I know this seems kind of backwards hearing about my first week of activities a few days before I leave but my time has been packed with cultural experiences, work at my volunteer placement and more. So this week I have a little free time an am trying to catch on my posting before I forget the freshness of the experience and before I can't read what I wrote in my journal! I hope you enjoy the postings. There will be more over the next couple of days as I prepare to return to the USA.
During the first week we attended different cultural experiences. One was visit to the Zawose family compound. They are a very musically talented family all from the same tribe and have traveled all over the world to show a taste of Tanzanian culture. I could not resist these young girls mimmicing their older counterparts. Way cute! Way talented! (Still working on uploading the video, some day)
22Aug2010 The first full day in Bagamoyo at CCS (Cross Cultural Solutions) Home Base mostly was spent recovering from our long journey the day before. We (the new volunteers) filled out our temporary resident permits that we basically use for ID instead of our passport. I have put my passport in the safe in my room for safe-keeping. With our resident permit we are considered residents of this country, we get discounts for being residents and do not have to go through the same immigration, customs hassles at train, bus and boat transportation as “visitors”. The cost for the permit was 120 USD. Money well spent for the benefits of being able to move around the country as a resident. The paperwork was returned to us all approved about 2 days later. Pretty efficient for something to do with the government in any country. But not everything here runs so smoothly or efficiently. We are slowly learning to adopt TFT (Tanzania Flexible Time) or it will drive you nuts.
Tanzania Flexible Time means you better be on time but for the local residents it can be ½ hour before the agreed upon time or up to an hour after the agreed time. So one must not schedule too many activities too close together or you will miss one. So I have relaxed, it is much easier to go with the flow than get all tied up in knots about the clock.
Oh, yeah that brings me to another adjustment the Tanzanian time is 6 hours off from the rest of the world and they only measure by 12 hour blocks. An example is the day starts with 0600 AM but that is not what it is called it is 12:00 in the morning, 0700 AM would be 1:00 in the morning and so on but we have to say a whole sentence to just to say the time but everyone seems to know what the time in the rest of world so they may say meet at 10:00 in the morning. In Tanzanian time there is no such thing as 10:00 in the morning so one would have to 4:00 in the morning if one meant 10:00 AM or if you talking about 10:00 o-clock Tanzanian, it would be either 10:00 at night (0400 AM) or 10:00 in the afternoon (4:00 PM). And of course this is all in Swahili so needless to say I learned my numbers in Swahili rather quickly if I wanted to know where I was going when!
23 to 27 Aug 2010 (Monday to Friday)
We started out the day with meetings. Learning a little more about our placements. Who our contact person would be and how we get to work. All of our placement contacts joined us for lunch so we could talk a little and make plans about how we could best serve our placement. I have been assigned to the Bagamoyo Nursing Training Center. The students I would be teaching are at the end of their first semester. As I will only be at my placement for 3 hours a day in the morning I would focus on teaching Anatomy and Physiology. Oh boy did I have to reach back in my memory on what to teach something so basic. And teach with no computer, no power point and where all of the students English is a second language. I felt handicapped. I was allowed to borrow a text book on anatomy and physiology, given a large flip chart write notes, and draw illustrations. This type of media reminded me of teaching Sunday School or Vacation Bible School. All I needed was some felt figures to stick up on the wall and I would have been set!
At first my mentor of the faculty from NTC, wanted me to teach First Aid and Triage. Something the students will be covering next semester. It seemed a little odd to teach content our of order from what was scheduled in their program. The next day I met the principal. He did not seem pleased with the idea that I would be disrupting this semester and the next by teaching content in the wrong order. I asked if I was not here what would be the content / subject material that would have been taught. What was already in their curriculum? Both my faculty mentor and the principal said they would finish their anatomy and physiology with the Respiratory System! Well perfect! Since I usually teach my graduate students ventilator management and I do know the respiratory system - I thought this was a much better topic to teach. Now to just tone it down to beginners with a language barrier without talking down to them and I was set. What a challenge.
The other challenge was the students had just started their first clinical assignment in the hospital and clinics on Aug 2nd, so they would not be in class every day. They would only sit for lectures on Monday and Tuesday and be at their clinical assignments on Wednesday, Thursday and Friday. So it was decided I would “help” mentor the students that were assigned to the pediatric ward & maybe the maternity ward. Helping them apply what they have learned in class to the clinical arena. I was a little hesitant about this because after our tour of the hospital and saw its lack of resources and technology I was not sure what I could teach them, mentor them about. But it has been great fun, teaching them how to take vital signs and the challenges of taking vital signs on children. I have started IV s and drawn labs, assisted with a LP and changed burn dressings. Demonstrated a more comfortable method for dressing the burns rather than taping all over the place. And unfortunately, I have witnessed the loss of children to malaria, AIDs and pneumonia. So very sad.
Health care, immunizations, health exams and illness treatment are free for children under 5 years old. Children from 6 to about 12 years can receive care with some sort of sliding scale payment system that I do not understand. But it looks like and sounds like many children do not get treated due to lack of funds or access to health care.
Price lists for a type of copay system. 1500 TSH = $1
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| Teeth brushing directions in Kiswahili |
Not everyone delivers their babies in hospitals though that is a goal particularly for first time mothers or mothers with health concerns. Another way to help improve infant mortality is to train birth attendants on newborn resuscitation. Many African countries do not have the technology Western healthcare has so the W.H.O. and AAP along with other organizations have taken our Neonatal Resuscitation Program and created a trimmed version for countries with reduced resources. The program is called "Helping Babies Breath". I talk about this a little more on my final week post. I mention this here to show the slide below on infant resuscitation capabilities in various African countries. It is amazing that there is such a disparity between "Western" healthcare and healthcare available in Africa - amazing that both can co-exist on the same planet for the same species. Maybe someday this disparity will dissolve as we humans evolve.
The unfortunate thing about my first week here was I was not able to start working with the students on the pediatric ward until my 2nd week due to some political who-ha having to get permission from the hospital administrator to work with students in the hospital. Same all over the world, got to get the head honcho’s permission before you can play in their yard. So my first week was spent preparing my lecture material (tons of flip charts). I am so glad I brought my little laptop with me to type out my notes and then go to the Internet café to print them or I would have spent a fortune at the Internet café using their computers!
My permission to work at the hospital finally was approved on August 25th. Too late to get started with the students so I was introduced to the Matron of the hospital and some of the doctors, given a lengthy, detailed tour and met a ton of people. Ahhh - so many names to try to remember. I tried to remember at least the names of the nurses on the pediatric ward as I would be working with them the most. I succeeded! The rest of the day on Friday the 25th, I spent observing in the maternal child clinic, well child and sick child visits, immunizations and weighing the children, plotting their growth on their growth chart. Interesting process. What seems like bedlam was quite organized and flowing. I wish I could have taken a picture of the whole process but I could not figure a way to respectfully take a picture so I didn’t.
27 to 29 August 2010 (Friday to Sunday)
My first weekend off! Of course I could not sit around and flake. I am half way around the world, of course I had to get out and see the sights and play! No matter how tired I am or was. So a booked a trip to Zanzibar, the major island off the coast of Bagamoyo. But no you can not leave from Bagamoyo one has to travel back to Dar Es Salaam to catch the passenger ferry to Stone Towne on Zanzibar. I was lucky that previous volunteers had already developed a relationship with a sort of an agent. So I called him. He booked a car and one of his employees to pick me up at the CCS home base Friday after work. So I scarffed a quick lunch and off we went. Anna, Kennedy's employee guided me through the port authority, bought my ticket and return, selected a legal porter to escort me through the ticketing and boarding. I was booked in first class (yeah!) which has air conditioning, just lovely! Movies and video clips were played on the 2 hour ride over to Zanzibar. If you have any tendency towards sea sickness be sure to bring Dramamine or your drug of choice. The ride over was not too bad because the boat was so big but the ride back to Dar Es Salaam was horrible due to the turbulence. I even got a little queasy on the ride back and the person behind me barfed (at least it was in the bag) – gross!
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| Juma, my Zanzibar guide |
I was met at the dock by another of Kennedy's employees or partners, Juma and his driver Malik. Very nice young men. Picked me up and whisked me away to the village of Kwenda where I was booked at Sun Set Bungalos. The whitest, softest sand I have ever seen. Unlike many other areas I have traveled recently remarkably clean! And the very best a hot shower!!!! What a glorious feeling!
I brought school work with me to work on as I had to teach on Monday. But on Saturday I gave myself permission to play for a little bit. While reading and writing in my journal a man approached me named Wiseman who runs a boat service for snorkeling, scuba diving and sight seeing. I told him if it could be short trip I would like to go snorkeling. So off I went with his partners, Mubarik and Ali and 4 other tourists. 2 tourists were from the UK and 2 from Germany. Visibility was iffy in some places but amazing in others. So 15 USD it was a good little adventure.
The restaurant on the beach was okay but I am now spoiled with how good our food is at CCS. My waiter's name was Karim and his supervisor was Dude (I kid you not!). Very nice and attentive. I am sorry to say the Mzungu (white people) were not so nice, almost mean. They were mostly European but that is not excuse to treat people like dirt just because of their ethnicity or employed status. Most of the wait staff would greet me with “Shikamoo” (a greating of respect for those older or more revered) because I was so different than the others they were serving. So I was honored that they greeted me in this fashion. The response for such a greeting is equally respectful: “Marahaba”.On Sunday morning before my departure Juma and Malik picked me up from Sun Set and took me to the Spice Farm for one of the famous Spice Farm Tour. Our farmer's name was Abeid, his sister who cooked my lunch was Majuma. The tour was great and learned so much! I bought fresh spices for some of my friends who cook. The food they made fresh for me while I was on the tour was fantastic. Unfortunately, my guide and the farmer were Muslim and could not eat with me, as it was the middle of Ramadan when they fast during the day. But the food was fantastic none the less.
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| Spice Farmer Mr. Abeid |
The chicken eat a lot of the fruits on the farm. Mr Abeid called them fruit chickens. When the chickens are cooked up they taste more like the fruit they have eaten than grain or even like chicken. Kind of an odd but true.
I will have to add pictures later, I am out of internet time. Badaaye (See you later!)
Kristie
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