see what the living conditions were like. It was, in short, amazing to think of the inhumanity of locking people in there. The cell was underground, with only a shaft cut into the top to let in a sliver of light and air. At any given time, at least 75 people were crammed inside for a few days, waiting for market day. The conditions were abysmal, with people defecating right there, and lying on top of each other. By the time slaves were let out for market day, at least several had already perished in the smell and heat. The slaves were then led to the whipping post, which no longer exists, but is where the church altar stands. They have marked the spot with a memorial. Britishman Dr. David Livingstone is credited with stopping Zanzibar’s slave trade. (He is, of the famous phrase: “Dr. Livingstone, I presume...) He appealed to his government to put pressure on the sultan to stop selling slaves. He is also memorialized in the church. Livingstone died in Africa only a few years after the slave operation was halted.

After our historic tour, Siobahn and I decided to head to the beach. We hopped a taxi back to my hotel, and then split our time between the Indian Ocean beach and my hotel pool. Those who know me well know that I would not, could not, actually swim in the Indian Ocean. Instead, I waded in up to my knees. But that still counts, right? Siobahn and I had a great time, drinking cocktails, talking and tanning. (My first real drink since my nights at the Lutheran Hotel had all been non-alcoholic.) Siobahn had lots of interesting stories to share about her time at the Kenyan orphanage. We had dinner that evening at my hotel and then said goodbye. She wanted to do a spice plantation tour the next day, but I was not interesting in boarding a boat of questionable seaworthiness, nor did I really want to sweat out a day on a jungle-like island. So, we parted with promises to keep in touch.

Current Location: Zanzibar, Tanzania

06:12 pm - 29 April -- Tanzania, Part 6

Today we headed out to Msitu wa Tembo to visit a kids club. It was another long journey, but worth it to see the kids playing. I did a long interview with a Salvation Army captain about the purpose behind this kind of program. He said the Army, of course, delivers their mission work, but in truth, the clubs are about drawing kids out and building their confidence. (In fact, a lot of the kids in these villages are Muslim.) They hold the club visits twice a week, and the volunteers do lots of organized games like tug of war, tag, and soccer for the older kids. Many of the kids were staring at me intently, and a few children pointed at me and cried. Victoria explained to me that for some of them, this is the first time in their lives that they’ve seen white skin.

Other kids followed me around with the mic, wanting to touch it, and hold my hand. It was really cute. I asked them to sing a song for me to put on the radio, and they performed three numbers, all with a dance sequence. I had Victoria translate the lyrics for me later. This is what they sang:

AIDS kills
So we have to take precaution
We are our families
Listen to what we are telling you
My friends, What is AIDS?
I am asking you a question
Please answer me
AIDS is the lack of immunity in our bodies
Symptoms too – getting thin, sores, coughing all the time, frequent diahreah
We should not segregate the AIDS patients
We have to take care of them
Cleanliness, good food, and also we should pray for them....

I’m sure you can imagine my surprise to later find out that this was the message of the song sung by lively children who were smiling. It gave me chills to think this is Africa. Something like this would happen only in Africa.

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Current Location: Msitu wa Tembo, Tanzania

06:08 pm - 28 April -- Tanzania, Part 5

Today was by far the most interesting of my time in Africa, albeit exhausting. We drove over 4 hours on unpaved roads to Kamadufa Same, in the middle of the mountains. (I was told the Pave mountain range connects to the Kili mountain range.) The roads were, of course, unpaved, and at times ran through game preserves so I was able to see some wildlife. No rhinos or elephants though. We were headed to see the Masaii, a nomadic East African tribe that is spread out from Kenya all the way down to Malawi. The Masaii are pastoralists. They move depending on grazing needs for their cattle, and they are a closed culture. Their children often do not attend school, they intermarry because they feel their culture is superior, and they have resisted modernization and any kind of change. The Masaii operate on the same traditions and customs that have characterized their 600-year history. They are, in short, what you think of when you picture an African tribe. This particular Masaii tribe that I was to meet is somewhat unique, because their cattle herd had died from the lack of rains, and they were forced off the game preserve by the government into a nowhere region in the middle of a mountain range. They were trying to regroup and save money to acquire more cattle. The women, in particular, were having a hard time providing for their many kids. (The Masaii are polygamists, so there are many young kids. Most women have between 4 and 10.) They consulted with their husbands, who allowed them to invite WORTH in to help them create some economic change.

We drove on mile after mile of unpaved, bumpy red dirt paths… each turn leading us to more grassy and rocky patches. We had to use a 4-wheel drive vehicle for this trek -- the Honda taxi would not have been able to make the journey. I have no idea how anyone would know where we were going. Nothing is labeled. Markers are noted just by trees and brush. At one point, we were blazing our own trail on the grass and there was red dust pouring inside the car cabin, sticking to my sweaty skin. I hadn’t even stepped foot out of the car and I was exhausted already from the effort of holding onto the side of the door to keep from clocking my head against something.

Makundi, our driver, came to a stop by a shady tree. Victoria then looked at me and said, ‘We walk from here.’ Walk WHERE? There was nothing around us but jungle and mountain. She started to lead us through the brush, and I had to push plants back to move forward. I started to worry that we would get lost, and I hadn’t brought my compass. (Not sure if I would have really been able to figure out the way anyway even with the compass, but still…) We continue to bushwhack our way through the jungle when suddenly, colorful people appear out of nowhere and start walking with us. Someone takes my bag from me. Another takes my hand. It was like a dream sequence. Tribal people leading me to their village. Who would have thought?!

We make it to a clearing, where there are 4 homes made of brush, sticks and mud, and a gathering point that has tree limbs woven together to form a shady seating area. The Masaii kids and women all crowd around us for the greeting, and then they break out into this tribal dance that involves jumping and whooping. It was an amazing scene. I felt like I had been dropped into the middle of a National Geographic photo.

I will need to post some pictures of the Masaii so you can see what I am talking about. The still wear their tribal clothing, which for the women, consists of a blue and red robe adorned with beads. The women shave their heads, and they create large holes in their ears. Some wear beaded head-dresses, others just wear layers of necklaces and bracelets. The young boys wear a loincloth-type sheath, with a knife strapped to their inside leg. The WORTH staff that accompanied me to this group were dressed African-style, in kangas, so you can imagine how out of place I felt in khakis and a T-shirt!

The Masaii speak their own tribal dialect, not Swahili, so this posed a problem for interviews. The only person in their group that speaks any Swahili at all is their chairwoman, Rachel. She apparently learned Swahili for 3 years in primary school. Why did she go to school when so many do not? The weather happened to be good for three years when she was a child, with enough consistent rain that the cattle had enough to eat, so her family stayed in one place and she was able to get some schooling. Now she is the leader of the women. Seriously. That is what luck is like here.

The way my interviews worked was that I asked a question in English, Victoria translated it into Swahili for Rachel, and then Rachel translated it into the dialect for the woman I was interviewing. As you can imagine, this took some time. The answers that came back were brief and not that creative. I am not even sure if the actual question was communicated fully, given the language barriers. Combining the translation issues with the lack of education that most women have, it was difficult to get a lot of substance out of the interviews. I think for this one, the trip was probably the most important part of the story and I will incorporate a lot of my own information and observations into the storyline. Still, double translation was a new challenge for me, and I proud to say that with patience, I was able to get something on tape.

After 4 interviews, which took over an hour to accomplish, the Masaii women said they had made some food for our visit. Victoria had warned me that the Masaii are known for performing sacrifices, so I started to worry that I would have to eat a slaughtered goat. Instead, they came out with their tribal tea, porridge, and a flat cake. The porridge is one of their traditional meals, made from goat’s milk and animal blood, and its thick consistency requires no refrigeration for days, so the recipe has survived for hundreds of years. I passed on eating it. Victoria did too. Hopefully, I did not offend anyone. I did, however, feel like I should eat something so I had the tea and the cake. The tea, I figured was safe, since the water is boiled. (I still regretted that choice the entire next day.) After our meal, the women did a presentation for each visitor, giving each one of us a piece of jewelry. They gave me a beaded cross, which they hung around my neck. It was very touching. They showed us their other beadwork, which they are now selling in a nearby village for money. They walk 2 hours every day to get to this village, with the jewelry and porridge balanced on their heads. WORTH is now teaching them how to create more money with that money, with the savings-led microfinance program. The women told me they were very happy about WORTH and that it is helping them get through this drought-season.

The Masaii women are an extraordinary bunch. They build their huts themselves. The do all the cooking and work with the cattle. They share husbands, yet they are all friends. The men were not present for my visit, but I was told that they are supportive of the program, which is culturally interesting, given that Masaii men are not typically in favor of women being independent. Masaii men, as far as I was told, don’t do much except lead. Quite a nice life for them.

Another interesting aspect to this group is that they have a nun as a member. A Franciscan Catholic nun! I am not making this up, though I would have never guessed that a nun would have anything in common with polygamist tribal women. They have only WORTH in common. The nun, who was the only person there besides Victoria who could speak English, told me that her convent is nearby and the Masaii women used to come up and ask for food when they were starving. She was very positive about the program’s impact and she had a lot of strong things to say about how these tribal women are put in a tough position by their men.

There was one more round of dancing and singing before we left, and then everyone walked us back through the brush to the car. When they bid farewell, everyone has to come over and shake your hand. On the trek back to the hotel, which took over 4 hours in the dark, I decided that if I had any free time, it would not be spent on a safari. Some things are better to be done with a group and air conditioning.

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Current Location: Kamadufa, Tanzania
Current Mood: contemplativecontemplative

06:05 pm - 25 April -- Tanzania, Part 2

Jambo friends!

It’s been a busy few days in Tanzania that I want to fill you in on. First, I want you to know that I appreciate all of your email replies!! It is pretty lonely here, especially at night since I am stuck on the Lutheran Hotel grounds for the most part because I was warned that it’s not safe for a woman to go into town alone. Also, I have thought about posting a blog, but I am not that computer-savvy, nor is this dial-up connection at the hostel that sophisticated, so this is it for the time being. I am planning to try to publish some freelance articles when I return, on my adventures in Africa.

Today I got a good lesson in African bureaucracy and politicking! I had heard a rumor, through some development workers, that there is a group of visiting American doctors – get this, from Florida!! – that are here to perform open heart surgeries on some Tanzanian kids. What a great human interest story! So this morning I went over to Kilimanjaro Christian Medical Center, or KCMC, with Edith as a translator, to see if I could meet the doctors and talk to them about what they are doing here. It ended up totalling 4 hours of time spent waiting, to get through the meet-and-greets with various hospital officials like the nurse matron, the PR director, the direct of hospital services, etc. etc. Finally, ALL of the different bureaucratic heads that I had already cleared things with met Edith and I together in one room, and we listened to the Hospital Director tell a long-winded story about the history of Kilimanjaro’s coffee crop for about an hour, before he then agreed to let us do an interview if we came back at 1pm!!! Seriously, I have to wonder how people get any work done here!

It turns out that there was a press conference already arranged for African journalists, but with me being a “foreigner,” they didn’t want to group me in with the rest for fear of losing control of their message. Still, it turned out to be a good story. They lined up 5 Tanzanians in their 20s to talk to me, through the aid of Edith’s translation, about their surgeries last year. What was interesting in particular, is that these young adults -- one woman was MY AGE -- couldn’t tell me exactly what work they’d had done. Just a generalized “heart problem”. The director later explained to me that most of the patients were only primary school educated and we put on this list because they stood the best chance of recovery because they are so young. It was moving to hear them talk about now possessing the ability to walk again. All 5 of them were here today to do a one-year checkup with the doctors who repaired their hearts a year ago. I was never able to get an interview with any of the Florida surgeons, though I left them my card with hopes that I can meet the Americans later this week, but the hospital director was a very colorful character who filled in a lot of information for me. Get this – he can speak German! Turns out he did his medical studies in eastern Germany years ago and then returned to his native Tanzania to run KCMC. He said the visiting docs are not going to come every year – this is supposed to be a training session for his staff so they can eventually be the only hospital in East African to be able to perform open heart surgeries. I have to say… I spent a lot of time at the hospital today and even though KCMC has a great reputation in this part of Africa… I would still not want to have ANY kind of operation done here. The building is aging, the bathrooms are unspeakable (especially when you think about the fact that STAFFERS use it before returning to patients) and it is thronging with sick people. Overall, an interesting insight into African health care today.

Yesterday I went out to a remote village called Yamu Makaa to meet up with a WORTH group that had set up a clinic in their village. They found an abandoned building – really, a brick edifice without a roof, window panes, or a floor – and roughly refurbished it so that it could function as a meeting room for a doctor and patients once a month. They did this because women from their village had to walk over 2 miles on unpaved roads with their newborns if they wanted to get monthly checkups. These women were so empowered by their microcredit program that they took it upon themselves to find this site, get the necessary things like a cot and towels stored nearby, and then contacted the government to get them to send the doctor out to his makeshift clinic. Every last Tuesday of the month, they show up with the cot, towels, and other items to help the clinic run efficiently for 8 hours. These women were able to accomplish this by selling woven baskets and bowls, which they gave me one of each, as a present. Now, not only mothers use the clinic, but also men who want to get tested for HIV and other local people with ailments, go to this monthly clinic.

The one recurring theme in my visits to these villages is that I am treated as though I am a person of wisdom, which I can tell by them saying “Asanti Sana” which is the formal greeting for an educated elder. The development workers have asked me each time to give a speech about myself, and what I want to talk to these women about, and I find myself feeling like I have to offer words of wisdom and inspiration. It’s a weird position to be in. Some of these women are 70 years old, have given birth, raised a family, dealt with hunger… I have had none of these experiences. They also want to touch me and sing to me. This last visit in Yamu, Makaa, they ended our visit with a traditional village song in which they surrounded me, carried my bag and equipment, and walked me out arm-in-arm toward the car, teaching me the words to their song. Of course, when I stumbled with the wording, they laughed and then tried again… while clapping and doing their high-pitched whoops. Obviously, I am in a different world here, but it really feels that way when I meet these villagers. It’s so hard to make a connection, with translation being the only way to communicate, but they are very patient and treat me with respect, and they are very proud of themselves and of their female WORTH members.

While these experiences tend to be uplifting and interesting, it can also be isolating here. At least in Germany and in Europe for the most part, I can understand what is going on when I hear a conversation. Here, I have absolutely no clue what is being said when Swahili is spoken. I met a white person today – the first since I have been here. I am the only white person staying at the Lutheran Hotel. It goes without saying that I am the only white person in a 5-mile radius when I enter these villages. This woman I met was, by chance, American, and she is from Vermont! Go figure on the connections to my past life. It was nice to chat with her.

I am getting used to adapting to things here, or at least being flexible. My brother, and really anyone who needs complete silence and darkness to sleep, would have a hard time with the sleeping arrangements here. Through my screened windows, I hear a cacophony of crickets, squawking birds, and moaning animals during the night. The maids sing in Swahili beginning at 7 in the morning. And there is a florescent light outside my room that not only shines bright but also attracts the world’s biggest and ugliest bugs.

I am also learning to figure out what I can and cannot put into my body. I think the malaria meds are causing my stomache trouble but I also think it is best for me to be a vegetarian while I visit Africa. The hotel restaurant, I am sure, thinks I am strange because I have been ordering plates of only boiled carrots and potatoes to make sure everything will stay down ok. Last night I went out to dinner with Victoria and Edith at a Tanzanian restaurant with a Mexican name that serves Indian food. Yes, you read this right. It’s called El Rancho. Clearly, someone needs to explain to them what Tex Mex is. But honest to God, it was the best vegetarian meal of my life! The first time I have cleared the plate since being here and no morning after effects.

OK, I can’t end this email until I recap for you things I have learned now not to take for granted. My Top 3 at this point:
1. paved roads
2. air conditioning
3. buildings that are sprayed for bugs

I also would like to mention some of the oddities that confound me here, one being that villagers who cannot afford bank accounts still own cell phones. Also, road repair here sometimes consists of filling in potholes with refuse that is then pounded down so it is somewhat flattened – until it rains. I am also unclear on how anyone who is not a native could actually navigate this country… nothing is labeled!

OK, I must sign off. I will write another installment in a few days!
Kwaherini!
Jenny

05:54 pm - 27 April -- Tanzania, Part 4

I saw absolute, crushing poverty today -- the worst kind of poverty that I have ever seen. And I have seen a lot, from the crime neighborhoods of Fort Myers to the trailer parks destroyed by hurricanes and Florida heat. But nothing compares to being poor in Africa. Nothing. They simply lack for everything. In the States, if you are hungry, you can get food. Granted, it doesn’t appear at your doorstep but there are places that distribute food. There are churches and non-profits that offer shelter. There are social service workers who visit homes to check up a situation and see how a kid is being treated. As a news reporter, I have reported on all of the problems and faults and breakdowns of these systems, but the systems still exist. In Tanzania, there is nothing. There is no government infrastructure that can step in and save a family from starving. The government doesn’t even have the money to pave the roads… let alone go into rural communities and see who is starving. There is only the charity of NGOs, and they cannot be everywhere.

Today I went out to 4 homes with a Salvation Army worker and a translator to learn more about their OVC program, which stands for Orphans and Vulnerable Children. Before the day began, I had thought the title was a bit overdone, because I had thought I had already met vulnerable children in the villages. Everyone I had seen these past few days seemed to be poor and vulnerable, and it was hard to imagine that it could get worse. Turns out, it can be much... much worse. The Army gets local villagers to volunteer their time to check-up on certain kids that are really isolated or are in either single parent homes. With every visit, I thought to myself that it couldn’t get any worse. And it did. Every time.

The first visit was to an 11-year-old girl who lives with her 79-year-old father. Not grandfather. Father. If you’re doing the math, that means he had her when he was 68 years old. There is no mother in the picture. I couldn’t get an explanation as to why. The father is old and sick. He was bitten by a poisonous snake 6 years ago and it shriveled up his hand so he can no longer use his arm. He also had a gaping wound on his foot that he says was caused by a falling brick. If you can believe this, out of our group, I was the only one carrying first aid stuff! (Kudos should be given here to Brian McCann, who along with the US Army base in Germany, was able to send me to Africa with some medical supplies.) I volunteered my stuff, though to be honest, not my help in bandaging the man. Maureen, the Army worker, used my wound disinfectant to clean his foot, bandage it with my gauze and seal it as best as she could. He had no shoes though, so I’m not sure how long that wrap will stay effective. The young girl obviously does all of the work in the household. She cooks, fetches water and buys things in the market for them to eat. They have no electricity or running water. She was very shy when I asked her questions, but the truth in her sad eyes revealed someone who had lived much longer than her 11 years.

The second home was of a 17-year-old boy who was stricken with some kind of illness that left him deformed, with a skin condition, not being able to talk or hear. He could still see. His name was Joseph. It is horrible to say this, but he honestly looked like a character out of a sci-fi movie. It was hard to believe that the human being standing in front of me was living in that condition. Maureen’s best guess was that he got polio at an early age an no one took him to the doctor in time, so that is why his body is shaped the way it is. He couldn’t use his feet or lower legs, so they had atrophied. He moved around on his knees. Someone had fashioned pads out of flip flops for his knees, to cushion the constant contact with the rocky earth. He had patches of hair on his scalp and spots covering other areas. His eyes were yellowed, his fingers with gray with dust, and he stood about 3 feet tall from the knees up. I was shaken when I found out he was 17. His aunt told me he had been having health problems since he was 2 months old. His parents left him, not wanting to deal with his problems, so his aunt and uncle took him in to raise him with their 6 other kids. They were very generous and seemed to care about him a great deal. They lived in the center of a small rural village and seemed to feel that they got a lot of support from the OVC volunteers and the community. Joseph is not able to talk, so I only did the interview with his aunt. She was very thankful to have the program come visit her.

The third home belonged to a woman who had 6 children and no husband. He left after the 6th was born. Her 7-year-old child was not going to school because a thief had stolen his school uniform. This, I think, is a fundamental problem in Tanzania. The kid has no uniform, so he is not allowed to attend school. How does this help anyone? He is not being educated, the mother is stuck at home with him and not able to work, and the country overall is going to be saddled with another kid who grows up to be an adult that can’t read or write. But he has no uniform. End of story in their book. The OVC program is in the process of making him, not buying him, a new one. Apparently uniforms can be expensive and its not like the OVC volunteers are wealthy. They live in these poor communities as well. They are just not as bad off as the people they volunteer to visit. The mother and the kid just cried softly the entire time I was there. I am not sure if it was out of shame, or despair, but neither seemed to have the will to do anything. It felt truly tragic. The village kids surrounded us as we did the interviews and they sang a song before left.

The fourth and final house contained 3 children and no parent. The mother, who is a single parent with 4 kids, was out working in the field. Apparently she has to do this to feed them, and she leaves them in the care of her oldest, a boy of 6, but he was also out when we arrived, running some errand in town. So the OVC volunteer introduced us to the 3 kids, aged 1, 2 and 4. They all were not wearing underwear, just a dress-like cloth that was chalky from rolling around in the dirt. They told us they sleep most of the day while their mom is gone. I could see the ribs pertruding from the 4-year-old, and the 1-year-old just clung to the OVC volunteer, who is a man, like it was his mother. I’m not sure what to say about this one. At least the mother is working. But leaving the kids at home is awful. But how else would they eat? In the US, leaving kids home that are that young is called child neglect. But in Africa, no such rules exist and there are no authorities to check up on things anyway, so the real neglect is letting the kids starve. This visit was probably the hardest. I didn’t have anything to leave with the kids because I had already emptied my bag of pens, gauze and food at the other three stops.

I have mixed feeling about the benefits of the OVC program. Surely it is a good thing to have people helping out their own in the community. But these are poor people helping even poorer people. They are admirable in that they do this as volunteers. The Army gives them training on how to counsel their parents and the kids with encouragement and also to point out what services are available to help them with food, water, etc. But OVC volunteers in most cases can’t give out food. They can’t spare it. They are also not educated, so I have to wonder how effective the counseling can be. They clearly don’t carry medical supplies with them. So what exactly do they do??? Try to make a desperate situation not as hopeless, I would surmise.




After the home visits, I went back to the room to shower all of the sweat and dirt and grime off me. Maureen and I met in the evening to go over to the doctor’s compound at KCMC to see if I could snag an interview with Dr. Cook, the lead surgeon on the volunteer heart surgeries. Maureen knew Dr. Cook and his wife through Lutheran Church work and she seemed to think it would be ok if we stopped by during their dinner hour, when we were sure to catch everyone together. KCMC’s housing for visiting teams (apparently there are enough of them to warrant a dormitory facility) is adequate, but not great. The Uhuru Hostel, where I’m staying, is arguably better. The nurses were telling me that everyone has to shower before 7am because after that point the hot water is shut off and directed to the main hospital building.

I listened to everyone talk about their impressions and experiences in their week at KCMC. There were lots of fascinating and interesting details to learn. I was shocked, for instance, to find out that there is no patients are fed while hospitalized. This is because there is no cafeteria on site and the hospital isn’t able to provide room services like that. So patients’ families have to take the day off from work to go to the hospital, wait for the visting hour window, and then deliver the food. Its maddening to think that someone who is already poor and has the misfortune of being sick, is not only racking up charges in medical bills and prevented from working, but also their family members are prevented from making money because they have to go to the hospital to feed them! Dr. Cook, in his first year on the team, insisted this be changed. The nurses told me that all of their patients are now fed during the day, but some questioned if this practice actually continues when they leave.

Everyone on the team is assigned their own shadow and translator, so they can educate their counterpart about the surgery. The American nurses found that they had to use math skills and simplistic diagnosis methods more often, because KCMC has limited facilities and the machines normally used in the States to measure things like blood pressure and heart rate don’t always exist in Tanzania. The nurses did admit that it caused them to sharpen their own skills, and they were interested to find out how the Tanzanian nurses were able to diagnose things by sight – for instance, making a deduction based on physical signs. They found their Tanzanian counterparts bright and eager to learn, but they also found that cultural differences affect the delivery of medicine. They told me one of their first patients was crashing because she was bleeding out, so they had to re-open her to find the source of the bleeding. In the US, the nurses said machines would be been beeping loudly and people would have been running around. In this case, everyone non-American seemed non-plussed and did not pick up the pace, and “STAT” requests for things like scissors or syringes did not serve to pick up the momentum. The Americans simply could not believe how laid back everything is!

For these surgeries to even happen, Dr. Cook had to order and ship over a heart-lung machine to connect to the patient’s heart when operating was taking place. Their first year, it was an extremely hot summer and the electricity kept going out. That left people attached to machines, waiting for the generator to kick in, which could take as long as 15 minutes. Dr. Cook insisted a bigger generator be purchased, at the very least, for the operating room. He also insisted on sealing off the O.R. with A/C units. That first year, fans were blowing to keep it cooler but the air was also picking up dirt and dust and blowing it into the chest cavities of patients! Obviously from these stories, a lot of hurtles had to be jumped and even 3 years later, the nurses still found a lot of inconsistency with hospital practice and procedure.

The visiting team consists of 10 people: 2 heart surgeons, 1 anaestesiologist, 2 OR nurses, 2 ICU nurses, 1 Physician’s Assistant, 1 profusionist to operate the heart-lung machine, and 1 fix-it man. Carl, the fix-it guy, has been on every trip. He has no medical training, but he has a background in engineering and is good at fixing things. Dr. Cook sensed that he would need someone like that with them, and Carl hangs around the operating all day long to handle problems as they come up. He told me that the hospital staff wait for him to arrive and then they bring him everything from EKG machines to irons to fix. I can just imagine what his checked baggage must contain!

Everyone on this trip, by the way, is only allowed one personal bag for themselves and then the other 50-pound bag is full of medical supplies like gauze, gloves, syringes, needles, you name it. KCMC doesn’t have enough and tends to re-use things (a scary thought) and so this team operates like their own mobile heart unit – everything they need, they bring with them. So, in theory, they could perform surgery just about anywhere.

I finally got my interview with Dr. Cook, which proved to be very interesting. He explained that in Tanzania, rheumatic fever is quite common, and the lack of basic antibiotics means that it causes great damage to people’s hearts. That’s why Africans in their 20s and 30s are dying of congestive heart failure. Their valves are about to give out because of the damage caused by the fever, so they need valve replacements. (This, by the way, is not a huge problem in the U.S. because when someone gets strep throat, they get an antibiotic to clear it up before it progresses into something worse like rheumatic fever.) One man cannot obviously solve the vast problem of the shortage of antibiotics in East Africa. But he can fix hearts. So, Dr. Cook and Dr. Swai, the director of the hospital, devised a grand 10-year plan, to turn KCMC into a leading heart surgery hospital that can be accessible to poor people dying of heart failure. Right now, people who need valve replacements have to either travel to South Africa or Egypt to have the operation! There is no other hospital in that great span of land in between that can do valve replacements. Poor people don’t tend to have those travel options, so they just die. The Tanzanian government, every year, pays for 200 people on a waiting list to be flown to India to get valve replacements. (I’d heard off the record from some that the people on the waiting list aren’t always the neediest, either, but perhaps connections or bribes get them the surgery.)

Dr. Cook and Dr. Swai want to open a heart center at KCMC so its easier for people in Tanzania and East Africa to travel there to get the surgery, thus making it possible for young people to double their life span. (Right now the average age of a Tanzanian is 43 years old.) So, as part of this grand plan, the team has invited an official with the Tanzanian Health Ministry to come observe them operating this week, to see if they can make some in-roads for government funding. KCMC is a public-private institution. Specifically, Dr. Cook would like to see the money spent on the 200 surgeries in India to be stopped and directed instead to building, staffing and outfitting the new heart facility at KCMC. With all of the dots now connected together for this story, I am inspired by the vision. It’s lofty, I’ll admit, but I think also possible, given the dedication and brains already put into it. But another big component that needs to be tackled is training. In Africa, there simply isn’t the medical education available for specialty fields like heart surgery. The people who will be needed to work in this facility are likely going to have to fly out of Africa, to Europe or the US to learn how to do it. A lot of times, when people leave for training, they don’t come back. Germany is even experiencing that brain-drain problem right now. But in Africa, it’s even worse and quality of life reasons are also to blame. KCMC is going to have to work to raise salaries and provide incentives to bring skilled Tanzanians back to their native land to work. Dr. Cook seemed to think that in a few more years, his team could arrive for more observation and backup, instead of actual operating. But there will need to be more action taken on the part of KCMC to either bring in a full-time educator or send staff overseas on education contracts that require them to return.

05:51 pm - 26 April - Tanzania, Part 3

I saw absolute, crushing poverty today -- the worst kind of poverty that I have ever seen. And I have seen a lot, from the crime neighborhoods of Fort Myers to the trailer parks destroyed by hurricanes and Florida heat. But nothing compares to being poor in Africa. Nothing. They simply lack for everything. In the States, if you are hungry, you can get food. Granted, it doesn’t appear at your doorstep but there are places that distribute food. There are churches and non-profits that offer shelter. There are social service workers who visit homes to check up a situation and see how a kid is being treated. As a news reporter, I have reported on all of the problems and faults and breakdowns of these systems, but the systems still exist. In Tanzania, there is nothing. There is no government infrastructure that can step in and save a family from starving. The government doesn’t even have the money to pave the roads… let alone go into rural communities and see who is starving. There is only the charity of NGOs, and they cannot be everywhere.

Today I went out to 4 homes with a Salvation Army worker and a translator to learn more about their OVC program, which stands for Orphans and Vulnerable Children. Before the day began, I had thought the title was a bit overdone, because I had thought I had already met vulnerable children in the villages. Everyone I had seen these past few days seemed to be poor and vulnerable, and it was hard to imagine that it could get worse. Turns out, it can be much... much worse. The Army gets local villagers to volunteer their time to check-up on certain kids that are really isolated or are in either single parent homes. With every visit, I thought to myself that it couldn’t get any worse. And it did. Every time.

The first visit was to an 11-year-old girl who lives with her 79-year-old father. Not grandfather. Father. If you’re doing the math, that means he had her when he was 68 years old. There is no mother in the picture. I couldn’t get an explanation as to why. The father is old and sick. He was bitten by a poisonous snake 6 years ago and it shriveled up his hand so he can no longer use his arm. He also had a gaping wound on his foot that he says was caused by a falling brick. If you can believe this, out of our group, I was the only one carrying first aid stuff! (Kudos should be given here to Brian McCann, who along with the US Army base in Germany, was able to send me to Africa with some medical supplies.) I volunteered my stuff, though to be honest, not my help in bandaging the man. Maureen, the Army worker, used my wound disinfectant to clean his foot, bandage it with my gauze and seal it as best as she could. He had no shoes though, so I’m not sure how long that wrap will stay effective. The young girl obviously does all of the work in the household. She cooks, fetches water and buys things in the market for them to eat. They have no electricity or running water. She was very shy when I asked her questions, but the truth in her sad eyes revealed someone who had lived much longer than her 11 years.

The second home was of a 17-year-old boy who was stricken with some kind of illness that left him deformed, with a skin condition, not being able to talk or hear. He could still see. His name was Joseph. It is horrible to say this, but he honestly looked like a character out of a sci-fi movie. It was hard to believe that the human being standing in front of me was living in that condition. Maureen’s best guess was that he got polio at an early age an no one took him to the doctor in time, so that is why his body is shaped the way it is. He couldn’t use his feet or lower legs, so they had atrophied. He moved around on his knees. Someone had fashioned pads out of flip flops for his knees, to cushion the constant contact with the rocky earth. He had patches of hair on his scalp and spots covering other areas. His eyes were yellowed, his fingers with gray with dust, and he stood about 3 feet tall from the knees up. I was shaken when I found out he was 17. His aunt told me he had been having health problems since he was 2 months old. His parents left him, not wanting to deal with his problems, so his aunt and uncle took him in to raise him with their 6 other kids. They were very generous and seemed to care about him a great deal. They lived in the center of a small rural village and seemed to feel that they got a lot of support from the OVC volunteers and the community. Joseph is not able to talk, so I only did the interview with his aunt. She was very thankful to have the program come visit her.

The third home belonged to a woman who had 6 children and no husband. He left after the 6th was born. Her 7-year-old child was not going to school because a thief had stolen his school uniform. This, I think, is a fundamental problem in Tanzania. The kid has no uniform, so he is not allowed to attend school. How does this help anyone? He is not being educated, the mother is stuck at home with him and not able to work, and the country overall is going to be saddled with another kid who grows up to be an adult that can’t read or write. But he has no uniform. End of story in their book. The OVC program is in the process of making him, not buying him, a new one. Apparently uniforms can be expensive and its not like the OVC volunteers are wealthy. They live in these poor communities as well. They are just not as bad off as the people they volunteer to visit. The mother and the kid just cried softly the entire time I was there. I am not sure if it was out of shame, or despair, but neither seemed to have the will to do anything. It felt truly tragic. The village kids surrounded us as we did the interviews and they sang a song before left.

The fourth and final house contained 3 children and no parent. The mother, who is a single parent with 4 kids, was out working in the field. Apparently she has to do this to feed them, and she leaves them in the care of her oldest, a boy of 6, but he was also out when we arrived, running some errand in town. So the OVC volunteer introduced us to the 3 kids, aged 1, 2 and 4. They all were not wearing underwear, just a dress-like cloth that was chalky from rolling around in the dirt. They told us they sleep most of the day while their mom is gone. I could see the ribs pertruding from the 4-year-old, and the 1-year-old just clung to the OVC volunteer, who is a man, like it was his mother. I’m not sure what to say about this one. At least the mother is working. But leaving the kids at home is awful. But how else would they eat? In the US, leaving kids home that are that young is called child neglect. But in Africa, no such rules exist and there are no authorities to check up on things anyway, so the real neglect is letting the kids starve. This visit was probably the hardest. I didn’t have anything to leave with the kids because I had already emptied my bag of pens, gauze and food at the other three stops.

I have mixed feeling about the benefits of the OVC program. Surely it is a good thing to have people helping out their own in the community. But these are poor people helping even poorer people. They are admirable in that they do this as volunteers. The Army gives them training on how to counsel their parents and the kids with encouragement and also to point out what services are available to help them with food, water, etc. But OVC volunteers in most cases can’t give out food. They can’t spare it. They are also not educated, so I have to wonder how effective the counseling can be. They clearly don’t carry medical supplies with them. So what exactly do they do??? Try to make a desperate situation not as hopeless, I would surmise.




After the home visits, I went back to the room to shower all of the sweat and dirt and grime off me. Maureen and I met in the evening to go over to the doctor’s compound at KCMC to see if I could snag an interview with Dr. Cook, the lead surgeon on the volunteer heart surgeries. Maureen knew Dr. Cook and his wife through Lutheran Church work and she seemed to think it would be ok if we stopped by during their dinner hour, when we were sure to catch everyone together. KCMC’s housing for visiting teams (apparently there are enough of them to warrant a dormitory facility) is adequate, but not great. The Uhuru Hostel, where I’m staying, is arguably better. The nurses were telling me that everyone has to shower before 7am because after that point the hot water is shut off and directed to the main hospital building.

I listened to everyone talk about their impressions and experiences in their week at KCMC. There were lots of fascinating and interesting details to learn. I was shocked, for instance, to find out that there is no patients are fed while hospitalized. This is because there is no cafeteria on site and the hospital isn’t able to provide room services like that. So patients’ families have to take the day off from work to go to the hospital, wait for the visting hour window, and then deliver the food. Its maddening to think that someone who is already poor and has the misfortune of being sick, is not only racking up charges in medical bills and prevented from working, but also their family members are prevented from making money because they have to go to the hospital to feed them! Dr. Cook, in his first year on the team, insisted this be changed. The nurses told me that all of their patients are now fed during the day, but some questioned if this practice actually continues when they leave.

Everyone on the team is assigned their own shadow and translator, so they can educate their counterpart about the surgery. The American nurses found that they had to use math skills and simplistic diagnosis methods more often, because KCMC has limited facilities and the machines normally used in the States to measure things like blood pressure and heart rate don’t always exist in Tanzania. The nurses did admit that it caused them to sharpen their own skills, and they were interested to find out how the Tanzanian nurses were able to diagnose things by sight – for instance, making a deduction based on physical signs. They found their Tanzanian counterparts bright and eager to learn, but they also found that cultural differences affect the delivery of medicine. They told me one of their first patients was crashing because she was bleeding out, so they had to re-open her to find the source of the bleeding. In the US, the nurses said machines would be been beeping loudly and people would have been running around. In this case, everyone non-American seemed non-plussed and did not pick up the pace, and “STAT” requests for things like scissors or syringes did not serve to pick up the momentum. The Americans simply could not believe how laid back everything is!

For these surgeries to even happen, Dr. Cook had to order and ship over a heart-lung machine to connect to the patient’s heart when operating was taking place. Their first year, it was an extremely hot summer and the electricity kept going out. That left people attached to machines, waiting for the generator to kick in, which could take as long as 15 minutes. Dr. Cook insisted a bigger generator be purchased, at the very least, for the operating room. He also insisted on sealing off the O.R. with A/C units. That first year, fans were blowing to keep it cooler but the air was also picking up dirt and dust and blowing it into the chest cavities of patients! Obviously from these stories, a lot of hurtles had to be jumped and even 3 years later, the nurses still found a lot of inconsistency with hospital practice and procedure.

The visiting team consists of 10 people: 2 heart surgeons, 1 anaestesiologist, 2 OR nurses, 2 ICU nurses, 1 Physician’s Assistant, 1 profusionist to operate the heart-lung machine, and 1 fix-it man. Carl, the fix-it guy, has been on every trip. He has no medical training, but he has a background in engineering and is good at fixing things. Dr. Cook sensed that he would need someone like that with them, and Carl hangs around the operating all day long to handle problems as they come up. He told me that the hospital staff wait for him to arrive and then they bring him everything from EKG machines to irons to fix. I can just imagine what his checked baggage must contain!

Everyone on this trip, by the way, is only allowed one personal bag for themselves and then the other 50-pound bag is full of medical supplies like gauze, gloves, syringes, needles, you name it. KCMC doesn’t have enough and tends to re-use things (a scary thought) and so this team operates like their own mobile heart unit – everything they need, they bring with them. So, in theory, they could perform surgery just about anywhere.

I finally got my interview with Dr. Cook, which proved to be very interesting. He explained that in Tanzania, rheumatic fever is quite common, and the lack of basic antibiotics means that it causes great damage to people’s hearts. That’s why Africans in their 20s and 30s are dying of congestive heart failure. Their valves are about to give out because of the damage caused by the fever, so they need valve replacements. (This, by the way, is not a huge problem in the U.S. because when someone gets strep throat, they get an antibiotic to clear it up before it progresses into something worse like rheumatic fever.) One man cannot obviously solve the vast problem of the shortage of antibiotics in East Africa. But he can fix hearts. So, Dr. Cook and Dr. Swai, the director of the hospital, devised a grand 10-year plan, to turn KCMC into a leading heart surgery hospital that can be accessible to poor people dying of heart failure. Right now, people who need valve replacements have to either travel to South Africa or Egypt to have the operation! There is no other hospital in that great span of land in between that can do valve replacements. Poor people don’t tend to have those travel options, so they just die. The Tanzanian government, every year, pays for 200 people on a waiting list to be flown to India to get valve replacements. (I’d heard off the record from some that the people on the waiting list aren’t always the neediest, either, but perhaps connections or bribes get them the surgery.)

Dr. Cook and Dr. Swai want to open a heart center at KCMC so its easier for people in Tanzania and East Africa to travel there to get the surgery, thus making it possible for young people to double their life span. (Right now the average age of a Tanzanian is 43 years old.) So, as part of this grand plan, the team has invited an official with the Tanzanian Health Ministry to come observe them operating this week, to see if they can make some in-roads for government funding. KCMC is a public-private institution. Specifically, Dr. Cook would like to see the money spent on the 200 surgeries in India to be stopped and directed instead to building, staffing and outfitting the new heart facility at KCMC. With all of the dots now connected together for this story, I am inspired by the vision. It’s lofty, I’ll admit, but I think also possible, given the dedication and brains already put into it. But another big component that needs to be tackled is training. In Africa, there simply isn’t the medical education available for specialty fields like heart surgery. The people who will be needed to work in this facility are likely going to have to fly out of Africa, to Europe or the US to learn how to do it. A lot of times, when people leave for training, they don’t come back. Germany is even experiencing that brain-drain problem right now. But in Africa, it’s even worse and quality of life reasons are also to blame. KCMC is going to have to work to raise salaries and provide incentives to bring skilled Tanzanians back to their native land to work. Dr. Cook seemed to think that in a few more years, his team could arrive for more observation and backup, instead of actual operating. But there will need to be more action taken on the part of KCMC to either bring in a full-time educator or send staff overseas on education contracts that require them to return.

05:48 pm - 22 April -- Tanzania, Part 1

Karibu!

I’m here! The flight was great… KLM is a really nice carrier and their meals are almost gourmet, as far as airline standards go! The flight was not packed, so I had a space next to me, which made it comfy, and I ended up talking to a Tanzanian woman who works at the International Criminal Tribunal for Yugolslavia in the Hague. Ironically, I had just visited that facility last month for the Bosch fellowship conference! She was on her way home to Arusha for a visit, so I got to ask her lots of questions about Tanzania. I had no problems with airport security regarding the equipment… no one asked, I didn’t tell. But in Germany they confiscated my bug spray and hair gel, and then in Amsterdam I had to go through one more screening for an African-bound flight and they took my sunscreen and my bottled water that I had bought in the airport! Agh! Go figure. I am worried about losing the satellite phone or the microphone, and instead they take my personal items! I have not been able to locate a place to buy bug spray here yet, the most important thing to have in Africa as a tourist, so I borrowed some from the program coordinator. I think she thinks I am overly worried about mosquitos but the German doctor warned me about being super cautious, even in the daytime.

The Lutheran Hotel and Conference Center is ok… when I arrived at night, it didn’t look like much but in the morning light, and especially after a trip through town, I realized I am staying in some pretty nice digs. Check it out if you like… www.uhuruhostel.org.

Oh, some interesting tidbits…. sleeping under a mosquito net feels like being a kid with a tent. The white candles provided by the Lutherans are not for prayer but instead for when the electricity goes out… which happened 3 times last night! I have not braved a shower yet… too scary to contemplate first thing this morning.

I had a meeting this afternoon with some Salvation Army staff and then got in a taxi to go to a rural village called Mabogini. It was about a half hour drive. Victoria, the coordinator, Edith, an assistant and I met up with 20 women who were having their weekly WORTH meeting. Their rendevous is a spot under a tree at the end of a dirt road. There were random chickens and goats roaming around. As a guest of honor with the program coordinators, we got little chairs to sit on that someone had apparently carried to the site. Everyone else sat in the dirt.

The WORTH chairs, who are village members, led the meeting where they called each woman up to the head table to hand over her week’s savings, which is 250 tschillings or approx. 25 US cents. In the year the program has been running, they have saved over 200 USD. They save this money in an old tin box which someone guards closely while someone else holds the key. The box is only unlocked during the weekly meeting. The money is not deposited in a bank because it is apparently too expensive to open an account, and anyway, the women treat this box like their own bank, so it is more convenient for them to have it on hand.

They borrow from the box at interest rates agreed upon by the entire group, and then pay it back within 3 months. I interviewed a single mother who borrowed 10 USD to pay for her kid’s school fees, and then she paid it back by selling skirts at the village market. Another woman, who is a grandmother, told me she didn’t know her age. Back when she was born, they didn’t keep records, but she assumed she was around 80 because her oldest child is 60 years old. She is a real character. She used to have goats and cows as a business but people stole them, so she joined WORTH, borrowed money for a brick selling business, and she has been able to repay the loan back and also take out a new loan to plant corn. It was pretty impressive.

All of today’s interviews were in Swahili. Victoria, who is the program coordinator for the Moshi-Kilimanjaro region, did all the translating for me. She is well traveled, having been a translator in her former job. She has been to Germany but she has never visited the US. Tomorrow I am going with her colleague Edith to another village to volunteers who work in the youth group program.

I am excited about tomorrow’s drive. There’s so much to see! Today’s drive took us past rice paddies which are apparently run by Japanese companies and then harvested for return to Japan, and also a sugar cane company which is run by South Africans. I got to see Tanzanians out walking with their kids, some transporting food and wood on bike, some cooking fish over a hot fire, some selling bananas. The little town centers are formed along the main road (which is unpaved) and people greet you as the taxi rolls by. Most of the roads are unpaved and unmarked in this country, except for the main highway which we took from the airport to Moshi. It is only 2 lanes, and the Tanzanians drive on the British side of the road. Several times during that drive, I was worried we could die when I saw oncoming headlights and it seemed like there wasn’t enough room for us to pass. People here also drive insanely fast for roads that are full of potholes and unlit.

Other interesting notes from today… many people speak English and a lot of the signs are in English. There appear to be more pubs in town than there are stores. There are lots of colorful and strange bugs that I am praying will not crawl into my room. The hotel folds the sheets in squares so you can make the bed up for yourself at night and not have bugs get in. The USD is apparently the best currency to work with here, other than Tanzanian Tschillings, and after a year of having the Euro butcher my dollar, I feel like a millionaire here with the exchange rate being 1240 Tsch to 1USD.

OK… that’s all for this edition. There is an internet café right on site at the Lutheran Hotel so it looks like I will be able to send updates on a pretty regular basis, so I will try to keep you all updated.
Bye! Jen

Current Location: Kilimanjaro, Tanzania

05:42 pm - 16 April - Leaving for Tanzania

Guten Tag Freunde!

Or... should I say "Jambo"!

My time so far in Europe has been full of adventures and it looks like I will have one more great experience before I return to the States in June!!!
Deutsche Welle Radio is sending me to Africa later this month, to do a series of reports on women and children living in poverty in Tanzania. I will be reporting on new, innovative microcredit programs that are financed mostly by private donors who believe investing in women is the key to positively changing Africa's future. It's a very cool and inspiring concept that I am thrilled to be covering. I will be shadowing two development groups -- WORTH Women and the Salvation Army International -- so I can see firsthand how the programs are working and see if they are having an impact on Tanzanian mothers and HIV-infected children. I am going alone in the sense that it is just me leaving from DW, but the groups have agreed to "host" me on their missions into the villages so I will have a driver and translator for all of the interviews. (Swahili is the national language of Tanzania, but there are many tribal dialects spoken in the villages that I will be visiting.)
I am very excited (albeit a bit nervous!) about this adventure, and I am now in the midst of preparations. I had to get 7 vaccinations to travel to Africa! Plus I am taking anti-malarial pills for the entire trip. I will be flying direct into Kilimanjaro from Europe, and it looks like I will be doing mostly day trips into the villages and then staying in the larger city of Moshi (near the mountain) in the evening. This is, obviously, going to be a very different kind of travel trip than I have been doing this year. I am bringing along alot of bug repellant and I bought a mosquito net at an outdoors store since I am staying in a hostel which does not come with A/C. I am expecting the time in Africa to be fascinating, physically challenging, sweltering and moving. This trip is a very unique experience for me to take my time to get to know the people I am covering, experience for more than a few hours what their lives are like, and really "get inside" the story. I do hope to fit in at least one safari day as well, for fun, probably to the volcanic crater Ngorongoro Park. I leave this Saturday and return to Germany mid-May.

This series will likely be my final broadcasts for Deutsche Welle, or my "piece d' resistánce." It will most likely air on our English-language World in Progressand Money Talks programs, probably running 10-20 minutes per segment. It will probably be resume-tape material as well, though I am not sure what comes next for me. My work stage as a guest journalist at Deutsche Welle ends in June, when my work VISA in Germany expires. I had thought a year in Europe to think about what I want to do with my life would be enough to give me some direction, but to be honest, this year has been so busy with travel and work, I am still not sure what I want to do! While I could stay on and freelance report in Europe, I am honestly about ready to return to my own country. I am thrilled that I have had the opportunity to do such creative and interesting work at DW, and that I will be travelling to Africa to work as a journalist. I figure I will take on this adventure and then figure out the rest when I return to the States.

If you are interested in learning more about the development work that I will be reporting on in Tanzania, you can check out WORTH's program at: www.worthwomen.org

Kwaherini! (Goodbye with Many Blessings.)
Jenny

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