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Thursday, May 31, 2012

Last set of pictures


Final post for 2012

Our ability to connect to the internet declined sharply over the past several days so this will be the final post of this year.  We have pictures uploaded, but have not been able to post the link to our blog.  You should check in a day or two to see if we got a strong enough connection to post our pictures.

Yesterday, Wednesday, we finished at the Njie Nne primary school and today we split the team and worked in two places--Ngerengere primary school and a very distant village called Tununguo.  Our final number is 1099 patients screened and many, many referrals for further treatment.  Tomorrow we go to Mikumi game park for our safari and the following day begins our journey back to our families.   We have some great stories to tell and look forward to seeing you all.

Tuesday, May 29, 2012

Work at the Primary School



Yesterday we began work at Njia Nne, or four corners, primary school, and we expect to be here three days.  Our health screening began with children in pre-school, which is the equivalent of kindergarten in the US.  The total enrollment at Njia Nne is close to eight hundred children, ranging from pre-school through standard seven. 

In Tanzania, parents must pay for their children to go to school and education is not mandatory, although most families are able to find the money for the fees, uniforms and supplies.  All schools require uniforms, white shirts combined with shorts for boys and skirts or jumpers for girls, and the colors vary by school.    Before a child can advance to the next level they must pass an exam.  So there is a wide range of ages in each grade and children can advance to the next level when they are ready.  Primary school is pre-school , followed by standard one, standard two, and so on.  Some children begin as young as four and we have seen one boy of fifteen in primary school.  After primary school, if the child has qualified, the next level is form one followed by form two and on up to form seven.  Form six and seven are comparable to our last two years of high school.  

Doctor Arleigh, Casey and Elise worked with the team for the first time and their skills were put to use at different stations.  Arleigh did an abdominal check of all the children, something we were not qualified to do before she joined the team.  Malaria is a severe problem in Tanzania and repeated bouts can cause an enlargement of the spleen, which requires treatment.  

The high point of the day was watching Cindy teach the OSU chant to a group of about 50 waiting children, forming the letters with their whole body and finishing with a shout of “Cowboys!”  The children loved it and their antics put a smile on our faces.

Because the “bell” to end the day (a rusted wheel from a car, struck with a metal rod) rings at 2:30, our work stopped earlier than usual and we arrived back at LJS well before dinner.  

While the team was working at the school, Bishop Mike was with Pastor George Pindua, assistant to Bishop Mameo, and journeyed to the Kilosa district.  Mameo is in Arusha, studying for his Master’s degree in Theology, and Pindua holds the reins during his absence.  Mike’s introduction to the parishes in the diocese will continue this week under Pindua’s direction .  Several stops were made before Kilosa and one in particular involved a lively and stimulating conversation with two lay evangelists in the Masaii village of Parakuyo.  In Kilosa, several hours were spent with the Pastor and his family and they finished their visit getting caught up on world news—watching the BBC, Aljazeera and MSNBC. 

Today, Tuesday, we had to make a quick rearrangement of our transportation because Barbara’s vehicle broke a stud off of the wheel and needed a few hours in the shop.  Most of the team climbed into the Dalla Dalla, and Kristen took her car with the last four members of the team.   A Dalla Dalla is a van-type vehicle that fits 14 Americans in addition to the driver…or 30 Tanzanians.   In Tanzania, there is always room for just one more.

Our work area at the school is a broad expanse of hard-packed dirt shaded by an enormous mango tree, with branches radiating out 15 feet from a broad, forked trunk.  We began where we left off yesterday and before noon  had surpassed the prior day’s number of 211 children registered.  The health issues we are finding are primarily low iron (anemia), enlarged spleen and heart murmurs.  We are writing referrals for a little more than 10% of the children we have screened.

Sunday, May 27, 2012

Sunday night, brief update

After a wonderful worship at Bungo this morning, listening to Bishop Mike preach, the team was treated to lunch by the congregation.  We spent a few hours after lunch at LJS relaxing.

The rest of our team, Arleigh, Casey and Elise, arrived in Dar es Salaam safely last night, after a delayed flight.  They were greeted by another ELCT missionary, Kristen, and her boyfriend Tisho, who is a member of the Masaii tribe.  After a relaxing night at the Catholic guest house in Dar, they traveled to Morogoro and joined the rest of the team at LJS midafternoon.

We are writing this from the Dragonaires restaurant where our large group has just been served pizza.  So ..... that's all folks.  We'll talk with you tomorrow.

3rd set of pictures


Day off but not an off day


Note from author—we have pictures to post, but want to get this blog up before we lose internet connection.  They will fall between yesterday’s post and this one.  If our connection continues to be good, look for pictures in a few hours.

While Cindy, Tom and Linda relaxed at LJS for the morning, the rest of the team hiked the Uluguru Mountains up to Morningside.  Godfrey arranged a guide for us, who met us at 7am in town at “The Coffee Corner,” a cluster of outdoor food stalls nestled in the foothills.   Some of us enjoyed a small cup of very strong African coffee before beginning our trek up the mountain.

Victor, our guide for the day, is a tall, slender man who spoke very good English.  He wanted us to start our hike in town so that the first kilometer would warm us up as we stretched our legs and we would be prepared for the climb to come.  We passed a parade of villagers, mostly women, walking into town with heavily laden baskets balanced on their heads, carrying produce to sell in the market—bananas, avocados, cucumbers and much more. 

As Victor led us out of town the paved road gave way to a rutted dirt road that got progressively narrower.  Then Victor stopped and gestured to a very narrow path, almost a goat track, which climbed steeply to a sharp turn in the trail.  We started up it single file and realized that this was going to be a serious hike.

The 4 ½ mile path to Morningside clings to the side of a steep hill and goes through a very pastoral scene of terraced farmland, banana groves, single homes and clusters of several homes together.  The farmers in these mountains use every available space to grow their crops, which feeds their families and provides a little surplus that allows them to generate some income.

We reached our goal shortly after 11 am and, shrugging off our backpacks, gazed in wonder at the site of the steep fields spread out before us, curling down to Morogoro cradled in the valley far below.  Snacks were shared and laughter and conversation wove its way through our impromptu lunch.
 
Downhill is always shorter, even though the steep terrain was tricky on footing (and aging knees), and we reached the foothills again a little after 2pm.  We bought sodas and more water at a stand and the cold drinks went down very easy. 

Our final stop was at a local wine shop where some of us made a few purchases to enjoy after dinner.  
The crew that stayed behind went into town with Barbara around mid-day and were treated to a driving tour in the neighborhoods around Morogoro.  They also visited the War Memorial cemetery that commemorates those killed in World War I.  Of interest to the trio was the noted segregation of the graves, where each race and nationality was marked and their cultural burial customs were observed.  That was followed by a leisurely lunch outdoors at Ricky’s CafĂ© and an entertaining half hour watching Barbara haggle for fruits, vegetables and staples in the local market. 

Our morning will begin early tomorrow because Bishop Mike is preaching at Bungo.  Barbara will translate for him at both services and word has spread throughout the town, so we are expecting a good gathering.

Friday, May 25, 2012

Kirangalo


Yesterday was a very relaxing day for most of the team.  Synod business that necessitated a meeting between the ELCA and ELCT pulled Bishop Mike, Cindy and Barbara away for the greater part of the day.  That meant we enjoyed a leisurely morning, splitting off into different groups and doing different things. 

Aaron, Mary, Bernie, Connor and Pati took a walk that led them off the campus a short way to a local shop in the village.  We purchased sodas (600 Tzs each—about $.30) and sat in chairs provided by the shop to enjoy some conversation.  While we were sitting there, a small girl about 4 years old walked by and we took pictures to show her her image on the camera.  She enjoyed it enough that she ran off and very quickly came back towing her toddler brother after her.  So we took his picture as well, showing him the camera with his picture.  And next thing we knew, her mother came by and also posed for pictures.

Carrie Beth and Shelby walked around the grounds and journaled about their experiences to date.  

Mike, Tom and Linda took advantage of the time to relax in their rooms.

In the afternoon, several of the group waged a fierce dice game of Farkle which ended just before the ELCA/ELCT group arrived back at 3pm.  We very quickly loaded up Barbara’s car with supplies that had been earmarked for Mazimbu, the hospital that has partnered with the surgical team for the past two years.  Because space in the car was limited, Aaron, Connor, Tom, Mike and Bishop Mike had to stay behind at LJS while the medical staff, along with Pati—who has worked with the Mazimbu staff-- made the quick drive to the hospital.

Matron Deograsia Seguru and the rest of the Mazimbu staff greeted us warmly and asked after the team members from past years.  Our medical staff enjoyed the tour of the hospital and seeing a Tanzanian medical system. 

While the group was at Mazimbu, Aaron, Mike and Connor went for a walk on the campus and met a school nurse, Bibi, who welcomed them on behalf of Tanzania and gave them a tour of the grounds.
After our visit was concluded, we met the rest of the team in downtown Morogoro and shopped the congested city streets, soaking up the sights and sounds of urban East Africa, buying sodas, crackers, chocolate and bananas at the market.  Our evening ended with dinner at a local restaurant that boasted Indian and Chinese food.

Our work today was in Kirangalo, a village about 20 minutes beyond Ngerengere.  We were able to plan ahead and were granted a pass to drive through the military base between Ngerengere and our work site.  This is a really big deal.  Tanzania has very strict rules that have severe penalties for photographing anything military and nonmilitary personnel are not allowed on military property.  If our application for a pass had been disallowed, it would have added more than an hour over bad roads to our travel.  As it was, the pass required a military escort through the military base.

Although we were expected, the church grounds were deserted when we arrived, except for two Masai men who were so happy to see us.  Very shortly though, another Masai man arrived on a dirt bike with 10 plastic chairs strapped behind him.  He was followed by the arrival of a villager with a wood chest bungied on behind HIS seat.  Tanzanian ingenuity at its finest.

Aaron recognized that there wasn’t a latrine for our use, merely a sparse brush screen.  He improved the facilities by digging a hole, but had to use only the tools on hand—a hammer, knife and Frisbee.  Much later he learned Barbara had a shovel stowed under her seat!

Our system worked as well here as in the other villages and we were able to screen 90 people of all ages.  During our day, we had many interesting conversations with the villagers.  One very old woman asked Shelby and Carrie Beth “what tribe they were from?” Aaron introduced the game of Frisbee to several children and Pati helped the boys learn how to throw underhanded to make the disc fly.  Cindy used a double stethoscope to let several children listen to their own heart.  Bernie was touched by the many numbers of people that told her they hoped they would see her again.  Mary remembers the flirting baby of 6 months that kept peeping at her and smiling through his wrap.  Tom enjoyed watching the whole scene and being available to help whenever a need arose.  Connor was proudly using the new words she learned and was able to use Swahili to say “Stand here.”

As we were leaving and saying our goodbyes, the children of the village flocked around Carrie Beth and Shelby, grabbing their hands and openly showing affection.  They followed us down the road when we left, running and waving to us and our last sight of the village is their smiling faces.  

Wednesday, May 23, 2012

Dete



Our screening was done in the village of Dete today, a small village 40 kilometers beyond Ngerengere.  The drive to Ngerengere is an hour and it takes an additional hour and a half to travel the remaining distance because the road is not maintained beyond Ngerengere, where we stopped briefly to pick up supplies.  Our supplies were 30 plastic chairs that we arranged to rent because we knew the facilities at Dete would be sparse.  It was fun to watch the guys on our team strap the nested chairs on top of the two Land Cruisers that are used to transport the team.  We also picked up Pastor Christian Seseme, the pastor of the ELCT church in Ngerengere, who will be helping us with translation.  

The “little rainy season” lingers on at this time of the year and the rain last night brought welcome coolness to the air, but increased the ruts and pot holes in the road.  Both SUVs lurched and rocked down the road and we arrived a little after 10:30.
 
Our work yesterday meant each team member knew our process and we set up beneath the spreading branches of a large Neem tree.  People had already begun to line up before we arrived and the village elder gave us a list of 78 names that were waiting for the team.  Our patients waited patiently on benches in the shade as we worked the same flow that was so streamlined for us yesterday.

We took a brief break for a picnic lunch of bread, peanut butter, Nutella (can you say Reese’s sandwich?), jelly, hard boiled eggs, bananas and tangerines.  By the time we had finished for the day at 4:30, we had helped 142 of all ages, from 3 months to 85 years old. 

First set of pictures

First set of pictures

Tuesday, May 22, 2012

Sorting out, first day of work and Bishop Mike’s tour



Monday morning’s call of the morning dove greeted us as we walked to our 7 am breakfast.  Cindy and Pati exchanged a smile, remembering Dr. Andrea from prior years and her imitation of the dove.  Our day began slowly, with free time until midmorning.  Barbara picked us up and we went to the Diocese office for a formal call on Bishop Mameo, who is the head of the Morogoro Diocese.  Our team is part of the ministry of the Ar-Ok synod (a division of the ELCA) which is in partnership with the Morogoro Diocese of the ELCT (Evangelical Lutheran Church in Tanzania.)  During this formal call, greetings are exchanged by both sides and we are formally welcomed into Morogoro.  Tanzanians value relationship above all else so before any work can begin, we are welcomed and invited to regard Tanzania as our home during our stay.

Bishop Mike was already at the Diocese office when the team arrived.  His relationship as head of the Ar-Ok synod mirrors Bishop Mameo’s position and the leadership of the Diocese will be working with Bishop Mike to show him the different parishes and churches throughout the area.  

After tea, our afternoon was spent organizing and planning for our first day of work.  We greeted Bishop Mike when he rejoined us in the late afternoon and he had reports of his tour with Bishop Mameo, which concluded at Maguha, where another AR-Ok team is working on a building project.   He scarce had time to shower and rest before we met for our transport into town.  We were invited to dinner, along with the building team, and were hosted by Bishop Mameo’s home congregation at his church, (which is called a cathedral in Tanzania.)

Our “dinner” ended up being a gala with a performance by two choirs singing wonderful African music in Swahili.  One of the choirs was a youth choir (which means under the age of 35) and they sang acapella.   The other choir was accompanied by two electric guitars.  Both performances were full of rhythm, syncopation, melody and counter melody and left us applauding with appreciation.
Our final surprise was a formal gift from Bishop Mameo, who is a member of the Masai tribe, to Bishop Mike.  The gift of traditional Masai robes was accompanied by recognition of him as an honorary elder of the Masai tribe, and followed by a ritual planting of three trees that are symbolic of our synod’s relationship with the Diocese.  We were all very moved by the gift and the honor bestowed to our Bishop.

The team again split today, with Bishop Mike joining Bishop Mameo to visit 5 congregations in the Diocese, and the medical team traveling to an outlying village to do a community health screening.  Ngere Ngere is an hour away, half of which is on the Morogoro-Dar highway.  The last half is a well-traveled dirt road that is maintained year round because it is used by a military base for access.  There was a building available for our use with tables and chairs. The majority of the health care in Tanzania is reactive, in response to illness or injury.   During a health screening, we invite the village to come and be checked for any health issues that might need to be addressed by a doctor, in hopes that preventative steps can be taken.  Our services are offered to all who come, Christian or Muslim.  
We used the tables to set up different stations, working with our translators:  Pati worked registration, greeting and recording basic information on our forms; Connor recorded height and weight; Mary and Linda each worked a station checking vitals and doing heart and lung assessment; our students, Carrie Beth and Shelby, recorded blood sugar, checked eyes, ears and throat and tested for anemia; Cindy floated between the different stations, helping as needed; Tom worked as team photographer; Aaron and Mike helped the team as a runners where needed; and Bernie was the final checkout, wrapping up the results and advising those who needed to seek further care from a doctor. After a slow start, we ended our day after working with 58 patients, from babies to youth to adolescents to adults.

P. S.—the internet has been too slow to upload any pictures.  If we get a better connection, we will upload pictures.