Final Ramblings

The last 2 weeks have been quite full and I'm disappointed in myself for not blogging more often. It's not that I haven't wanted to, however. Between the internet being unavailable one day, electricity the next, and a nasty case of the flu in the latter part of my last week in the hospital, it was an honest oversight.

The problem is that I'm afraid of forgetting it. Although east Africa is only hours behind me - so recent that I can still smell it in my clothes and the dusty fabric of my backpack - I am afraid to let it become a distant memory. I wish I could bottle and take with me the sounds of the kids on the street and the taste of cold Fanta in recycled glass "choopa" from the shop across the street. I want to make sure I don't forget how simple life was and that it was okay. Not always convenient, and sometimes simply uncomfortable, but always easy. It was a privilege to meet my patients and help them get well - and sometimes not - and learn from them that the problems in my life are really pretty minor. The important things are not things. And there's not enough time to get all worked up about them.

Here are a few pictures of my last weeks in Tanzania, with more entries to come as I get settled back at home and have time to reflect on them. Thanks to all the friends and family who take the time to read this sight and let me ramble on about things that I wish I'd learned much earlier in life.

Oskar and Chloe Wendell, our backyard Neighbors

This sweet Little boy to the Right is Christopher, a child who suffered severe burns years ago and was worked on by the plastic surgeons this month. His smile is unforgettable.

Internal Medicine Rounds with Dr. Debes and Univ of MN med students Katie and Maiken

Megan, Kurt and I at the Snake Park. Photo taken by Rob

This is a photo of some of the members of our church choir at a fundraiser for Hospice. We joined about a dozen other Tanzanian choirs for the benefit, which culminated in a massive group performance of Handel's Hallelujah Kuu from "The Messiah", sung in Kiswahili. It was pretty powerful. But here's the best part: after a rather long, hot day of each choir performing their own songs and several solos, it was time for all of us to join together for the finale. Just as they called us up to the front of the church, the rain began. It rained so hard that the sound of it beating on the aluminum rooftops completely overcame the sound of our voices. There were a lot of very happy locals in the crowd that day. We waited for the rain to subside before we sang...

Happy Feet

With only 1 week left in Arusha, our "to-do" list of things that we figured we'd have time for later started to feel dauntingly long. Thanks to our fabulous family and friends,

we brought to Tanzania several bags filled with donated items for kids. Rob's mom and a friend, along with Rob's aunts and sisters, donated a giant bag of shoes and some soccer balls. My parents donate toys and puzzles, which have been a hit with my peds patients over the weeks. And Brenden left what may be the most popular item yet - glow in the dark dinosaurs, among other toys and stickers for the kids that I have met here. The good news is that our lives are filled with generous people. The bad news is that, over the past 8 weeks, I have failed to distribute all of these things appropriately. But the bad news became good news last night when we made a trip to Weather Mother's Daycare in a suburb of Arusha.

The kids you see here are the orphans who live with this lovely woman, named Aweather. The cute young couple sitting with them in the photo at the bottom is Kristy and Ben, a particularly friendly couple from New Zealand that we met randomly at a coffee shop one Sunday afternoon. They are living at Mother Weather's for a few months, taking care of and teaching the kids. They are bright, caring people with great taste in coffee who love to travel. It will be fun to see where this experience leads them.

The pictures you see here are photos of some of the kids who received the benefits of the donations sent by everyone at home. The photo at the top shows a group of kids with their shiny new shoes, which will be especially useful when the rainy season comes (hopefully soon). I guess because of our skin color and age, the kids referred to both Rob and I as "Teacher," and apparently refer to Ben as "Teacher Mzungu."

The best thing about the kids that i've met here, especially those who have very little in their lives in the way of money, or in this case family, is how happy they are to be with you. Happy to receive gifts, of course, but also happy to have someone to play with, happy to show off for you with their new soccer ball. And according to Ben and Kristy, happy to learn.

I suppose i didn't need to travel all the way to east Africa to remind myself how important childhood is. But here I am and these kids are a powerful reminder.

Update on Elisa

For those of you interested in my earlier blog about Elisa, the girl we flew to Haydom for the CT scan: Yesterday I ran into Elisa's grandmother and 2 of her aunts at Selian. They were there to pick up more medications for Elisa. I have no idea what they said to me, but all three shook my hand and went on to thank me in Kiswahili. and to describe that she's eating and running and jumping, and apparently doing very well despite occasionally having seizures. I found a nurse passing by to help me translate and we made sure that they had the right medications for her, and that was that... we'll see her in clinic on Tuesday.

I really wonder what will happen in her life in the coming years.

And now, for your viewing pleasure, here are a few pictures taken with our camera by some of the Maasai kids in the bush. They love cameras and don't really have any of their own, as far as I can tell. I think we may have some budding photographers out there...

(the 1st one, the one with the boy squatting down, is my favorite - which is yours?)

Evolution

Monday morning, as I was walking to Selian to begin another week on the Internal Medicine wards, I received a call from Sarah asking if Rob and I were available to leave town for a few days to help with the Flying Medical Service Clinics. Are you kidding me? Yes, we were available. Not even a little case of Sultan's Revenge could prevent us from boarding the plane. 1 hour later we were in a cab, bound for Arusha airport, with most of the things we'd need for 3 days in the Tanzanian bush -- and really who needs a change of socks around here anyway? It only takes a 10 minutes walk down the road-footpath-cattle trail to turn everything you own an even shade of brown. Like instant camouflage (sp?). What's amazing is that, in the Tanzanian countryside in times of drought like this one, the only colors you see are browns and grays...until the Maasai people emerge. They wrap themselves in sheets of cloth that are often bright red or deep blue, or patterns of yellow, orange or purple. I have no idea how the colors remain so vibrant. But the vision is actually pretty amazing - the brown huts, the leafless trees, the endless hills of dirt...and the shy, proud people of the Maasai tribes providing every color missing from the landscape.

Our experience with the Flying Medical Service will be hard to describe. Fortunately we have pictures... We spent 3 days in the bush, flying to 2 to 3 different clinics each day and offering exams, vaccinations and medicine to the people of the surrounding area. From the air we saw herds of elephants and ostriches. On the ground we met the people - so different from us, i can't stress that enough. But, although they seemed to think we were interesting and strange too (why do we wear such tightly fitting clothing??), there was common ground on which we worked: we were there to help them and they trust the full-time employees of the flying medicine team. FMS has been doing this for 25 years for these communities, who otherwise have no access to healthcare, and have virtually eradicated certain birth defects and complications as well as diseases like polio from this population. So the village people showed up in pretty impressive numbers, and seemed to appreciate us being there. I learned a lot from our pilot Jack, who has been doing this for the past 7 years and was able to communicate via Swahili (and a bit of Kimaasai when necessary) with these people. He knows that what he does is important for them, and for the overall well-being of Tanzania - and they seem to understand its importance as well.

This photo was taken from the airplane, as were leaving one of the clinic sites. The building on the left is our clinic. The people on the right are actually a group of kids that were particularly (and understandably) fascinated by the plane.

What's amazing is that the people we met have maintained such a simple life over all of these years. They still provide their own food from the land and their livestock, still carry spears for hunting. Most don't wear pants much less underwear. They live in bomas with thatched roofs. They deliver their babies at home, no questions asked. I have no idea if they know what "pasteurized" means. In some ways i felt as different from them as i did an entirely different animal.

This is a photo from the air of a group of Maasai bomas, which are huts with thatched roofs, in which the people live. There are 7 large bomas in this photo, and possibly a couple of small ones.

But here are some things that are the same about us: they care about their kids, and are protective of them and feed them well. Those were some healthy-looking babies, let me assure you. They respect their elders. They mourn loudly and with meaning when someone dies. They laugh with each other when they are happy (sometimes i get the distinct feeling they're laughing at my pathetic attempts at speaking Swahili, but so it goes...)

So, in some very important ways, we're not so different after all. And anyway, what's wrong with eating goat? Plus, being busy is overrated.

Here are a few photos of our experience withFMS in the bush. I'll post more later this week, when I have more time...but for now:

This woman is feeding her son milk from a hollowed gourd.

One word: Plastics.

Although it seems like weeks have passed since Rob's arrival in Tanzania, it's actually just been one single action-packed week. That's the way it is here, though. You lose track of time and get so wrapped up in all that there is to do here that before you know it, the week is gone. It's all good, though. It has been a great week and i think Rob would say the same...now that he's over the jet lag.

I spent this week on the internal medicine wards with Dr. Debes, also known as Jose, a former co-resident at the U of MN who is now the attending on the IM ward here. Together we saw an amazing amount of illness and tried to manage it as best be could with almost no tests (you've heard this all before...) I won't lie, it was frustrating at first - mostly because you are never really sure of what you're treating here. But as the time goes on I've gotten used to it, and started to rely more on my physical exam skills and, well, gut feelings. Does that seem un-doctorly? In Tanzania, it's absolutely necessary. I wonder what it will feel like when i'm back to the U.S. (in just 3 weeks!) and have so many lab tests and radiology options available to me...completely overwhelming? Suddenly the VA hospital seems like the lap of luxury.

On Wednesday Rob came to Selian with me to meet people and plan his video project. (he has been incredibly busy since his arrival - turns out there is a lot of interest in making short films on the volunteer and charitable organizations that are here) That day Megan readmitted a little boy that I took care of with heart failure a few weeks ago - this time he needed a blood transfusion, as did another child who was admitted simultaneously. The problem is, there is no blood in the "blood bank" here. The solution: Rob's blood and Megan's blood type matched those of the little boys. So they became instant donors and both children did well. Way to go, R & M. Now that's dedication.

Other remarkable events of the week:

-Thursday we had dinner at the home of a man from the church named Cifa. Cifa (KEEF-ah) takes in homeless adolescent girls and raises funds to get them through secondary school. There are 18 girls in the house with him - some of the smartest, sweetest kids I've met here, but all with their own sad stories and problems. We spent the night talking with the girls about "being teenagers" (read: puberty and beyond) and then they made us an amazing meal of traditional Tanzanian food. Here is a photo of the girls with our crew (U of MN med students Christine, Maikon and Katie - who led an excellent discussion with the girls - as well as Kent, Rob and I).

-Saturday marked the arrival of Dr. Bill Brown - a truly inspiring and talented plastic surgeon from Colorado who visits Selian twice yearly to help repair cleft lips/palates, burn wounds and whatever else comes through the door. Rob and I, along with our roommates Kent and Jennie, spent the day in clinic with Dr. Brown's people and helped prep the kids for a week of operations. Some of the kids who will have operations this week are pictured in the shots from the Plaster House (bottom of this blog entry).

Dr. Brown, et al, reviewing patients in plastic surgery clinic

Kent, Rob and Megan solving the world's problems.

Or making plans for the evening. Either one.

-Today We visited the Plaster House, which is a home for kids with disabilities which is a project of an amazing woman named Sarah Wallis and the ELCA, with Dr. Jacobson and other leaders from the Selian community. I've said it before: It is the people of Tanzania that make it great, despite its hardships. The people from the Plaster House, kids and adults alike, exemplify what i'm talking about. It's no wonder Brenden had such a great time here - he got to spend time with the people through volunteeringwith our friend Jennie, the Australian Occupational Therapy student. Pictures are worth a thousand words, so here you go:

Harvest Festival

After a very entertaining day at the ACC Harvest Festival auction (where I bid on a couple of very nice melons and have received several compliments on them since) I am back at the Oasis, getting ready to leave again to meet Rob at the airport. I am excited, and a little nervous, to see what he thinks of this place. It's definitely unlike what we are used to at home...
But first things first, I'll be happy to see him after 5 weeks apart.

And a correction from my brother: only certain types of bananas are going extinct. Never fear - at least certain species of bananas will outlast all of us.

Have a great Sunday, everyone. More pictures later.

Sun Salutations

Baobob Tree. One of the Wonderful Trees of the World.

This morning I woke up and waited patiently for the cramps in my abdomen to start again. They didn't. You see, yesterday I spent the day at home, sick. I've decided that being sick is much more fun on a Tuesday or a Thursday around here because the maid isn't milling around all day while i'm trying to mope privately. Yes, I said maid. We pay a woman to clean the house and do laundry for us three times weekly. She's a lovely woman and sometimes brings us sweet bananas. (Brenden said that bananas are going extinct - which is truly tragic when they taste as good as they do in Africa). Anyway, having an african maid isn't as politically incorrect as it sounds. That's the way it's done here. We provide her with a job...and around here that's not always easy to come by. Unfortunately i'm getting quite used to this...I'm not looking forward to doing my own laundry when we get back. Fortunately we have the luxury of a washing machine. Christine washes our clothes by hand.

So I feel better today - even well enough to eat a piece of sweetbread with peanut butter and Nutella on it. Who says i'm roughing it here?

I did yoga in my backyard, facing the sun. It's a very different experience than being in Jeffrey's studio at home - here, when i do my forward bends and peer through my legs i see a rooster and flock of baby chickens scavenging the ground about 10 feet behind me. And the background during Shavasana (sp?) at the end is a chorus of cows mooing and cock-a-doodle-doos.

But the sun feels just as warm here and yoga can always help me back on my feet. Now off on a trek into town with my roommates...we'll see what kind of adventures befall this troup of Wazungu today...

This is the rickshaw full of cabbage that we helped push up the hill.