Heading South

Tomorrow Amy and I are heading to Njombe, which is about 13 hours south of Karatu, where we'll visit a hospital that MIHV is considering partnering with to send medical volunteers to in the future. I'm really looking forward to seeing another part of Tanzania, and after a few days in Njombe, we'll head to Dar es Salaam, and then spend a few days in Zanzibar!

Where is the rain?

The rainy season started in Uganda just before I left for Tanzania and a few weeks ago Karatu seemed to be following suit, but after a couple days of rain, the skies cleared.

The slightest breeze sends dust everywhere. Today, walking into town, the wind picked up and all the people in the street had to stop, shielding their eyes with their hands, hiding their faces under congas, as the road jumped up and around, into hair and noses and mouths.

It's the end of November and supposedly the middle of the short rainy season, but we seem to be missing a key ingredient...

Ngorongoro Crater

This weekend, we visited Ngorongoro Crater, one of the most spectacular safari spots in all of Africa, that's just 15 minutes from MIHV's Karatu office. Ngorongoro is reputed to have the densest population of mammalian predators in all of Africa. Inside the crater, we drove past hyenas, herds of zebra and wildebesets, buffalo and elephants, a pride of lions and even a black rhinoceros! (In 1965, there were estimated to be about 108 black rhinos left in the world; in 1995, this had fallen to between 11 and 14).

Give Thanks

If the only prayer you said in your life was “thank you,” that would suffice – Meister Eckhart

This was my first Thanksgiving away from home.

I was expecting it to be a difficult day, anticipating that most of the traditions that mark the holiday for me would be absent. There were different people around the table and different food on our plates, but I was surprised that it still felt like Thanksgiving.

Thanksgiving is a completely American tradition and some parts of the holiday were difficult to explain to my Tanzanian coworkers (Pilgrims? Cranberry sauce? Balloons of cartoon characters on 5th avenue?).

The important parts, however, translate. There was good food, good people and a day to appreciate the generosity I’ve received. Silent thanks for teachers who have inspired; for family who have loved selflessly and siblings who have always been my toughest critics and most loyal companions; for friends who have walked with me and strangers who have made the journey a little easier; and this year, most of all, for the many people who have welcomed me into their country, their homes and their lives.

Another deeply American tradition is expressing our gratitude by sharing what we have with others; sharing a meal, sharing our stories, sharing our wealth. Americans have a long tradition of giving and, looking at charitable giving as a percentage of a country’s GDP, Americans give over twice as much as any other country. In 2006, Americans contributed $295.02 billion and nearly 76% of this money came from individuals. (You can read more here).

According to a July 2007 study by the Charities Review Council, Minnesotans are especially likely to support charities, with more than three-fourths of Minnesotans giving to non-profit organizations (other than religious groups and colleges and universities).

Consider supporting MIHV. Your generosity makes a difference in the communities we serve.

$50 for a brick will help establish and support on-going activities at Health Mother/Healthy Babies Centers throughout the project area.

$80 will purchase a bicycle for use by a Village Health Worker in the provision of community based health education and identification and follow-up on pregnant women and sick children under 5.

$10 will purchase a delivery kit for project trained traditional birth attendants to provide safe deliveries of women in emergency situations and isolated areas while protecting the traditional birth attendant and mother from blood-borne diseases.

$500 will provide training to 20 traditional birth attendants in safe delivery, antenatal care, post partum care and referral services.

$3,000 will provide training at ward and village level for community-integrated management of childhood illnesses.

$100 will support performances in two communities by the project’s trained cultural troupe disseminating life saving information on malaria, diarrheal disease, MNC, pneumonia and child spacing.

$250 will support one year of meetings for a village level Survive and Thrive Group providing health information and capacity building training to young, unmarried, pregnant women.


For more information and to support MIHV, visit us online.

Sundays are for Scrabble

On Sundays, Jolene, Amy and I try to find a place more beautiful than the week before to play our weekly scrabble game. In such a small town you’d think we’d be running out of places, but Karatu is a mighty beautiful small town.

Funerals

In the last seven days, there have been two funerals.

A week ago, our District Medical Officer died and Saturday, one of the women on our staff lost her sister.

I can count the number of funerals I’ve been to in the last 18 years on one hand, so two in one week seems to me quite a lot.

At the last funeral I went to, the horses pulled my grandfather’s body across his farm, his home, to the grave and we followed, a trail of black. Here, as the doctor is carried across his farm, his home, to the grave, women in brightly colored congas follow: greens and yellows, red, lavender, white, patterned with flowers, chickens, the moon and stars.

For days before the funeral, the family holds all night vigil. Everyone goes. We sit for hours together, sometimes in silence, sometimes drinking tea and eating pilau, sometimes talking about Doctor, about work, but mostly silence.

The Burden

Malaria Program Featured

Check out the article on our new Malaria Communities Program, featured in the New Vision's Health section this Monday.

Duka La Dawa

A child gets sick. Often, Tanzanian parents take the child to a traditional healer first. If, after a few days, the child is not better, they will then take their kid to a duka la dawa (drug shop), which has medications, but no one licensed or trained to prescribe them. The medication may not be the correct treatment for the illness or it may not be the right dosage. So, a few days later, if the child still is not better, the parents now take the child to the health facility (a facility where they could have gotten the correct medication, at the correct dosage, for free). The child is now very, very ill; and has been sick for several days. Sometimes, the health facility can help, but often the child is now too far gone. The child dies, and of course, “the health facility killed my child.”

This compounds the problem and only makes families less likely to seek out the formal health sector. Meanwhile, duka la dawas prosper. In Karatu alone – a town with a population of just 71,000 – there are 14 drug shops. In August and September, to assess the extent of the problem, MIHV trained “secret shoppers” to visit the shops with their sick child. Our “shoppers” found that while correct medications were usually prescribed (two-thirds of the time), they did not provide proper dosage and consistently gave partial dosages. For example, if a parent comes in with a feverish child, the drug shop keeper may tell them the child needs to take an anti-malarial -- the first line malaria treatment in Tanzania, ALu, is 24 pills -- if the parents have only, say, half of the cost of the drugs, the shop keeper will take the money and give the parent 12 pills.

Involving these informal links in the chain of health services is crucial. In October, MIHV held the first of several drug shop keeper trainings, where they discussed the importance of not giving partial dosages (in the short term, people don’t get better; in the long term, partial dosing leads to drug resistance) and if a family can’t afford the full amount, then refer them to a health facility where they can get the drugs for free.

Recently, Jolene, MIHV’s Tanzania Country Director, started feeling sick. We have a pile of partial dosages left over from the “secret shopper” assessment, so Jolene took part of the medication she needed and then sent someone to a duka la dawa to buy her the rest of the dosage.

The drug shop keeper refused to sell the man a partial dose.

Tembo