"Strive not to be a success, but rather to be of value."

- Albert Einstein

Friday, October 1, 2010

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 cafĂ© 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!