The Sticks

I have just arrived at an outpost setting in Tanzania.  I was told I was going to a dispensary (what the Tanzanians call a very small clinic), in Lushoto. As Lushoto is a small fairly isolated town in the Usambara Mountains of Tanzania, I was somewhat mentally prepared to be isolated. However, as we drove up the mountains, Lushoto came and went.  And so did the next small village, and the next, until an hour and half later, I arrived.  Talk about rural, Aaron, who has been Volunteering at the hospital with me in the lab, eating meals with me and just generally being a good person to vent frustrations with came on the trip with me but was unable to stay for the ten days I am to be posted here.  So I am by myself.  The children here are malnourished, the lack of education, an issue I thought was bad in Tanga, is multiple times worse, general hygiene in the population is poor, and the pharmacy that I thought was worryingly limited in Tanga compared with this one seems like a Shoppers Drugmart TM superstore.  I saw a plethora of frustrating experiences ahead. And while I haven’t ruled that out completely, that feeling was abated greatly when I saw how well organized the clinic is, when I met Sister D, and Sister C and Dr. N and his wife.  The Two sisters run a tight ship, and ensure that most of the essentials are present.  Dr. N, when he first met me, was warm and jovial and has taken every opportunity possible to educate me on the cultural practices here, the procedures performed, the illnesses present, and the frustrations of working in a setting as rural as this one.  His Wife, a nurse-midwife has been equally warm and welcoming and plays a variety of roles here at the clinic.  The two of them have been working in rural Tanzania for almost 10 years now.  To say they are inspiring would be an understatement.  Over the last two and half months I have been extremely frustrated with the sub quality care provided by even fully qualified nurses.  The two of them are working extremely hard to not only provide care but also pass their knowledge on to the next generation of health workers.  They, along with the Sisters here provide classes and training for almost twenty nursing students and volunteers.  As I said, I had been very frustrated with the lack of teaching that I had observed.  It seemed to me an almost hopeless system, that poor nurses would breed more poor nurses in the next generation, my experience thus far.  However, after seeing this exceptional group of Tanzanians, I have seen that this is not the only truth.  While I am not wrong, presently poor nursing  is breeding poor nursing, this group has proved to me that it is not a hopeless cause.  There are people making a difference, working tirelessly to provide care, and improve the medical system here.  And it is amazing what can be done with a little elbow grease, and a few resources.