Saturday, June 22, 2019

Final Thoughts



Friday

Friday was our last day at Mazimbu. This is always a bittersweet day, filled with farewells and promises for next year; yet it is also the beginning of our short time to be tourists in this beautiful country.

Four short out-patient procedures were on our calendar and we quickly learned than one patient cancelled due to a death in his family. That patient was invited to call Mazimbu next week to make arrangements for Dr. Kivuma to do his surgery. By reserving our last day for out-patient procedures, Doug ensures that he does not leave anyone still admitted to the hospital.

Once the work was done, we had to return our pharmacy to its former state as Matron’s office. Our supply of meds were divided up—many were left in Dr. Kivuma’s care at Mazimbu, giving him a store to draw on for patients who cannot afford their price. The balance was divided between a store to be sent to the Diocese’s remote dispensary, Mkulazi, and to Andrew Olsen, a Lutheran missionary we met at LJS who is preparing for a 10 year assignment in remote northern Tanzania with his wife and young daughters.

Since we left Mazimbu around 1, Epsilon suggested a rooftop restaurant for lunch. The view was spectacular, boasting 360 degrees of Morogoro with the cloud-capped mountains soaring above the rooflines. Conversation flowed among the team, Kilatu, Epsilon, Kishumu, Samwel and Denis. We talked of the weeks past, our homes, our families, our hopes and our dreams. It was a good thing that we all enjoy each other’s company because the restaurant kitchen was totally overwhelmed by our group and it was more than four hours before the last of our group received their meal.

Our arrival back at LJS left us only a few hours to pack for our return to Dar es Saalam.

Saturday

Our bus pulled out of LJS at 5:30 am, before sunrise, to take us the 2 hours to Mikumi National Park, where we transferred to three open air safari vehicles to tour the game park. The driver of each vehicle spoke great English and was very knowledgeable about spotting birds and animals and explaining interesting information about each find. The animals are totally oblivious to our vehicle, which means that often they are very close. The most impressive were two Mama elephants with their suckling young that were grazing only about 15 feet from the road and continued grazing right up to our vehicles, crossing our road and continuing on their way. We also saw giraffe, warthog, impala, water buffalo, jackal, zebra, hippopotamus, wildebeest, crocodile, baboon, black-faced African monkey and monitor lizard.

After touring, we enjoyed lunch in a beautiful lodge overlooking the grasslands and wildlife. We were back on the road to LJS at 2, arriving at 4 pm. Following our plan, we scattered to grab the bags packed the prior night and loaded the bus and the extra car provided by the Diocese to make our trip to Dar more comfortable. Our final goodbyes were said to Epsilon and Samwel and we began our trip back to Dar (with Kishumu) at 4:30.

Traffic in Dar is beyond description. What used to take about 3 ½ hours 10 years ago took us almost 6 hours. After grabbing a quick bite at the KFC in Dar, we checked in to our Air BnB just before midnight.

Sunday

Our plan today is a brief bit of shopping at Slipway, a local upscale shopping area with extensive vendor stalls in tents outside. This will be followed by lunch at Sea Cliff, which looks out over the Indian Ocean. We plan to arrive at the airport at 2 pm for our 4:45 pm departure.

This will be our last post for 2019 until we are able to be with you again and give you all our stories in person.


Wednesday, June 19, 2019

Bridge over Mkundi

Portion of fence completed with sand and gravel for mixing cement on site

Hand stretching chain link

Example of poured concrete base for fence
Bintis with babies

Berega baby

Newly constructed goat house for evening safety

Fence posts waiting for chain link

New water tank for goats and cows

Berega and Beyond


Monday….

Monday morning our bus set off to Berega at 8 and we were joined by Kishumu, Epsilon and Mama Kilatu. Mama Kilatu is our liaison with the Morogoro Diocese. She is invaluable to the team and takes care of arranging all the required government documentation with the ministry of health and immigration so that once we enter the country, all of the proper permits are in place.

Berega is about 2 hours away and our route took us up into higher elevation, allowing for panoramic views of the stunning scenery. As we neared our destination, our bus turned off of the highway at the town of Berega and began rumbling over a rutted dirt road. The Mkundi river is a very shallow and wide river that is the final landmark before Berega infants’ home. The rains last fall were very heavy, and the river flooded, doing serious damage to the only bridge. Our driver navigated the remnants of the bridge as the team held our collective breath, knowing that if the bridge collapsed, the drop would not kill us.

As we turned in to Kristen and Tisho’s house, Ethan came running to greet us, jumping into Pati’s arms, who just happened to be the first one he met. Everyone was favored with his rowdy greetings, but he saved the most exuberant welcome for his friend, Megan.

The babies were in the arms of their Bintis as they came out to greet us and we were treated to a lovely song, their young voices lifted up in praise to God for His many blessings. Mama Kilatu offered up a prayer before the babies were laid down for their naps.

Terry was excited to introduce us to the new dairy goat and cow, explaining to all of us the merits of each and why they were chosen for purchase. There was a second goat that Tisho purchased before Terry’s arrival, but on his advice it has been ear marked for the stew pot for the next big celebration.
Tisho’s goal is to make the infants’ home self-sufficient. To that end, they have found two more dairy cows that will be purchased this week and the current cow and goat will be bred once they have matured a bit. An important part of this plan is the fence that will allow for safe and theft-free grazing for the animals during the day. This fence is a marvel. The uprights are made of poured concrete and each one weighs about 160 pounds. They have five forms and were able to make 15 posts each day. This is done up near Kristen and Tisho’s residence so four men heft each finished post, carrying it to the site where it will be embedded 2 feet deep. Then chain link is manually stretched with a hammer and pliers between each post. Eventually, more cement will be poured at the base of the fence to secure the bottom.

After a lovely meal prepared by Kristen, we said our farewells and headed back down to Morogoro. Megan and Bethany remained in Berega and we look forward to hearing their stories when they join us again on Friday.

 Tuesday…

Our work began again on Tuesday. Although we had left word with the guard at the front gate that our schedule was full, we saw 50 or 60 people waiting for us as our daladala rounded the last turn to Mazimbu. One of our senior translators, Epsilon, showed why he excels in that position as he diplomatically explained to the crowd that the team is still caring for patients registered the prior week but that no new patients would be seen.

Doug and Chris were busy all day with six procedures. Chris, especially, received Doug’s highest praise—“He is the hardest worker.”—because Chris is not only assisting with every case but is also cleaning and wrapping the instruments for each procedure.

Eileen was kept busy dispensing reading glasses and sun glasses from the pharmacy. She has an eye chart that each person reads to help determine the strength that will work best. She even has different styles so each person gets to choose their favorite frame. They leave with smiles, often adding “I love you” to their farewell.

Dr. Swai, the Mazimbu gynecologist, began seeing our patients on Tuesday. His list of 25-30 women resulted in 4 surgeries scheduled so far. Our arrangement with the hospital is that Dr. Swai will perform his surgeries after we leave, but the team will still bear the expense of their procedures. There will undoubtedly be more cases added to the list once all of his lab and ultrasound results have been reviewed.

Wednesday will be a bit easier for us with only four cases scheduled. This is still a very full day but we hope to be finished with our work by 6 pm and are planning to have dinner at the Arc Hotel restaurant, sitting under the stars.


Saturday, June 15, 2019

Saturday Night and All is Well




Since our last post about work at Mazimbu, the team had two very busy days to complete our week. Thursday and Friday saw four procedures each day for Doug and Chris, while the rest of the team worked with the queue of patients waiting for us each morning. We were at the hospital very late each day but the kitchen staff at Lutheran Junior Seminary, our home base in Morogoro, keeps our meal warm until we arrive and are able to enjoy our dinner.

When we have a day at Mazimbu with four scheduled procedures, the team works to manage the new patients so that they can still be seen by Doug. His day will begin with rounds to visit the patients admitted after the prior day’s surgeries. Then it is hit and miss if he will be able to see a new patient before he is called into surgery. We can usually plan that one or perhaps two new patients can be seen during the break between each case. However, one of those breaks must be used to allow Doug and Chris a chance to eat lunch. So the decision was made by late morning to send most of the patients home that were waiting to see Doug. The nurses chose the five patients with the most urgent need for surgery and the rest were given set times next week to return.

Of those five patients, Doug scheduled four for surgery. At that time there were only three remaining slots, so we had to squeeze in the last case. That means that we are completely full for surgeries that will be done by Doug this year.

Dr. Swai, our friend who is the Mazimbu gynecologist, has been gone this first week but will be back on Monday and will be working with the team. We have about 30 women scheduled to see Dr. Swai over Tuesday and Wednesday. This will undoubtedly result in some needed surgeries. In past years, we have made arrangements for these types of patients to continue to be handled as our patients, but their surgeries will be done by Dr. Swai for us after we have departed.

Therefore, we will not be doing any additional screening of patients next week—our schedule is full. So without the need for the front desk or the nurse’s triage, our need for team and translators is reduced also. This has created an opportunity for Bethany and Megan—keep reading.

Friday night dinner was at a local restaurant, Dragonaire, where our group enjoyed laughter, conversation and stories over some great cracker-crust style pizza. It was a good thing that our Saturday morning started a bit later than normal because we didn’t return home from Dragonaire until close to midnight.

Saturday found the team on an air-conditioned bus travelling in comfort about an hour away from Morogoro to visit the Maasai cattle market. We were joined by Epsilon and by four of our Maasai friends—Kishumu, Obale, Samwel and Magreth. Of the four, only Samwel was wearing western clothes. The other three wore their Maasai robes, which are draped and tied artfully to fully cover all the important parts. At the cattle market, we met back up with Tisho, Kristen, Ethan and Terry. Tisho is also Maasai so we had quite an escort for our visit.

Kishumu gave us a brief overview of Maasai culture and answered our many questions. We then strolled around the area, watching all of the Maasai herding their cattle—each small group being kept together by several warriors with their long sticks until a buyer offers an agreeable price and possession of the animals changes hands, It is common for one of the cattle to bolt from their group, which triggers one of the warriors to run after it yelling and waving their stick. Our Maasai hosts were very careful with all of us, being sure to watch for bolting cattle and stepping in to turn any charging beasts away from our group.

At the market, “farm to table” takes on a whole new meaning. We see every step of the process of cattle or goats being butchered and roasted for consumption. In fact, this is a highlight for us—eating the freshly roasted beef and goat. One of our Maasai friends chose a tasty section of meat and walked over to our area carrying the large portion of beef or goat on a sharp stick. Two Maasai would then work together—one would hold the stick, still with the meat attached, while the other used his VERY sharp machete to slice the meat into bite sized chunks. Both the holder and the cutter would pop a juicy bit of meat into their mouth every so often. But most of it is put on a plate that was passed around for us to eat with our fingers, first dipping it into a bit of salt.

After our lunch, Kishumu and Tisho were able to recruit some friends and we were treated to ceremonial Maasai dancing and chanting. This involves much jumping and a beautiful low=thrumming chant to create the beat. Our smiles echoed the joyful look on the dancers and we all showed our appreciation for the dozen or so warriors once their dancing was done.

We said goodbye to Terry again, as he is returning to Berega with Tisho, Kristen and Ethan to continue his work. The team is going to Berega on Monday to visit and see the work that is being done there and here is where the opportunity has happened for Bethany and Megan. When our bus leaves on Monday to return to Morogoro, they will not be on it because they have been invited to stay several days. They will get to play with all of the babies and see what goes into their care. They will also get to learn how to cook over an open fire and to work with the young girls, called Bintis, who come from the families of each baby and stay with the baby until they reach two years old and return home. The Bintis are learning English, and Megan and Bethan will be encouraged to have conversations with them to further their skills.

On our way back to Morogoro, we stopped briefly in Kimbala, Bishop Mameo’s home village, to greet his wife, Rose, and their children. After a delicious cup of Maasai chai, we were on our way again, arriving back at LJS around 8.

So it is time to say good night. And we will update again after our trip to Berega.


Thursday, June 13, 2019

A bit of Background on Berega

Berega Orphanage was founded in 1965 by the United German Mission Aid. In 2005, Berega changed its caregiving approach by recruiting relatives of the orphans to move into the orphanage and help with the caregiving until the orphans return to the village, about three years of age.  Several years ago, the New York Times wrote an excellent article (https://www.nytimes.com/2009/06/25/world/africa/25orphan.htmlabout Berega.  Ute Klatt, a German missionary, was the director of Berega at the time of the New York Times article. For the past two years, Tisho has been the director of Berega and he, Kristen, and Ethan have made Berega their home.

Berega has 8 acres on one side of the road and two acres on the other side.  Much of the land has been unused in the past and Tisho wants the orphanage to be as self-sustaining, especially in good production, as possible.

One of the sustainability projects is the Berega Orphanage Dairy Herd of goats and cattle, which will provide milk for the orphans.  However, the land is unfenced and needs a few improvements before the dairy project can be successfully initiated.  The fence will endure the safety of the goats and cows from village dogs or other nuisances.  In addition, it will safeguard the pastures from encroachment by crops or other grazing animals.

Wednesday, June 12, 2019



From left to right--Terry, Ethan and Fundi Watson working on the goat house

News from Terry in Berega

Kristen, Tisho, Ethan, Lucas (Tisho’s cousin), and Terry left Morogoro to inspect four goats as prospects for the Berega Infants home Dairy Herd.  They drove up a narrow and winding mountain road that eventually turned into a foot path. As they crested the mountain, they had a wonderful view of Morogoro behind them and a beautiful mountain village before them.  Picking up a local guide, they went further down the foot path until they could no longer continue by vehicle.  Disembarking, the walked the final kilometer on foot.  They came to the farm of a farmer who had received crossbred dairy goats and cattle from Heifer Project many years before.  His goat and cattle had multiplied and he was now in the position of being able to sell a few.  Two of his goats had potential and Tisho started the bargaining process while Kristen, Ethan, and Terry inspected the dairy cattle.  Ultimately, it was decided to purchase the better of the two goats and a one-year-old heifer from his best cow. The beginnings of the Berega Dairy Herd.  Thanks be to God.
From left to right--Tall Chris, Short Chris

Short Chris was our first surgery--attacked by the autoclave

Surgery on our youngest patient

Beginning surgery on a 3 year old boy

Sheila checking blood pressure

Comforting her son after his surgery

View from inside our daladala

Work Begins....And Continues



Begins…

While Doug, Cindy, Sheila and Laura joined the Mazimbu staff for morning meeting, the rest of the team met with our seven translators to discuss expectations and goals. All but one of the translators have worked with us in past years so their prior experience helped as they began their work with us.

The hospital is shaped like an inverted “U” with Mazimbu reception on the west end of the “U”. A table was set up on the east end of the “U” for us, which became our own reception area. Pati’s job is to register patients coming for our help, working with one of our experienced translators, Epsilon. Some initial screening is done to look for people that might need a surgical resolution for their problem. There are many more non-surgical patients that are hoping that the US doctors can cure their ills and one of the Mazimbu doctors, Dr Richard, who is working with us as one of our team doctors, sees those patients.

After reception, the patient is shown through to our next station, triage, where Laura or Sheila work with their translators, Sara and Margret, to take the patient’s history and physical. One of the challenges of the triage station is weeding out the one real reason why the patient wants to see the doctor; most patients have a very long list of problems. Laura and Sheila make the decision on whether to send the patient to see Doug or Dr. Richard. Anna and Bethany work with the triage desk and once the patient is done there, one of them will walk with the patient to take them to sit on a bench outside of the office of the doctor they will be seeing.

Meggan works as the helper in Dougs office, managing the flow of patients and generally helping to facilitate and communicate with the rest of the team. Doug, working with his translator, Denis, makes the final decision on whether surgery is the best course of treatment. If that is the route to be taken, labs will be ordered which are processed by the lab on premises. The patient waits for the results and once those are reviewed and approved, the patient is added to our surgery schedule. By the end our first day, six procedures were scheduled and that number will continue to grow each day.

If surgery is not indicated, they will likely be given medicine to help their condition. Doug has been on this team many times and knows what medicines he is likely to need; those meds are part of our medical gear so most of our patients visit with Glennis and Eileen, who are working our pharmacy. Samwel, who first worked with us last year, stays close to help Glennis and Eileen when they need to explain the meds to our patients.

Dr. Richard is, of course, able to work without translation, but our newest translator, Obale, has been managing the patient flow outside of Dr. Richards exam room.

Nancy is circulating throughout all of the stations, helping wherever there is a need and spreading goodwill with all of our patients.

It is a point of humor on the team that we have two Chris’ with us. Chris Buzzelli, is a scrub tech and his job is to assist Doug in his surgeries. Chris Pope is a retired general contractor and is working as a fundi (fixer) with Lance. The humor comes from their names. Chris Buzzelli has become “tall Chris” and Chris Pope has become “short Chris.” Refer to the picture to see why we are so amused. Kishumu, working with us for the third year, helps the fundis as they hunt through Morogoro for unique parts or for team supplies that need to be purchased each day.

And finally, Cindy is available for the whole team and for the Mazimbu staff, answering questions and helping where needed.

And Continues…

Our second day working with patients was a bit busier than the first. We knew that word of mouth would have spread overnight, so we enlisted the help of the night guard to record the names of the first 50 patients arriving to get in our queue. So when our daladala arrived, our patients were waiting—all 50 plus a few hopeful extras.

Our procedures worked well and facilitated our work so all patients were seen as promised. This is a huge improvement over past years when it was mid afternoon before we finally made the decision on the # of remaining patients who could be seen, turning away many many people who had waited all day hoping to make it into our queue.

Doug and Tall Chris will be very busy with surgery starting tomorrow. We have 4 procedures scheduled for each day, so our schedule will likely be completely full by the end of our day tomorrow.



Monday, June 10, 2019


15 people, 45 bags and a daladala

Inside our daladala

Formal picture with Bishop Mameo at the diocese office

Greetings and Gizmos



A bright cool morning dawned as the team had a leisurely start to our day. After our communal breakfast, we did a bit of organizing and then our driver arrived in a daladala, which is a very common mass transit vehicle here, like an older Toyota minivan. Daladalas hold about 10 people comfortably, so our group of 15 was very friendly with each other.

Bishop Mameo met us at the diocese office where we were formally greeted and welcomed. Newcomers to the team were introduced and we all enjoyed our visit, exchanging good hearted humor about the extremes in weather between our two countries. Bishop Mameo is studying for his doctorate in divinity through Luther seminary in St. Paul, Minnesota and was most recently in the US in February.

Our families may have noticed a bit of deafening silence from us since we arrived because we have not had access to internet or phones. Both tech problems were on the list today, along with moving all of our medical gear to Mazimbu. One of our translators, Kishumu, has already been working with us and was invaluable in helping with our communication and his familiarity with Morogoro meant he was able to tell us just where to go.

Communication has not been our only tech problem… until today we had been unsuccessful in exchanging money. Oddly enough, every bureau de change that we stopped at, beginning with the airport in Dar es Salaam, was closed or not functioning. We learned today that nationwide all of the exchanges are closed pending an investigation. That left the local bank as our only option for changing money. When our troop entered the lobby, it prompted an excess of courtesy so what we thought was a set of routine transactions ended up taking more than an hour and a half!

After high finance, lunch was the order of business and the team joined Tisho and Kristen at Ricky’s, one of our favorite restaurants. Tisho and Kristen are a married couple that are missionaries with The Mission Society and are directors of Berega infants home. Berega is about two hours away from Morogoro in a very rural area and the home is working to acquire livestock to become self-sufficient. Terry is a goat expert and his role on the team is to go with Tisho and Kristen and facilitate the purchase of several nanny goats. So we said goodbye to him after lunch and will meet up with him again this weekend.

By now, the day was waning, so Pati went with Kishumu to solve internet and phone issues, while the rest of the team went back to LJS to gather up our medical bags. We met at Mazimbu after 4 and again renewed our friendship with the doctors and staff at the hospital.

After dinner, more prep was done for the following day. Dr. Doug, Cindy, Sheila and Laura will join the Mazimbu staff at morning meeting while the rest of the team has our first organizational meeting with our translators.

Stay tuned for new of our first day after Tuesday is done!


Sunday, June 9, 2019

We have arrived!


Welcome to Tanzania!

The Tanzania surgical mission trip began Friday mid-morning when all 15 of us joined together at Dallas-Fort Worth airport for the flight to Dar es Salaam. The first hop was 14 ½ hours with a plane change in Dubai, UAE. Then just a short 5 hours down to Dar es Salaam. Our trip was long but uneventful…all 30 of our checked bags arrived intact. The plane from Dubai was almost empty, which made it easier to sail through customs.

It was only a bit before 10 pm when we were checked into our rooms at a local hostel, the Catholic Guest house. The morning sun revealed the beauty around us, from lush greenery to vivid local flowers. A hot beverage was in store, after which we climbed onto our bus for the short ride to church.

Worship in Dar es Salaam was with a Lutheran congregation at the Azania Front. Our chosen service is an English language service and you could see the smiles on the team as we joined our Tanzanian brothers and sisters in song.

A brief overview of our team:

Cindy Pennie, nurse and team leader, Stillwater, OK
Doug Treptow, general surgeon, Rogers, Ar
Glennis Treptow, helper, Rogers, Ar
Pati Murdock, 2nd team leader, Rogers, AR
Lance & Eileen Miller, Hot Springs Village, Ar
Terry Gipson, goat expert, Stillwater, Ok
Chris Pope, Stillwater, Ok
Anna Long, helper, Stillwater, Ok
Bethany and Megan Pierce, helpers, Trinidad, Co
Nancy Bean, helper, Weatherford, Tx
Sheila Weyenberg, RN, Norman, OK
Laura Brown, RN, Rogers, AR
Chris Buzzelli, Rogers, AR

As this blog is written, we are just finishing up a fabulous brunch at the Southern Sun and will shortly begin the final leg of our trip up to Morogoro, which will take about 5 hours.

We will post our updates ever day or two, so stay tuned. And we love comments!