Third installment of the trip
Now is into the beginning of the main part of the volunteering. Not before some more welcome to Africa type shit. Mai was cool enough to lend me a towel and good thing that I have a sleeping bag. But meals are also supposed to be included. But NOOOO!!. So last night when I went for dinner after some language issue. I.E no one in the canteen spoke english that day and my Swahili does not yet extend to food items. Plus I’m the only Mzungu there. Well after a bit of work on my part and a lot of patience on their part I get rice and beans and a coke, Then when I get up to leave I say asante and kwa heri
Then go out the door. 2 seconds later the cashier is chasing me and yelling in Swahili. Now I’m supposed to pay. I’m like NO !!!(Hapana). Either way I go back and sign the book as I saw other staff doing and left. He was not very happy. But he and you will be cool later. Young Kid reminds me a little of my godson AK. They look to be the same age. This all gets worked out the next day with the head doctor and administrator. Plus Mai and I have a full kitchen. So you know how I do. I went shopping. I don’t cook every day but we have an old fridge. We live near farms so the veggies are fresh. Not much meat cause there is not any really good refrigeration. So the meat needs to be stewed to tenderize.
So after waking up at 6:15 am and then again at 7 am (LOL). Luckily I can look fprward to hot water. It’s hot as Mai gets up at 5:45am to turn on the heater then she goes back to bed … then showers and does morning bathroom “ish” until 7:00. Then my turn… We head down to morning service. 8am every morning.
It also the morning staff meeting. Births, Deaths, and new admits and other announcements are made. I’m introduced to the staff. Dr Julius tries to explain what I do but EMT means doesn’t translate. Everyone is cool. Susan Emily, Carla and Michele also introduce themselves. The last two are from Cultural Crossroad Solutions. Susan and Emily are also Global Cross Road. CCS provides volunteers mainly to the orphanage from 8am till noon. The ladies are both in undergrad and pre – med majors. CCS has volunteers as young as 16 in country. Interesting.
So after chapel I take breakfast with Susan and Emily. Tea and Chapati which is a flat bread tortilla at the canteen. Keep in mind that the canteen is not the western variety. It has a small kitchen with charcoal fired ovens and an electric range top. So there are not many options. Basically chapatti, Banana Stew, rice and beans, and sometime stewed beef, chicken or goat(not often that is more in Kenya). For breakfast fried or boiled eggs. To drink we can get Chai (tea) or coffee (all day), Coke, Fanta( Yes Fanta is huge here) orange and pineapple. Then for your dining pleasure and entertainment - Tanzanian gospel videos ( this is a KKKT (Lutheran Church run) hospital. But the food is pretty good. It definitely fresh and well cooked. They do prepare it well so no one gets sick. The folks there are friendly. The canteen also feeds the patients, staff and school kids in the area. The hospital does not have a kitchen so patients families either have to bring them food or the patients have to buy it from the canteen.
So after breakfast I go on rounds with Dr Mbezi. The hospital has 4 doctors. 3 full time (Dr Kwesa, Dr Julius and Dr Mbezi all Tanzanian)) and 1 part time(Dr Jo, she’s a New Zealander). On the rounds I assist with vital signs thus freeing up a nurse and the Dr discusses each case with me. Rounds take from 9 until 1 pm.
This 96 bed hospital services a community of 196,000 people. It has 2 wards male and female in 2 bungalows styled adjoining buildings. (See the videos and pics that have been posted). There is also separate maternity ward, isolation ward, outpatient clinic/pharmacy wards, a dental office, surgical theater, Lab/Xray, staff housing, chapel,(also a new one is being built), and the orphanage all on the grounds. Plus we have cows and chickens and a few goats all over the grounds. We are surrounded by farms. Most of the place was built between 1930 -1960. It’s very serviceable but needs a lot of work and upgrades. Most westerns would not want to be here. But this place seems to do good work in the community. It is amazing to see the families and people in the hospital. While they don’t have a lot, they definitely work with what they have.
Some of the cases I saw:
A couple of cancer patients that were pretty much told that they were terminal. They were receiving supportive care. But that was it. Most had some surgery in the past. The masses came back. One patient’s abdomen was full of palpable masses. After surgical options had been exhausted they were sent home basically to die. They come here to get what support they can. But most did not seem angry or sad. Just accepting. Glad to be receiving some treatments.
AIDS Patients - of course this is Africa. The only continent that AIDS is still growing at unchecked rates. We can discuss the reasons later. AIDS affect roughly 7-8% of the Tanzanian population which is not very bad for an African Country.( It also a major shame that I can say that). This region has a 4-5 % rate of infection. Interestingly some of the problems that exist here are the same world over. There needs to be much more education throughout the country particularly at the middle school and high school levels and in rural communities. The chuches need to get on board a little more. This is a very conservative society so AIDS education runs into the same roadblocks here that it does in fundamental communities around the world. Don’t teach sex education and disease prevention. The view is teach abstainance only. People should not be have premarital sex or extra marital affairs. I’m not here to knock that. It should be taught. But isn’t part of the mission to also help the people that sin get whole again. Once the horse is gone closing the barn door doesn’t help the issue. But yes abstinancy and dedicated clean tested sexual partners is the best defense. Oh well !! There is some work being done but not as much as needed. There are patient confidentiality issues also. A patient can only be tested if they consent to it and their status is kept under the strictest confidence. One cannot be tested even if the doctors are sure the person has it. All they can do is send a health consular to talk to the patient and advise them about the disease. But for many reasons including stigma and discrimination, many people refuse to get tested. We have one case in which the hospital knows a patient to be positive but nothing can be done as this is secondhand knowledge from a credible source. Anyway she is in with an infection with her infant and breast feeding. She also will not consent to the test. So there is nothing that can be done at this point. Very frustrating. But like many places.. along with treatment and education it is going to take some cultural change to get in front of the AID issue here.
Untreated Diabetes is an issue here. Several cases both coma ulcerated legs and other repercussions of diabetes. There is no home testing. There is some nutritional consulting but there is not enough. Home equipment and better in hospital testing would help a lot. Better awareness and management would help eliminate the revolving door.
Asthma is not uncommon here. There are several cases currently in the hospital
Being a rural area there are quite a femoral shaft fractures. They reduce using skeletal and skin traction as appropriate. But the traction is done by using nail and attaching sandbag and sting then hanging off the bed. The bed is elevated and the patient stays for 8 weeks in the bed not moving very much. This leads to quite a few bad cases of bed sores and other issues. I think that they could benefit from some simple things such as Hare and Sagar Traction splints. Also modifying the technology for hospital use so patients can be more comfortable and also have more mobility.
There were a few cases of various types of chronic heart issues. Most that are very treatable and manageable at home. They are not very treatible here.
The thing that surprised me quite a bit was that there are several patients here recovering from suicide attempts. That was surprising and concerning.
The maternity ward covers the full range of maternity and female issues.
Lastly we have a case of severe bed sores.( pics posted under medical pics on other website) this patient was brought into the hospital after being home in bed for 1 month with no feeling/mobility in his legs. His butt and thighs were an open sore down to the bone. The staff us using moist gauze dressing but padding with sanitary napkins and then taping that. I was able to find and demonstrate a better dress technique with equipment from the pharmacy. Nana (big ups to you) also pointed out that the patient probably had a huge protein deficiency. Which the doctors agreed. So we were able to find some donated protein shakes and vitamins in the pharmacy after a helping reorg the pharmacy. We also enacted an egg a day program to augment the meals that his family brings. I funded the first 15 days. Dr Jo will continue as needed.
Some more observations.
While donations are definitely welcome and needed. I have observed the following.:
A lot of donations that have expired both medications and supplies. For some things that may be ok but for the most part its just using this place as a dump since all we can do is throw it out here. That is not right. People should keep in mind that it does take a long time for supplies to reach the final end point. If the expiration date is coming up as one sends a donation if you believe that it is still serviceable … send a note as to how much longer it can be used… If you find some shit in the back of the store room that expired in 1985 or 1960 ( Yes I found a case of stuff from the Washington DC Red Cross taken from a fall-out shelter. Yeah what the F#$%K!!!) Just throw it out !!!!
If you are sending loose mixed items label and separate into small baggies if you can. After all you do want the gift to help someone not live in a container because there is not enough man power to sort thru it.
Send instruction or at least a note with websites where instructions can be gotten. Don’t assume that even the trained folks will understand your equipment or complex product. Also remember english is a second language here. So diagrams are great. Folks here are very smart but somewhat under trained and overworked. As you can see all the Medical staff have to be “jacks of all trades” and “masters of none” so a little guidance goes a long way.
Sending donations and money can be tricky. Use reputable organizations or try to make direct connections with organizations on the ground. I’ll take a minute to thank Robyn Pitts for her mammoth efforts. She also discovered the red tape and difficulty in dealing with this part of the world. DON”T LET THAT DETER YOU !!! The effort may be a little bit difficult at first. But once you’ve done it once. It’s repeatable. Also you’ll know that you really helped out. Also share your findings and info with others so they can join in on the good work.
Many volunteer and donation organizations take a lot off the top. More then the actually forward on. But in their defense they do and have done the leg work of make the connections in many of these countries. They also have to deal with multiple governments red tape and other BS. But still I get the impression that they are profiting little bit too much. So do as much investigation as you can or want to. If you just want the tax deduction then something is better then nothing.
Also understand that a certain amount of graft and bribery is just how the system works. Factor it in and keep it moving. Try to minimize if you can.
Volunteering is very interesting. I’ve had numerous conversations with other volunteers so a few things.
YOU SHOULD DO IT. Volunteer somewhere, anywhere . make it some where that you really want to see. If done right you’ll always get more out of it then you put into it. It will be a working vacation. Most places only ask that you do a minimum of 30 hrs per work( But you can do more then that too. The pay is the same). One group that services Nakaranga works from 8 am to 12 noon. Then does cultural enrichment(sight seeing). Plus they get weekends off. Plus you can then go safari or traveling before or after whatever your assignment is. One good thing about volunteering is that it’s generally a cheaper way to go. You’ll see and experience more the just the tourist shit. Plus you get a tax deduction.(Maybe)
More African- Americans in general need to get out and see the world in general. Definitely more men need to get out. So far I have not met another AA man in my travels. I think people need to see that many people look very favorably on the African - American people as the Diaspora’s fore leaders. We need to really understand the benefits that you do have even at the bottom of our system. Conversely the only way to actively fight the negative stereo type about us that are out there is to introduce ourselves to the world. Remember to the only folks that everyone sees is one MTV or in sports or in the military. I think we have more to offer then just that.
In my view at least for the places I’ve been… Human resources are needed more then material resources. African has plenty of natural resource. African human resources are underdeveloped. They need people in all fields to bring there expertise here and train folks to think and do. Anyone can volunteer. You don’t have to be medical pro or a teacher. They can use all people that have some knowledge and a desire to help. Carpenters mechanics plumbers clerks anyone can add to the knowledge base. We all have professions and hobbies and interests that can make lasting improvements here.
OK actually volunteering… There are many organizations out there. Some are not that good … some are great. Just like with charities ..do your research and find one that matches your goals. In the end they all will get you here. Some are mainly tourist shops that use volunteering as way to get you a tax deductible vacation. The other extreme will have you in hut living and working as a native. Find you lane get in it. But do it.
Try to find programs that have tangible things that you can do. A program that has short term projects that you can do within 1 -2 weeks is good for your psyche and helps the people on the ground. Similarly joining an on-going project can be good as it keeps the program going. No matter what… be flexible… you may not be able to do exactly what you came to do… But you can be helpful …. Jump in were you can with the things you can do. .. remember you are there to help not to be helped.
Ask your agency lots of questions but don’t always expect a complete answer. Try to get a feeling of what your money is paying for and try to find out what it actually costs so you can understand what your agency is really about. Many are charging what the market will bear but paying out nothing. This is important because I’ve seen people paying to volunteer and live and eat at host family housing at a 3-4 star hotel rate. One company charges $400 per week (neither transport is included nor does that include safari). They are paying out $50 per week plus a little more of local guides and admins. I figure they are making at least $300 per week per person. Meanwhile you “could have had a V-8”. Staying and eating in Africa is very cheap even a decent places. Don’t think US pricing.
If you do come, expect miscommunication and or no communication( as you’ve seen in my previous notes). Bring all your documentation and local contacts in your carry on. Buy an unlocked or have your GSM phone unlocked. At the airport by a sim card and pay as you go. This way you can easily reach people locally. But expect things not to go as planned. Go with the flow .. Beware be careful… But expect it and work with it. Most times things will work out correctly. But the ugly American move ONLY HURTS YOU.
If you do come, realize that there are different cultural norms and beliefs. Try to read up on the place you are going and try to fit in or at least be understanding of things happening. And remember that you can not change a place with 2 weeks of volunteering. You can have an impact.
All that being said. Anyone and every one how wants to can do something if they wish to. While I may have been on a soap box for a moment. But I have been volunteering at home since I was 15(25 years). So this is not new to me just a new venue for me. I don’t care if you do or you don’t volunteer somewhere. I’am offering my advice if you choose to volunteer or donate international or domestically. Do as you see fit.
OK that is enough from me for now.
See you on the next installment.
Sean
