sijambo

2008-05-31T21:49:00.000-07:00

2008-05-29T13:11:00.000-07:00

We're going to be blogging a lot for another website while we're in Israel. If you just can't get enough, would like another perspective of our trip, or a really detailed account of what's going on, check out: http://imerisrael08.wordpress.com/

A Tale of two hairstyles

2008-05-29T13:07:00.000-07:00

The end of my time in Tanzania and the beginning of my time in Israel didn’t have too many similarities, but more was done with my hair in a four day period than had been done in the previous four months. While returning from a walk around town several weeks ago, one of my neighbors invited me to get my hair braided. I’ve always been interested in getting my hair braided, but a little afraid. I’ve seen how people look when they get off the cruise ship. Frankly, most white people look ridiculous with braids. So I turned down the offer, but told her I might return at another time. Over the next days, I kept thinking about getting it done. I figured now was my chance, they wouldn’t charge me very much money and it wasn’t too difficult for me to convince myself it was an important Tanzanian experience.

So Wednesday afternoon I went to the woman’s house and asked her when she would be free to braid my hair. She told me to come back at 3 and to give her some money to go buy extensions. This was becoming more of an affair than I had intended, but the extensions were less than two dollars so I figured it was still worth a try. When I returned she was busy braiding another woman’s hair. I was very surprised by how fast she could work. I had always been told getting your hair braided was an all day affair, but she finished this woman’s hair in about an hour. I sat around attempting to chat with the women in Swahili, but unfortunately as my time in Tanzania came to a close, the effort I was putting into learning Swahili decreased significantly, so my conversation skills were a bit limited and I often resorted to pantomime.

After she finished braiding the other woman’s hair, it was my turn. I sat down on the mat, my friend Teresa separated the extensions into braid sized pieces and she got started braiding my hair. I had never really thought much about how much you have to pull on someone’s hair to get those tight braids in and make them look good. It was a bit uncomfortable but certainly tolerable. My rear end also got a bit sore from sitting in the same place for a couple of hours, but I was easily distracted by the enjoyable conversation with the woman and her neighbors, visits from my friends from the office and the intrigue of children, most of whom hid behind rocks to get a peek of the action, but avoid my glance. After about two hours I was all set, they tied my hair back, showed me a mirror and I was on my way. It did look pretty nice, but I was quite self conscious about it. I still felt a bit like the person on the cruise ship. The other issue was that my own hair is pretty big, with long extensions added to it, it was gigantic, and difficult to sleep on. Between the two issues, the braids only lasted a day and a half. Even still, it was a worthwhile experience, and it convinced me beyond a shadow of a doubt that any attempt at dreadlocks would be a dreadfully bad idea.

I arrived in Tel Aviv at about 6 am on Sunday morning, then had about 12 hours to spend in town before the rest of the groups arrived. I hadn’t had a haircut since I was home at Christmas and I had heard Tel Aviv had many good salons so I thought I’d give it a try. Wandering through central Tel Aviv looking for salons was a bit intimidating. Many of the salons looked quite expensive and others were full of men who looked like they would judge me harshly for not having a haircut in four months. For some reason being judged harshly by a male hairstylist seemed much worse than being judged harshly be a female hairstylist, but after wandering around for several hours I found a salon that looked a lot more mellow and affordable. I got a good vibe from the place, so I headed in. The man cut my hair with reckless abandon, but in the end I really liked how it looked. I headed to the internet café to share my success with the world and then for the best lunch I’d had in a while.

Unfortunately, I'm a putz and I can't find the braid pictures anymore. I'll have Katherine send them to me again, but it might take a while to e-mail photos from Tanzania. I'll get them up as soon as I can.

2008-05-20T00:11:00.000-07:00

2008-05-20T00:10:00.000-07:00

2008-05-20T00:08:00.000-07:00

2008-05-20T00:06:00.000-07:00

2008-05-20T00:02:00.000-07:00

2008-05-19T23:54:00.000-07:00

My trip to Kili started with the typical Tanzanian travel frustration. I had planned to take the bus to Moshi, but a friend from work knew a person who was driving to Arusha, so I was supposed to get a ride from him, then take a shorter cheaper bus ride to Arusha. However, my ride was over three hours late, so then my friend arranged for me to ride with another person, but his car battery had just died, so we finally ended up beginning our journey about five hours after I would have left on the bus.

When I arrived at the hotel I was surprised to find that both the route and the number of days I was climbing had changed. I had been planning on climbing the Machame Route in six days and found out that the next day I was leaving to climb the Rongai Route in five days. I was a bit worried because I had heard your likelihood of success increases dramatically from a five day to a six day climb. Because of the change in route I didn’t know anything about where I was climbing, much less that Rongai is essentially in Kenya and about a four hour drive from Moshi.

We arrived in Rongai and after lunch and another hour of fiddling with equipment and other delays we were on hour way. There were four other American women about my age who joined us for the first day of the climb, then were slowing down to make it a six day hike. The walk was surprisingly easy and we arrived at camp a little before 7 pm. The camp we stayed at was at about 2700 m (about 9000 ft). It was starting to get chilly and by the time we ate dinner at 9 pm, it was downright cold. I’m sure it was much more of a shock for the rest of my group than for myself, as they were all staff from the Highview Hotel in Karatu, Tanzanians born and raised. I was excited to climb with them because I felt a little weird about the traditional Kilimanjaro trip where you talk a little to your guide and mostly with whatever other random white people are climbing in your group. Climbing with the group from Highview and knowing a little bit of Swahili helped me have a much richer experience, becoming great friends with all of the porters, cooks, and guides.

The next morning, I awoke to incredible views of Mt. Kilimanjaro, and after breakfast we headed out for our day’s hike. We hiked for three hours, stopped for lunch, then hiked for another three hours. We finished the day at a camp at about 3900 m (about 12,700 ft) and I continued to be surprised both by how easy the climb was and by how cold it got at night.

I suppose now is as good a time as any to tell you about the worst part of the trip. I took a special type of diuretic to prevent altitude sickness while I was headed up the mountain. The medicine was fine and didn’t have any ill effects except for the expected having to pee more. I had to get up at least once, sometimes twice a night to go to the bathroom. Because it got so cold at night, this was always at least a 20 minute process. The first ten minutes devoted to determining how much of a necessity going to the bathroom actually was (it was always an absolute necessity), and the next ten minutes devoted to putting on my coat, and hiding under my sleeping bag until that got warm, then putting on my boots and headlamp and navigating my way to the pit latrine. This certainly disabused me of any notion that I might enjoy snow-camping. (Maybe when I can attach a heated bathroom to my tent).
The next day was a short climb. We walked for about three hours up to 4700 m (15,300 ft). I’m surprised to find that I’m not feeling any effects from the altitude at this point. I was expecting my head to be starting to hurt. I did notice my appetite had decreased significantly and I was trying to force myself to eat as much as I could stomach. The other interesting development was that it was cold enough that I didn’t want to drink anything cold. I also didn’t want to drink any tea because it might make me pee even more, so I decided to mix my Gatorade powder in with the hot water. Hot Gatorade is a better drink than you might imagine, but probably not something I would recreate in warm weather or at sea level. Because we were leaving to summit at midnight, I took a nap right after lunch, then went to sleep for the night right after dinner.

I woke up to prepare to summit at 11 pm. I drank as much Hot Gatorade water as possible until it was time to go. It turned out that was a bit of a mistake. We set out at midnight and I was a bit nauseous until the water exited my stomach. We started our climb, four guides, eight people from Highview Hotel, and me. A couple people started feeling dizzy and nauseous and one of the guides took them back to camp and we continued onward. Then two more people were feeling bad, so another guide took them back. One more person started feeling really nauseous and decided to turn back with another guide. At this point I’m starting to get worried about how this climb is going to go because there are four of us and one guide. One of the four girls is having a lot of trouble staying warm and has been dizzy since just after we set out, so the odds of her being able to continue are looking slim, and the last guy in our group isn’t looking too good either. We have made it about 750 of the 900 m up to Gillman’s point, the first point along the crater that you reach and the horizon is just starting to lighten. I’m feeling great, the nausea has passed and I have a little flash of headache every now and again, but really I’m mentally preparing myself for having to turn around because the guide will have to go back with this sick person. She finally decides that she wants to go back, so the guide asks me what I want to do. I figure I don’t have much choice, they won’t let me continue on on my own, but I give it a try and ask. “Can I wait for the next group coming up and walk with them?” He looks down the mountain, doesn’t see any head lamps, and tells me that anyone who was behind us has turned around and returned to camp. “Can Esther and I keep going?” Esther has been feeling great the whole climb to this point, and has been rousing us up from breaks to continue onward. “Esther wants to go back, too.” That shocked me, so I tried one last thing. “Can I keep going on my own?” And the guide said, “Sure”, though I was even more shocked by that, I said okay, and turned to continue onward. The guide planned to take them back down and come back up to meet me as quickly as he could.

By the time we got all of that figured out, the sun was starting to rise, I climbed for a little bit, then took some sunrise photos. A little later, much to my relief I reached Gillman’s Point at 5695 m (about 18,500 ft), rested for a while, then continued on to Uhuru Peak. From Gillman’s Point to Uhuru Peak the climb was much easier than the climb to Gillman’s Point, all of the ascents were short and the sun was coming out and it was warming up so resting was no longer more painful than continuing to walk. I really enjoyed this solitary winter wonderland in the middle of Africa. About an hour and a half after Gillman’s Point, I reached Uhuru Peak 5895 m (19,344 ft), snapped some photos of myself, then turned around to return back. I met with my guide again at about the point I left him, about 750 m above our camp.

Upon return to camp several of the guides and porters greeted me and gave me hugs and helped me carry my things. I’m pretty sure if I had looked any more tired they would have just carried me to my cot. After an hour nap and lunch, I hiked another six miles down to our camp for the night. This was the most difficult part of the trip for me. My legs were extremely tired, mostly from the descent and I was quite sleep deprived. I got to camp and fortunately dinner was already ready for me, unfortunately, I still had no appetite from the altitude. Then, I pretty much went to sleep for the rest of the night.

The next day we woke up early to head out of the park. My twelve hours of sleep had revived me and I was feeling good again. We left the park at about 1 pm and headed back to Karatu. Our trip back to Karatu was another adventure for another time. A trip that should have taken 4 hours took about 10 hours, but we made it and I got to eat a ridiculous amount of kaichumbali (a vegetable salad with tomatoes, cucumber, peppers, onions, and carrots) on the way.

As an epilogue of sorts, Saturday night Katherine and I went to a party for Highview Hotel, part of the celebration was for those of us who climbed the mountain. One of the highlights of this was our assignment to the VIP table, which involved us having to switch seats four times in five minutes to adjust to the moving location of the VIP table. The other highlight was the magistrate, who had had a few too many dragging me up on stage during the hotel owner’s speech. I wriggled away as quickly as possible. Also, today I heard that I am now famous beyond Karatu, as the crazy running white girl, I was on Tanzanian television last night for this trip up Kilimanjaro. It’s pretty funny, but not that exciting because I think all you have to do to get on the news is pay the news people to come cover your story (I think Zara Tours, the company I went with, paid ITV to come).

2008-05-02T09:18:00.000-07:00

2008-05-02T09:16:00.000-07:00

2008-05-02T09:15:00.000-07:00

2008-05-02T09:12:00.000-07:00

2008-05-02T09:04:00.000-07:00

The Marathon

2008-04-25T05:26:00.000-07:00

On Monday, I ran my first half-marathon. It was generally a positive experience, and I finished in 2:10, not too bad for my first one. However, it was also one of the most ridiculous experiences of my life. We enlisted the help of a local runner in recruiting participants. He recruited about 200 international elite runners. There were no other runners besides these runners, David (another volunteer) and myself. So my time, that I was pretty happy with, was about 30 minutes after the next closest woman, and I think about 25 minutes after David. Everyone was waiting on me to start the awards ceremony, so I had mixed emotions of embarrassment and pride as I crossed the finish line. These feelings were soon enhanced. It turned out that several of the women who ran the race didn't finish. This meant that I finished 20th (and last) amongst women. However, prizes were given to the top 20 men and women finishers, so I won 5,000 Tanzanian shillings (about $4) and had to go up on stage to claim the prize. The runners were generally very kind and congratulated me on finishing the race, and my prize. Some of my office colleagues made fun of me for finishing last. Katherine and Natalia took pictures of the race, so when I receive them I will post them here as well. I'm sure everyone can appreciate the humor of me lined up next to several Tanzanian Olympians. There have been a lot of other activities around Karatu that deserve comment as well. I'll write about them tonight and post soon.

2008-03-31T06:15:00.000-07:00

2008-03-31T06:09:00.000-07:00

2008-03-31T06:08:00.000-07:00

My family came to visit for a week and a half. The beginning of the trip was not too great as their flight was delayed, and the next day our trip to Lake Manyara turned into a bit of a debacle. However, after that our trip was great. We went to the Serengeti for two days. Unfortunately we weren’t near the migration, but the scale of Serengeti is still beautiful and awe inspiring. Then we went to Ngorongoro Crater. The highlight of the trip to the Crater was the cheetah sighting. I had been hoping to see it each time I went and it finally happened. They were up running around as well, so it was interesting to see how the wildebeests and zebras reacted even though the cheetahs obviously weren’t on the hunt.

The next day I introduced my family to Karatu. We met some of the people I work with, though many people were out in the field for trainings. My mom was very excited to meet my friends at the market, so that was our next trip. They had also been very excited to meet my family. In fact, they had been asking about my mom for at least a month. She made new friends by taking some great photos, and Karla made friends by passing out candy. Next we visited a local orphanage because some people I work with were going there donate an Easter meal and others were going to film a commercial. Everyone had a great time playing with the kids, and I think my family was struck by the kindness of the children. That evening, we enjoyed dinner and watched a drama troupe performance at Highview Hotel. It was similar to other drama troupe shows I’ve seen, but I was glad to share the experience with my family because I knew my mom would like it, though I’m not sure my uncle Mark appreciated the high pressure sales tactics of the performers after the show.

That Thursday we took it easy. We did some souvenir shopping, then I introduced everyone to ugali. Ugali is made from corn flour and its texture resembles very thick mashed potatoes. It’s not my favorite food, but it’s not bad, and I felt it was an important part of the Tanzanian experience.

The next day we woke up early to travel to Lake Eyasi. While there we were able to meet the Hadzabe people, a hunting and gathering tribe in that area. They were especially skilled at finding honey, and the honey they generously shared with us was delicious. Interestingly, one of the types of honey tasted like mango juice. Then we drove to Lake Eyasi to see it. I had been near the lake, but never on the shore. I was surprised at how low the lake was, even though rainy season has started. We then met the Tatoga people. They are pastoralists, similar to the Maasai, who graze cattle. This was probably my favorite part of the day because the women were preparing for a wedding and we joined in the singing and dancing.

The next day we relaxed around the house and Gibb’s Farm (a fancy hotel nearby) and played cards and scrabble, and on Sunday it was time to leave. We traveled to Moshi so we could see Mt. Kilimanjaro, then back to the airport for my family’s departure.

Since then we conducted a drug shopkeeper training. It went well, but it didn’t seem like it would initially. In retrospect planning the training for the day after a five day weekend was a mistake, but after everyone arrived and we adapted the training for the participants we weren’t expecting it went well. We reviewed information about history taking and danger signs, discussed childhood illness, STIs, family planning, and their role in educating the community.

Now I am preparing for MAISHA training next week. It will be a tight squeeze to get everything ready in time, but it seems that in Tanzania everything falls into place at the last minute. I continue to train for the half-marathon and I’m preparing to spend four weeks in Israel on my way home from Tanzania. I’ll return to Minneapolis on June 20 and start classes two days later.

2008-03-10T06:00:00.000-07:00

2008-03-10T05:48:00.000-07:00

2008-03-10T05:47:00.000-07:00

I haven’t written for a while, in no small part because other that work and training for the half-marathon not too much has happened. I finally got the results to our Secret Shopper Survey, and they were really good. In the fall 45% of drug shopkeepers would not sell partial doses to patients, now 90% of drug shopkeepers will not sell partial doses. (This is important for preventing antibiotic and anti-malarial resistance). More drug shopkeepers are referring people to the hospital or advising customers to go to the hospital if symptoms worsen and the percentage of secret shoppers who felt confident in the treatment they received increased as well.

Since then, I’ve been continuing to work on a new Drug Shopkeeper curriculum to continue to work on the weaker areas of “history-taking” and recognizing danger signs. I’ve also been working on a study protocol for some research about Rh incompatibility and finishing up some details about MAISHA training.

We found out last week that the President of Tanzania will be coming up to Karatu for our marathon and the opening of the Healthy Mother Healthy Baby Center. It will be an exciting and busy time for us and should bring a lot of positive attention to MIHV and malaria awareness in general.

The Serengeti

2008-02-21T00:36:00.000-08:00

2008-02-21T00:34:00.000-08:00

2008-02-21T00:31:00.000-08:00

2008-02-21T00:30:00.000-08:00

Joe had an urgent need to see some photos from the Serengeti, and occasionally I try to be a good girlfriend so here goes. Our trip to the Serengeti was incredible. The beauty of the Serengeti was strangely familiar, as much of it was prairie land. Obviously, the zebras and giraffes weren’t part of our summer drives across Iowa, but anyone who has ever driven across Kansas or Nebraska knows that Serengeti, the Maasai word for “endless plain” isn’t too far off. Because of the size of the park it was more difficult to see animals up close than in Ngorongoro Crater, but it seemed more natural and thus more interesting.

We had the opportunity to stay in a tented camp out in the middle of the Serengeti. According to the national park rules, camps like this have to move every three months and ours had just moved two weeks ago, so we couldn’t have breakfast any earlier that 7:30 for fear that the animals would come.

As most of you know, President Bush came to Tanzania last week. It was interesting, because even though I’m in the country I heard most of the news of his trip from friends and family back in the states. He didn’t come to Karatu to see us but his visit did essentially shut down the town of Arusha, two hours away. Ken, another volunteer, was leaving to travel to Zanzibar that day. He had to walk about 2.5 miles with his luggage to get to the Arusha Airport because the one road to the airport was closed. The president did spend a lot of time focused on malaria projects, which is, of course, an important part of our project. I think some people around the office are hoping we can use that picture of him wrapped in the bed net to make a poster.

At work, I’ve been continuing to work on organizing the MAISHA training and I am eagerly awaiting the results of a Secret Shopper Survey we conducted last Saturday. The results of that survey will help us assess if the first Drug Shopkeeper training was successful and give us an idea of what we should focus on for the next round of training.

2008-02-10T22:01:00.001-08:00

Since I last wrote, the volunteer population in the Minnesota office has doubled. Ken, a fourth year medical student from Temple, and Katherine, a soon to be first year medical student, have arrived. Our trip to Serengeti was postponed until next weekend, so we’ve been keeping busy in other ways. I’ve been working on getting a couple research projects started regarding maternal alcohol and water quality, and I’ve been preparing for MAISHA training and a survey for drug shopkeepers that will help me design the next curriculum for shopkeepers who have already had one round of training.

Our trip to Ngorongoro was incredible. I was able to see lions and rhinos, which I hadn’t seen in my travels yet. In fact, the lions came as close as 10 feet from our vehicle. There were also a lot of baby zebra, lions, warthogs, and even baby rhino around. It was hard to shake the song “Circle of Life” out of my head.

The drama troupe that performs at the monthly market day had to conclude their performance early due to rain so the new volunteers missed it. Ken and Karen will leave before the next market day so we went to a local hotel where they perform on Saturday night. They performed a traditional dance from Zanzibar, Southern Tanzania, and did some acrobatics as well. At one point during the act one of the performers bends himself in various directions to fit through a narrow metal cylinder. I think it was pretty stressful for Katherine, who was quite concerned that he would get stuck.

Sunday morning two of the Peace Corps volunteers in the area came over for brunch. Veronica, the Maternal-Newborn Care assistant manager, is staying with us right now because her house isn’t quite ready yet. The chapati she makes is very crepe-like, so needless to say brunch was quite fancy and delicious.
I also found out this weekend that my mother, my sister, and my uncle will be coming to visit me in Tanzania in mid-March, so I’m quite excited about that.

Some interesting things happened in Tanzanian politics this week. The prime minister resigned amidst a corruption scandal, in which he received $150,000 per day over two years through dealings with an electricity company. and the president decided to clean house and fire the entire cabinet. He will probably rehire many of them who weren’t involved in corruption, but I think it’s great that the president has decided to take such a bold stand on corruption.

This coming week, we’ll be conducting a secret shopper survey in the drug shops, heading to Rhotia, a nearby village, to do some clinical work and community observation, and President Bush is coming to Tanzania, so we are hoping he will visit us in Karatu on the way to the Crater.

2008-02-07T02:02:00.000-08:00

2008-02-07T01:55:00.000-08:00

2008-01-28T00:24:00.001-08:00

I will also be blogging form MIHV at mihvblog.blogspot.com. It will be 99% the same as this, but I did put a couple photos up on there.

Back to Karatu

2008-01-28T00:21:00.000-08:00

After two days of travel, I arrived in Karatu Tuesday evening, and because all of the sleep I got was on planes, I don’t think I’ve ever been so tired in my life. The next day I took it easy, but did visit my friends in the office. I had almost forgotten how much fun everyone here is while I was gone.

On Thursday, it was back to work, and Friday, Karen, the other volunteer, conducted a planning workshop. It was really great. It can be difficult to track people down to make plans when they are out in the field, so it was wonderful to be able to sit down with everyone and make sure our plans all work together.

After work on Friday, I went out for a jog, and upon returning home my friend Margaret was at my house. She told me there was a man under a tree across the street that was quite sick. He had been throwing up for three days, and had walked from a town that is over six hours away by car without eating or drinking. He had been working in Serengeti, but got sick and was trying to return to his home near Mt. Kilimanjaro. Needless to say he was quite confused.

I made him some oral-rehydration solution. He was able to drink it, but soon vomited again, so we took him to the health center for some additional help. Because his pulse, blood pressure, and temperature were normal they asked him to come back the next day if he was still sick. There were some men in town who tried to help him find some food and a bed. My guess is that he had an electrolyte abnormality, and needed IV fluids, but I did not have access to the necessary lab tests or an IV, so I couldn’t do much more to help. Unfortunately, I don’t know what became of him.

This weekend, Karen, Veronica, and I went for a short hike to the Elephant Caves and a waterfall. We were a little disappointed that we didn’t seen any wild buffalo or elephants because we could tell they were nearby, but next weekend we will be going to Ngorongoro Crater, and the following weekend we will go to Serengeti, and we won’t have any difficulty spotting wildlife there.

MIHV is planning a half-marathon for malaria awareness on April 25. I am excited about this because, initially we had planned to organize a full marathon, which I had no intention of training for. Karatu is about a mile above sea level and the surrounding area is very hilly, not a good place for a first marathon, if I were interested in participating in a marathon in the first place. We changed the plan because many local marathoners are training for a marathon about one month after ours. They were interested in a training race, but running another marathon would have been too much. This works out great for me personally because I think a half marathon is something I can do, so I look forward to participating, even though I probably will be the last one to finish.

This week, a new volunteer, Ken, is arriving. He is a fourth year medical student from Temple University. We are planning to work in the clinics at some of the local health centers and do some community observation regarding water sources, latrine availability, standing water, cooking fires, etc. I will also be putting the finishing touches on our MAISHA training materials, for a training at the beginning of March and working with the District Pharmacist to plan the next round of Drug Shopkeeper trainings.

Unfortunately, I don't have any photos to post yet because I look stupid in the photos from the elephant caves. Oh well, plenty of photos to come.

2007-11-29T04:25:00.000-08:00

This is probably my last blog entry before I return to the States for the Holidays, because I'm on the way to Southern Tanzania tomorrow. I went to Dar Es Salaam last week. I bought a bunch of paintings, so I'll have an awesome apartment when I get back, and I bought a bunch of gifts. I also got to spend some time on the beach on Friday and Saturday, which made me feel a bit smug, since I hear there was snow in Iowa and Minnesota. Yesterday and the day before I was in a small village called Mang'ola for drug shopkeeper training. I'm starting to be able to understand more Swahili so it's easier to understand what's happening at the training and if people are enjoying the training and finding it helpful. I got to interview some of the women at the training to help Karla with her article too, which was fun, they seemed to get a lot out of the training, although it's hard to tell for sure because Tanzanians are too polite to say otherwise. That's about all that's new here. I'll see you all pretty soon.

2007-11-19T00:54:00.000-08:00

2007-11-16T03:17:00.000-08:00

The past couple weeks have been marked by some sadness for MIHV. The district medical officer, who happens to be the uncle of one of our staff, passed away this week. The sister of another co-worker passed away this week as well. For the wake and burial I wore traditional African clothes. I thought everyone would get a kick out of it, so some photos are below. Wakes in Africa last for several days, day and night, and women are responsible for cooking, so I learned how to cook dishes called pilau and kichumbali.

Other than that I continue to work on preparations for drug shopkeepers and MAISHA training. I am also excited to help Karla with a newspaper article for her class. I am hoping she can publish it somewhere and people can hear about some of the cool stuff we're doing here. I'm leaving for Dar Es Salaam tomorrow to go to a friend's graudation and see the sights. After I return I'll be going out into the field to a village called Mang'ola Barazani for drug shopkeeper training. Then I'll be travelling to Southern Tanzania to visit a hospital and school that are "friends of MIHV" and see if the hospital is a good place for medical volunteers to work. On our way back from Southern Tanzania we will visit Zanzibar for a few days. That will get me pretty close to time to come back home for a while, but if there's time I'd like to climb Mt. Meru as well, we'll see how it goes.

2007-11-01T22:15:00.000-07:00

I've been working in the office and at the hospital for the past couple weeks, so I don't have any new photos, but I've been keeping quite busy. I've been working on arranging things for our next drug shopkeeper training and beginning to design a curriculum for MAISHA (maisha means life in Swahili) training, which is a group of taxi drivers that we want to train in basic emergency response and community health so they can educate their customers and families. One nice story to follow up our first drugshopkeeper training: Jolene, our Country Director, had a bit of a stomach bug, and sent one of the MIHV staff to a drug shop to try to buy a partial dose of the medicine she needed (she already had a partial dose from when we had done a survey to see if they would sell them before training) and they refused to sell her the partial dose. So apparently, the eduation is having an impact. Today, I am doing a presentation on chronic diseases for my co-workers and members of the District Council Health Management Team.

This week, I was out for a bike ride and I saw a large crowd by the side of the road. I stopped to see if I could help. A woman had been hit by a car, and her arm was badly broken, but other than that she was ok. I couldn't do much to help so I made her a sling and helped carry her to a car to get her to the hospital. We then saw her in the hospital the next day, but had to send her to Arusha for surgical repair of her injury. Other than that events at the hospital are about the same as usual, but I've been trying to learn as much as I can about prevention and primary treatment of rheumatic heart disease. I'm not sure why I found the prevalence of this disease so much more surprising than other infectious diseases. I guess because I thought all it took was a little amoxicillin and the problem was solved, which is pretty much true, but as with everything else, somehow it gets more complicated here.

I have a busy month and a half before I come home. I'll be helping build a school this weekend. Next week I'll be continuing to prepare for drug shopkeeper training and MAISHA training. Next weekend, I think I'm going to Moshi to do some hiking around the base of Kilimanjaro. After that, I'll be going to southern Tanzania to visit a site that would like to host international medical volunteers, then back to Dar Es Salaam for my friend Eveline's graduation. Then drug shopkeeper training. In December, travel will keep me busy. I plan to climb Mt. Meru and then relax in Zanzibar. I found out that I can climb Mt. Kilimanjaro for free in April, so that's pretty exciting.

2007-10-18T02:05:00.000-07:00

2007-10-18T02:01:00.000-07:00

2007-10-18T01:38:00.000-07:00

Much has happened since last I wrote. MIHV started a drama troop event at market day to help spread messages about malaria, pneumonia, and diarrhea. It was a lot of fun. The performance mainly consisted of singing and dancing.

The next day I began working at Karatu Lutheran Hospital. The first day was quite a challenge for me. I saw a lot of difficult cases, including a young man whose hand was crushed and he had to have two fingers amputated and a young HIV positive mother with a complicated C-section. Over the next few days there were many interesting cases, a young woman with very high blood pressure (we're still trying to figure out the cause) and a young woman with very severe anemia (the same). Most of the issues I am facing in the hospital are not unexpected, but it is certainly challenging to balance the realism of accepting things are they are and the idealism, that it is not the way it should be. For example, we were unable to give the woman with anemia a transfusion because they had no blood reserves. They could not get blood from the hospital 3 hours away because they did not have a cooler to transport it. The doctor I worked with and I offered to donate blood, but the bags were expired and in bad condition.

Last weekend. A Peace Corps volunteer and I went on a bike trip. We had planned on going through the Ngorongoro Conservation Area, a cool mountainous region with many Craters and a lot of wildlife. However, the trip fell through because we found out we needed a guide, but obviously we could not provide him with a bike. Instead we decided to bike from Lake Natron up near the Kenyan border back down toward Karatu. This was a bit more than we bargained for. The road was almost entirely sand up to 6 inches deep, and we ended up travelling at a rate of about 2 miles an hour during the day before we gave up on the idea of biking the rest of the way home. The experience was still very enriching though, as we got to see Oldonyo Lengai, an active volcano, which is currently smoking, we spent two days in Engaruka, a Maasai village, where they were quite welcoming, and we saw some ruins from a settlement from hundreds of years ago, that were quite impressive and interesting.

Now I'm back in the office for a while, another thing I've been considering doing is teaching 1-2 periods of chemistry each day at the local secondary school, but I'm not sure it will work out. Other future travel plans include climbing Mt. Meru, visiting Dar Es Salaam for my friend Eveline's graduation, and travelling to southwest Tanzania to see if a hospital in the town of Njombe will be a good place for medical volunteers to visit.

2007-10-04T02:35:00.000-07:00

2007-10-04T02:11:00.000-07:00

This past week I travelled to Lushoto, which was very beautiful. I continue to have a bit of bad luck with travelling though. The guide I hired tried to take a shortcut through the rainforest because we had walked 36 km (~22 miles) the day before. He ended up getting lost and we found ourselves in very thick forest where I fell and twisted my knee a bit, then had to hike out about 10 km because there weren't any roads any closer than that. I decided to forego other hiking plans for a bit after that and I think I'll plan beach vacations until after I complete my climbs of Mt. Meru and Mt. Kilimanjaro. Hiking 36 km through the mountains again would probably kill any desire I had to climb anything.

Rainforests aren't quite as exciting as I had expected. Of course, I expected technicolor flowers and monkeys 10 feet away, which wasn't exactly realistic. In fact they're pretty much just like other forests, but the surrounding mountains were beautiful and the people were very kind and friendly. I also learned that it was easy to make friends with local kids by taking their photo and showing them the results, which was really fun.

The next things on the agenda are starting work in the hospital on Monday, making a reference book for local drug shopkeepers, and a bike trip though the Ngorongoro Conservation Area up to Lake Natron, which promises to be incredible, if for no other reason than I'll get to spend almost a week on my new bike, which is super sweet and came with an awesome bell that will be returning with me. I'm hoping at the end of October, beginning of November to head to Mt. Meru, then to Pangani to lay on the beach. The photos are from my travels this past weekend.

2007-10-04T02:06:00.000-07:00

2007-10-04T01:56:00.000-07:00

2007-09-24T05:09:00.000-07:00

2007-09-24T05:03:00.000-07:00

2007-09-24T02:55:00.000-07:00

2007-09-24T02:41:00.001-07:00

Here's a photo of the people I work with, we are on a trip to Ngorongoro Crater.

This past week I completed my first project in Tanzania. I developed training materials and helped coordinate training for women who work in drug shops. As I've mentioned before these women are very important people in the health care community and often prescribe important medicines including antibiotics themselves, without any consultation with a physician or pharmacist. These women do not have health care experience, so giving them some insight into proper prescribing and when children are critically ill will hopefully have a big impact. We are planning on using secret shoppers in six months to see if the training was effective and what areas we need to do further training.

The other fun this weekend was a trip to Ngorongoro Crater, which was incredibly beautiful. I didn't see quite as many animals as I did on last weeks trip, but the more beautiful surroundings more than made up for it.

There was also some humor on this trip. We got out of the park and parked at the gate for everyone to stretch their legs and get checked out of the park. There was a baboon walking right past our cars so I walked up as close as our second car, about 15-20 feet away and shot some photos of the baboon. Then the baboon started walking toward me, which made me a bit nervous since I had heard they're quite mean. So I started backing away from it, until I had backed my way into the back seat of our car. The baboon jumped through the window into the front seat of the vehicle, which was quite a shock for me and quite hilarious to everyone else in the group. Soon the baboon jumped back out the window, no harm done, but I was pretty concerned for a bit. Hopefully I can include a photo of him above.

2007-09-18T05:25:00.000-07:00

2007-09-18T05:07:00.000-07:00

2007-09-18T04:48:00.001-07:00

Quite a bit has happened since my last post. The first was working at the eye clinic. It was really great. I worked with a British doctor, Dr. Savage, who has been working in Tanzania for 10 years, and a Tanzanian woman, Dr. Kombo, who is doing something like an Ophthomology apprenticeship with Dr. Savage. It was a really great experience. I learned a ton. We saw many, many cataracts and performed about 15 cataract operations over two days. We also saw some people who had some problems with their free cataract operations. I saw a woman who had a retinal detachment, a girl who lost her eye to shingles, and several other interesting cases that only nerdy med students would care about. I'm still looking forward to participating in other clinics and working in the hospital, but unfortunately the man I need to meet with, the district medical officer has been in the hospital with pneumonia almost the whole time I've been here.

The other project I've been spending quite a bit of time on is creating training materials to teach drug shopkeepers about how to prescribe drugs correctly with full doses, proper instructions, and according to the government protocol. There are a lot of system wide problems with regulation of pharmacies and some problems with the quality of health care providers, that make it seem more worthwhile to go directly to the drug shops, rather than seeing a clinician. The training will occur this Thursday, so I'm hoping we can get it translated before then.

I went on my first safari this past weekend. The game drives themselves were very good and I have some amazing photos that I hope to post soon, but the rest of the trip was a bit of a disaster. The car broke down on the way out to Lake Manyara. Then I joined another group for safari at Lake Manyara,after that we left to go to Tarangire Park, where I was supposed to have a luxurious tented camp waiting for me, but it was full, so I ended up staying in a guest house that cost about $3, you can guess about how nice it was. It was actually very tidy and had mosquito nets so it was fine, just not really what I was expecting. Then on the ride home we ran out of gas. I'm still haggling over price with the guy, but I think I'm going to have to pay full price for the trip. So I have decided I will start a small scale smear campaign against Fun Safaris. The next travels are into the rainforest. I'm setting it all up myself and I'll be camping, so I know exactly how luxurious it is.

2007-09-09T03:00:00.000-07:00

To be honest, there's not too much new here. We finished up our health facility assessments this week, and found that not many kids were going into dispensaries and health centers, which those facilities claimed was because there weren't sick kids, but after checking in with local drug shops we found they were treating many kids, so people were just skipping the doctor step and going straight to the pharmacy. Many of the people in the office will be travelling to the village of Mang'ola this week. I've elected to stay in town because some doctors from out of town are coming in to perform an eye clinic and surgeries, which I am hoping to at least observe, if not participate in. The next big plans are travels to Tarangire NP and Lake Manyara NP next weekend, and travels into the rainforest two weeks after that. My mom wants some photos of people, so a few more photos up above, this is Rose and Halima looking at some baby clothes we bought as a gift, while at market.

2007-09-01T03:53:00.000-07:00

I'm starting to get settled into what I'm supposed to be doing here. We began some health facility assessments this week in health centers and dispensaries in the area. Though they are not far away, the farthest was 50 km away, the roads aren't paved and they wind through the area, so the 50 km drive took about 3 hrs. Seeing the clinics were interesting too. Since the clinical officers have five years of post-secondary training (including their internship) before they are out practicing on their own, much of their practice is based on protocols. This takes away a lot of the art and detective work of medicine and may result in missing something important, because often these clinicians don't even examine the patient. They hear the word cough and reflexively prescribe an antibiotic for pneumonia. In the circumstances where people are traveling for hours to reach you you might think better safe than sorry, but antibiotic is becoming a major issue as pharmacists give out antibiotics without a prescription and may not give a full course, even if parents get a full course of antibiotics they often stop taking it as soon as the child is feeling better. It is my opinion that antibiotic resistance in Africa will be an even bigger problem in Africa than it currently is in the states because most people won't be able to afford the new antibiotics we use to treat resistant infections.

Last night, I went out for nyama choma (barbecue)with the staff at MIHV, we had a great time. The staff here is very kind and friendly and they are helping me a lot in my quest to learn Swahili. Though sometimes they forget I don't speak it until they see the blank stare on my face.

I'm using my free time this weekend to look into some options for travelling. In September or October I'm hoping to climb Mt. Meru, fortunately last night I met a man, who works for a Canadian NGO, who grew up right by there and his brother is a guide. It sounds like he will be able to help me find a good deal and a great trip. I am also excited for a trip I'm planning to Tarangire National Park. It's one of the few big parks that has most of its wild life during the dry season, so I hope to take advantage of that and see an elephant migration. Some other trips in the works are a trip to Zanzibar and a trip to Madagascar once I've done a little more research.

This coming week I'll be going out into the field again to continue the assessments before we start training community members in recognizing signs of severe childhood illness. I might go to Arusha to pick up a cell phone (so I can stop mooching off the office phone) and I hear they have last minute safari deals, so I might try to find a good deal on those as well.

2007-08-28T22:52:00.001-07:00

Here's some of the gorgeous scenery around me:

2007-08-28T22:44:00.000-07:00

Here's my room:

2007-08-28T22:38:00.000-07:00

Here are some photos. My house:

2007-08-27T03:10:00.000-07:00

I made it

2007-08-26T08:08:00.001-07:00

My travels to Tanzania were pleasantly uneventful. I arrived Saturday and I'm getting settled in. I went to a bbq today which was quite fun. I hope to have several photos up shortly. I was supposed to have a 15 h layover in Ethiopia. Luckily Ethiopian Airlines put us up in a hotel and gave us dinner and breakfast, and I made some friends who were climbing Kili along the way. I'll post photos of all the beautiful scenery, my surprisingly nice accomodations and the gang in Ethiopia when someone else is not waiting for the computer.

Welcome

2007-08-09T19:41:00.000-07:00

After many requests I decided to establish a blog about my trip to Tanzania. I'm not there yet, but I thought I'd start posting information on this so you can find it when I get there.

Sijambo means "I'm fine" in Swahili. I chose it as the title since I've heard inferences that some people are worrying about me more than they should. That, and surprisingly the Swahili word for togetherness and the Swahili word for dancing and drumming were taken.

I'll be arriving in Tanzania on August 24. While I'm there I'll be working with Minnesota International Health Volunteers (MIHV). I'll be splitting my time between working in hospitals and clinics and helping with a public health project to improve early childhood survival in the Karatu district in Tanzania.

I also plan on doing some tourist stuff. Hopefully, I'll have time and money to climb Mt. Meru as a warm up for Mt. Kilimanjaro. I'll also be living about 5 miles from Ngorongoro Crater, which is one of the premier sites for safari in the world. There are many other safari sites nearby as well. I hope to have a chance to travel to a few other countries in Africa, as well. Regardless, I look forward to having great photos to share with you all.

As I've told many of you, I'd love to have some visitors on this long adventure, especially anyone interested in sharing a Kili climb before all of the ice melts. So even though I know that my friends and family who happen to possess both time and money right now are few and far between, know that my door will be gladly open to you.