My Sister's Month in Tanzania - Part 3

Date: Sunday, December 19, 2010
Subject: Finally, internet
From: 007’s Sister

Habari za asubuhi!

Here I am in the funny little town of Lushoto, in the foothills of Kilimanjaro.

I have-- miraculously-- found a spot with FAST internet. Trouble is, only one computer is equipped with a USB port, and that computer is currently occupied by what looks like a quarter of a gospel group which is listening to youtube clips of gospel songs in anticipation to Christmas. TIA (This is Africa).

Things are really great on my end. I have just finished wandering 'round the markets here, navigating somewhat confidently with the Kiswahili knowledge of an 18 month old. Bei gani? Mizawah. Robbo kilo. Asante sana. Sitake! I

'm really enjoying Tanzania. I find the people nice, non threatening (well, so far), and once you attempt to speak to them Swahili, much more helpful.

I am staying in the scrappy little town of Muheza, which is not a tourist destination at all, but very conveniently located in what seems to be a transport hub: so, few muzungus [white people or foreigners] (actually none apart from those working at the hospital, which is to say, 3 doctors and us 5 medical students, plus 3 Dutch midwives), but very good access to destinations all over the country via dala dala (super cramped busses).

The 5 other medical students are all, strangely enough, Aussie, which is great because it means they're low key, non competitive, and adventurous. Consequently I've been able to get lots of clinical experience, and see lots of things on the weekend too. The hostel, predictably, has no running water, but I use the bucket showers get the job done. Recently, fans were installed in the rooms, which is a total godsend.

All of the muzungus gather once a week for a "muzungu dinner", where everyone can touch base on how they're doing. [Doctor 1] and [Doctor 2], which have been working at Teule hospital as part of their mission in the UK, have been around for 8 years now and run a pretty tight ship. They have 3 children, which have all grown up in Tanzania. [Doctor 3], another UK doctor in her 50s, has been at Teule 6 months. She's hit the slump-- that horrible troph [?] of home sickness and culture shock, and she's basically running two wards at the hospital. In the UK, she's a GP, so I think she's finding the transition and level of health care hard. She is also very threatening, I think, to the local doctors, and too nice to the nurses, both of whom make life really quite difficult for her at times. There is so much to say about how the hospital is run, but I've only got 19 minutes of net time left so I will be brief.

There are 3 types of doctors in Tanzania.

- MD, medical doctors, who, like us, have had full medical training (including phsysiology and basic principles). The best education, until about a decade or two ago, was to go to Russia or Cuba and train there (communist countries promoted a lot of training to Tanzania at the time). When on the ward with the MD, it's possible to ask questions, and we speak pretty much the same language, medicine-wise.

- CO, clinical officers, have had 2 years of training, and learn everything didactically. This means they rote memorize algorythms: if this person has fever, and signs of jaundice, plus signs of anemia, then it's malaria. There is no underlying understanding of how the human body works. This leads to really baffling situations sometimes, and also means that they are very rigid in their diagnosing / prescribing, and that if you question any of their decisions, well... Better leave that sentence unfinished.

- AMO, Advanced medical officers, are basically CO with two extra years' worth of training and specialization, such as surgery and pediatrics. This means they can be really good at certain things, but the problem remains that they don't have a full, holistic understanding of human physiology. It's also pretty interesting-- they will never, ever get paid as much as an MD. In fact, there seems to be a pretty strong hierarchy throughout medical training; the CO get put down so often that they are often quite dejected, but also all too happy to put down people when they can. Also, it's interesting that medical training is very expensive whereas CO training is less so. So obviously: there is a bit of a class difference when it comes down to who trains as an MD and who trains as a CO.

Finances is a whole other can of worms-- because so much of TZ healthcare is dependent on donations and charity, it's been really impacted by the GFC [?].

Skipping right along...

Last weekend we all went down to the beach. The water is so warm it feels like a bath (especially after cold bucket showers), and so salty! We rented bicycles and cycled 16 KM to the hostel we'd rented through some really amazing country side.

This weekend we went on an 8 hours hike up to the Irente viewpoint in the mountains, where it is blessedly cooler.

Next week is Christmas! All of us muzungus will be celebrating together. The kids let it drop that [Doctor 1] and [Doctor 2] have gotten us presents, so we student are fetching them lots of fresh cheese and other 'designer' food which is hard to find/very expensive. We're all cooking something-- I'm roasting the chickens and, for once, no one is competing with me to cook (I've got a bit of a reputation as the best cook, although the two Sri Lankan boys make a mean curry). Us girls have also gone into town and purchased some great fabrics and ordered some dresses. Agatha, a nursing student we've befriended (and whose volley ball team I've joined), comes over in the evenings for some food and she teaches us swahili gospel songs, which we sing to and play on the ukelele. She's also teaching us how to make chapati, and shows us the good stores around town. She's really great; she showed us where the nursing students stay, and frankly it's pretty bleak.

For New Year's I'm going to be accompanying the UWS (Uni of Western Sydney) students to Moshi, then we'll climb Mount Meroo. While it isn't as high as Mount Kili, it's meant to be a tougher climb—[007’s Brother], this has me a bit nervous. The idea is to hike 3 days and reach the summit for sunrise. In the evenings we'll camp out in huts along the way and cook our own food. Cross your fingers!

After that, I'll head back to Muheza to finish my project (which, bizarrely, is actually clipping along nicely). Then finish off my time in Tanzania in Zanzibar... not bad.

I can't believe how fast it's all going-- this is really what I needed, I think, after my tough year last year.

[007’s Brother]: I'm going to spend 2 nights and a day in Dubai, any suggestions of what I should do? I'd like to see the desert...

Ok out of time!!

Gros gros bisous, [007’s Sister]