Fast and furious, Tanzania style

Things have been fast and furious here, in a Tanzania sort of way.  I now have a modem, which allows me to post to the blog.  At least as I have energy to do so.  Since there has been much water under the bridge since we arrived a week ago, I have much to recall.

This is likely to be a chronological mess, so dear readers, just understand that it has all happened in one week.  From the perspective of geological time,  it would appear as an instant anyway.

When we arrived, we learned that tragedy had struck the family of one of our team.  Randy and Kari informed us that the brother of one of our students, Sandy Lee, suffered serious injury in Afghanistan.  He is a medic in the Minnesota National Guard.  He was seriously injured by an IED.  Consequently, he was air-lifted to Germany and then flown to Walter Reed in Washington, DC.  He suffered multiple life threatening injuries.  I believe he is stable now.  Sandy was able to arrange travel to join him Saturday morning.  MwaMoody, Dr. Kvasnicka and Pastor Lamont Koerner have shepherded Sandy home.

We are not without local tragedy surrounding us either.  One bad car accident took two victims, one of Dr. Saga’s relatives (half-cousin) and a pastor’s wife, when the car’s brakes failed.  Another car wreck put at least two people in the hospital here and one of them needed to be transferred to Iringa.

We lost a three-month old and several other patients for various reasons.  This how life is in Tanzania.

A child with marasmus is slightly better, but mama wanted to take him home.  Care is free to children under five but he is six.  Atu, one of our dear ILH nurses intervened and has arranged a week of a free bed with the hospital.  Then we hope he is stronger with good diet and can be discharged to Home-Based Care coordinated with Amani Orphan’s Home Mbigili (AOHM).  They are calling me Dr. Plumpy’Nut, which is fine, just not Dr. Plumpy, however apt.  The supply of P’N has been interrupted, but will resume with the next distribution.

We went to AOHM just after lunch and examined a few kids and an adult.  I value their trust and appreciate being asked, which does not mean I am fully confident of the diagnoses.  Hey!  There are exotic things in Africa!  But also some very familiar things too.  The baby I saw a few days ago, Tuesday if I remember correctly, is better.  Whew!  I always appreciate nature doing her thing.

Late this afternoon we had a big celebration for three retiring staff people, including Dr. Saga.  We thought it was supposed to be at two, then three, then four.  It started at 5 PM sharp (ha!).  It was delayed in part due to a funeral for one of the car accident victims, then the ILH board meeting which went on and on (and on).  Eventually the meeting was over and the dignitaries were all here.  Dr. Saga, Mama Sanga and Eliza Mtweve were all dressed up.  Dr. Saga looked sharp in his black suit, white shirt and red tie.  There was singing and speeches, clapping and celebrating.  I was honored to speak just a little about Dr. Saga.  It was a joy to do so, if not perfect.  The audience did laugh at the appropriate times, but we wazungu are worth laughing at anytime anyway.  They really know how to throw a big shindig! 

We miss Dora Saga.  I know Dr. Saga misses her terribly.  With her absence, the was much laughter about finding a new wife for Dr. Saga.  He is definitely the most eligible bachelor in town and likely all of the Kilolo district and Iringa Diocese!

It is just after 11 PM here now.  We had our second movie night and finished about half hour ago.  In the morning we will take the bus to Iringa, catch up with Dennis Ngede and I hope get a vehicle and driver to take the group to Isimila. Our dear friend, Tuli Hingi, will accompany us to Iringa.  We all love having her.

So, that is it for now.  I will see if I can upload this!

In Iringa today

After a very successful Ilula International Medical Conference, the pharmacy students including myself, are in Iringa to learn more about the distribution of medications in Tanzania. In particular, the MSD distribution center. It is governement run and supplies hospitals wth medications and supplies at a lower cost.

Also, we will be on the radio in the morning.

Will update on that later. :)

The conference
I have added a picture of Tully, a nurse at Ilula Hospital,  teaching others about newborn resuscitation.

In addition, I added a photo of one of our presenters. I apologize for the quality of the photos as they were taken with my tablet from far, but soon we will be able to upload our photos from our cameras.

Two Weeks Later. ..

Hi everyone,
I have updated a previous post due to some missing sentences about my expectations for Tanzania before we left.

Someone shared the following link. I think you will enjoy it.

"Our lives, our cultures, are composed of many overlapping stories. Novelist Chimamanda Adichie tells the story of how she found her authentic cultural voice -- and warns that if we hear only a single story about another person or country, we risk a critical misunderstanding."

http://www.ted.com/talks/chimamanda_adichie_the_danger_of_a_single_story.html

Thursday in AMS

Well, here we are.  No problems with the flight at all.  John Kvasnicka has just joined us in Amsterdam, Schiphol Airport.  I think it is pronounced close to ski-pole.  We didn’t sleep on the plane.  After all, it is only about midnight or so to our bodies, despite the clock here saying 8:30 AM.

We should start the boarding in about half an hour.  The personnel are arriving already.  Quite a few people waiting now.  Lots of American accents in this general waiting area.  Our flight leaves AMS at 10:15.

We are all excited if somewhat weary.  It is always a surprise as to who will be meeting us at the airport.

More soon, I hope.  We will see if we can connect a few times or not!

There must be something else I should be doing…

I am busy with my personal preparations and have now finished my two talks for our First Annual (we hope) Ilula Medical Conference.  I will publish a schedule for the conference in a separate post, after arrival so I can make sure I have all the names in the correct topics.  The students will all be participating (whether they know it or not at the moment) as well as the faculty.  I have only scant information to report at the moment from Ilula.

I know they needed to have water transported from the village for non-potable use.  The bottled water is fine for drinking.  Food is cooked thoroughly and water for coffee, essential for the wazungu, or tea is boiled.  That is safety is not an issue, just convenience at this point.

My hope is that the U of M miracle workers have done magic, drilled a new well, replaced the pump and installed a water purification system.  (Well, OK.  That would be magic, even for our intrepid U of M Engineers.)

We were hoping to have things all in order for opening the Nursing School in March.  Unfortunately, even if the building is finished, I believe the water situation has pushed the opening to September.  It was supposed to be two full years ago, but that is another story….

We have planned our departure rendezvous for Wednesday and for all our fans who want to see us off, we will meet at the Delta Group Check-in on the lower level at 12:30 PM.  We are Ken Olson, Leslie Pratt, Jill Stebbins and Norrie Thomas.  John Kvasnicka is meeting us in Amsterdam.

TIA

"This is Africa."

As I prepare for departure next week, I am waiting for news from Ilula.  To be an American visitor in Africa does take a suspension of certain expectations of many things we take for granted here at home and simply do not tolerate in our environment.

The well has failed at Ilula.  I do not know exact details yet and perhaps won't until arrival next week.  I can tell a story about it and correct the details later.

When we were in Iringa last summer, there was a problem with the well at Ilula.  One explanation for the problem was that the pump installed had a capacity too small for the demands on the well.  I presume the well supplies the hospital with water too, not only the residences where we visitors stay.  Water is being carried to the residences and hospital daily for washing and toilet use.  We drink bottled water and soda or beer.

We do have a group of intrepid, heroic engineers visiting Iringa and surrounding area, including Ilula and will commandeer their expertise offering little more than grateful thanks for there efforts.  I wonder if I will be able to bring a pump from the US.  But is it bigger than a breadbox?

Also, on a much less important note, apparently the internet is out at Ilula.  Possibly, there is some electronic upgrade I can bring.  Again, is it bigger than a breadbox?  So that is why, I presume, that there has been no update from the residents of the Ilula Campus so far.

We can only hope...

Update from Kristi

Kristi Hembre has left a new comment on your post "Almost time... but wait!":

I am posting this as a "comment" in place of a regular post because of technical difficulties. (Ed. Note: cut and pasted from her comment post. kpo)

The view form the residences

We are now a week into our trip and have settled into Ilula. Despite Tanzania being insanely gorgeous, the people here have been extremely welcoming and kind. I thought as an initial post that I would quickly introduce the members of our group ....
Sandy Lee - 3rd year medical student at University of Minnesota
Laura Hanson - 4th year medical student at University of Minnesota
Cole Pueringer - 3rd year medical student at University of Minnesota
Chandra Cherukuri - Family Medicine Resident
Deepthi Malepati - Internal Medicine Resident
Jill Strykowski - Pharmacy administrator and frequent Ilula volunteer (and Julie's sister)
Julie Hause - Physical Therapist (and Jill's sister)
Erin Morris - Pastor looking to make ties with local Ilula churches and a US church back home
Treya Connell - University of Iowa student (and Lanette's grandaughter)
Lynette Franklin - Nurse with experience in many fields (Treya's grandmother)
Kristi Hembre - Physician Assistant
Shana Steinbeck - Pharmacy student at the University of Minnesota
Kelsey Bartz - Pharmacy student at the University of Minnesota
Astrid Steffen - Pharmacy student at the University of Minnesota, originally from Guatemala
and of course...
Randy Hurley - Oncologist, Leader of our group
Gary Moody - Family Physician, Leader of our group
Kari Hurley - Nurse, Leader of our group

We have such a great group and have been enjoying a few days of heavy rains lately amidst a recently broken well system at Ilula. We have been introduced to the outpatient and inpatient medical wards/clinics, HIV/AIDS clinic, Maternal and child health clinic, taken a few road trips to local villages and dispesaries, seen several babies be born, c-sections be performed....no shortage of learning and interesting cases to discuss. I look forward to posting more in the future!

Vicarious Arrival

It is 3:00 PM CST and in Ilula 11 PM, with our 8 hour time difference.  The first group should have arrived in Ilula several hours ago and now may be heading off to dream land.  Lala fofofo. This idion is translated a "sleep very soundly."  However, I have noticed that when you say this to a Tanzanian they always seem to laugh or at least giggle.  I have taken this to mean that the literal translation is slightly different than "sleep very soundly," as in "sleep like the dead."  The Tanzanians are too polite to tell the wazungu (white people, mzungu is singular) the literal translation.

The travelers should be settled by now, with Gary Moody and Dr. Saga seeing to their needs, probably with some sodas and perhaps a Kili, Safari, Serengeti or Tusker beers.  (There are also a couple others like Ndovu.  Why would I be so familiar with beer brands?  Well, you can't drink the water!  OK, there is bottled water too.)

Of course, I will be anxious to hear how things have gone.  It can be a long hot drive from Dar es Salaam to Ilula.

Below are door photos of the buildings where the travelers stay.

Isimila is the student residence

The students can upload photos of the interior of their building.  Likewise Chandra and Deepthi, the couple's residence.  This will actually be the residence of the Nursing School Principal once the school is operational.

All three buildings were built for student and faculty use, if I understand correctly.  We will be making good use of them!

The couple's residence

Faculty residence

Ruaha is one of the national parks where the group will go on safari.  Isimila is a stone-age park, not to be missed.  Mufindi is a town of about 5000, some distance from Iringa.  I will need to check the significance of the name in the context of Ilula.

MSP Excitement!

Astrid, I hope you were ready to publish your note.  Of course, you won't really know it is for another day at least!

That is because our first wave left for Tanzania today on the 3:10 flight.  Here is a photo of the group.  You will have to sort them out, but generally the order is left to right.

Cole, Sandy, Laura, Erin Shana, Kristi, Kelsey, Lynnette, Astrid, Treya, Angela, Kari and Randy.

I am not quite sure who was more excited, me or the departing group.  I know I felt a little twinge of jealousy having to wait another two weeks to go myself.

Randy and I commiserated on the holding of others' passports.  And true to form, there is always a little drama somewhere with a large group traveling.  In this case, no frozen pipes but some anxious family members to see their loved ones off to the exotic lands of Tanzania and one sick cat.  This is literally a cat, not a reference to the nature of the group members.  In that vein, they are all cool cats, no sick cats.  No, Randy's cat truly got sick before they left, so a fast trip to take the cat to the vet ensued, with Gramps left to retrieve said feline.  On a personal note, I see daily that our 15 year old cat is wasting.  She doesn't seem ill.  She still romps and races, but she is also content to purr in my lap for extended times.

In Tanzania, there are many dogs and cats, some surely being pets.  Unlike here, where we see many breeds, the dogs in Ilula all appear phenotypically similar.

The group is now over the Atlantic.  There is an 8 hour time difference (no Day Light Savings time to account for).  The group will pick up Chandra and Deepthi in Amsterdam and Jill and Julie had checked in separately.  I am relieved that all have gotten at least to the gate, to me the most difficult part.  The will overnight in Dar at Wista's, tomorrow night.

All: do not hesitate to leave a comment, especially questions for your loved ones!

Almost time... but wait!

  

These past few months, I have been anticipating the opportunity to go to Ilula with great excitement. When I first applied to this pharmacy rotation, I thought about how my experiences in Tanzania would help shape my future career as a pharmacist. One of my long-term goals has always been to serve for an organization such as Doctors Without Borders. 

Over the past few years, I've sought opportunities that would allow me to volunteer my time and skills to the betterment of medically under-served populations. I have often pondered, however, how volunteering my time to such cause would impact the people I am trying to help. There are many ethical dilemmas, which I will not cover today but should be something to think about. 

I have been asked about the type of work I will be doing in Tanzania. Often, I sense that there is an expectation for me to answer something along the lines of helping people or somehow helping fix problems that are often reported in the media. Problems that of course have merit but are often viewed as technical and not adaptive problems. Money and volunteering my time often cannot fix problems abroad or locally. 

The work that we will be doing in Ilula is fantastic. Learning about the work that has occurred over the last decade at this hospital is inspiring. I will be going there to learn. I am not there to fix anything necessarily. Rather, I will be there with colleagues to learn and to offer our thoughts and support to help others learn and grow. The following will make my comment make sense.

A couple of years ago, I came across this short documentary. Please click here to view (http://vimeo.com/6200458).