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. 

Some photos

Hello to all my admiring fans.  I wanted to post some pictures on this venue but after trying several times unsuccessfully to load them i grew impatient and and posting this link for you to see them elsewhere.  This probably makes me an awful blogger but i think my sanity is worth that.  Here is my link:
http://www.facebook.com/media/set/?set=a.10150354408679584.354757.508134583&type=1&l=ad70900cdd

Nyumbani

It has seemed like quite some time since I updated this space, however, I don’t actually think it was that long.  Time seems to slow down in this part of the world.  However some things of note have happened since my last posting:

-My colleague, a distant relative of mine, and I have moved into a new house.  It has company, a gecko or two and a colony of carpenter ants.  It also has a big crack in my bathroom ceiling that rains leaves and occasionally, but not too often a cockroach.  Nevertheless it is cozy and Our “nyumbani” or home for the next couple of months, and I have to say I love it.  We have great neighbour’s  and couches.  Both are big pluses. 

-We have monkeys.  Although I think they are the equivalent to the Canadian Raccoon as the other day the next door neighbour had a dead was in his hand and was also throwing stones at another. 

-I have a Tanzanian Mama, who is also incidentally a nun, not sure if that is a contradiction or not but no one has yet been smote so I see that as a good sign.  I hope you don't mind mom, you're kinda far away right now. 

-A couple of marriage proposals. 

-A dance party in the nursing station.  Apparently there are people in the world, and they are Africans no less, who think I’m a good dancer. 

-I went swimming in the Indian ocean.

-My colleague got a flat tire on the other side of town.  Fun fact; it is possible to get two people and a broken bike home with only one functioning bike

-I saw a three year old child riding a bicycle that might have been too big for me.  It probably doesn’t sound as exciting as it looked.

-I saw a goat in a box on a bike.  I think Dr. Seuss must have gotten some inspiration from Tanzania. 

-I went to a wedding.  And I thought Canadian weddings were long.

-I was given a beer by a nun. 

-I have also spent a bunch of time in the hospital.  Just so you know, it hasn’t been all play. 

Some Thoughts

Africa is a continent with so many dichotomies.  When one thinks “Africa is…” a million sentences could come to mind but for each adjective to describe it there are half a dozen contradictions.  I think the best I can come up with is Africa is crazy.  Nothing here is surprising, the unexpected always happens and every time you think that you are beginning to understand, something happens and you’re right back to where you were, blissfully confused.  I think it is precisely this craziness which has brought me back to Tanzania.  This is my fourth time in this beautiful land, but my first time as someone interested in providing health care.  This country, its needs, its people and my experiences in it are to a great extent why I decided to skip kinesiology and get into nursing. It is simply amazing to be able to be practicing as nursing student here.  It’s almost as if my student practice has come full circle. The land that inspired this odyssey is the land that I get to spend one of my final consolidation terms in. 

However, it has been an interesting last week or so.  I feel like somehow I was mentally prepared for what I was going to encounter but not emotionally.  It has a challenge to say the least.  I arrived in Tanga not knowing a single person.  I now have the utmost respect for immigrants and refugees, who have to uproot and start an entirely new life like that; three months is easy.  Starting to work at Tumaini, the health centre, was a challenge too. There is a distinct language barrier with some staff members, and it is exhausting always having to think about the way you talk and the words you use.   I have heard plenty of people talk about the challenges of working in the developing world, lack of resources, cultural differences, system differences etc.  I guess, again, I knew it in my head but seeing these differences manifest themselves has indeed been a challenge.  There are no alcohol sanitizing dispensers in the hospital, basic germ theory concepts are either not understood or are ignored, and the idea of having one’s own personal stethoscope is absurd.  Encountering these differences in care have been difficult.  The Nurses here have a high commitment to cleanliness and are very proficient, and then something is done that would cause someone to lose their license in Canada and it is completely normal.  I have really struggled with what to do in these situations.  I know that these things are wrong and can be potentially harmful but I’ve also read enough nursing theories on providing culturally competent care to know that you can’t just go changing people’s ways of doing things, it’s not going to get you anywhere.  And even so, their care and approach to nursing is in so many ways far superior to mine, why would they even listen?  Could I do what they do with the resources they have?  Would I listen to some young upstart who had been here for a week? Probably not.  And yet watching sometimes makes me want to scream, "Your doing it all wrong!"   I just hope and pray that I have the wisdom to learn, know when to try to change things and be content with where I am. 

Arrived!

I have safely arrived at my final destination for the next 3 months.  Tanga Tanzania.  It is a lovely place, and I am excited to be a part of the community if only for briefly.  I start at the hospital tomorrow, God willing. 

Departure!

I am minutes away from boarding my flight. The new free wifi thing, is awesome, by the way.  I have to admit I wondered if I would be able to get it all together in time to go.  There certainly were moments along the way where I felt like throwing in the towel, but now that it comes to this moment where my fate is sealed and I am at the very least going to have an extended educational vacation, all the work, the stress and the blood sweat and tears seam worth it.  I can almost taste my own anticipation.  I still have some reservations but I am feeling calm, collected and cool.  I cannot believe how many people have stepped behind me, offered support, and just been there to talk me through things.  I have an amazing set of family, friends, and a great community of people from all walks of life who have made this trip possible.  All i can think of is "Therefore, since we are surrounded by such a great cloud of witnesses, let us throw off everything that hinders and the sin that so easily entangles. And let us run with perseverance the race marked out for us."  I am eagerly anticipating running the race set before me and it is made all the easier given who is behind me.  Thank you to all of you, if your reading this you have been integral in this journey.  I pray that I will be receptive and focused on the path, and that i will run the race that He has set out for me, and not the one I have set for myself.  The gun just sounded, the race begins and so does my boarding call.