9 April

Pole sana for taking so long to post. The internet has been out at the house for around two weeks and we can’t get on the blog website at work (and the internet at work has gone kaput)...very frustrating. There is a lot to report so I apologize if things are a bit disjointed. First thing to report: no dogs. Dr. Tambukwa decided they would be too expensive to keep which I don’t get it since they’d eat leftovers and a flea bath is only 500 Tsh which is less than fifty cents. I must admit I am sad that we don’t have them but maybe it’s better since at night the dogs on the street start a barking chain similar to the one in 101 Dalamatians. Our last Germans left, Monika didn’t get the job she came here to check out which was very sad and the new person looking at the job (who is also staying at the guesthouse) is not someone I care for. We have a Canadian lady staying with us for a month and she is nice although way more energetic than I am (she doesn’t like the idea of lazing around reading/doing crossword puzzles/eating etc. as much as I do). We have yet another German staying with us now...he seems nice enough despite Jenny’s description of him as a heavy smoking, short short wearing beer drinker. Somewhere in there we had an American who will be taking a high up position in Mbeya with Walter Reed and Edward (the country director) at the house too. Busy busy.

Work has been going very well for the past week or two. We haven’t had the time to continue teaching the HIV course because we have been tied up visiting NGOs to assess their nutrition assistance programs. Last week we went to NGOs in Mbeya town, almost all ones that we had visited back in January when we first arrived. We had the opportunity to spend time with the Anglican NGO which we hadn’t visited before and they took us to the home of a woman who was involved in mushroom growing as an income generating activity which was really neat. With KIHUMBE, we went to a school to look for a child to interview and ended up causing a mini-riot of children wanting to practice their English with us. This week we have been visiting NGOs in districts far from here. Monday we went to Tunduma, which is where the Zambian border is, and visited one NGO there and one on the road back. The visit went well but because of transportation issues we didn’t leave until 1:30 and Tunduma is around 120km so we didn’t get home until 8 p.m. Tuesday we traveled to Kyela which is right by the border with Malawi where we visited three NGOs. We didn’t have time to meet with clients because once again we got a late start. Kyela is also 120km or so away and the area is totally different from here...it’s hot, humid, flat, and full of thick vegetation. At one of the NGOs that focuses its work on orphans and vulnerable children we saw one kid who looked like he was two or three but was actually five...apparently he was so malnourished when the NGO started looking after him that he couldn’t even sit up or talk. As sad as it is to think about that, it is amazing what a difference the NGO has made. Yesterday we went another 100 plus km away to a place called Mbarali where we visited another three NGOs. While visiting the organizations went really well, the highlight of the trip might have been when we pulled into the middle of the “town” and say a 7-11 sign complete with the logo. Sadly it wasn’t actually a 7-11 but instead was a restaurant where we later went for a soda and not the slurpee I was secretly hoping for. The scenery in Mbarali reminded me a lot of Ghana...dusty and dry. Thursday we went to Tukuyu where we visited a Lutheran NGO and then we went to a Catholic mission hospital. The Lutheran NGO we had seen before but it was our first time at Igogwe which seemed like a pretty nice hospital. In addition to getting info on nutrition assistance at Igogwe, we got to see the orphanage they run for kids who are up to 3 years old. All of the kids were sooooo cute and there was a sassy little girl who seemed to be the leader of the pack. As we walked around it was obvious that some of the kids were severely malnourished and we saw one baby that I thought was a doll at first. He was two months old and his head was about the size of an apple...I wanted to scoop him up and take him home with me. It seemed like the place was really well run and once the kids are developing well and hit 3 or so, they are sent back home to live with relatives (all of the children are mother-less and many have lost their fathers as well). On the way home we stopped at banana central a.k.a. Kiwira where we managed to buy approximately 15 passion fruit (fruits?) for about 50 cents...40 or so little bananas (or maybe even more) are around 80 cents total.

Friday we didn’t go anywhere and it was nice to be able to rest. Saturday we went to Mwanjelwa, the big clothing market here, with Juliana (the secretary/receptionist from work) and the lady staying at the house (Yasmin). It was a lot of fun to dig through clothes and see a completely different way of shopping. We spent a good part of the afternoon watching shipments of bags from Korea (all used of course) be unpacked...it was a really interesting and entertaining experience. A bunch of clothes in Mwanjelwa had Salvation Army and Goodwill tags on them so I guess they were rejects from there. Today we went to Ifisi with Elizabeth, Mama Martha, and one other doctor to visit their new CTC. It’s a really nice mission hospital that has been set up by some Swiss doctors. On the way there we were pulled over for speeding—apparently they have radar guns here although I am not sure if they actually work or if they just have a set speed that shows up on the screen. They had no problem with the fact that we had too many people shoved in the car...just the fact that we were doing 50 in a 30 (kph not mph). Luckily after pretending we were headed to Ifisi for an emergency they let our driver off with a warning and not a fine. On the way home we got to ride in an ambulance (kind of like a Land Rover with a stretcher and bench seat in the back) which was amusing.

I have a feeling the next few weeks are going to fly by and it seems like we are going to be home in no time at all. This week we have Tuesday and Friday off and also Easter Monday when we are going to go to Juliana’s (I’m super excited...she is cooking for us and I think we are going to get to see marriage preparations take place which will be really cool). Perhaps during our mini vacation we will hike on our days off or maybe we will laze around (last week was super exhausting). I can’t think of much else...we keep buying large batches of maandazi (the donuty cake things they make here) from Juliana. They are tasty tasty and will probably turn us into small elephants. We purchased a bootleg DVD of Tom Hanks movies so maybe we will be spending our days off watching those (we’ve watched DaVinci Code and Philadelphia so far). I think that’s all for now...hope spring has arrived (we have been having SO much rain which means mudddddy showers) and that everyone is getting excited for Easter (candy)!!

18 March

Jambo everyone! Last week ended pretty uneventfully work wise. We finished up two articles that we were writing for Kelley in the US Walter Reed office. One article looked at the improvements in the care and treatment center since it was moved to the COE. It was a fun article to write because we were able to interview Mama Martha and we also managed to talk to a patient who had a lot of good things to say. The other article focused on the Saturday pediatric clinic and the new toy area which meant we got to take lots of pictures of the kids playing. Apparently Friday we were supposed to begin teaching the HIV/AIDS awareness course but that message was not relayed to us so it didn’t happen. I think Dr. Tambukwa wasn’t happy about it but there wasn’t anything we could have done...oh well. Over the weekend we went to Tunduma, the Zambian border town, with Juliana (she’s the secretary-ish person at work), her son Stephen, and Ajabu, one of the drivers. The weather was pretty nasty but it was still fun. We managed to walk into Zambia without showing passports or talking to a single authority which was very strange seeing as we had to walk under a gate thing, through a customs parking lot and then through another gate. If we had wanted to, we could have gotten on a bus and gone pretty much anywhere in Zambia we wanted. I have now been in 5 African countries (Ghana, Burkina Faso, TZ, Malawi, and now Zambia) and if there is one thing I’ve learned about crossing borders it’s the importance of the word no. No I would not like to exchange money, no I would not like to get in your bus, no I would not like to buy a tie, no I do not want any bananas/peanuts/etc.

Monday we taught our first HIV awareness course. By taught I mean I gave basic guidelines to Mama Martha and she told them everything in Swahili. Instead of addressing the whole waiting area, we decided on taking a smaller group to a room to talk. Having fewer people meant everyone was paying attention and also allowed for a sort of open discussion about things. Since everyone is HIV positive, the point of the course is to answer questions, highlight the ways to prevent transmission to others, let people know about services for the HIV positive population, and encourage everyone to spread their knowledge to others. I think it will take a few weeks to really get the hang of things but so far so good. Ultimately we will take the HIV fact sheet we have made and translate it into Swahili so that it can be handed out to patients and healthcare providers here and at the other Walter Reed sites. Tomorrow we are going to get underway with the nutrition assistance survey. We are now the proud owners of a fancy scale and soon to be owners of a height measurement thingie (all to calculate the body mass index of people on nutrition assistance). It finally feels like we are doing things that are useful and which will have a positive impact even after we leave. Hey it’s only taken 2 months to get to this point! Slowly slowly/pole pole.

We have a new German, Monika, staying at the house for 3 weeks. Norbert, another German who has been staying with us for a month, leaves Thursday or Friday and we are getting two more people. I had no idea we’d be staying in such a busy little guesthouse. Today or tomorrow we will be getting two dogs at the house—they were found by Elizabeth, Jeni (we finally know how spell her name thanks to an invitation we found on the counter!), and Juliana in an empty compound. Jeni has been feeding them and while they are guard dogs and won’t be allowed in the house I’m still excited. I want to name them Snorklebert and Humdinger but Melissa has vetoed these names and we have yet to settle on any. Not a whole lot else to report...the weather the past few days has been icky with lots of rain (yeah yeah I know we are in rainy season but it’s been especially bad). Tomorrow everyone in the office is supposed to return from Dar so after 2.5 weeks things won’t be so quiet around here. 2 months down, 2.5 to go...

Photo-graphs

Waiting area in the COE














Play area we set up for the kids














A present on my pillow from Melissa...














A terrible picture of the tea room in the COE














The cross at the top of the mountain behind the house

10 March

Apparently time is flying by—I thought it hadn’t been very long since my last post but I am way off about that. I’m not really sure where to begin with the updates. Work wise there is little to report (as usual). You all probably think we don’t do anything but we do...just nothing that is super exciting to report. The past week we have been working on a HIV fact sheet so that we can teach lessons to the patients at the hospital. Not sure when we will start doing that but Dr. Tambukwa seems like he really wants us to and it is sure to be entertaining. We’ve also been working on a survey to administer to a few people who are supposed to be receiving nutrition assistance from the various NGOs. The ultimate goal is to get a better idea about exactly what nutrition assistance is being provided. It’s a project that I think will be really worthwhile assuming that we get it off the ground. No one was in the office last week, they are gone again this week, and next week most people will be in Dar. Luckily Mwaipopo will be around so hopefully he will be able to help us out. We’ve also made visits to the CTC to check on the toy corner that we set up and it seems to be a success. One day when we went up to check on things we found that the nurses had locked up the xylophones and the mini piano things presumably because the kids were making too much noise. If they are playing with them you can hear them out the windows of the CTC when you are walking up there which is really funny. I’m glad the toys are finally being put to use, especially on the pediatric HIV clinic days—I think it’s only fair that those kids have something to look forward to when they come to the CTC.

We got our visas extended until the beginning of April (we were given two months when we first arrived). Mwaipopo happens to know some high up guy in the migration office here in Mbeya, so Juliana took us there (Mwaipopo was traveling with everyone else). Not sure what will happen in April but the worst case scenario is that we will have to cross a border. Two weekends ago we spent Saturday night at Utengule, the coffee plantation that’s about a 20 minute drive away, with Elizabeth. The place is beautiful and sits up on a hill overlooking a valley on the road to Zambia. We ended up eating with three Irish people and while the food wasn’t too spectacular (although the banana splits for dessert were amazing) it was nice to be out and about. Sunday we hiked again, getting lost along the way. We ended up in a village where some angry children threw dirt at us (they were mad we didn’t have anything to give them). After booking it out of there we finally made it to the cross that is on top of the mountain sort of behind our house. It was a nice hike although very slippery on the way down and, much to the amusement of Melissa, I ended up on my behind a few times. This past weekend we didn’t do a whole lot of anything which was nice since the last few weekends have been busy. We walked into town and bought some little ice cream things which were very tasty but other than that we just lounged. One of the Germans has left and the other one was at Matema (the beach on Lake Malawi) for the weekend so we had the house to ourselves which was nice. I can’t think of anything else to report except that Mama Martha now thinks my name is Jenny and Melissa’s name is Mona (or Mona Lisa depending on the day). Today is a day off—it’s some Muslim holiday based on the moon so we had no idea which day we’d get off. We thought Monday was supposed to be the holiday but we got no calls telling us it was and Melissa likened the feeling to getting pumped for a snow day only to wake up and realized the storm hasn’t actually happened. It was a nice surprise then when Jenny told us last night that we didn’t have to work today. She told us that we should use the day off to “Sleep, sleep sleep, eat, watch dstv, sleep, sleep, sleep”. This weekend we might be driving to the Zambian border just for fun (Dr. Tambukwa’s idea) so we’ll see what happens...it could be an interesting/entertaining Saturday excursion. That’s all I can think of to report for now. Hope everyone is doing well!

Our most social week yet and a whole new meaning to ants in your pants...

Sorry I’ve been slacking on the posting...I get a little computer lazy sometimes and then the internet breaks and there is no way to post. After I last posted, Melissa and I opened our Valentine’s Day packages which Mom had sent along with one of the Americans who had visited a few weeks ago. Not only did we have the giant bar of Cadbury we bought but we also had m&ms and Cheez-its (for me...and crushed but that didn’t matter...I just ate them with a spoon) and zebra cakes for Melissa. At work, we were mainly focused on our malaria project, which has been interesting, as there hasn’t been a lot to do with the outreach team. It’s been a little frustrating not having Walter Reed work to do, but hopefully that will change over the next week as we let our US contact know and she is going to help as much as she can from her end. We had more Americans (Walter Reed) people staying with us during the week which was nice...we are beginning to prefer having a full house to an empty one. Thursday night we were invited over to the Wabitsch’s house—they are a German couple, both doctors. The wife, Elizabeth, works for Walter Reed and it is her husband, Rudi who is helping us with the malaria project. It was nice to get out of the house for an evening and we had some amazing food: homemade pizza (with all sorts of fresh garden veggies), salad (they grow the lettuce in their garden), and for dessert, cooked bananas and honey and ice cream. Needless to say we were in heaven. Friday night there was a going away dinner for the Americans that we were invited to. It was at a restaurant that the Americans thought was called carnivore but is, in fact, called carnival. Although carnivore is an appropriate description as it is a bbq place where you basically have a drink and then there are plates of meat brought out and you eat whatever. The meat was all delicious even if we weren’t always sure what we were eating...the goat there was the best I have had to date (yes, I’ve eaten goat on a number of occasions).

Saturday we got up and went over to the CTC to see the pediatric clinic in session. It turned out to be far from exciting as the nurses run a tight ship and the nurse we usually work with was no where around. We spent the rest of the day lounging and enjoying the empty house (we were going to go into town but it stormed). Today we went hiking up the mountain behind the house with Rudi, Elizabeth, and one other German (Karen I think). On the way up there were some amazing views of Mbeya and large numbers of ants. The ants were of the biting variety and if you weren’t careful where you stepped they would end up in you pants in a matter of seconds where they would bite you until you squished them. Melissa had the first round of them and then at later points we all ended up with nasty biting ants in our pants. In addition to the smaller biting ants, Melissa was nibbled on by a massive one that refused to let go and took a chunk of skin when she finally got him off. When we got to the top of the mountain, Rudi decided to explore another route home which turned into quite the adventure. Our path down included a rickety bridge, some extreme rock climbing down, and a thunder storm which would catch up with us every so often. Despite the difficulty of the trip back down the mountain (we had to ask all sorts of people which way to go...luckily Elizabeth knows a good amount of Swahili) and the mud and the rain, it was a fun thing to do and it felt amazing getting exercise.

Sunday night two Germans arrived and from what we can tell they will be staying here for a few weeks...they seem nice enough. Not much to report from the work end this week except that we are currently without our little office as Edward, the country director, is here from Dar for the week. We celebrated fat Tuesday by going into town and buying an ice cream bar and a bar of chocolate. We tried to explain the idea of Mardi Gras to Jenny who didn’t understand and was sure to inform us that she would be checking to see if we were fatter today (she says we are the same). Tomorrow we are supposed to set up a play area in the CTC for the kids. Dr. Tambukwa also mentioned the possibility of having me teach an HIV prevention awareness course to people attending the CTC at some point so we will see where that leads. That’s all for now...hope everyone is doing well!!

Pichas

A rickety little bridge we had to cross














Donkey and amazing tree














Melissa sporting her rain coat and refusing to pet the donkey we found

I believe this was right before she got ants in her pants

A bush with Mbeya in the background

Hiking through a eucalyptus forest

The waterfall we pass on the way to work

The river that runs from the waterfall that reminds me of the jungle ride at Disneyland

Our Valentine's Day spread

14 February (Valentine's Day!)

Happy Valentine’s Day! Today officially marks one month since Melissa and I arrived in Tanzania and it seems like things are finally settling into place. I know it’s been a while since I last posted but we had some pretty uneventful days between then and now. Monday and Tuesday we helped Rehema, who heads the home based care program, with some data entry and I helped her put together a presentation for a training that was taking place later in the week. She has discovered that we can type quickly and as a result, I have become her go-to typer. On Wednesday almost everyone left to conduct the training which was scheduled for Thursday and Friday in a region that is a couple of hours away. Dr. Tambukwa went as well which meant Melissa and I were on our own with absolutely no work to do. Wednesday we hung around the office and ended up coming home about half way through the day since we saw no point in sitting at work with nothing to do. On Thursday we decided that despite not being given the go ahead from Dr. Tambukwa, we go ahead and work on a project with one of the German doctors, Rudi (I mentioned his wife Elizabeth in another post I think). The project involves getting records from patients who were admitted to the male ward during two separate months and collecting data regarding malaria testing and diagnoses from the files. While it sounds like an easy project, it looks like it might be on the harder side. First there is the issue of getting the files which means going to the records department, home of Mr. Msafiri who loves loves loves talking. Once we pull the files (another tedious process compliments of the confusing filing system) we then have to decipher what is written in them. It appears doctors world wide have terrible hand writing and in addition to that little problem, the files all seem to be thrown together haphazardly. Despite these challenges I think the project will be interesting and will give us something to do with our time. Obviously any Walter Reed projects that come up will take priority but I don’t think any conflicts will arise. In addition to talking about the project, we talked with Rudi about all sorts of international health things, especially problems that are exemplified so well at the hospital. He’s been working in international health for a long time and, boring as it may be for Melissa, I really enjoy hearing his perspective on things.

Thursday afternoon we came home early again and went for a walk around the neighborhood. We ran into two Tanzanian guys who wanted to marry us...luckily I always have a ring on so I can pretend to be married. Melissa on the other hand gets full declarations of love despite her claims of having a boyfriend or fiancé back home. Friday was when we met with the records department and began sorting through things and preparing data to pull files. We came home after work and didn’t do a whole lot...we went to watch a DVD later in the evening and spent 20 or so minutes trying to figure out how we got the DVD player to work last time. Yesterday and today the weather has been amazing which probably means more rainy days soon. Today we finally went in to town with Jane (Jenny...there is confusion over this since Jane is often pronounced Jenny) and she showed us some restaurants, the market and a mini-mart where we bought a massive bar of Cadbury chocolate which we plan to eat tonight to celebrate Valentine’s Day. Now that we know where things are I think we will be heading into town a lot more often. We also saw a whole lot of white people (sadly most looked much older than us)...by a whole lot I mean 5 or 6 which is way more than the 1 or 2 we usually see.

There isn’t a whole lot else to report. We are getting more American visitors tomorrow and I’m not sure how long they plan on staying but we have discovered that when there are visitors (that aren’t us) the office buys mandaazi (donut things) for tea which is fantastic. Our quest to learn Swahili is coming along very slowly...it seems like telling people we don’t speak Swahili is not an option...if they don’t speak English they just keep talking as though we understand. There have also been a lot of hilarious conversations with people who speak minimal English because they fail to use the correct pronouns. She could mean he or she...I could be you or I...etc. Final thing to report: the things I want most right now from home are my pillows. The ones here just aren’t doing it for me...