Tanzania in a Flash

The Journey Home...

(Pictures to be posted later)

10 September 2010 (Friday): Its official the Muslim Immams saw the moon last night officially ending Ramadan. Now our Muslim friends, co-workers and staff can eat with us which makes for a much more enjoyable meal. Now breakfast is full of people, conversation and stories – quite interesting.

I had my exit interview with the CCS staff, well sort of an exit interview. I had filled out a questionnaire about what my role was at my placement, what resources did I use or need to complete my job, what else needs to be taught or completed that future volunteers could help with. I thought we would review my answers and clarify if needed. Nope. They asked questions about my placement and what had I learned from this experience. Well this takes some thought and consideration – not something I can answer so casually. But now I have had some time to think, to respond…

From my placement at the nursing training center I learned I can be quite resourceful in finding a way to teach complex systems and issues that I do not absolutely have to have a computer and technology to teach, (though it would have been a lot easier!). I learned if I was patient, listened and watched my students I could find ways to engage them in the learning process that didn’t cause them to lose face, embarrass them – gave them opportunities to shine. I role-modeled to the faculty, students can learn and have fun at the same time. I hope both the students and faculty have seen the only way to learn is not just rote memorization particularly with complex issues and topics like anatomy and physiology. And I hope the students understand the value of studying together, asking questions, practicing their English. For the students on the wards, I hoped they learned part of their patient assessment has to include asking the parent how the child is doing and what their concerns are. I encouraged them to put aside their own discomfort and reach out to the mothers who lost a child to disease or injury with some words of comfort or encouragement.

One of the things I think would be useful someday is for the students to have to do some sort of community service time or a project. One of the areas where I helped was a place called UKUN, an AIDs support, treatment, mentoring and education center. Multiple home visits are performed to help persons with AIDS stay on their medications, supporting the individuals with encouragement and education. This would be a perfect place for students to volunteer not just to learn but to help educate the public, particularly in the school programs about AIDS prevention and treatment. Another place the nursing students would be valuable would be to teach home safety regarding open fires and injury prevention. We saw far too many young children come into the hospital with terrible burns which could have easily been prevented. To be taught by the nursing students, would not only help them in their future dispensary placements but also benefit the community at large.

I was and am impressed at how the staff on the pediatric ward or for that matter the whole hospital could accomplish such good care of their patients and families with such limited resources. I am impressed that the children of Imuma orphanage could find daily joy from something as simple as a cloth ball to play soccer with while not knowing where their next meal was coming from. Amazed at people afflicted with AIDS could find such joy at a brief home visit from a stranger. I was totally amazed by the how hard everyone works in such austere conditions but still find life so gratifying and joyful. People on the whole were so generous with their time, resources and food, no matter what the socioeconomic level. As a whole the Tanzanian people have a thirst, a hunger for knowledge like none I have seen and are grateful for anything that they have been taught and anyone who can teach! Even the word for teacher, Mwalimu, sounds like a word of respect. I am grateful I have been able to impart some my knowledge in some small way to so many people in such a short time.

In the afternoon, my friend and colleague, Veneranda stopped by CCS home base for a little visit. She shared with me that the students were going to miss me and my style of teaching. We brainstormed ways to get the students involved in the class instead of just being recipients. I suggested each group of students make their own flash cards of the topics they presented and use those to quiz each other in class and to help with their studies. She thought this was also a good way to see what areas students were having difficulties understanding and how to re-aim her lectures to improve their understanding. We had a great time talking about some of the stronger students and using them as natural leaders to help everyone have a better learning experience. We talked for so long, it was nearly dinner time before Veneranda departed for her home about a mile away.

Veneranda’s English was probably the best out of the faculty and staff I had to work with at the hospital except for maybe the doctors. So it was fairly easy to have a nice casual chat with her. She shared with me she will be retiring in about 3 years and it would be an honor if I could find a way to return and teach with her again. I can’t say I haven’t thought about it. It seems like I barely got here, established some rapport only to have to leave. It would be great to return while the current students were still in their program to see how they have developed and how my part in their education has affected them. Veneranda suggested I return when the current students were in their maternal/newborn rotation sometime near next May or so. That may be a little soon for me financially, but it is something to think about. And then maybe in the interim I would be able to get more information and supplies to teach the “Helping Babies Breath” program if I were able to return.

I do not know what kind of “wash-out” rate the nursing program has or if “failing” or “quitting” the program is even an option but it would be interesting to see how many are making it and how they are preparing for their placement out in their communities. What would be great (I know this sounds a little grandiose) is to visit students once they graduated and were assigned to their village dispensaries to see how everything is working out. I know I would not be able to visit all over Tanzania but it would be a great experience to at least to visit the surrounding villages and their dispensaries – maybe…someday… who knows.

Since Friday was a holiday, none of us had to go to our placements. But that meant extra time on our hands so all of the volunteers and a couple of the staff headed down to Imuma orphanage to play with the children. These children are so hungry for human contact, attention and love, they don’t care when or how long you can stay. They are genuinely thrilled to see us, any of us or all of us. They are always dirty and most only have one pair of clothes to wear but their joy and love blinds you to their situation. We decided to take them to the beach. We had about 30 of the 50 kids who come to Imuma in our little walking caravan. It was like a parade – fun!

When we got to the beach the kids ripped off their clothes to dive in amongst the waves fearlessly! It was exhausting, hilarious and gratifying on my last day to partake in so much happiness. After about an hour, we were able to scrounge up a van to help take the kids back to the orphanage. Everyone was exhausted. I still needed to pack and now get cleaned up so I headed back to home base ahead of the others. Had a quick shower, clean clothes and our usual afternoon snack of popcorn. Wrote in my journal and started the process of packing.

My goal was not to take back everything I brought with me. After all, what the heck was I going to do with skirts at home! So even though we are forbidden to give gifts directly to individuals or organizations I could leave supplies and clothes with CCS to be dispensed as education supplies or to individuals in need. Many of my preventative meds and first aid supplies I gave away to the existing volunteers. I managed to lighten my bags quite a bit. I was able to make room for the painting I bought from one of the local, young artists, my spices from Zanzibar, my kangas (which will someday be placed in a quilt, I am sure!), a couple small carved wooden statues and bracelets made by the children of Imuma.

The bracelets are a way for the children to raise money for food and school supplies. Sherif, their caregiver splits the money between the child who made the bracelet and the orphanage. Sometimes the only money they have for food is what they earn from selling bracelets. They seem to make ends meet most of the time. On occasion one of the CCS volunteers will help them develop a fundraiser to help bring in money for operating and growing the orphanage. One of the fund raisers was selling bookmarks drawn by the children on one side and the story of Imuma on the other. I suggested when the children are interested in creating more bookmarks I would be happy to sell them in the States to help raise funds for their needs. Hopefully, before the end of the year they can get them sent off to me as I think this would be a cute stocking stuffer for many families while also helping children in need at the same time.

11 September 2010 (Saturday): Today I leave. Sad. I get up early, have breakfast. Everyone is already talking about their plans for later in the week. I will be gone. Not a part of their activities plans or lives anymore. On the other hand I am a little home sick for Tillamook cheddar cheese, and good chocolate and of course Diet Pepsi but most of all to sleep in my own bed – aaahhh!

Everyone is coming with me this morning. A trip to Dar is too valuable to pass up. So Claire and Michael have decided to come along to spend the night in a hotel to enjoy hot water, flush toilets and room service and a bed big enough to sleep together. Hope they have a relaxing weekend. Sarah is coming along to have Didase help her with fixing her modem on her computer or some such gadgety thing. Elias drives as usual. On the way to Dar we pick up Didase at his house – a darling little oasis in new area of Bagamoyo, on the outskirts of the village.

It was kind of fun to have everyone join me on my trip – kind of like a send off party! We made good time to the airport – actually got me there 3 hours before my flight! I was whisked along with my bags to the check-in counter which involved going through a security scanner with my bags and me. I had to say good-bye to everyone here. I almost sobbed but I was brave and went on by myself anyway. I was missing everyone already! I didn’t realize once I was through this first layer of security, I was stuck in the airport and could not leave to go get money exchanged for US$ or do any last minute shopping. I thought no problem, I will get my Tanzanian schillings exchanged in Qatar. So mistaken, the exchange in Qatar, New York and Salt Lake City only exchange the major monies of the world like Euros, dollars and such. So I made it all the way back to the US with all of this useless money- darn! I briefly thought if I ever return I could use it then but not likely as their big national elections are coming up in October and more than likely their money will change – oh well…

I had decided to ask for assistance at the airline desk as my friend, Joyce (the friend I had made on the journey here) had advised me to do. The stairs to get on and off the plane in Qatar were terrible and unsafe and the very long terminal to walk and haul my stuff was exhausting. I decided to swallow my pride about being such a whimp and go ahead and ask for help. Well I guess one can not just ask to have some help getting on and off the plane, one must accept help from the moment at check-in to the final disembarkation. I thought okay, it was better than getting all over-tired, short of breath and edematous – so okay! So my assigned porter, Mbende, insists I sit in a wheelchair to “assist” me. And off we go. He parked me at the café while he continued with his “porter” duties. I lowered my standards and had a Diet Coke along with some fries. Mbende returned to take me to my gate where I had to go through another security area but Mbende made me stay in the wheelchair. Hands swarmed around me helping me off with my shoes, my purse, my carry-on supplies to go through the x-ray machine. And then the wheelchair and me were rolled through the metal detector (mmm…something is wrong with this picture)? A very polite, young Muslim woman security person patted me down everywhere and then I had to explain all of my meds in my carryon. Thank goodness I had decided to keep them all in their original containers otherwise they would have chucked them!

When Joyce and I had landed here in Dar Es Salaam, there were several people who needed assistance which made it easier for me to ask for assistance leaving the country. Kind of like safety in numbers. This time I was the only one! Well needless to say I felt a little self-conscious. I mean I was physically able to walk I just did not have the endurance to do everything by myself or deal with the stairs in Qatar. Oh well, there I was the only person in a wheelchair ready to be loaded. I was loaded first. Mbende warned me even though it was my heart that was weak and gave me poor endurance he said to say it was my legs that were weak. Okay… So by the time I was loaded on the plane I had been sitting nearly 2 and a half hours in this darn chair – I was so stiff I did not have to “fake” having weak legs. The flight attendants were very nice and checked on me often to see if I needed anything or any assistance. I felt like I was in first class!

Made it to Doha, Qatar on my short flight of 6 hours. The elevator truck came to pick me up (so I didn’t have to use the stairs) and took me to the terminal. My assigned porter, Mukess, a young man from Nepal, picked me up from the truck in yet another wheelchair and escorted me through the airport to get my hotel voucher, transient visa and passport control and customs. Because I was in a wheelchair, I was taken through an express line, an unexpected benefit. Mukess stayed with me until I was safely loaded on the shuttle to my hotel. The hotel was equally accommodating! They “helped” me to my room and to the restaurant. Being a Muslim country and Ramadan over, the food was fabulous and everyone happy (no more fasting). I had a great time. Not to mention the hotel was only a month old, modern and fabulous. My shower had 3 showerheads – all with hot water!! Aahh – I was in heaven! I slept so well! And so clean, too!

 

12 September 2010 (Sunday): The next morning I was greeted with another “assistant” to help me to the airport where I was passed off to another porter, Muhommad, who escorted me through all of the security, passport control and lines which went much easier with his assistance. Since I was USA bound, the final security scanner we went through before boarding the plane, I did have to get out of the wheelchair. Gladly, I was beginning to feel imprisoned. My feet were a little puffy from the flight the day before so it took me a while to get my shoes back on. The porter on the other side of the security scanner saw my frustration and went and got me another wheelchair – very nice. This time there were about 20 people who needed assistance so I didn’t feel like I was so obvious. Some were walking with canes, some in wheelchairs and I was the only one who was young – okay so I was a little obvious. We all got loaded onto the elevator truck to get loaded into the airplane. The airplane was jammed pack full. Lots of Indian families and young people heading to the States for college. The families had young children who obviously had not learned about using their indoor voice yet! OMG, one child had the highest pitched, piercing yell and cry! By the time I got to New York I felt like I had shock therapy. Every time I started to fall asleep, this child would screech or yell or cry at the top of its lungs --- aaahhh! This is a case where some sedation would be recommended, encouraged or even mandated! No such luck!

Each seat had its own screen for movies, TV or games. I played everything, watched 3 movies, all of the Friends episodes loaded, all of the Fringe episodes, all of the CSI episodes. Between the screaming child and being glued to the screen, I was fried after 13 hrs of flight by the time we reached New York! At JFK, they had regular walk-ways to get off the plane so I deferred “help” and made the very long walk on wobbly legs to the baggage claim area. I waited about an hour for my luggage to come through – OMG – if I had known how far I would have had to walk and how long I would have to wait I would have reconsidered declining help! Made it through passport control and customs unscathed. I landed at Terminal 4 and had to catch my Delta flight at Terminal 3. JFK is much easier to get around than say 10 years ago. They have a nice little connector train from terminal to terminal. So I sprung for a luggage cart, loaded up my stuff and headed for Terminal 3. Helped some lost people along the way, a lost child, an old person to the loo and made it over to Terminal 3 with plenty of time to spare or so I thought. I kind of had forgotten how much time I spent waiting for my baggage so I really had only about an hour and half before my next flight instead of the 4 hrs I thought. Oh-oh…

I scanned my reservation number and got my boarding pass and decided to spring for curb side check-in. While I was standing in line, the curb side porter’s computer went dead all of sudden. Well no computer, no check-in. The line was huge inside. Now my time was beginning to crunch down. Still calm, I asked if I could help. I suggested if the power was suddenly lost and everything else was working in the area it suggests that maybe his computer became unplugged. There was really no way to get to the back of the computer to see so since my hands were small I offered to feel around. Feeling around, sure enough the power cord had become unplugged from the back. I took off my bracelet, my watch and my ring and shone my flashlight along the back and was able to plug in the computer. By that time everyone else waiting in line had disappeared – too impatient to wait. The porter thanked me profusely and checked both of my bags in for free in return for his gratitude! How sweet! With this nicety I felt re-energized to get through TSA line and find some real American food. Off I went to look for a sit-down restaurant, found one at the opposite end of the terminal from my gate.

Okay, I thought I had a bunch of time. It took awhile to get waited on, then served and then to pay my bill. I shopped casually on the way back to my gate. Wondered in and out of duty free and headed towards my gate. As I approached the gate the sign flashed “final boarding”! Oh no, how had I miscalculated the time! If I had dinked around any longer I would have missed my plane! I got on board, we weren’t full so had my aisle seat without being crowded for the last 6 hrs of my journey. I was exhausted. Slept most of the way. Since I was coming in so late, basically the middle of the night, I had elected to take a cab home. My cab driver, Ali, from Somalia, was thrilled I had traveled to East Africa and was loaded with questions about my experience. We had a delightful conversation on the way home. He graciously waited at my door with the lights shining on my locks so I could see until I was safely in the house. Very nice.

I was home! Yeah! I took a shower (hot water)! Got in my clean jammies! Slipped into my sleep number bed (I am a number 55) and put the head of my head up, hooked up my oxygen and turned on the TV. I do not remember a thing after that – I was promptly asleep about ten seconds after I turned on the TV. About 5 in the morning, I flattened my bed and turned off the TV and went right back to sleep glorying in the end of my fantastic journey to Tanzania.



On my long flight home I have adjusted my values from what I learned from experience in Africa:

• Refrigeration is for sissies

• If you can't ride a bike with at least one live chicken, a door, or two other people, you can't really ride a bike

• If the only thing that you can balance on your head is a hat, you're wasting precious space

• Besides food - all one really needs is a bucket and a kanga

• Narcan is a luxury!

• Speed limits are for Westerners

• "Clean" is a relative term

• If you really want chocolate, but it has ants on it, one quick blow will clear that right up

• Consistent, reliable electricity is for wusses

• If you're not sharing your room (and maybe your bed) with at least one critter, you're not in Africa

• When one is really desperate, Diet Coke will do.

• Three marriage proposals by complete strangers in the span of an hour simply means that it's Tuesday

• Why bring dead people back with CPR? They’re dead.

• Goats and chickens have right-of-way in the road. Humans? Not so much.

• A steady diet of carbs with a side of carbs is completely sustainable.

• It's normal for children to run out of houses and down the road toward you at full speed...then fling their arms around you - even if you've never seen that kid before in your life.

• Shower curtains just get in the way...a shower not only cleans you, but the rest of the bathroom, as well.

• Running water next to a toilet is no substitute for toilet paper!



I hope you have enjoyed sharing my experiences with you. If you have any questions about my trip or how you can get involved with Cross Cultural Solutions or have any suggestions for fund raising for Imuma orphanage, feel free to email me at kaykayem@juno.com.

Thanks for your interest!

Final Week Already!

5 September 2010 (Sunday) The ride home from Mikumi National Park was anticlimactic and fast. Joshua, my guide was anxious to get me back to home base so he could get back to Dar Es Salaam, his home so he take a shower in his own place, eat his own food and sleep in his own bed. Mmmm…that is the same thing I want to do but all the way back in the good ol’ USA, not just CCS home base. We drove one more time through Mikumi to sort of say good-bye to the animals that had given me such a fabulous experience the day before.

The watering hole where the elephants bathed that I inserted in the previous weeks post was totally dry. I guess between the heat of the day and all of the drinking, the water was gone. No more Hippo lounging in the water. Just empty and all the animals gone, kind of freaky.

I asked to stop at the lodge where we had eaten lunch the day before (inside the animal park) to see if the gift shop was open. My fellow volunteer, Claire and I have been looking for post cards to send her grandkids, everywhere! None. After all it’s not like the village of Bagamoyo is a hotbed for tourists. So I figured since all of game reservations are “tourist-type” places then maybe they would have postcards. Yeah! I scored. I bought 3 postcards for Claire and one for a souvenir for me. Of course I had to shop in the gift shop as well but it truly was just “touristy” stuff. I had seen many types of baskets at vendors alongside the road on our trip to the park. My friend Susan collects baskets from all over the USA and the world, so I did find one made in that region of Tanzania to give to her. As I mentioned, Joshua was in kind of rush to get home, so I was pretty sure I would not be able to get him to stop at one of the roadside vendors and then wait for me to haggle down the price in my broken Kiswahili so I made the purchase while I could.

 

As we exited on to the main road heading out of the park, 2 gorgeous giraffe crossed the road right in front of us, saying good-bye. It made my heart sing to see them so close. They had barely cleared the road then a speeding bus went barreling by, just missing the heels of the 2nd giraffe. Ahhh! Creeps!

We did stop for food about 2 hrs into our trip back to Bagamoyo. It kind of looked like a cross between a truck stop and tourist trap greasy spoon. The food was okay. I thought great, I can use the loo while we are in a structure that might have a toilet rather than pulling alongside the road to take a pee. I don’t know what I was thinking – a toilet! In the middle of a desert – Ha! Nope just a pit potty and me in pants! So I hitched my pant legs up to my knees to avoid cross contamination with previous visitors deposits and managed just fine. Yeah! I don’t mind using pit potties when I am in a skirt for obvious reasons but it is a challenge in long pants. Enough of my potty adventures.

Back on the road again. The time went by quickly. The last hour of the trip back to home base was on a “short cut” on questionable roads. Let’s say I would have preferred to have had a sports bra on for all of the jarring and assault from this road. It did make me glad to reach CCS home base!

 

6 September 2010 (Monday) Today’s course content was to review what was presented last week by myself as well the student presentations. Remember they learn best by repetition. At least this time all of my flip charts and lecture notes were already done, so all I had to do was review the content and then get to my favorite part asking challenging questions!

I had picked up the lecture notes turned in from the student presentations from the faculty office as the list of students for each group was on the lecture notes. Ah-Ha! Now I could call out the names for each group to know exactly who presented and which questions I could ask them and feel relatively confident that they could answer without losing face. Great!

Needless to say this was much easier on me but I think very stressful for the students. I did want them to be held accountable for the content they presented by being able to answer questions on the topic their group was responsible for. I wanted to make sure it was not just the speakers that knew or understood the content but their whole group. And in turn by repeating information known by the individual groups teaching the remainder of the class the content as well. So I had everyone in the first group stand up. Slowly and painfully I finally got all 8 members to stand. Then I started out asking questions, almost too easy of questions. No one was answering because they could not believe the questions were so easy – they thought I was tricking them. Not so! So I made the questions a little harder. One timid little hand at the back of the class room volunteered to answer the question. She got it right! Yeah! She got to sit down and be put out of her misery. Pheww! I asked 3 or 4 more questions of this group. With each answer they got a little more confident. So I allowed them to sit down. I moved on to the 2nd group. Now they were getting the hang of it – easy questions are asked first – if one answers a question one gets to sit down and hide in ones seat. So this time I had more ready volunteers to answer questions. But this time I didn’t stop with just 3 or 4 questions for the group, I made sure everyone had a question to answer. They did it! Yeah!

Group 3, had not listed their names on the presentation notes so I had the whole class stand up! Oh they hated that – being made to stand up. The classroom is 95°F, nearly 100% humidity, you would think they would beg to stand up and try to cool off. After much encouragement, they were all standing, listening intently for the question that would release them to the safety of their seat. I had a great amount of difficulty conveying the concept of diffusion of gases. I couldn’t decide if it was my English or the lack of their English or the way I was explaining it to them. So I kept trying different ways to demonstrate diffusion and then asking questions to check comprehension. I posed the question “What is the process of a gas in high concentration moving to an area of low concentration called?” Silence. I asked the question again. And just when I was starting to get a cramping pit in the middle of my stomach that no one was going to answer the question, 4 hands timidly were raised. I was smiling inside. One of the young men, Simoni, was first to raise his hand so I chose him to answer. In a very quiet voice he answered: “diffusion”? I just about did jumping jacks of joy! I told him to say it again, louder. He said it so loud I had to step back. I cheered and clapped. And said he could sit down. I looked around the room and saw that many others would have guessed correctly and said “if you had the same answer, you may sit down”. Nearly the whole class sat down! Good I think…

The rest of class session went much smoother with more questions and answers, building their confidence until it was time for tea break – time had just whizzed by!

When the students returned from break I brought out another way to quiz them – flash cards. I so wish I had done this sooner because it was extremely successful. I had been listening to the volunteers who teach young children and how successful flash cards are. So I thought I will make my own medical terminology, respiratory system, clinical questions flash cards. They loved them, so much that they wanted to keep my cards to use during studying. I said they must be shared with the whole class not just the person that held the cards. They agreed.

An interesting note of our routine, after every lecture the class leader would come to the front of the class with a notebook for me to sign stating how many hours I taught. She would write in the hours, I would sign. What I found disturbing was she would only log hours where I was actually presenting a lecture not the time I was asking questions or writing on the board or reviewing vocabulary. Hmmpf! I felt like all of what I did was teaching and some of the best learning on their part was when I asked questions. Oh well, it’s not like I was getting paid by what was in the book but it still bothered me.

In the afternoon, I was planning to go pick up my skirt from the tailor, Pili. Sarah, one of the other volunteers said she would go with me but she forgot and went after her placement instead of coming back to home base to escort me back down the road. I had only been there once with Claire and was not sure which turns to make in Pili’s neighborhood to get to her house so I didn’t go. I get too tired in the heat and humidity to be wondering around in the wrong direction. I had wanted to wear my wrap-around skirt to the last day of classes the next day. Oh well, maybe I can wear it during clinical later in the week.

I think I was still quite tired from the busy weekend at Mikumi, and everyone else seemed tired too, so I laid down for a short nap. Ahhh…sleep…then all of sudden, doors slamming, building alarms gonging – what the heck! The alarm technicians had finally shown up from Dar Es Salaam to fix the short in the security system. Oh for Pete’s sake – I thought it was fixed! Nope, the guards just had not been turning on the alarm at night. Just locking us into the house after we went to bed and unlocking everything before we got up. Kind of scary, to be locked in and no fire department if we caught on fire. But oh well, I guess we could have pushed the mosquito screens out of windows to climb out if needed. So no nap!

I got out my little laptop and fixed up my lecture notes so I could finalize the files and store them on the CCS home base computers for future use if needed and to make hard copies to give to the school. I could print one copy at CCS but if I wanted more I needed to have them copied out in the community. The internet café near CCS did not have a working printer so I asked Sarah, where there was another Internet café. She told me near CCS Summer house. During the Summer when there are more volunteers than can fit into the home base house or home base and the annex across the street (where we were staying) then they open up Summer house down the street about 4 blocks. So Sarah walked me down to Churchill’s Internet Café for my printing needs. What a nice young man! He had a printer but it was not a copy machine. So each copy had to be printed one at a time, very tedious and right in keeping with TFT (Tanzania Flexible Time) – after all “this is Africa!” The electricity went out in the middle of my print job so we talked awhile to see if maybe the electricity would come back on. Churchill is originally from Kenya, hence why his English is better than most I had met so far in Bagamoyo. But he admitted his Kiswahili was not very good. He said in Kenya they tend to speak more slang and in Tanzania they speak “proper” Kiswahili, but he was learning. So we spent some time quizzing each other. The electricity returned and he resumed printing my materials, one page at a time.

By the time I was done it was nearly dinner time and the sun was setting. We (volunteers) are encouraged not walk alone nor walk at night. If it is dark we are to catch at Bajaj (a sort of a pedal cab) or an approved taxi to get back to home base. Well I had not brought my list of phone numbers with me and it was more light out than dark so I started walking back. It is considered rude to not say “hi” to people you meet along the street. As I walked back to home base I practiced my greetings: “Mambo”, “Hujambo”, “Harbari za jioni?”, “Mchana”, Most people responded with one word answers: “Poa”, “Jambo”, “Nzuri”, “Nzuri sana”, as they should. But there is always some young man who wants a longer conversation in partial English and partial Kiswahili that the ultimate goal in the conversation is to seek a relationship. Which just makes me walk faster. Hmmm, it’s the same all over the world, nothing new, it’s just tiring.

The remainder of my walk was uneventful. I watched children playing alongside the street and playing soccer in an open field of stones and dirt. The soccer ball was made out of cloth, left over remnants of kangas (a length of fabric used to wrap around the waist to form a sort of skirt) and such. How adaptable kids are! I finally made it back to home base for another great meal and relaxed.

7 September 2010 (Tuesday) My last day of classroom time with my 57 students. I was little sad, still wondering if I have made a difference in their lives. I know I feel different but have I in some way improved their lives, their education by my short interaction with them? I may never know but I hope so.

The faculty had requested I teach CPR with a particular focus on bag-mask ventilation for infants, children and adults. My tools offered were two baby dolls, 3 self-inflated ambu bags and 2 masks. Everything had been cleaned up for my use but the dolls were not CPR manikins so all I could do was demonstrate position and troubleshooting airway problems. I had them return demonstrate airway position, opening the airway, face mask position and reviewed normal respiratory rates. We talked about chest compressions but they could not imagine doing CPR on anyone in the hospital and definitely not out in the community. If someone was dead – you leave them dead and get on with life. Not mean just a fact of life. So the question “why teach them all this?” begs to be answered. After all I was trying to teach an 8 hr class in 3 hrs and struggling with this concept of “why do any of this?” So off I went to the faculty office (a room next to the classroom) and asked “when would they use this information?” I was told that children are often inadvertently over medicated with morphine so one may have to provide manual breaths until either a reversal agent can be found and given or until the medication wears off. Okay good to know! Another clinical situation would be during surgery, if a local anesthetic is used or surgery needs to be performed quickly, there is not always another physician to manage the airway so a nurse manages with manual breaths. Can you imagine doing a whole surgery with only bag-mask ventilation! Exhausting! And flashes of my early transport years before transport ventilators were available having to give manual breaths during the whole transport. Back into the classroom again to reinforce manual breaths and what situations they would use manual breaths.

The last hour of class was spent on learning the Heimlich maneuver or abdominal thrusts to clear an obstructed air way. I had made a couple of posters reviewing CPR and the “Helping Babies Breath” program but ran out of flip chart pages to be able to draw choking and abdominal thrusts. But these young people have a fantastic memory so no worries. This was hilarious to teach as well as to watch! I think everyone was able to do it. While I was checking each student as I walked around the room, 4 creative students decided to get imaginative and create a Heimlich maneuver chain. One student was giving the next student an abdominal thrust while she was giving the same procedure to the next student. I wanted to take a picture because we were all laughing so hard watching the 4 of them all chained up doing the Heimlich on the next person. But they all seem to shy away from photos so no picture for ya – you just have to take my word it was hilarious! I was so proud of them for finally feeling comfortable enough with me to be silly and show off! Maybe I am making a difference…

We ended the class about a half hour early. We cleaned up and put the equipment away. I said good-bye to the class as a whole, a little sadly. But no one left, the students just sat there. I should have been suspicious. It was the last day of classroom time with all 57 students. I would have my 9 to 15 students in clinical but this was the last chance to see the group. I was a little sad that they weren’t a little more involved with saying good-bye. So I was feeling “poor pitiful me”, my students don’t even want to say good-bye to me. I went into the faculty office to give over my copies of lecture notes for their files, and have a mini exit interview. Again I should have been suspicious; all of the faculty were in the office including the principal (I never saw them all in one place before). I told them all the equipment is put away and was going to go stand outside for my ride back to CCS. They said wait. Okay….

Veneranda had gone to the classroom, still filled with students. She was speaking to them in Kiswahili so I didn’t know what she was saying but I heard “Kwa Heri” (good bye) and “Madame Krist” (for some reason many people would shorten my name since I was not Kristina and they didn’t understand it was Kristie and just shorten to Krist not pronounced Christ!). Then she came out closing the door behind her and I hear laughing inside. She pulls me back in the office and we chat with the principal. Mmmm…its chit chat, I think I am being kept here for a reason. Then we all head back into the classroom and the students start singing a good-bye song to me in English and Kiswahili! These quiet, docile students are rockin’ out for me! I loved it!

The class leader stood and said a formal good-bye in her very rehearsed English. Very sweet! Then another student had written a song to say good-bye and thank me for teaching about the respiratory system, CPR, Heimlich, positive pressure ventilation, vital signs, etc. Amazing! Then another rocking out song – they had voices like a choir – it gave me goose-bumps! Fantastic! And finally some parting words from the principal, my mentor faculty member, Veneranda and then I was encouraged to speak and say my good-byes. I gave them words of encouragement in their studies, their education and for their exams planned for next week. I hoped that they got something from this experience – I know I did. They stood and clapped for me! Very heart warming. And when I thought the good-byes were over – parting gifts were brought out! Oh boy! They gave me 3 meters of batik fabric in my colors of royal blue, purple and mint green (absolutely gorgeous!) and another length of fabric with zebras all over (great!). The wrapping was an empty page from the flip chart (uh-huh(!) the missing page I needed to draw the choking poster on!) *grin*

The best compliment I could give them for my gift, was I immediately and genuinely threw the batik fabric around my waist into a makeshift kanga (wrap skirt). They loved that I loved their gift! I was warm and fuzzy feeling all over! Sigh….

I shared my day with everyone at dinner that night. Everyone expressed their sadness about my pending departure but that was still 4 days away so don’t say good-bye yet. I am seriously thinking of coming back some day. It would be great if I could swing coming back while this particular group of students are still in their program. Veneranda shared with me she would like to retire within the next 3 years, so that is something to consider as well, as we got along so well. Maybe…some day…

8 September 2010 (Wednesday) Today was another day on the pediatric ward. I was excited to go as now I was feeling more comfortable with the staff, routine, and my students. I knew Madame Veneranda would be making a surprise visit to start assessing what the students had learned in their first month on the wards. I was nervous for them but I was sure they would do well if they stayed calm. The week after I leave will be their big exam covering the whole semester. The students started firing questions at me in their franticness to remember everything they think they will be tested on. Thank goodness I was able to answer everything – eek! After all its been many years since I attended my first nursing classes.

We only had one patient in the whole ward; A child quite ill with malaria and severe anemia who was just finishing a transfusion. Most of the kids from last week had been discharged home and some had died. So with only one patient and 9 students, it was decided to clean everything in the ward; curtains, bed stands, beds, mosquito netting, equipment carts. One by one each piece of equipment was carried out side on the covered walkway between wards, water hauled in and everything soaped up and rinsed off. Once dry, each piece was returned to ward after the floors had been cleaned. What a process but very thorough!

Since we had CPR the day before I decided to review the emergency equipment available on the ward. There is one corner room which is air conditioned where equipment is stored and where admission exams and procedures are performed. We pulled down the emergency box, sort of like our crash cart, but in a giant tackle box and began reviewing all of the contents and what the purpose was for each item. While we were in the exam/admit room, my thirsty students asked if I knew how to operate all of the equipment in the room. Yup! (thank goodness) So one by one we reviewed each piece of equipment, how to turn it on and off, what it was used for, how to clean it after patient use, where it was stored, what types of patients would need this type of equipment, etc. While I was reviewing all of this, 2 new interns from England who were going to meet Dr Paul (pediatrician) to begin their orientation to this area came in the room. Thank goodness they arrived because many of the meds in the tackle box were British, so even though I could guess at their names and uses, it was nice to have them confirm I was guessing correctly. The interns elected to stay and listen to the review of equipment and meds, knowing they may have to use this room some day when they start working. They thanked me for including them in our review. And my students respected me a little bit more for sharing our knowledge with strangers. At least that is how I interpreted their behavior.

I left my students to head to my pick-up stop for Elias, our driver to take me back to home base. On the way to my stop, the Matron of Nursing, stopped me to see if I could stop by the maternity ward the next day to “go over” the “Helping Babies Breath” program. Helping Babies Breath is a modified NRP course for third world countries with limited resources. Dr Douglas, one the OB physicians had asked if I would teach the program to the midwives, L&D nurses and staff but Dr Douglas had been called out of town. I kind of needed him to reinforce whatever I taught. I told the Matron I would certainly try. As soon as I returned to home base, I zipped over to the internet café to pull “Helping Babies Breath” info. Finally found some info on a British website including a little poster showing the algorithm. So I went to my back-up internet café to print the one page poster so I could make flip chart page poster for the next day. Thursday was to be my last clinical day as Friday was to be a holiday, Eid al Fitr (end of Ramadan). I was little sad I would be taking time away from my students to teach another group of people but I was in Africa to teach as many people as possible so decided I should go ahead with this project. I promised my students I would at least stop by the pediatric ward to say my final good-bye.



9 September 2010 (Thursday) My last day of work, tomorrow is a holiday. I presented myself to the Matron (Aeisha) who in turn escorted me to the maternity ward. The nurses were still in report for change of shift. It had been a busy night. They asked if I could wait an hour or so before I did the in-service on resuscitation. I left to return to my students on the pediatric ward. They were genuinely pleased to see me. I told the Matron I would continue working with my students until someone came to retrieve me to teach in the maternity ward. She said that would probably be the best use of my time.

3 patients had been admitted overnight. More malaria and another burned baby. Ouch! My students and I got to work, taking vital signs, preparing for a dressing change and talking about complications of the medications our patients were receiving. They are so much more relaxed with me now, comfortable asking questions and doing some tasks independently. We were busy so I did not even notice the maternity ward staff never came to get me. I walked back over to the maternity ward before I left and everyone was busy with lots of mothers in various stages of delivery. I reported to the Matron I was not able to teach a modified “Helping Babies Breath” program. She told me since I did not meet my objective – I would have to return some day to teach. Maybe I will…

An interesting note about ID of infant and mother. When a mother is admitted to deliver, she brings 2 or 3 kangas with her (the wrap skirt fabric, I have mentioned before). Each kanga has 2 halves that are identical. When the mother delivers she cuts the kanga in half, she wears half and the infant is swaddled in half. So at a glance one can match up a baby with their mother by the color and pattern of kanga. Great! This is done in the pediatric ward as well. The mother brings sets of kangas so if her child is sick, swaddled or covered with a kanga, the mother wears the same thing so everyone knows who belongs to who. Colorful and efficient!

In the evening, the Imams saw the moon which heralds the end of Ramadan. So Friday is now an official holiday. Eid al Fitr. No clinical. No placement. No work. Sad, as I would have preferred to work up until I left.

10 September 2010 (Friday): Got to sleep in a little. So conditioned now, really couldn’t sleep. And my stomach woke me on the dot for some of that good CCS breakfast.

Packed my bags. Sorted out clothes I would not need back home to leave with CCS to donate where they see fit. Donated my remaining teaching supplies to the CCS resource center (where the volunteers get supplies to teach or train at their placements. Checked in on the internet or tried to for my flight but because my final destination is USA, I was not allowed to check-in on line. What a pain.

Mama Thea our Program Manager for the country of Tanzania took all of the staff and volunteers out for Eid dinner. We went to a hotel restaurant along the beach. It was quite windy but it was great to eat close to the water. There were a couple of craft vendors on the beach. Of course I can not pass up one more opportunity to shop. Took a look but nothing that interested me – ho hum…

We finished our lovely meal and all piled back into the CCS van, kind of looking like one of the local daladalas (minivans that get backed to gills with passengers going short to medium distances. Sometimes with chickens, children, men, women, bags, fruit, etc until everyone is overflowing out the windows).

The daladala vehicles are saturated with countless people. I never saw an empty daladala. Seats would be filled and still more would be loaded into the aisles, windows, tops of van. Daladalas house an array of people, with children in their school uniforms sitting alongside of business people in more formal attire heading out to their jobs, alongside Muslim women heading to market. The driver never seems to interact with the passengers, yet there is a conductor of sorts that hangs out of the open door taking exit requests and fare money. At every stop along the way whether for traffic or a stop, hands would protrude from each window offering peanuts, fruit and scarves from the nearest marketplace.

Various daladalas traveled in front of our home base but I never saw the same one twice. Everyone seems to know where they are going and which one to catch. It seems pretty efficient but a lot of chaos!

I watched the busy-ness of Eid celebrants up and down the street and realize my time is almost done. I wonder if anyone will remember me. I hope I can keep all of my memories, feelings, values I have gained from this experience intact. This blog helps. I wonder if I have made a difference for my students, the hospital staff, the orphans I have played with, the women I have crafted with and the CCS staff that will remain long after I am gone. I have been honored by my students, the NTC faculty, the nurses and doctors at Bagamoyo District Hospital and even passers by in the streets. I don’t know if any of it is real but it all makes me feel like a better person for coming here and interacting with another culture. Maybe I have made a difference…



Adventures of my 2nd week in Tanzania

30 August 2010 (Monday) My first day to start teaching to the nursing students at Bagamoyo Nursing Training Center. They are at the end of the first semester of nursing school. Today we started the end of their anatomy and physiology class with the Respiratory System. It was a struggle to provide a college level course with flip charts, hand written notes and some computer generated notes. I realize how dependent I am on technology when I teach with Power Point presentations instead of back to the basic tools but I managed. It is very time consuming to write, draw and detail everything on flip charts. I was so worried I would not be ready in time for class as I had limited access to the Internet with electricity outages and server outages. I took my little laptop with me that has a basic word processing with me to Zanzibar so that did help me get a lot done. I was lucky enough to find an unsecured server on Zanzibar to be able to pull some clip art into my lecture notes. When I was done doing my 4 lecture classes, I made copies for the faculty to keep on file along with the flip charts. But just in case faculty change or the notes get lost, their is a digital copy on the CCS computers under my placement. I offered to make a hard copy on a CD but they really do not have a reliable computer to be able to access it so that was the best we could do for them was to give the paper copy.

Around the classroom they have commercial posters of the various systems they have learned about during the semester. The nervous system, the gastrointestinal system, the musculoskeletal system, etc. A poster for almost every part of the anatomy except the respiratory system. So I got approval to send back a wall posters with the parts of the anatomy they do not have yet. Before I return to work I will shop the University of Utah medical book store and get those sent off so the students so the posters should arrive by the time they start their 2nd semester. I have approval from CCS and the principal of the training centre.

I admitted at the beginning of class that it was going to be a challenge for them to understand my English with an American accent. They agreed! And since the students are from all over Tanzania I would also have to take my time to train my ear to listen to their English with the various accents their tribal languages lend to their speech and pronunciation.  Working together we would hopefully both learn together. I encouraged them to ask questions whether it was related to the lecture topic, nursing or not. After all we are to be sharing our cultures with each other. They are so shy with me, quite fragile. I am a little nervous about pushing them with questions as I don't want them to lose face but I also want them to be interactive.

57 nursing students in one hot classroom!

Apparently the style of learning from Primary school on is rote memorization and learning info in particular order. Students have a great deal of difficulty answering questions out from the order of how the content is presented. The other volunteers who teach the younger students said the same thing about teaching the ABCs and 123s, etc. They can say what something is in English if you ask them in order but ask a question about the alphabet out of sequence and there is a problem. So at college level I was having the same problem. So after each lecture we would have a verbal quiz to help the students stretch their minds and check and see if they truly understood their readings and my lecture. At first verbal questions surprised them and stressed them but by the end of my time with them they were getting the hang of it - it became quite fun! The best help in this style of reinforcing learning worked best when I introduced flash cards. That way the students could read what I was asking and not have to deal with my accent - perfect! I finally got the students to be competitive wanting a turn at answering questions!

After placement, we (the volunteers) were taken to the art center. Dickinson trained us on making our own swatch of batik fabric, drumming and making our own woven bracelet. Great fun! The time went by fast. I met woman sewing a dress together for one of the kids without a pattern on a manual sewing machine. I had one of the artists speak to her for me about I sew as well. She just beamed a smile at me. So I asked if I could take her picture while she was sewing. Yes! At this artist compound there was the usual array of wandering chickens but these were blue! I thought well they do belong to artists that is probably why. But no, they died them so that predator birds do not recognize them as food! How smart is that!

                  

    

Hot all day long, wears one down and builds quite an appetite. Headed back to CCS for another fabulous dinner!

31 August 2010 (Tuesday) Today the students were responsible for presenting the details of the respiratory system. Monday I have presented an overview. The 57 students were broken up into 7 groups with me finishing up with the nervous system control of the respiratory system. Each group of students had 8 to 9 students. Most designated one speaker which was too bad because I thought I would hear from everyone. The remainder of the students must have contributed to drawing the illustrations to accompany the spoken part of their presentation. The drawings were phenomenal! Granted they were copying the illustrations from their text book but they were making them poster size - no easy task! Wish I had thought to take some pictures of some of their work but I think that would have embarrassed them.

I ended the class with more spontaneous questions about what they had just presented. It was still kind of a painful process but at least I was starting to get volunteers to answer! Yeah!

In the afternoon our cultural experience was to visit a traditional healers house / office. I was excited about this as I am always interested how the past health care influences the present. I thought it was quite interesting! So interesting I forgot to take a picture of the Dr Id. He is 74 years old and still a very active practitioner. Most of the younger volunteers thought of him as a little loco but one has to look past the verbiage used like "being made ill with a bad genie" is really the same as mental health can influence your physical health and wellbeing. So he not only treats the physical symptoms but is a counselor for the behavior or mental health issues that are contributing to their illness. I think he is just like conventional medicine just goes about it in a different way with age proved "herbs and medicines" instead of our scientific proved methods. He gets the same results, sometimes better!

Mama Christina our Kiswahili teacher

We have Kiswahili lessons for an hour 3 times a week for the first 2 weeks. I love languages especially when they make sense. I do not like learning the grammar though, I just want to be able to speak and get around and not be so dependent on others speaking English. We learned this week about time, numbers, etc but I think I explained that in an earlier post. Kind of confusing but at least that explains why there is sometimes confusion about what time we are supposed to be someplace.

Dr Ponza, pediatrician

1 September 2010 (Wednesday) I was dropped off at the Matron of nursing's office for her to take me to the pediatric ward to meet the staff and make sure I could find my way. Matron Aisha is quite a personable person. She is friendly and supportive but she can also be stern and directive when the situation demands. Her presence demands respect and everyone leaps to their feet when she enters the room. It was like I was in the military all over again!

            

Grace, Monica and Sara

My first clinical day with my students on the Pediatric ward. I am dreading this as well as looking forward to it. The hospital is very bare and basic but still have to deal with life and death issues. Its a good thing I have been in the military and have had to "make do" with minimal resources before and that I have a head for "figuring" things out. I figured there would be 3 or 4 students assigned to the Pediatric ward but no their were 9! There was more staff and students than there were patients! There was one patient recovering from pneumonia, another being admitted with pneumonia, 2 with slowly recovering from malaria, 2 with acute symptoms of malaria in the isolation area (due to diarrhea). Both the patients in isolation were severely dehydrated and nearly unconscious, very sad. The last patient was a little 2 year old with healing burns. Most family meals are prepared over an open fire with children playing near by. Very scary! One of the older children was pouring porridge from the boiling hot pot into her bowel when she lost control of the post and the whole pot of porridge poured down the front of this child. How painful! She had to go through painful dressing changes every day with only a little oral morphine to take edge off the pain. Apparently there is too many problems with respiratory depression if too big of dose is given so they tend to under dose. Sad!

I was a little overwhelmed with severity of the patients and how basic the conditions but they all seemed to take it in stride. My job with the students was to help them apply what they had learned in class to their clinical setting. So we got to work with practicing taking vital signs on each other, listening to normal then obtaining vital signs on the patients. Vital signs need to be recorded before the physician starts rounds. The physician mostly does sit-down rounds and has the mother bring the child to the desk. Yup with IV fluid, dressings and all. No poles for the IV fluid either. These are truly multitasking moms. They just sling the child up on their front or back and carry what ever is connected to them and sit down in front of the doctor. The doctor asked the mother if there is any improvement or concerns not the nursing staff! I kind of think it should be both! The doc will write orders in his or her notes and then one of the nurses transcibes the orders into a log book so everyone knows what needs to be done for the patients. That first day there was a lot to do for me and my students. We started an IV, drew lab work and helped admit new patients. One patient got to go home, which was exciting!

All of this done with a minimal amount of sleep for we had been woken up with the building security alarm sounding "whoop-whoop-wa-wa-wa-whoop-whoop!" At first security thought it was a cat or something on the fence but it ended up being a short in the system but that was determined after trying to reset it several times hence the little sleep! Another adventure in Tanzania...

2 to 3 September 2010 (Thursday and Friday): More time on the wards with my students. I thought I would have the same students but no some students rotated to afternoon shift and some rotated from afternoon to day shift. I thought how am I going to learn anyone's name if they keep changing who I am working with so I decided to take pictures of 2 to 3 students at a time and list their names so I could start learning their names. I did pretty good with this method which in turn helped me know at least a few of them by name in class. The students that I would remember their names would just beam at me. The men were the easiest to remember as there are only 9 men out the 57 students.

Sania, James, and Hadija

The little burn patient had to go through another dressing change and I was asked if I had any ideas on how to make it more comfortable for her - you bet! Its so much nicer to be asked than to barrel ones way into a situation dictating what needs to be done. After all who am I to say do this different when this is the way that has worked for them for so long. So I demonstrated how to soak the dressings off more thoroughly by squirting with a saline bottle than just splashing bath water up on her dressings and then I demonstrated how to layer the new dressing without lumps and to secure with ties instead of copious amounts of tape that made it eventually more difficult to remove the dressing (having the layers of tape not the way I showed them how to dress the burn). The mother could see right away that this was going to be easier on her daughter and she bowed to me and called me little mother in Kiswahili! I almost cried. The charge nurse I think respected me better as well because so far I had not shirked any task she had tossed my way. I felt very good about how the week was ending.

I do have to interject in my jubilation that there was also some great sadness. Every day there would be at least one child who died. So sad because it was often so unpredictable. It was not always the most ill child. I think the random death was one of the hardest things to deal with and sometimes interfered with my concentration on what I should be doing with my students. Extremely sad. The illness and death rate for children under 5 years of age is extremely high and unfortunately I got to witness this fact daily. The  mothers are fractured by the death. The staff seam to leave the mother to her grief rather than do any consoling. I don't know if this is their culture or is it because the nurses are pediatric nurses and do not know much about taking care of adults and adult grief. But it is my culture to give my condolences so on one child who had died just before I arrived for the day, I went to the mother and hugged her and said how truly sorry (pole sana) I was for her loss. She knew I was genuine and hugged my hand in response. I can still feel the wetness of her tears on my hand - so very sad...

Thursday afternoon we got to cook with our chef Chiku and her assistant Edna. We were allowed to pick a couple recipes we wanted to learn. I was tempted to decline and offer to teach some Mexican food but I really wanted to learn how to make Chipati (Indian flat bread but made the Tanzanian way). So I requested the Chipati recipe and experience and one of the bean dishes. Claire and Michael requested to learn one of the veggie salad type of recipe. We all worked together while learning. It was great fun! Just what I needed after a stressful day at the hospital.

Chiku, one of our fabulous Chefs



Michael (fellow volunteer) following the recipe



Yes they let me use sharp objects! Amazingly trusting!



Joshua, my personal safari guide





3 to 5 September 2010 (Friday afternoon to Sunday afternoon): Mikumi National Park Safari! I almost did not book this trip because I was exhausted emotionally and physically! But I called our travel contact Kennedy to see if he could book be a short notice safari. Yes! He came through for me! Since I was the only one going and only going for a short safari we had haggle over the price but finally came to a compromise. He would provide a guide and driver all in one and we would use his own car a 4 wheel drive Toyota. Worked out great! Joshua was my guide/driver. A very nice 34 year old young man. Being the only two together all weekend and on the long drive we talked about everything. Work, school, family, travel, languages, opinions, etc. I had a great time.

Smile Twiga!

When we reached the entrance to the park on the way to the lodgings, we saw all of the animals I wanted to see, giraffes, elephants, zebras, impalas, snakes (well I didn't really want to see that but we did), warthogs, and baboons! Amazing! I thought if I see all of this so close to the road right away what was I going to see the next day on entry into the park? Well it was even more amazing!! I saw lions, more baboons and tons of giraffes and zebras. But probably the very best was sitting at the watering hole watching the hippo and then the elephants come in to have a drink and a bath. Fantastic! They were so close I could smell them, hear them probably could have touched them if it had been permitted. I will try to put the video in of their bath. The elephant bath ended when the bull elephant decided we were too close and postured for us to leave by stomping feet and flapping his ears. So needless to say we booked on out of there! Thrilled with the experience!

Bull Elephant ready to charge!