Final Days

Arrangements were made for a gynecologist from Dar es Salaam to join the team for our second week of work.  Dr. Harold arrived Monday at noon and his consults began with four women that were waiting for his arrival.  The following day was our busiest day yet and both doctors rotated between surgery and patient consults. 

By mid-day on Tuesday, our surgery schedule for the rest of our stay was completely booked.   And there was a big reason to be thankful for Bill’s talents with mechanical repairs.  We lost power for a brief time at noon and decided it was a perfect time for our lunch break.   By the time we had returned, power was normal.  Doug began his third procedure early in the afternoon but midway through the surgery the hospital lost power for the second time.  That meant Doug had a patient on the table with an open wound and was working without lights or cautery.  One of Bill’s first jobs after the autoclave was the repair of two emergency battery operated lights.  As soon as the hospital went dark, Bill grabbed the lights and took them to the operating room where Doug was able to finish the surgery with the help of Bill’s repaired lights. 

Because of the power outages, Doug postponed Tuesday’s last surgery to Wednesday morning.  The surgery schedule was already at the max, so the team arrived an hour and a half earlier to get a head start on the full day.   Dr. Harold had his first surgery with this team and asked Doug to scrub in with him.   The patient was a young woman who was 3 months pregnant and a large ovarian cyst was removed.  It was amazing to see her full, round uterus resting on her belly while the two doctors successfully removed the diseased ovary, after which they replaced her uterus and closed the wound.  Both doctors say that the prognosis for a successful pregnancy is excellent.  Praise God!

The other half of our team has continued to work in Lugoba the past two days, helping to educate the school children, parents and adults of the village about their health and the benefits of preventative medicine.  Tanzania has a culture of reactive medicine and many people see a doctor for the first time when they are in the middle of a health crisis.  One of the strategic goals of the Morogoro diocese is to change that and our team is blessed to be a part of making that happen.

We are looking forward to dinner at a local restaurant tonight and Barbara and Dr. Harold are joining the team at “The Oasis.”  We will be celebrating with Elise (birthday) and Bill and Sophia (anniversary.)  That will make for a late evening but we enjoy the change in dinner fare and the chance to socialize together as a team.

Thursday is our last day of work and the village people are becoming hospital crew!  While part of the team will be working as support for the doctors, the rest of the team will be doing public health screening at Mazimbu.  We expect a very busy day.

Since our work will be completed, Friday morning we head to Mikumi National Park for safari and arrive at sunrise.  It might be possible to post pictures before we leave, but there won’t be a chance to write another blog.  Packing and final farewells must be completed by late Saturday morning, when we start our long journey home.  Our time here has been a blessing and many team members are already talking about returning next year.

Our day in the Maasai village with Tisho's family

Saturday as tourists and Sunday in a Maasai village

Saturday saw the team split into two groups—hikers and non-hikers.   The non hikers, Glennis, Emily H, Pati, Elise, Sophia and Cindy were joined by Nova, Kristen, Jennifer (Kristen’s roommate) and Kadege, our Maasai guide and we all piled into Barbara’s Land Cruiser for the short trip to the Maasai cattle market.   There was a bit of gloating going on between the two groups as the hikers had to make a very early start—before breakfast—while the non-hikers slept in and began their day around 10 am. 

Kristen works with an organization called the Mission Society and is assigned to the diocese here in Morogoro.  She was raised in Iowa and she has been in Morogoro for more than two years.  She is fluent in Swahili and her help with contacts and translation over the past two years has been much appreciated.  Her boyfriend, Tisho, is a Maasai who has also helped the team with translation.  Tisho agreed to guide the hikers up Mount Uluguru.

Emily S, Jamie, Cassie, Brooke, Michelle, Bill and Doug tackled the steep climb up the mountain, which goes to a house about 2/3 of the way up the peak that was built in 1911 as a retreat for German missionaries.  Michelle and Cassie set a brisk pace and the hikers reached Morningside in two hours.  The path up is unusually steep and goes within a couple feet of several private homes.  As they were resting at the top, Tisho’s phone rang and he handed it to Doug—Matron needed his guidance on one of the surgical patients from the prior day.  The return trip took only an hour and Tisho dropped all but Doug back at LJS around 2pm before taking Doug to Mazimbu to check on his patient.

For the other half of our story, the cattle market was a very large area where Maasai from surrounding areas come to buy or sell their cattle or goats.  Tradesmen also set up stalls to sell goods and crafts and there is an area sheltered by trees for those who want food or drink.  Kadege took the team through each area, answering questions and helping with negotiations for purchases.  The team enjoyed shopping for unique Maasai souveniers—knives, sheaths, clubs, stirring rods, long thin hiking sticks, fabric and many other items.  Elise, who is a pre-vet student with a goal to practice animal science among cows, was particularly entranced.  She is working on a presentation for a class that will give her 3 credit hours and found much fodder for her research at the cattle market.

Sunday arrived and the team had the opportunity to worship at two services.  Barbara’s home church of Bungo is in downtown Morogoro and she invited the team to be with her at the early service where she made a special offering in thanks for her years here in Tanzania.  After Bungo, we travelled to Tisho’s family village of Melela Kibao where we were invited to join them for worship. 

Guests in a Maasai village are always hosted with food and drink.  When we arrived at 10:30 (for a 10 am service) we were greeted warmly by Tisho’s mother and his other 3 mothers.  Traditionally Maasai practice polygamy and the KKKT does not try to change that for men who convert that are already married to more than one woman.  However, polygamy is not allowed for Christian Maasai who wish to marry.  Each wife has their own house and the semicircular grouping of homes for a family are arranged to provide shelter for their livestock.  Tisho’s mother ushered us into her small sitting room where benches were ready for us.   We were offered a fragrant chai tea with chapati, similar to crepes, and squash.  Tea was a leisurely affair and Kristen warned us not to be concerned about time.  We were fairly sure the worship would not start without us since we were honored guests and expected.  Shortly before noon Tisho led us on a path through the bush to the wattle and daub church.  Tisho’s father had us sit on benches at the front of the small church where we were treated to the girl’s choir singing to a drumming accompaniment and dancing choreographed steps.   We were taking photos and video and were surprised when one of the women in the church turned her cell phone on the team and began videoing us in return! 

The service began at 12:30, almost 2 ½ hours later than scheduled, when the travelling evangelist arrived.  Maasai sub-parishes must be numerous to allow the villagers, who travel by foot, to have a church within a reasonable distance.  There are not enough pastors for all of the churches so sub-parishes have been established and an evangelist, or travelling preacher, is assigned to two sub-parishes.  He will preach a service at 10 and then a second in a different location later in the day.  The start of the service is determined by when the evangelist arrives.

Worship normally lasts for 2 hours or longer.  This tiny church had only the small girls’ choir but some churches have 2 or 3 choirs and each choir will have their part in worship.   There are usually several offerings—each with a designated purpose—and the congregation stands and walks (or dances!) to the collection basket to make their gift. 

After the service, we all exited single file, forming a circle outside and shaking each person’s hand in the process.  Sophia added her hand-made necklace to the offering and an auction was held to find the new owner of this prize.  The bidding was fun and light hearted and the winner paid the winning bid to the church and gave Sophia a big hug of appreciation.

As we left the church down a path different that the one taken earlier, Tisho explained that the site chosen for the building was subject to flooding during even a mild rain.   So the village is looking for a better site and will try to raise the funds to build.  The money raised so far has been enough to get several truckloads of rough blocks that will be used to shore up the foundation and he led us to this building site.

When we arrived back in Tisho’s home a meal had been prepared for us.  We sat on benches under a tree and were given rice and cubes of beef in a delicious milky broth.  After our meal the women brought out some of their hand-made beaded jewelry and smiles were on both sides as goods changed hands.  As our time drew to a close we took photos for all of us and bid this wonderful family goodbye.      

Uluguru mountain hike and Masai cattle market

Lugoba Primary School

Lugoba and Mazimbu early days

Mazimbu team

Work at the hospital has not been as busy as in past years.  Because Doug is our only doctor this year, the word was spread before we arrived that the team would see only patients who had previously seen a doctor and been told they needed surgery.  We do not know why we have had so few requests for surgical help, but by Friday morning the pace has picked up.

Doug has still been busy in the OR, though, because Mazimbu has asked for his assistance on several surgeries that were timed specifically for our first two days so that he could lend a hand.

And we are excited to report that Bill’s talents as a handyman are being put to good use at Mazimbu.  Midway during a procedure on Wednesday the cautery machine stopped working.  Doug had to finish the surgery tying off all of the small vessels with suture, a very tedious process.  And if we had to work without cautery, we would have to rethink our plan to have a gynecologist from Dar es Salaam work with the team next week.  Gynecological surgeries are bloody procedures and cannot be done without cautery.

So Bill came with the hospital team yesterday, Thursday, to see if he could repair the cautery machine.  And he found and fixed the problem very quickly.  Matron promptly adopted him and began giving “Babu” (grandfather) many different odd jobs around the hospital.  Bill turned our pharmacy into his workshop and at one point his arms were full of small appliances including an iron and a small lamp.  At the end of the day, Matron asked Bill to return and look at the generator to see if he could help.  If you will remember, this is the big generator that will power the entire hospital during a power outage and it is a very expensive piece of equipment.  That invitation is quite a compliment to his talents!

It might be a couple of days before another post is added to this blog.  We are all eating dinner at a local favorite restaurant, Dragonea, because Friday night is pizza night.  Our translators and Barbara, Kilatu and Kristen are joining us and we are looking forward to lots of conversation, laughter and pizza.  Tomorrow, Saturday, half of the team are hiking the mountain and the other half are going to a Masai cattle market.  Sunday we will be enjoying two worship services—the first with Barbara at her home church and the second in a Masai village.  So we will have lots of stories to tell of our weekend adventures!

Please comment!

Many of us have heard that you are enjoying our blog.  Please post comments!  We look forward to reading the comments out loud when we are together as a team.

Travelling from Dar and settling in

Shopping and working

The Village People

It has been two days since we have added to our blog.  Despite a few minor gastric rumbles, we are all well.  Our days have been very full and the hospital crew has waited for the village people to join us back at LJS so we can all eat dinner together.  That is usually followed by a team meeting that might include reorganizing and packaging vitamins for the village people.  So by the time we could begin working on the blog, we are all ready for bed.

It is Friday morning and the regular breakfast fare is supplemented with “sausages” that look a lot like hot dogs.  The village people are heading out for their second day at Lugoba primary school, where children are as young as 6 and up to 14.  We are seeing only the lower grades and expect to see about 600 of the 1300 students at the school.  Of interest is the fact that the current president of Tanzania is from Lugoba and attended this primary school.

For the health screening at the school, the team has arranged desks in a classroom that has been cleared for our use.  The interpreters with the village people are Kristen, a missionary from Iowa who is loaning her services to the diocese; Eliyuko and Nova, two Tanzanians who have worked with the team in past years; Gamma, a Tanzanian who is new to the team and Kilatu, an officer in the diocese.

Emily H begins registration with Gamma’s help, recording each child’s name and age.  Some children do not know their age so Gamma gives Emily his best guess.  After registration, Jamie and Glennis measure their height and weight and take their temperature.  Eliyuko floats between stations and helps where needed.  The next stop is “look and listen” where Emily S and Michelle listen to their heart and lungs and check eyes, ears and throat.  Then the team can see the fear grow in each child’s eyes as they go to the “pricking station” for a finger prick by Cassie or Brooke to check for anemia. 

Finally, each child presents their completed form with the results from each station to Cindy, working with Nova.  Advice and recommendations are written on their form so that parents have follow-up instructions.  They are given a packet of vitamins as they leave and have forgotten their worry about the finger prick.  Despite the language barrier, most of the children are flashing happy smiles and are clearly entranced with this American team.

Lugoba and Mazimbu

NOTE--It is late here at LJS and the internet is too slow to post pictures.  But we have more than 20 pictures ready to upload and will add those tomorrow morning from Mazimbu, where we can get a stronger connection.

Doug, Sophira, Elise and Pati worked at Mazimbu while the rest of the team travelled to Lugoba, a village about an hour and a half away. 

Mazimbu

International air fare includes 2 checked bags and we allocate one of those bags for team gear.  So a team of 13 can bring 13 50-pound bags of gear.  The majority of that gear is medicines and surgical supplies so the first part of the day was spent unpacking and organizing more than a half ton of gear.  Word of mouth has not spread throughout the community so we saw very few patients.  However, Dr. Kasuwi, the head of Mazimbu hospital, has asked for Doug’s help with three surgeries.  Sophia and Doug worked together to do the pre-op examinations and the first surgery begins tomorrow morning at 9am.

Dr. Kasuwi brought up one area of concern—a recent power outage fried the hospital’s generator.  Electricity is very undependable, especially when there is heavy wind or high rain.  With the generator crippled, if an outage occurs during surgery it could be life-threatening to the patient so we ask your prayers for a solution to this problem.

Lugoba

After a couple of short stops the village people arrived in Lugoba at noon and were organized and ready to begin their public health screening a short time later.  Though things were a little hectic at first, everyone was able to master an efficient system to aid the people of the village.   At the end of the day the team enjoyed some playtime with the children, singing songs, laughing and posing together for our designated photographer, Bill.  The children absolutely loved being able to look at pictures of themselves and the team even spotted a few of the adults trying to subvertly take their own photos of us.   Despite the slow start, more than 50 people were screened today and we expect that number to double tomorrow.

To finish our story of today, Brooke was touched by a woman she helped, Rose, who was one of only a handful of English speakers.  Rose asked Brooke what our goals are and how we planned to help the people of her village.   After a lengthy conversation, Rose thanked her and the team for our help in the village. She said to Brooke,  “You are all angels. I know that God sends angels at the right time and to the right place. God has sent you and your team here.”

Relationships matter

Like all meals, breakfast at Lutheran Junior Seminary is served family style.  Most mornings we have a choice of millet, home-made yoghurt, granola, fresh fruit, toast and hard-boiled eggs.  After our meal our ride arrived promptly at 8am—a Tanzanian dala dala.  This is the primary public transportation in Morogoro and dala dalas resemble a VW van.  The seating capacity in American terms is 9 people.  However, some things are lost in translation.  So the capacity in Tanzanian terms is about 50 and there is always room for one more.  When locals see our van go by full of Caucasian faces, they assume we are rich since we are all seated.

Dressed in our Sunday best, we arrived at the diocese office to be officially welcomed by the assistant to the bishop and offered refreshments.  This formal welcome and greeting expresses the Tanzanian priority of putting the relationship first.  Only after taking the time to relax and exchange pleasantries over tea or soft drinks can the team switch our focus to the work awaiting us.

Our next stop was the office of immigration where we had to present the completed forms required of all non-Tanzanians.  Again, we saw the value of relationship—it was possible that we would have to pay an “immigration fee” for the privilege of working in Tanzania.  There are different regulations that are subject to interpretation and we were fortunate that the officer interpreting the regulations for us knew Barbara through a connection in the local Rotary Club.  She also welcomed us and was particularly happy to meet Doug, who invited her to come by Mazimbu and see him if she had any health issues.

Once we were finished with immigration we went to Mazimbu to introduce the team to the staff and give them a tour of the facilities.  Again, we were welcomed with wide smiles and happy hugs.   Matron Seguru was proud to show the team the preparations that had been made for our arrival and we are looking forward to working with the staff again.

The afternoon was spent playing tourist in Morogoro and doing a little shopping.  Doug and Bill were very patient while the rest of the team visited a fabric shop and then met with a street tailor to order clothing made out of their new purchases.  Emily and Michelle have to leave early so the tailor has promised to have their clothing completed by Thursday, which leaves a couple days to correct any problems.  The rest of the order will be delivered the following Monday.  Tanzanian entrepreneurial spirit is really amazing—without having any patterns, just descriptions, the tailor has agreed to complete more than a dozen garments in a week!       

Tomorrow morning we split the team into two groups:  Doug, Sophia, Pati and Elise will begin the work at Mazimbu to identify surgical candidates and the rest of the team will go to Lugoba to work with the village on public health screening.

It is Sunday evening and we are winding down after unpacking.  Cindy wants all of our family back home to know the contact is her husband, Dana.  If you send Dana your email address to pennie@brightok.net Dana will email you whenever he receives an email update from Barbara, who will have better internet access than the team. 

We just posted the first blog and are trying to upload a few pictures.  If the internet cooperates, look for them tonight.

Dar es Salaam via Istanbul

Flying earlier in the season gives the team more options when choosing an airline.  For the first time this year we are on Turkish Airlines and are routed through Istanbul.  We left home late in the day on Friday and arrived in Dar es Salaam in the wee hours of Sunday morning.   After a short rest at the Catholic guest house, the team enjoyed a luscious brunch at The Southern Sun and then made the final 3 hour drive to Morogoro.

We had a brief layover in Istanbul and the team enjoyed learning everyone’s names, home towns and background.

Cindy Pennie, our team leader is an RN from Stillwater.  She has led the surgical mission team each year since the first trip in 2008.

Doug Treptow, surgeon and his wife, Glennis Treptow, live in Rogers, Ar and this is their 4th trip with the surgical team.

Bill Carr, a retired radar systems specialist, house builder and all-round tinkerer and his wife, Sophia Carr, an RN, live in Newalla.  Sophae just recently retired from her job as a triage nurse. 

We have four students from OSU this year--Elise Francel, prevet from Piedmont, OK; Jamie DeGeorge, pre-nursing, from Stillwater, OK; Cassie Gutierrez, premed, from Grants, NM; and Brooke Elmore, premed, from Guthrie, OK.  Elise was with the team last year and enjoys leading Tanzania children in the OSU cheer.

Emily Harkins, is a youth minister in the ELCA from Waverly, Iowa and is serving along with her sister, Michelle Warner, who is an RN living in Kingman, Az.  This is Emily’s fifth trip to Tanzania, after serving on the building team last year and in prior years.

Emily Smith, an RN from Neosho rounds out our nursing staff and Pati Murdock, from Rogers, AR, works as the team manager.  This is Pati’s sixth year trip with the surgical team and she is looking forward to seeing all of her friends in Tanzania.

2013 starts in T-48 hours

Another year has passed and God has assembled a team with some new faces and some familiar faces.  Our flights leave our home towns late Friday afternoon and we meet up in Chicago before a long flight to Istanbul and then on to Tanzania.  We are looking forward to seeing our friends again at Mazimbu hospital and working with Barbara.

Pictures and team info will be posted Friday.  The team would love your prayers for safe travel and that we will follow God's will as we work in Tanzania.