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.

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.

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.

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.