Breast Feeding and TBAs

By Sarah Sevcik Tanzania
10 July 2008

Today I went “into the field’ to participate in a Survive and Thrive Group meeting. Honest, our driver, took us to the town of Rhotia, where we first met with the Community Leader to introduce ourselves and accept his blessing. Then, in one of the community buildings most often used by military men, a group of 20 young village women gathered together with their notebooks and pens, eager to learn more about today’s topic: Breast feeding.

A photo of us sharing the road. We had to get out of our car and let our driver go into the field to let the people go by. It was fun!

Photo of Joyce teaching about breast feeding.

Although the session was conducted in Swahili, we were able to follow along decently well. The women learned about the benefits of breast feeding, when they should be breast feeding, and the importance of continuing to breast feed even when they (the mother) are ill (since antibodies get passed to the child). I became quickly entranced with one woman’s baby, who just as quickly became entranced with my jump drive/ carabineer device and decided to chew on it, throw it to the ground, and hit her mom with it. I tried to take the child into my arms so her mother had free hands to write the lesson, but she refused to leave her mother’s back or arms. That was, until we started playing “catch the jump drive” on the ground. :-)

The baby and me.

After the breast feeding lesson, the three Traditional Birth Attendants (TBA) in the room continued their lessons with the MIHV staff. Traditional birth attendants are a lot like midwifes; they are female community leaders who have been trained in helping village women deliver children. The pregnancy monitoring tool Lizz and I put together yesterday came into view, and Veronica and Eveline (MIHV staff members) walked the TBAs through the form, teaching them how to use the form and making sure any questions were answered. The women were very excited about this new tool, as it keeps all the needed information in one place and is easy to use. We were all pleased. :-)

Eveline and Veronica showing the TBAs the new monitoring and evaluation tool.

Mothers studying about breast feeding.

More studying.

I’m currently working on some capacity building initiatives, such as putting together an Excel tutorial for some of the MIHV staff, especially those who want to use Excel for accounting and budgeting purposes. Chloe (a Temple med student) is putting together a tutorial for STATA, a statistical software program. We hope to conduct some lessons in the next week or two.
Another thought:I’m reminded of things we take for granted in America. I had a conversation with Peter, a Peace Corp volunteer in Karatu, who mentioned that when we go into a store or a restaurant, we expect the things on the menu or shelves to be there. And we expect them to look the same, taste the same, smell the same as every other time before. (Think McDonalds.) Here, it’s different. You may go to a restaurant and ask for chicken, but they don’t have it. Rice and beans? Maybe not today. Last week when we went into the town of Arusha to buy bread, no one had bread to buy. Water and electricity are similar issues. Last week the power went out all over the country, so we just had to wait to begin work. In the past couple of days water has been low, so we have been cautious about taking showers or using water for other washing. Although I enjoy consistency and predictability, I also love to be challenged with this kind of flexibility and unpredictability, realizing how unrealistic my American “sure-thing” upbringing is for most of the world.

Curtains and Pregnancy Forms

By Sarah Sevcik Tanzania
9 July 2008

This has been our first real week “on the job”, and it has been fun and interesting already. My first day involved putting up curtains in the new Healthy Mothers Healthy Babies (HMHB) center. HMHB is in the old office of the District Medical Officer (DMO) next to Karatu health center. The idea is to allow intense education on prenatal and antenatal care for women with high-risk pregnancies. There will be private counseling for women and their families, a nutritional area, growth monitoring, and access to the health center garden for education on healthy weaning foods and diet. The center isn’t quite finished, as it still needs furniture, toilets, and a brick walkway, but Jolene hopes it will be open before we leave. We didn’t have enough curtains to cover every window, so Lizz and I spent the rest of the morning walking around the village trying to find more identical fabrics. It didn’t work out so well, but we enjoyed the process of having village men assist us by running ahead into fabric shops explaining the colors and designs we needed.

Putting up curtains in the HMHB Center.

Today we spent the day putting together a pregnancy-monitoring tool for the Village Health Committees and Traditional Birth Attendants of eight villages in Karatu District. This consisted of revising and editing the final monitoring document and then using a ruler, pencil and scissors to cut poster-sized paper into legal size paper (which doesn’t exist here) to use for printing. Often there are no (or few) records of children born in the hospital, and certainly few (if any) records when children are born outside of a clinic (which is the case for the majority of families). The record-keeping document will be used to keep better track of pregnant women in the district and make sure they are receiving adequate care during and after pregnancy. Once we printed out such booklets for each village, Lizz and I took them to town to get bound. However, there were no legal-sized binding, so each cover didn’t quite reach far enough. No problem—we just added packaging tape to the edge to make it more laminated. :-)

Lizz and I with the monitory book.

I have recently started running, and I’m thankful for the chance to do so. I find that I see the most interesting things about a culture by running through new areas and keeping an eye out for the colors that make up people’s lives. Whenever I run, the adults walking by shout out, “Pole! [Po-lay!] Pole!” which means, “Sorry!” I smile back and say, “ham na sheeda” which means “no problem”. People feel sorry for me that I’m running, but I want to! The children, on the other hand, come squealing out of their homes and dash to catch up to me. They love to run beside me for a few hundred meters with amazing pace despite their lack of footwear.

Speaking of children, I have only seen joyful and excitable kids around Karatu. They are such an inspiration to me. I just love how little things impress the children. Today Lizz and I passed Theresa’s (our house and laundry cleaner) home and saw her children playing with a broken tennis ball. We asked to throw the ball with them and they jumped up and down with joy. We probably could have stayed there all day and they would have been happy. Last week we visited an orphanage, and all of the children there were full of laughter, smiling eyes, and a love of play. We played football (soccer), let the kids use our cameras to take hundreds of photos of themselves, and found it humorous that nearly all 30 children had bright and bold colored crocs on their feet. Perhaps a gift from the states?

Some cultural experiences:
*Americans eat food much sweeter than Tanzanian’s desire. When we were camping outside during a safari, we offered roasted marshmallows with melted chocolate to our drivers. They didn’t like it at all—much too sweet. Even Mark’s banana bread has been too sweet for many Tanzanians.
*Nearly every business, tourist attraction, hotel, school and public landmark here are advertised with Coca-Cola. No joke. I think Coke must have offered them free advertising posters or something. Even the police station states “Police Post” with the Coca-Cola sign attached.
*I bought some fabric to bring to the tailor to make cloth napkins. The man didn’t speak English, and I don’t speak Swahili, so it was difficult to get my idea across. “Napkin” certainly wasn’t a word that was getting us anywhere, so I ran down the street to get a paper napkin from a restaurant and ran back, where the man said, “tissue?” Yes, tissue! It worked. :-)

The view of a village watering hole from the Healthy Mothers Health Babies office.

Jambo from Karatu!

Jambo! We are Lizz Hutchinson and Sarah Sevcik, the newest volunteers at MIHV’s Tanzania site. We are Masters of Public Health candidates in Community Health Education at the University of Minnesota and will be spending the next eight weeks or so helping with MIHV’s child survival project in Karatu, Tanzania.

Our first week here at the project has been great. By far, our favorite thing about Karatu (and Tanzania more generally) is the people; everyone had been so welcoming and friendly. Kiswahili is the primary language spoken by everyone, although many speak some English. As you walk around, shouts of Jambo or hello, come from adults and children.

A funny side note about MIHV—as you know, the name Minnesota International Health Volunteers is long, and not everyone speaks English, so everyone in Karatu calls the organization just ‘Minnesota’. This often leads to confusion when people ask us where in America we are from.

After putting up curtains for the new Healthy Mothers, Healthy Babies center and completing a pregnancy monitoring tool book used by traditional birth attendants, we starting to really get our feet wet in our projects. We are excited for what’s to come!
Please check back regularly for updates on our journey and experiences in Karatu and with the project.

Asante sana (Thank you very much),

Lizz Hutchinson and Sarah Sevcik

I leave Tanzania tomorrow afternoon. It's been a wonderful, life changing experience. Everyone I've worked with and everyone in town has welcomed me with open arms. Of course there have been a few difficulties and frustrations along the way, but I'm certain I would have had at least as many had I spent these nine months in the States.

Last week, I climbed Mt. Kilimanjaro it was unbelievable. It was so beautiful and such a great way to challenge your mind and body. I was very lucky and didn't suffer from altitude sickness at all, so I was able to summit and appreciate the beauty of Tanzania from an entirely new angle.

Some of my friends told me that they got the impression that I didn't enjoy my trip to Kilimanjaro from what I had written here previously, and I'd like to apologize for that. To say that my experience of Kilimanjaro and Tanzania in general was anything less than amazing would be a lie. My intent was to show both the good and the bad parts of the trip, but I don't think I did a good enough job writing about the good. Thank you for this wonderful opportunity.