Machame Hosptial

     After returning from Zanzibar, I spent one final night with my host family in Moshi and then was driven to my internship placement at Machame Hospital in Machame, Tanzania. Only about a 30 minute drive from Moshi, Machame is a collection of villages on the slopes of Kilimanjaro. At roughly 10,000 feet, I now am always wearing pants and the one bright green Patagonia fleece I brought with me.

            It was a sad goodbye leaving my host family in Moshi. Although at times I felt like I was an intruder and completely out of place, it now feels like a home and I think I would be warmly welcomed back when I return.

            The Machame Hospital is a very different organization than KCMC. When I had my stomach rash (which has now subsided altogether), I walked through a very busy regional hospital that was constantly filled with patients and had clearly distinct wards. Machame, a private hospital set up by Lutheran missionaries in 1904, now beds about 50 – 60 patients, of which the majority are women preparing for childbirth. I often feel like there is not a lot going on, especially when there are no surgeries. I expressed this sentiment with one of the newer doctors, Dr. Garrison, and he said that when he first came to Machame, he felt bored because he had finished all of his work by about 1 every day.

One cool aspect about Machame is that it caters to the Maasai women from all across northern Tanzania. Many will walk for days to get to admitted to Machame, spend a month or two before the delivery, have their baby and then walk home. “Typical” Tanzanian life (cooking, clean, farming, childrearing) is hard on women, especially the Maasai because of the environment in which they live, so the month or two at Machame before childbirth is often a much needed break.

            Another interesting aspect that I have had to deal with is the daily morning devotion. Every morning, at about 7:45, the majority of the staff gathers in the hospital church located at the very bottom floor of the building, fairly close to my house. After about 20 minutes of singing and a small sermon, all of the non-medical staff are dismissed and the nurses and clinical officers (like a Nurse Practitioner) that were on duty the previous night stand up and state new cases and give an updated total of the patients in the hospital. Often, the doctors critique the nurses and clinical officers for their diagnoses or try to get the staff to get in the habit of stating all the necessary information regarding a certain patient.

It is during this time that I find out if there are any interesting surgeries that day or if a person has come in with a new sickness. I also use this time when all the doctors are together to ask if I can follow a particular doctor around on his rounds to the wards or if I can accompany them in surgery. I have spent most of my time in surgery but am hoping to spend these last two weeks seeing other aspects of the hospital, including the pharmacy, laboratory, and radiology departments. I find the orthopedic surgeries the most intriguing so if a particular surgery comes up, I may sneak back to the surgery theaters. So far, I have seen: two c-sections, a re-circumcision, a screw/plate removal from a woman’s ankle, two pins put into a fractured elbow, a pin placed into a dislocated finger, a hysterectomy, and a cleft foot operation. I think the hysterectomy and the cleft-foot operations where the coolest so far.

I think the hysterectomy surgery was technically an incomplete hysterectomy because they did not remove the woman’s cervix in addition to the uterus. The entire uterus was removed because of benign tumors that were causing internal hemorrhaging and pain. After its removal, the doctors noted the size, which was about the size of a soccer ball when it should have been the size of your fist.

A cleft foot is a condition found in about 1 out of every 1,000 births in which the tendons and ligaments on the medial side, or inner arch of the foot. This makes the foot point inward and the person becomes very pigeon-toed. To correct this problem, Dr. Lyimo, the orthopedic surgeon, sliced the ligaments and tendons down the middle, cut one of the strips closer to the foot and then cut the other closer to the leg bones. By tying these two strips together, he was able to lengthen the ligaments and tendons and with a cast, correct the issue.

Spending so much time at a hospital and around patients has really affirmed my desire to go to medical school. Seeing surgery, I constantly want to learn how I can perform these operations and help people. I feel useless a lot of times because I see someone with a distinct predicament but I don’t know how to fix it. Hopefully now, with a lot of hard work, I’ll end up at a medical school.

A Little Bit Of Tourism

 Although I have been mainly focused on the class that I finished on June 24^th, I have been able to spend a little bit of my time in Tanzania as a tourist. Two of the other Cornell students were placed into a host family in which the father, Bwana Chuwa, runs a Tanzania tourism company. Bwana Chuwa must know everyone there is to know in Tanzania, because he hooked the group up with an awesome safari and trip to Zanzibar.

            Maybe not quite as densely populated as the Serengeti, the Arusha National Park had a decent amount of fauna including a lot of giraffe, zebra, water buffalo, baboons, and colobus monkeys (they look a little like skunks but with really fluffy white tails). At one point during the safari, we got out of the car and climbed up a hill to an overlook from which you could see a crater from a collapsed volcano. I was a little upset that I didn’t get to see any other big game, like lions or elephants, but the safari was worth the day’s travel.

            The Zanzibar archipelago is located off the eastern coast of Tanzania and is composed of many islands of various sizes. Technically, the name of the country in which I’m currently volunteering is the United Republic of Tanzania because back in the day, the mainland, Tanganika, and Zanzibar were two different countries. When they decided to team up, the president of Tanganika became president of the United Republic and the Zanzibar president became his Vice.

            If anyone can afford to go to Zanzibar on a holiday, I would definitely recommend it. A two hour ferry ride from Dar Es Salaam places you on a beautiful island that feels entirely different then the African mainland. With about 95% of its inhabitants Muslim, the island definitely shows off its Arab influences. This was also the first time I had completely immersed into an Islamic culture, although I’m guessing that it would be very different to be a tourist in a Middle Eastern country.

            Walking through the small corridors of Stone Town, the prominent town in Zanzibar, I felt as if I was back in Europe, walking through alleyways that have endured countless generations of people. One difference between Stone Town and it’s European counterparts are the elegant, carved wooden doors of the Stone Town buildings. Each door is said to symbolize the wants and desires of its original owner, and some are older then the buildings in which they live. Many also have metal spikes protruding from the doors, additions borrowed from India that were once used to prevent elephants from breaking down the buildings.

            Like Moshi, Stone Town also has a very lively outdoor market, but with a complete different set of staple foods. Zanzibar, once the spice capital of the world, offers an enormous variety of spices to the public. The fish market is also a sight to see, and a smell to experience. Like the fish section of Wegman’s on steroids, I had never seen so many types of fish on display. I will admit that the smell was a little strong for me so I couldn’t stay in the market too long.

            With pristine white sands and turquoise water, the beaches on the Northern coast were incredible. Like pictures on the Discovery Channel, the scenery included small wooden Dhows (the name given to Zanzibari boats) dotted the horizon as they fished for local fare. After lunch, five of us decided to trust a local entrepreneur and went snorkeling out on the nearby reef. Although it wasn’t the most colorful, we were still able to see a good amount of wildlife. I have taken a lot of pictures from this beach day and I’ll try to make an album on picasa soon.

            Leaving Zanzibar on possibly the worst 9 hour bus ride of my life, I was a little disappointed that I couldn’t continue my tourism and see all of the other incredible sights Tanzania has to offer. I would really like to see the inner region of the country, as that is where the majority of the population lives and I would really be able to see the livelihoods of these warm and welcoming people. I guess that’s another reason to come back.

            

It takes a village

            The electricity is out again. The family had brought in a woman trained in the art to lead the ceremony. With the help of the house girls, they all surround Catie, my young host sister of 6, carefully picking at her head but still cautious not to block the candle light. Every few seconds, the two blades of the scissors come together with a resounding “click”. I sitting a few meters away on the couch, trying to eat dinner. As the steam rises off of my meal, I am mystified. I had wondered about the actual actions, but this was my first time witnessing anyone getting extensions.

            My first day walking the streets, I was a little shocked to see that almost every single child under the age of 10 had a very short buzz. My only clue to the sex of the kids is their school uniforms: shorts for a boy, a skirt for a girl. Slightly puzzled to why the girls have short hair I tried to come up with an explanation. Only later did one of the other Cornellians explain that everyone keeps their hair very short so they do not get lice. To make up for the lack of natural hair, a lot of the women and girls get extensions or put their natural hair in tight braids that run along their scalps in varying directions.

            What captivated my attention the most from the extensions process was the way in which everyone chipped in to help. Although the house girls could have spent this choice amount of free time relaxing, they both decided to help the woman with Catie’s hair. This helping sentiment seems to be prominent throughout Moshi.

            Lincoln, the 1 year old, can be a handful at times. However, this doesn’t stop the whole household from taking care of him. And by whole family, I mean the two house girls, the parents, young daughter, and even the guard. I would expect, and hope, that a child’s immediate family would take care of their blood, but I wouldn’t really expect this of a man whose sole job is to watch the property for thieves. This Saturday, when I came back from town, I was greeted by the guard who was bouncing Lincoln on his knee.

            I was trying to express how everyone in the house cares for Lincoln when one of my peers in Tanzania stated that the same thing happened in her house with a young child named Ibu. I have met Ibu before and he looks like a 2 year old version of Jay-Z (Brenna has a picture of him with her sunglasses on and he looks incredible). Initially I thought that Ibu was another child of Brenna and Kathy’s house mom, but it turns out that Ibu is living with his grandmother, who resides in the house directly behind Brenna and Kathy’s. Although Ibu isn’t directly related to their host mom, Mamma Grace, this doesn’t stop her from feeding and taking care of him. I would expect the same from an American mother who has a neighbor roughly the same age as one of her children, but Ibu is 5 years younger then the youngest in Mama Grace’s family.  

            I wonder if it is the hardships these people go through that draw them closer, or they are just generally nicer and more caring people. Whatever the cause, I’m happy that there are multiple sets of eyes looking over Lincoln and Ibu so that one day, they can become the next leaders of Tanzania. Hopefully then, they won’t have to live their lives continually contracting malaria, an infection that my house father and Brenna and Kathy’s host father have contracted over the last few weeks. 

Lincoln & Catherine.... But Mainly Lincoln

Hanging with the kids

Tanzanian Vittles

African food. Try to conjure up that image. I had no idea what I would be eating for two months this summer, but now I am very familiar.

My first experience with Tanzanian cuisine was actually at Cornell toward the end of the spring semester. I was taking a semester-long prep course for the trip and we were all invited to eat lunch one Saturday at our professor’s house. Lunch was prepared by two Cornellians who spent 13 weeks last summer volunteering at the Weill-Bugando hospital in Mwanza, Tanzania. They cooked ugali, a polenta-like paste made from corn, a shredded collard greens-ish dish, and an egg dish that had red peppers and cheese. Unfortunately, I haven’t had this egg dish yet.

Unlike the variety of foods that my incredible cook of a mother makes, and the interesting dishes the infamous Deb produces, I have had basically the same meals every day. During my first breakfast with my host family, I was greeted by a large spread of hard boiled eggs, hotdogs (this seems to be a morning food item), tea, natural orange juice, bread, butter, and jelly. I poured my self a cup of the tea, let it cool, and then tried the jelly. The first wave of flavor was intense. I think the closest description would be to take a fruit medley jelly from the U.S., add a cup of sugar and Gatorade’s Fruit Punch ready-mix powder. I continued to eat the jelly for a while, until I felt like it was eating the enamel off my teeth. I starting bringing a jar of peanut butter to the table, and it eventually made it into the breakfast rotation. I really enjoy hard boiled eggs, but two every morning are starting to take its toll on my taste buds. I am thinking about waking up early to cook myself an omelet or some scrambled eggs.

Unlike the U.S. system of 3 meals daily, the Tanzanians have added half a meal in between breakfast and lunch, known as Tea. One thing that I am not sick of is the Tanzanian tea. Locally grown, the flavor is unlike anything else I have tasted. Most of the locals drink it with whole milk but I prefer a cup with a spoon of sugar. With tea, it is common to have some form of fried dough. It’s pretty interesting to note that at one of the most respected medical campuses in Tanzania, there are no baked or boiled goods sold at the campus Canteen. The one healthy alternative is a bowl of fruit salad that is not always available.

For lunch, I have had some form of banana and / or rice every day. The lunch places make a dish called “pilau”, which is seasoned rice and beef that tastes pretty good. Ndizi is another dish that I like, which is cooked bananas, covered in a somewhat salty banana sauce and beef. With one of these meals comes a form of vegetable, sometimes the collard green that I mentioned above, or often shredded cabbage. There is also a complementary piece of uncooked banana which I think is the highlight of the meal. I have never tasted such good bananas. The Chagga, the prominent tribe in the Moshi area, are known to make most of their essentials out of the banana plant (food, beer, houses, etc) and I think they have perfected the art of banana growing.

Dinner everyday is basically the same. The meal is usually rice covered with a sauce, vegetables, and a meat. The meat is either chicken, fish, or beef, but most often beef. The fish is… interesting. I think the first time I had the fish was about two weeks ago on a sunny Wednesday. As I was walking back from KCMC, I passed a woman sitting on the side of the road selling whole, roasted fish about 6 – 8 inches in length. I’m not much of a fish person and but I wasn’t the first to say that these fish did not look very appetizing. I thought about the lack of local water sources in the area, and then tried to dispel the thought of eating the animal. That night, atop my heap of rice was one of those fish, cooked in some type of spice. Not to upset my hosts, I ate as much as I could, but did not come close to sucking out the eyeballs as did my host parents. It actually wasn’t as bad as I thought it would be, but I would rather eat as little of it as possible.

To me, the highlight of dinner is dessert. Where as Americans most often enjoy foods like ice cream, cake or cookies for dessert, the Tanzanians choose to eat fresh fruit. Although they have many more seeds then the fruit I normally eat back home, I think the fruits I have eaten here have more flavor and possess a natural sweetness that I don’t taste in America.

Overall I have enjoyed all the foods I have eaten so far, but am looking for a change. I look forward to Thursdays when the Cornell students go to our professor’s house and she bakes us some sort of American dessert. The first time we had cookies, followed by strawberry shortcake, and then last week was chocolate-zucchini cake. I am hoping this time it will be cookies again, or if I had my choice, Popsicles. I also heard that one of the Cornell girls brought some Gatorade mix, so I’ll have to investigate that. Hopefully, next weekend’s trip to Zanzibar will bring out some new dishes.

Additional bracelet. I traded the coffee bean one for this one. Technically #5

More Pictures

As per a request, here are some pictures of my living quarters

The family room

My room / bed

Front of the house

Host family's banana trees

Pathway to my host family's house

New Bracelet. Aquired in deal for other gifts

Roman Catholics, Second in the Eastern Division

This Sunday, I went with my house mother, Lincoln, and the house girl to church. Unbeknownst to be before I arrived in Moshi, but my host family is fairly religious. I may have mentioned this before, but I often come home to see my Mama Catherine watching the gospel channel on TV.

This week’s service was a little different then last weeks. Last Sunday was the Pentecost and the church was significantly fuller. Although a there was a good amount of Tanzanians there this week, no one had to sit in sections that were actually outside the church.

The building itself is fairly small, at least according to American Roman Catholic standards. Arranged in the classic cross formation, each of the three wings looking at the alter area have about 30 pews. Mama Catherine likes to sit to the right of the altar, probably because when Bwana Theophile is home, he sings in the choir which is located in that wing.

Opposed to the elegant buttresses and arches of large churches I have seen, this particular one has ceiling tiles, occasional colored yellow, turquios-ish green, and red in the shape of crosses. If they are working, the ceiling fans spin freely and add a cool and soft breeze to the chamber. There is a number of stained glass, although there are no scenes in the glass. The colored glass is either arranged in a mixture of purples, yellows, greens and pinks, or complementary colors in the shape of what else but a cross.

When everything began around 10:30am, I couldn’t help notice the similarities between the service and a basketball game. It sounds like a weird connection but it kind of fits. Here goes the explanation:

On the interior walls of the edifice hang pictures of Christ, like banners of past championships or advertisements preaching life lessons. The pews, or short wooden bleachers, wait for the spectators and are filled at random. At the center of the three wings is tile, or hardwood, that is separated from the churchgoers by a low metal barricade. The music, brought to you by the choir, provides entertainment before the actual action begins and announces the start of the ceremony.

Although there is only one team in this game, the players come in one at a time, waiting for their cues from the choir. First come the bench players and main assist leaders on the team, the alter boys. Swinging the golden Censer, one presents the game ball to the audience. I envisioned these young kids as tiny fragments of Scottie Pippen, ready to help out the superstar. They kneel at the altar waiting for the rest of the team.

Next comes the badass, the one who likes to look different, the Dennis Rodman of the team. With his sweet brown cloak and hood, like an outfit from Monty Python’s The Holy Grail, he arrives at the altar next, kneels and waits.

Last and certainly not least, here’s the superstar. I think the choir’s music is slightly different at this point. I hear them saying “number 23, Mmmiiiiccchhhaaaeeellll Jjjjjooooorrrrddddaaaannnn!!!”. In strides the priest, clad in an all white garb, decorated with two small chalices on the very front, the hero of the team. He kneels at the altar, says a few words and instead of chest-bumps, they all rise in unison.

The choir ends its singing and the game is underway. I don’t exactly know what went on most of the time, mainly because the entire service was in Kiswahili and I’m still not fluent. However, I did understand a little, mainly the words “takatifu” which means saint, and “kazi”, the word for work.

About halfway through the service, after a few iterations of the crowd standing and kneeling, I decided it was halftime. And what happens at but the cheerleaders, or nuns, entertain the crowd while the team takes a quick break. One of the sisters walks up to represent the entire squad and begins a sermon on family. I think I understood something about it doesn’t necessarily matter the size of the family, as long as it is close and everyone loves one another. But I could be completely wrong. Her speech is a little long and I can see a few members of the audience nodding off. But they didn’t come to see the cheerleaders; they came to see the Lebron James of their Roman Catholic Church perform.

Michael Jordan said a few more prayers and the choir chipped in. And then, Dennis Rodman got a few rebounds in the form of a monotone prayer that lasted about 2 minutes. The small Scottie Pippens helped by ringing a bell, bringing in the Censer, and holding the Bible for Michael. The entire service was definitely a team effort.

Towards the end of the service, the team asked if any of the fans would donate to their cause. The majority of the congregation said yes in the form of Tanzanian shillings. I even decided to kick in about 100 Tzs. And at the very end of the service was communion. I thought that since I am not a loyal fan of this team, I shouldn’t receive Christ’s body so I sat in my seat while Mama Catherine went and received her portion. I didn’t sit alone, as the house girl did not receive communion as well.

All in all, I thought it was a fine service. I enjoyed the singing from the choir, probably because I didn’t really understand what they were saying and they harmonized well. The Waiters would be proud, but I don’t think it was quite up to their standards. Taking an anthropological view of the experience definitely helped me get through an event that I would probably not have gone to otherwise.

Thinking about religion in this country, I wonder about its origins. When did people start to say, “Yea, our tribal views are silly. We should believe in your religion, with only one guy who has supernatural powers”. I imagine that mission trips have something to do with it. I would think that Islam would have a larger pull in the mainland, as the Arabs made a larger influence in Tanzania’s history from the beginning. For example, many of the Swahili words have Islamic origins. I should talk to Bwana Theophile’s father, Babu Theophile (babu means grandfather) since Bwana Theophile said his grandfather was Muslim.

I was thinking about going to an Islamic service while in Tanzania, to see something that I have never witnessed before. Maybe my globetrotting cousin who also went to Cornell could give me some advice?

All in all, I see religion as an extremely interesting topic. I don’t really want to express all of my views on the subject, as I might offend some people. However, if you do practice, good for you and I hope that turns out for the best. To put all of your faith into actions from thousands of years ago is truly a strong belief. And if you don’t regularly practice, then I’m right there with you.