My Personal Reflection: Amy

Unfortunately our time in Tanzania was too limited…we didn’t get to do most of the things on our bucket list. You might think…” you went to Africa and never saw a lion?” and actually, we came to Africa and the only animals we saw were monkeys (which were still really cool!) but that’s not what this trip was about. I’m perfectly okay saying that my time and money were better spent on learning about a healthcare system that is full of cracks, even more than our own. We got to meet so many people and see so many eye-opening things that the original bucket list we made seems insignificant. Of course, eventually I’d want to see and do all of those things, but this time I am content in knowing I can say I learned A LOT. Here are some of the things I learned and observed this trip:
-the people of Tanzania have beautiful souls. Every. single. person. greeted us with a huge smile on the first day, and by the end I feel as though I’m a part of a big huge family.
-the people of Tanzania are extremely resilient. The vast majority of the people that live here wake up and start their day knowing it will be a struggle. A struggle to make a living, a struggle to stay healthy, a struggle to be happy, a struggle to live.
-a little bit goes a longggg way. We can pay for one student to attend medical school here for $6,500 a year, which covers tuition, books, food, and accommodation. Compared to $40,000 a year in the US that’s nothing!
-people here die as a result of the cracks in the system. Whereas in the United States, if a baby died because the hospital didn’t have any oxygen, it would be a huge lawsuit. Here it’s normal. Extremely sad, but normal.
-countries that suffer from extreme poverty are largely a young population. There are no nursing homes for the elderly, there is no social security. When I first started noticing all the young people around, I didn’t put the two together, but then I started realizing its because life expectancy is so low. I can’t imagine losing my parents at the age of 50. They would already be gone. The same goes for new babies, though. It’s normal for couples to have a lot of children in case one or two die when they are young. It’s brutal here. If we lose one family member, it can shatter us. Here, they plan for it.
-people in every nook of the world are corrupt. The government here, like in most developing countries, lavishly feeds itself before giving whatever small amount is left to its people, including to hospitals and health centers where people are dying.
-Tanzania, and Africa in general I’m sure, is nothing like I thought it would be. I came here with preconceived notions (no doubt just like most people would) but those notions were blown away. It’s a beautiful place.
-despite all the hardships, the people make the best of what they have. This doesn’t mean they are happy with the way the system works, but they don’t take anything for granted like we do. Its extremely humbling.
-Africa needs help. This doesn’t mean I know in any way shape or form where to start with the help they need, be it education, politics, healthcare, aid etc, but they need it. Somehow in the mess of history, Africa was tortured and didn’t (until very recently) have the chance to truly give independence and development a shot (without anyone trying to influence the way it was done). Now, the effects of all the failed attempts are taking their toll, and I’m not sure anyone really knows where to go from here.
-I love it here. Dr. Jim brought us here hoping we would love it like he does, and it worked. Me and Melissa are so grateful that he brought us with him this time, and we did fall in love…with the people, the culture, the music, the soul.

Now it’s off to the next part of our adventure, and we can only hope it is as wonderful and beautiful as this one has been

PS we did end up learning roughly ten phrases in Kiswahili
1. Hakuna matata – it means no worries! (okay maybe we knew this one already but they actually say it!!)
2. Cho kiko wapi? : where is the bathroom?
3. Naomba maji biridi : I would like some cold water
4. Jina lako nani? : what is your name?
5. Jina langu ni Amy : my name is Amy
6. Unatoka wapi? Where are you from?
7. Moja qua moja, kushoto, kulia (straight, left, right…it’s almost a sentence!)
8. Hujambo? Sijambo : everything good? Yeah, I’m good!
9. Mambo! Poa : slang for #8
10. mbaya barabara…bad road!

A Glimpse of Paradise: Zanzibar!

We managed to fit in a weekend trip to Zanzibar!! How could we not I have been to many a tropical place, but I have to say, Zanzibar takes the cake. The water on this island is seriously clear. We went just for 3 days, 2 nights, and stayed in bungalows right on the beach!! The first day we relaxed in the water and under a palapa, rented kayaks (and found an INCREDIBLE isolated beach, but we forgot our cameras!!), bought local art called tingatinga that shows the Masaai tribe of Tanzania that still refuses to modernize (meaning they still walk around with toga-type wraps and spears in their hands at all times). We watched the sunset from our restaurant and then went to a party on the beach!! We were in a little town called Kendwa, about an hour drive from the capitol on the island, which is called Stone Town. Stone Town is a really interesting place, it’s a UNESCO world heritage site because of its history with the slave trade. Arabs have ruled the island of Zanzibar for a long time, and had started trading slaves long before the TransAtlantic slave trade started.  The island is also really famous for its spices! So we went to a restaurant called the House of Spices and had some fantastic food J We got to walk around the town, where the streets remind me of Europe (so tiny not many cars can get through!), see the markets, and look at the slave memorials. It was such an awesome weekend! The only thing we missed was snorkeling, but I imagine we will be doing that when we get to the islands in Malaysia and Thailand.

 

Working in Dar: Projects, Adventures, Extremes, Emotions

We’ve been in Dar for almost 3 weeks now, and we’ve truly seen more than we could have imagined. We’ve been in the city working at the hospital on various projects most of our days, but also had the chance to go into the villages and to an AIDS orphanage on the other side of the city.  Here’s the stories:

Mikocheni Hospital and HKMU:
Melissa and I have been heading up a few projects that are going on. Dr. Jim is friends with a woman back in California that works in hospice care. The extra supplies that her company keeps usually go to waste when their patient no longer needs it. We have contacted her and are trying to make a plan to have the supplies shipped here to the hospital, where they can use pretty much anything they can get that isn’t expired yet! Another project is a small scale Pap Smear project that consists of one lab tech here in Mikocheni that knows how to do the pap smears and stain the slides. She then takes a picture of the slide and sends it to a pathologist based in Switzerland who can diagnose the slide and return the results. HealthSpan attempted this project a few years ago, but the hospital and university didn’t have the bandwidth to make the project efficient enough. Thus, we are trying it again. Cervical cancer is the number 3 killer in Tanzania, yet the system here gives absolutely no privilege to pap smears at all. There are only 4 qualified pathologists that can diagnose cancer at the regional hospital in Dar, which has over 7,000 beds. There isn’t a pathologist at all at Mikocheni. So as much as we would like to build Tanzania’s own capacity to train more pathologists, cervical cancer is already at a dangerous point. For this reason, we have contacted the doctor in Switzerland and the lab tech here, as well as the pathology department at the regional hospital in Dar that has access to the resources we need! Very exciting. Hopefully with this collaboration we can reach even more people than we could on our own here. Another project we have going on is fundraising: we have agreed to send one medical student per year to school, which only costs a total of $6,500 for EVERYTHING. We’ve promised that as soon as we get back, we’re going to get started! We have high hopes for these projects, so wish us luck!

 

Orphanage
We also had the chance to go to an AIDS orphanage that’s on the other side of Dar, and WOWW!  was it an incredible day. The orphanage houses 20 children full time, and 20 children part time. The part time children are ones whose parents have died but whose families don’t have ability or willingness to take care of them. We got to spend a whole entire day playing with these kids, and it’s so crazy to me how happy they are. We went there thinking we would teach them something, but came out learning so much from them. They have nothing. The orphanage struggles to put food on their plates every day, yet they were so happy. We got there and they immediately started smiling and singing songs for us and giving us hugs J They all share one ball, and have so creatively come up with a game where they can all be included with that one ball (which seemed to be made of socks). We brought them little goodie bags with pens and pencils and paper and candy, and they ended up drawing us pictures all day! Dr. Jim generously fixed the water pump that was broken, which will save them about $20 a month that they can use for food. Melissa and I are trying to find a way for them to have everything they need for school: backpacks, pencils, paper, a book, plus some hygienic stuff like toothpaste and soap. These kids were just so awesome. Yet again, we’ve learned how lucky we are to have the life that we do. Why do we worry so much about all the small things?? It makes us so sad to see them living like they do, when we have so much back at home that we don’t need. The disparities are vast and this is a huge reason that we’re trying to do the work that we are!

 

 

 

 

 

Kibiti/Utete
The next adventure we got to go on was into the villages outside of Dar. One of the daughters of the founder of HKMU and MMH, Clementina (the head OB/GYN), took us to two villages, Kibiti and Utete. In Kibiti, there is a health center that has 2 doctors, 6 nurses, and 12 midwives, but that serves a catchment area of about 120,000 people. This health center was so amazingly different than ours. They lost a baby last month because the government hadn’t provided them with oxygen. They also hadn’t performed any C sections because the government didn’t give them any IV fluids. Jim always says, “it’s not that Tanzania doesn’t have anything, it’s that Tanzania always doesn’t have one thing that keeps it from succeeding.” In this case, the oxygen and the IV fluids.  Even just the rooms at the health centers were vastly different from our hospitals. It’s hard to even compare the two because they are just on such different levels. The maternity wards have around 12-16 beds, each in the same room, with mosquito nets (thankfully), and one room in the back that serves as the delivery room and the storage closet. The women are all together in the one room, there are open windows that let all the flies in, and their toilets are holes in the ground surrounded by a plastic lid. The babies have no cribs, so they lie on the same bed as their mom, which doesn’t even look like a bed. Yet somehow, the doctors make it work. All the healthcare is free, and the government is sponsoring a field study that Clementina is doing to collect maternal and child mortality numbers. We got to sit with her while she instructed the doctors and nurses what to do in different birthing situations, and we got to meet everyone that worked at the health center. In Utete, we went to a district hospital, one step up from the health center, where a 25 year old guy runs the entire maternity ward. This hospital was a little bit bigger, but served a lot more people out in the villages. We did pretty much the same thing here, observed, asked questions, and learned. The doctor at the health center had brought a new pulsometer (the kind where you put your pointer finger in the clip and it takes your pulse) and the director of the district hospital had never seen one before. This is how different the levels of technology and access to resources are. We want to figure out a way for all the hospitals to be able to contact each other if they are running low on supplies, so we are working on a communication network for them.

 

 

 

We’ve done a lot of different projects these past two weeks, and we’re wrapping everything up this week. The online nursing program is getting started, we are just lacking the support we need from the IT department here, so as soon as they are on board we are good to launch! Dr Jim and Barbara and Cynthia are applying for a grant in order to continue the program after we leave this time. Cross your fingers for them! Melissa and I are so happy that we got to be here and learn about how all of this functions. We are DEFINITELY planning on returning next year to make sure all of our plans work out. OH and we have official titles at HealthSpan now: Project Managers J

We’ve alsooo been having a littttttle bit of fun here and there A family friend of Jim took us out on the town one night to see the nightlife in Dar…it’s pretty much the same as ours haha We started the night at a local pub, then moved onto a bar, and ended up a dance club where we danced the night away…and part of the morning J We also got to go see two different movies! They have the same ones here as we do at home, so we saw Tin Tin (granted we had to bring our own 3D glasses, supplied by the same family friend) and The Girl With the Dragon Tattoo!

We go to this place called Shopper’s Plaza to add money to our phones every week, and instead of walking there, we get to ride in these weird  3 wheeled taxis! They’re something like a motorcycle with 3 wheels and a cover…kinda scary at first, but we always make the drivers go slow (except for when Melissa tries to say “faster” in Swahili haha)

 

 

 

 

 

 

 

 

 

 

 

We’ve gone to a few dinners with the staff at Mikocheni and HKMU, everyone is so nice its really amazing. They barely know us and invite us into their homes for dinner! Last night we basically attended a family reunion at one of the nurses homes, but it was like we belonged there! We have one last dinner tomorrow night at Mama Kairuki’s house, and then one last weekend with Jim’s family friends, and then we’re off!

We’ve decided to change our flight to move on to the next leg of the trip since we got so much done over these three weeks! SE ASIA here we come!!

First Day in Dar: Heat, Heat, Heat!

1/1/12 “so…it’s like the future!”

Today was the first full day we had in Dar es Salaam! Talk about hot!! Probably around 90 degrees in the sun with probably 100% humidity, but we still had a fantastic day! We arrived yesterday at around 4, where we met Mama Kairuki and Karoma. Mama Kairuki is the wife of Hubert Kairuki, who died a few years ago.

She is now the matriarch of the family, and owns and operates Hubert Kairuki Memorial University (HKMU) and Mission Mikocheni Hospital (MMH), where we are going to be based this whole trip!

 

Karoma (so far both me and Melissa’s favorite person!) is called “Uncle” because he is a cousin of the family picked us up from the airport and brought us to our hotel where we are staying: the Pattaya Inn.

The hotel is…hot, stuffy, andddd pretty smelly until you get into the air conditioned rooms. We managed to ask for some air freshener (thank goodness! Heat + sweat + cigarette smoke = badddd combo) so they really aren’t bad at all. The women that work here know a few words in English, and were trying to teach us words in Swahili as we all attempted to make coffee this morning…that was an experience!! Imagine: coffee from home, boiling water on a gas stove that has a separate gas tank fueling it, filters but no coffee maker, and only plastic cups. Boiledwatercoffee it is!! There were four of us trying to help out, but Barbara mostly did all the heavy labor while Jim supervised and me and Melissa swatted away flies!

We are eating our meals at the hostel that is more like a dorm than an actual hostel. It is across the street from MMH and it’s where the students from HKMU live. We have an executive chef even.. His name is Justin! So far we have always had rice, then an assortment of potatoes, plantains, something-close-to-spinach, some chicken and fish (which so far we are avoiding since Dr. Jim does too!!) and then a really good sauce that goes over it all. All in all, its pretty good!! Just a little heavy on the starch side.

Karoma took us for a tour after lunch  today..We left around 2:30 and headed out to look at all the places surrounding us. We saw the slums of Mikocheni and Msasani, as well as the suburbs of those towns…what a difference between the two.

Not only does the entire city of Dar es Salaam only have a few paved roads, but the slums were really affected by recent floods, so the streets are currently allll mud. The few cars that pass through (because EVERYONE WALKS EVERYWHERE)  are forced to risk the mud on their tires and getting stuck. It was extremely humbling. Dr. Jim told me once “When a Tanzanian goes to America they are overcome by plenty. When an American goes to Tanzania they are overcome by emptiness. There is no infrastructure, sanitation, education…the people make do with what they have to survive and seem generally happy, but it opens the doors to what we as HealthSpan are doing and can do in the future. It’s exciting!

We drove past the fish market and by the resorts on the beach, snapped some photos of the gorgeous view, and headed to the downtown area.

Karoma stopped at a corner, got out, and bought us all mango and coconuts fresh from the vendors…so good!!! Im not usually a huge fan of mango personally, but I cant even begin to tell you how sweet this was!! It was like I could taste the sun in my mouth!

We stopped at the Double Tree Hotel right on the coast to see how the vacationers live and to watch the sunset go down. It was so pretty looking out over the Indian Ocean, sitting in the sea breeze, basking in the calm before the storm (metaphorically of course…tomorrow is our first day!) We caught our breaths and a second wind from the cooler breeze and headed to dinner at a place called the Arizona Grill.

This is where I started to truly get a feel for the types of projects we are doing this trip and in future trips to come, and when I truly got  excited. The Kairuki family is an extremely prominent family in Dar. Mama K runs the hospital while the five children she has are all doctors or lawyers in the community or studying to become a doctor or lawyer abroad. This made for a fabulous dinner. Three of the Kairuki children came. They are all SO NICE and inviting! It’s like we’ve known them for years instead of only two hours. We all chatted, combining friendly chit chat but also serious inquiries into the kinds of work we will be doing this trip. Clementina, the OB/GYN and Deputy Director of MMH will be taking me and Melissa out into the villages to see how the  healthcare system works and open our eyes to the way she and her staff work. But everyone was just so excited it seemed, especially Dr. Jim. He is “home” and has brought us with him to introduce us to his second family..We’re both so grateful to him for letting us come!!

Another bit of good news: I survived the day without a single mosquito bite! Score!

A Night in Dubai: 16 Hours of Luxury!

12/30/11

From the moment we got on the Emirates flight, the United Arab Emirates and Dubai have been synonymous with “extravagance.” The all-inclusive flights (including all-you-can-drink wine, beer, and hard alcohol), beautifully designed traditional women steward’s uniforms, actually delicious tasting airplane food that left you really full, constantly being called “madame” despite being dressed like a gross hippie, beautiful shop windows decorated with gold and diamonds, and the TALLEST building in the world right next to the best “dancing fountain” in the world are just some aspects of Dubai that SCREAM luxury. And even though Dubai’s prices have significantly dropped since it was first being built, the prices for most things are still pretty high, or at least about the same as American prices would be.

 

We arrived at our free layover hotel around 8, ate our free buffet dinner and left to explore the city at like 9:30.The first cab driver we got was from Pakistan and was adamant about giving us an AMAZING cab ride. This translates to him blasting Rihanna and Nikki Minaj while dancing his butt off and zipping around the corners leading to the Gold Souk (jewelry market). After leaving this area, we waited for about two minutes before Melissa jumped into the street for the next cab despite the line of about 8 men waiting for one at the same time..needless to say we got picked up first J We went to the Burj Kahlifa (tallest building) and toured around the Dubai Mall, met some awesome people from Egypt and chatted with them about traveling/culture/coldplay for a while before heading to a café.

Best part about Dubai: smoking shisha (one of the three words we learned in Arabic during our sixteen hours…meaning hookah), eating roasted nuts, drinking a cocktail, and listening to all the conversations around us while basking in the idea that our trip had ACTUALLY started. We were off to Dar es Salaam the next morning to get settled in! Much love and more to come.

Here we go!

Today is the day! Our flight is at 3:45 today, we fly to Dubai and stay overnight and then on to Tanzania on New Years Eve.

What I’m bringing:

 

Deuter 60 + 10 Liter Backpack
3 skirts
2 pants
6 shirts
socks/underwear
sarong
Merrel’s (merkels? )
Tennis Shoes
Rainbows
Scarves
Hat
Hippie over-the-shoulder bag
SE Asia Train routes map
Electronics
Protein Bars
Toiletries
Kindle
iPhone
bug spray!

This is going to be a crazy challenging exciting adventure unlike any other that we’ve had. Wish us luck and check back for updates soon!!

T-Minus…

T-minus 29 days until departure!

Country List:
United Arab Emirates (16 hour layover)
Tanzania
Egypt (12 hour layover)
Malaysia
Thailand
Cambodia
Vietnam
China

We’re creating a bucket list of things to do/places to see!!
first on the list: the world’s tallest building in Dubai: Burj Khalifa.

Follow Melissa and I on our adventure!