Posted by: lydiahartsell | August 7, 2010

Kwaheri Tanzania. Nashukuru.

(Goodbye Tanzania. Thank you.)

 On Sunday morning at 8:45am I left Tanzania.  It was truly a bittersweet moment.  Over the past year, I have grown to love many parts of Dar es Salaam and had started to call it home.  Alternatively, certain parts of the city still make me cringe (ferry port, bus station…) and specific traits of Tanzanian culture irritate and sometimes infuriate me.  Throughout the last month, I reached my peak of frustration in persistently trying to complete my thesis (and finally finishing my requirements!) while seeing the most amazing sites of Tanzania with good friends, Wes and Nila.  Upon reaching my last week in Dar es Salaam, I felt an attachment to the city that I thought I would never know.  Unfortunately after a series of trying events halfway through the week, I was more than ready for my return to the United States.  I plan to detail the last two months of my life in Tanzania to a greater extent than this short paragraph, but first I wanted to let you all know that I have returned safely to the US.  I have left a part of me in Tanzania, and plan to return to revisit them throughout my upcoming years in medical school and thereafter as a physician.  Foremost, thank you Rotary for this opportunity to experience a new culture, to uniquely develop my understanding of international health, and establish relationships that will last a lifetime.

Posted by: lydiahartsell | July 6, 2010

New Vocabulary

In living in a new country for the past year (and especially a country previously colonized by the British), I have learned to phrase my English words a little bit differently than my American-born English.

Here is a list of some of the new words that may now pop up in my everyday language:

Jam – when speaking about city Traffic

Que – when referring to a Line in which you must wait, like a que for the bathroom or at the bank

Take Away – instead of To Go (this one took me a long time to learn)

Mobile – in reference to Cell phone

Voucher – when speaking about Credit for a phone card

SMS – instead of receiving a phone Text

Plait – when talking about Braids in braiding one’s hair

Petrol  - in reference to Gas or Gasoline

Soft Copy – when speaking about a computer file or an Electronic File

Net – in reference to Internet

Paracetemol – instead of Acetaminophen (different name, pretty much the same drug)

Your most welcome – when inviting someone into your home and saying, Come on in or Welcome

Venue – In referring to Location for a meeting place

Tissue – instead of Toilet paper

Full-stop – in referring to . or a punctuation Period

I know you have been waiting for this article for a very long time, but here it is finally rewritten from the Rotary Korea 2010 Magazine.  It relates back to a previous post about the Kibaha Mother and Child Hospital that Rotary sponsors and that RI Past President (PP) DK Lee and other Rotary members visited several months ago.

“In September of 2008 at the Seoul Presidential Conference, fifty thousand Korean Rotarians committed to build a mother and child (maternity) hospital, in support of reducing child mortality.  Donations came from both Korean Rotarians and the Community Chest of Korea, which matched funds, Won per Won, totaling to a collective donation of 1 billion won (about USD 870,000).  After securing one billion won, then RI President DK Lee, in cooperation with the Korea International Health Foundation, launched a project to build a hospital for mother and children in Tumbi, Pwani Region of Tanzania.

This past April, DK Lee and several directors made a trip to Tanzania to inaugurate this project.  But the project was not without obstacles; the major one being the 20% tax levy on all materials and construction of the project.  Needless to say, 20% going to taxes would have made quite a dent in our initial budget.  Fortunately, with the help of Sir Andy Chande, past TRF trustee, and Bill Bali, a club President, and their tireless efforts and petitions to convince the Tanzanian government to waive the tax levy was successful.  Other Rotarians gave their time and knowledge, like PP Mohamed Sumar who provided and donated the architectural design of the project.

However, the process of getting MOU signed and selecting a contractor did not move as swiftly as anticipated.  The MOU had to be cleared by several ministries before the Pwani Regional government and Tumbi Hospital could sign.  The bidding process also took considerable amount of time as the aim was to make the bidding fair and transparent.  After six months of countless emails, numerous telephone calls, and several intercontinental trips later, finally a local contractor, M & M Construction, was awarded with the contract and the work begun in late October 2009. 

A 55 bed facility with a new Operation Theater, X-Ray room, Ultrasonography room, Intensive Care Unit will be provided in the renovation of the existing 3-story building of about 1,200 m squared and a newly constructed 2-story buildings of about 500 m squared.  The Korea International Cooperation Agency (KOICA) is tapped to provide sustained assistance for 3 years from 2010 to provide exchange program for medical staffs, technicians, administrative staffs for long term training.  This additional funds from KOICA of 450 million won (about USD 391,000) will also enable Rotary to supply an emergency vehicle which can be dispatched to more remote areas of Pwani Region.  The accumulated total amount from various sources comes to 1,883,700,000 won or about USD 1,638,000.  A nice gain of  USD 435,000 with which it all began. The Tumbi-Rotary Mother and Child Health Complex is scheduled to be fully functional by June 2010.  It is hoped that this project, which started off as a small commitment, will be responsible for saving 42 lives daily, making dreams real.”

Posted by: lydiahartsell | July 2, 2010

The Miracle Dala

The miracle dala is a phrase coined by my brothers study abroad group to mean a dala dala which runs late at night when all other dalas have stopped.  It shows up at just the right time when no other cheap public transportation is available.  It is truly a miracle dala. 

My miracle dala, however, takes on a little bit different manifestation.  It is the dala that appears after I have been waiting at the bus stand for over an half an hour for a dala that I can actually fit on.  I know that in dala rules, you can always fit one more person, but during rush hour from 5pm until 8pm on Ali Hassein Mwinyi Road, it is physically impossible to fit one more person on a dala going from Posta to Mwenge.  So I wait.  I already have my first permanent scar from a packed dala back in February when my shin got smashed up against a seat’s metal support.  Since it was so packed, I could not move it for at least a couple minutes.  I didn’t know that I had an inch-size gash until I reached down to wipe a sweat droplet from my leg, only to find out that it was blood.  I am all too familiar with the pain that a packed dala inflicts upon a standing passenger. 

So as I was wait for a small crevice of an opening on a passing dala, my miracle dala is the smaller 20-passenger utility van that pulls up and calls out, “enda Mwenge, mia tano” (to Mwenge, 500 TShillings).  Yes this miracle dala charges double the price as an ordinary dala, but upon boarding I know that I will have a seat and if especially lucky, air conditioning, for only 30 cents more.   And for me, that is truly a miracle dala.

Posted by: lydiahartsell | June 25, 2010

On top of Old Smokey…

Well not quite, but close…very close.

Here are finally my picts from spending two and a half weeks in the Kilimanjaro region.  The major town where I stayed is called Moshi.  Moshi means “smoke” in Swahili and rightly so.  For the whole two and a half weeks that I spent in Moshi, Kili’s peak only showed its face three times.  Two of those times it lasted long enough in order for me to get some great photos of the second tallest mountain in the world, Mnt. Kilimanjaro.

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Posted by: lydiahartsell | June 24, 2010

Rotary on the Catwalk

In early May, the Rotary Clubs of Dar es Salaam held a fundraiser for Mtoto wa Afrika (Children of Africa).  Having heard about the planning for the last 6 or so months, I was excited to see it to fruition.  One of the leading Tanzanian designers is a Rotarian, Ailinda Sawe, and she is said to be the mother of Tanzanian fashion design.  Her style is uniquely Tanzanian.  She uses fabrics from all over Tanzanian and I love seeing her at Rotary meetings because her outfits are always so beautifully Tanzanian.  She is also an amazing lady.  She is very humble, kind, and so welcoming to Anand and I at every Rotary meeting.  And as a side note, she even waived specially to the two of us from on stage during the fashion show.  We were thrilled since it as such a big event.  To check out her website, click here.

Ailinda (and her husband) owns Afrika Sana design and she was the lead designer for the Rotary fashion show.  She was joined with 4 other Tanzanian fashion designers to make up this years Rotary Fashion Show Fundraiser for Mtoto wa Afrika. It was one of my favorite Rotary events of the year!

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Posted by: lydiahartsell | June 23, 2010

Make sure to wear a hermet.

And my favorite R/L flipflop yet… (continuing from a previous post):

I was riding the dala this morning after being back in Dar for the first time in two and a half weeks and I passed a construction site that had this painted on the sheet metal enclosure surrounding the site:

“When you are inside, make sure to wear a hermet and boots.”

I died laughing.

Posted by: lydiahartsell | June 8, 2010

Welcome to my day

This is my second day of research in the Kilimanjaro region for completion of my dissertation from Muhimbili.  Yesterday was a great start! The morning I was hassled and talked down to by four women in the data office at the large hospital here.  Things changed when the head of the department, an older man, returned to his office.  He took my letter, accepted it, and offered to give me a ride to the regional hospital where I could meet with the regional medical officer to get introductory letters to the districts.  He was a very kind man.  At the regional office, it got even better.  The regional medical officer, who is a lady, was the most helpful person I have met so far (depsite the fact that she had about ten people in her office and she was frantically working all day).  She greeted me warmly, sat down and talked with me, and then personally wrote letters of introduction for me to the district managers. I then received help from a fellow classmate to find a research assistant for the upcoming week.  To top off the day, I arrived back at my cheap hostel in late afternoon to see the clouds clearing over Mt. Kilimanjaro directly out my bedroom window! It was so amazing! I will post pictures later, you can be sure.

Today, however, the whole scene changed.  Instead of moving forward with my research, I remained static, with frustrations building.  I woke up early to take a 2 hour bus ride to a distant district.  Crammed on a bus with venders standing in the aisles yelling out their products’ prices in Swahili, I tried to sleep.  Arriving at the district hospital, we were informed that we needed to walk a half a kilometer to the district council to meet with the district health manager.  We walked over and as soon as we stepped into the office, the secretary started talking to my research assistant in rapid Swahili about what I was doing there.  We tried to explain that I was a Muhimbili students working on my dissertation and we needed to see the district manager to get some information.  She ranted off for another ten minutes about how she didn’t have time, even one minute to talk to us, and that we could not see the district manager today or go to the health facilities without her permission.  She ended with saying, “niache!” (“leave me alone” in Swahili).  I have never heard anyone use that word yet in Tanzania, much less me.  She refused to talk to us after that and told us to return tomorrow.  So we hopped back onto the bus and returned on an even more crammed bus to Moshi town. 

Frustrated, we had lunch and then decided to make the most of it and head to the other district hospital today.  We headed west of Moshi town down a road that turned into a two track of packed mud and potholes.  I didn’t mind the drive, despite the rough condition, because it was uphill at the base of Kilimanjaro and the lush landscape with low misty clouds was very surreal.  Once at the district hospital, we waited for the district manager to return from surgery, only for him to come out, see the address on my letter, and laugh, “you don’t need to see me, you need to see the district manager.  He’s located at the district council south of town.” Again, another bump in the road, but at least this time the man was very jolly, unlike the fiery lady that I had just encountered at the other district office. We left the hospital and returned to our taxi, only to find an older woman trying to barter our taxi driver to take a lady who had just had delivered by caesarean section. Since we had two extra seats I told them they could ride along back to Moshi town.  They gladly agreed and the woman who just had surgery edged her way into the middle of the taxi next to me.  For the next 3o mins, I winced with every pothole and dip in the road because the lady next to me would hold her breath as she writhed in pain.  When we finally got to Moshi, her and her husband got out and found another public transport to take them to their home.  I paid the taxi driver and then stood in awe.  This woman had just delivered a child and had surgery and now was riding through the bumpy Kilimanjaro mountain side heading back to her home.  Most women have trouble walking for weeks after having a c-section and here she was holding it together on rough roads only a few hours after surgery. That’s impressive.

Anyways, that’s my day.  Frustrating, but interesting to say the least. I will write another post soon about the traveling bus salesmen because they are quite entertaining.

Posted by: lydiahartsell | June 4, 2010

A visit from Anne!

One of my best friends, Anne, came to visit me at the beginning of May right before she started her clinical rotations.  It was more than great to see her and have a familiar face to travel with. Despite raining everyday she was here, we had a really amazing time.  The first day I gave her a tour of Dar in continuous downpour.  The second day we traveled north to Bagamoyo and visited the 13th century Kaole ruins and historic colonial buildings of Germany and England.  Friday we departed for Zanzibar and actually had an afternoon of sun to spend by the pool overlooking the ocean.  Elizabeth then met us later that evening and we explored Stone Town, visited Forodhani Gardens nightime food court, and ate dinner on the beach.  The next day we took a boat to Prison Island and saw the tortoises and snorkeled.  The snorkeling was absolutely amazing too! It was a little scary though because some parts of the reef were so shallow that you dare not kick to swim out because you might get stuck with a sea urchin or hit coral.  Anne did scratch her leg on coral accidentally, but was happy to have a mark of Tanzania.  We then drove up to northern Zanzibar and spent the afternoon and night at a very nice, but cheap beach resort.  Alas, it did rain that afternoon as well, but it was pleasant to just sit and read by the beach.  The next morning we drove down to the south central region of Zanzibar and visited the little creature community of the Red Colobus monkeys.  Elizabeth even got to grab the tail of one.  We then caught a taxi to the ferry port to make our boat back to Dar.  Unfortunately, it decided to storm and I experienced the worst ferry ride I have had yet! Poor Anne and the hundreds of other passengers who fell ill…it seemed to last forever. The next day we spent the afternoon at the beach and visited Mwenge Craft Market so Anne could practice her new Swahili skills. She flew out that evening after eating at an amazing Indian Restaurant. 

THANKS for coming Anne! I loved having you here! Below is a slideshow of pictures from our adventures:

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Posted by: lydiahartsell | June 3, 2010

Donor $ Recipient

Anand and I had the first-in-a-lifetime experience two weeks ago when we became the newest recipients of international donor funds.  Our class had traveled to Tanga to gain firsthand experience in health systems management and monitoring and evaluation.  We were told that we would receive payment upon our return.  A week later, the professor called us over and handed each student  US $100!! As we counted the money, Anand and I giggled with glee at the thought of just receiving a good chunk of money for attending an educational conference.  We couldn’t stop smiling;  Christmas had come in May.  On the contrary, our fellow students acted as if nothing had happened.  They remained stoic, if not unimpressed.  Concerned with their unappreciative attitude, we asked them why they were not excited to have just received the money. Most replied that it was the norm to get paid for attending a training or conference and some even complained that the sum was too small.  We both were flabbergasted!  I guess the saying, “Pay for sitting,” instead of “pay for performance,” is really the case in Tanzania.  Health professionals get paid to sit and attend conferences to improve their skills, not in the actual utilization of those skills.  We told our classmates that they should be thankful because in the United States, health professionals have to pay for their own education, pay for continued educational credits, and pay to attend conferences.  Apparently in Tanzania, donor money pays for not only attendance costs, but also per diems to all those in attendance.

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