safari day one
picked up at 7am sharp by mohammed, our safari guide for the trip. apparently he first entered the house where the canadians stay (they never lock their door) and tried to get them to come on safari. chalice and paul, both feeling friday night, were none too happy and ‘hapana’-ed him over and over until paul finally got up and was like ‘do I look like im ready to go on safari?!’ – poor mohammed, wrong mzungus. then again, we all do look alike ;) when he finally tracked down the right people, he piled our packs into the car and we went to the soko office (plug for soko safaris, they were absolutely wonderful and locally owned, as opposed to a lot of the other safari companies here owned by Indian families) to get the other safariers – here are their bios:
Anne: from amsterdam, only 21 years old. here volunteering as an optometrists. she has a 15 month old daughter named flower that she left home with her parents (crazy, we know). she was nice and easy going, we enjoyed her company.
Michelle: from ottawa, canada, 23 years old. here volunteering with TVE (tanzania volunteer experience) working at orphanages. she was very quiet but also nice and easy company on safari.
Avigail: from israel. maybe in her early 30’s? she was a character to say the least. she never listened to the guides and paid the “I told you so” price several times on the trip. she consistently drank too much coffee in the morning and made us stop to allow her to pee way too often, and did I mention she forgot to bring toilet paper? she sang off key to buffalo soldier for a majority of the third day… the stories will keep coming, she kept the trip interesting and consistently left us giving each other looks behind her back that said “what the $%*&!”
our final company for the trip was our daktari wtumbo (stomach doctor), prosper, a cute and quiet young guy who had learned to cook at a school in moshi. he did not let us down and kept us fed and happy the entire the trip. more details on the menu later…
the eight of us set out for our serengeti campsite, a 6 hour journey, most of which was on unpaved roads at speeds so fast that I thought the safari vehicle might rattle apart. we saw a giraffe before even entering the park. it’s wild to me that these animals really do live amongst the people here. we also passed many maasai, a big draw for safariers and great income for the maasai and their villages, from charging the safaris to bring people through. these maasai were very different than our lengasti tribe, they know how to exploit the tourists and in addition to selling ‘maasai necklace and bracelet’ they jump at capturing a photo with you and then charge for their appearance in it. mohammed told us that there was one maasai man in the village we passed through who had 34 wives and over 100 grandchildren. apparently they opened a school for his children alone, and all of the kids are in class with their brothers and sisters.
we had to pass through ngorogoro on our way to serengeti, the road is steep and winding that takes you to the ridge of the crater, and as we climbed we passed from the dry, brown of the warm valley to the lush, cool jungle atop the crater rim. the clouds were flying by, touching the treetops. the fog faded the trees farther from the road lighter shades of gray. moss hung thick from the trees overgrowing the road, greenish-black in color and it made the branches look fuzzy. red dirt, kicked up by the safari vehicles, stuck to the nearby plant life, and just out my window everything was a monotone brick color. our first glimpse of the crater was breathtaking: miles down the floor was faintly visible through the clouds, I couldn’t help but imagine all of the animals too small to see. satisfied that he had given us our crater preview, mohammed drove on. we could look down the steep right side of the road into the crater, then down the left yet steeper side into the lush jungle. we were quite literally driving along the edge of the crater and it was incredible! my gaze was fixated out the window, taking in the scenery that reminded me so much of home, but in a more wild and overgrown way. it felt like we had entered jurassic park, and I was eagerly searching the jungle for exotic wildlife.
the road leading to the official gate into ngorogoro was littered with olive baboons, far too comfortable in the presence of humans. we got out to stretch as mohammed paid our entrance fees, and within seconds we watched a lady flee for her life as a baboon, irritated that she had gotten too close when snapping a photo, charged aggressively. needless to say we backed off after that, and gave baboons a wide berth for the rest of the trip. they’re funny to watch though, picking bugs off each other just as you imagine the stereotypical primate interaction would happen. one in particular, a big male, was sprawled on his back beside the road, feet resting in his hands, as a smaller female picked bugs off of his tummy. they were definitely entertaining to watch, a little scary, but mostly funny.
at this point we had been driving for hours and prosper and mohammed were trying to manage a car of six ladies getting progressively more hungry. not a minute after I had asked prosper when we eat, thu climbed back into the car and asked him when we get to eat. avy begged for bananas and prosper distributed one to each of us to tide us over until lunch.
at the 15 minute mark mohammed started giving us minute by minute updates of how long it would be until we get to eat. it was cracking me up. 5 minutes… drive down the road a little further, 4 minutes… around a corner, kicking up red dust behind us, 3 minutes…. turn a corner and a sign labeled for picnicking, 2 minutes… as he’s pulling to a stop in an opening overlooking the crater… 1 minute!! he’s been leading safaris for 15 years and you can tell he is very experienced dealing with tourists. two stories about that:
first, he pointed out several different safari cars during our trip saying that he had worked for that company before. apparently a ton of the safari companies are owned by indians and the locals tend to strongly dislike the indian families in tanzania. they own businesses, exploit the locals, underpay them, don’t treat them well, and so on. mohammed pretty much told us that he wanted to shoot one indian owned safari company. he took out his imaginary air rifle and shot his imaginary air bullet, specifying that he does not want to kill them, just shoot them in the leg as well as have each indian person in tanzania spend 3 months in jail each year. he has apparently really thought this one through. this was the first we’d really heard a local talk about their frustrations with the indians in tanzania, though we’ve caught on that there’s some conflict – ‘we are like cats and dogs’ mohammed said. pretty interesting to hear about. we all laughed and took it light heartedly, but made a note not to get on mohammed’s bad side as none of us would like to be shot in the leg or spend 3 months in prision.
second: mohammed talked a little about what makes good safariers and what makes bad safariers. naturally we were curious whether we’re the best safari group he’s ever had or what?! :) get this, he’s had tourists come on safari with him who will sit in the very back seats even when there’s only two of them (this is odd – there are four rows of seats, and the closer you are to the front the less bumpy it tends to be), and he has to yell to try to talk to them. he says he’s had people who read a novel in the back while they drive around – what?! and that often the difficult people are those who don’t want bumps (aka no driving fast, driving fast was the best part, more on that later), don’t want dirt (dirt is part of the experience, we embraced it and used the ‘we’re on safari’ excuse so that we didn’t have to shower for three days :), and want to the AC on the whole time (fresh air is the way to go, nothing better than smelling the animals, part of the experience!)…we were baffled that he’s had such picky people on safari, and sometimes for weeks at a time!! luckily our whole group (minus avigail ;) was very easy going and he thought amy, thu and I were quite funny (the other two girls didn’t talk much)… I think he really liked safariing us around, and prosper took a quick liking to us to, which was reflected in his particularly amazing meals that got better and better each day.
ok, back to lunch, box lunch, it’s the standard: banana, orange, boiled egg, two vegetable samosas (mmm delish), a bread and bread sandwich, as avy called it, not sure what was on it, great for feeding to the huge birds that look like crows on steroids with white chests. they’re a bit aggressive, I have a great story about that for the third day. lunch also included a muffin, some crisps, and maybe something else im forgetting – oh, pineapple juice in a juice box that’s a triangle shape so I think it should be called a juice triangle enough about the food, I get too hung up on the food, I think I will be able to make an entire album of pictures of food slash me putting food in my mouth. what? eating is a huge part of the travel experience!!
our safari started for real post-lunch when we hit the serengeti. the roof of the car went up, my shoes came off, and I don’t think my butt was in my seat for the rest of the day. I stood in my socked feet on the seat, sitting atop the headrest, hanging on to the bars around the edge as we flew down the rocky roads. I was still rocking as I wrote about the day by headlamp in my tent that night. it is such a bumpy ride, so noisy and dusty and you’re hanging on for dear life as mohammed speeds around the corners - awesome on every level! here’s an idea of the animals we saw on day one:
thomson’s gazelle – this one is funny because the first one you see you want to take like 40 photos of it, even if it’s really far away and all of your pictures are blurry, then as you safari on you realize they’re everywhere :)
simba!! - not a few kilometers down the road after entering the park we came upon a stopped safari car. on our safari we quickly learned that the more safari cars stopped in a given area, the cooler the animal. We knew that a crowd of safari cars meant we were about to see something very rare and awesome :) here we came upon a mama lion with three babies!! It was funny because mohammed was like ‘simba!’ and we’re all eagerly scanning the horizon, im looking off into the distance grass, trying to pick out some irregularity and I can’t see anything. ‘where, mohammed, where?’ I ask. ‘there!’ he points, a little exasperated, and there, maybe 20 ft from the road, I can see the mama lion and babies laying the shade of a small bush. I had to laugh, here im desperately searching the distant grass for a speck of a lion and there are four right in front of my face. we watched them for a while, snapped many photos, and reluctantly moved on. I could watch the animals all day. stick me in front of a big cat and im endlessly entertained. they’re so beautiful!!
plains zebra – same thing, first zebra you see from wayyy in the distance and you snap endless low-quality photos and then you realize zebras are everywhere and you’ll get pics of them directly next to the car. I like zebras a lot!
hartebeest – which I think of more as heart beast, since the horns look like they’re in the shape of a heart. This guy was big and we saw quite a few of them, I like them a lot, they’re easy to mistake for the topi, except the topi have more interesting color markings on their legs.
pumba – the warthogs are so freakin’ ugly! We saw two near a muddy water hole, seemed appropriate. They have these gross mohawks of course hair and knarly horns from the noses and they kneel on their front legs and sniff through the dirt and grass for food. And they totally waddle when they scurry along, but apparently they’re pretty fast and mean. I wasn’t a fan, though we did eat pumba early on in our trip (yes, the vegetarian tried a piece), and it was delicious, so I dunno… don’t judge a book by it’s cover? :)
duma – mohammed definitely had a radio in the car, and there was muffled talking in the background for most of the safari. we had heard this was a good thing, because it meant that he was in touch with the other drivers and could get a head’s up if someone found something good. soon it became apparent that he had a destination in mind. we had been driving along more slowly for the start of the safari, stopping periodically for each of the more common animals we saw. suddenly he sped up, was on the radio speaking quickly in swahili, and it got to point where we were flying down the road faster than I thought possible on such rough terrain. that’s the best by the way, it’s an african roller coaster!! we loved it, amy and I had smiles ear to ear when he’d take off at top speed, both of us up on our seats hanging on for dear life! what a ride!! and get this, he suddenly turns completely offroad, just up and over the rock pile on the edge of the road, and we’re cruising in a random direction through the tall grass. this cannot be wildlife preserve kosher :) but he was on a mission and we didn’t question his decision, just held on extra tight as we couldn’t see the bumps and holes the terrain threw our way beneath the tall grass. soon we spotted a car in the distance (we were infinitely amazed that he could find his way around these parks, I mean, what do the other guides tell him, hey I found a cool animal near a gazelle by a tree in some grass? mohammed is awesome). as we drove closer mohammed slowed respectably and asked us ‘what will we see here?’ – he obviously already knew, but we were amateurs to this safari business (unlike the pros we are now ;) and we all had no idea. it looked to me like a dead thorn bush of hell in the middle of a bunch of grass. as we got closer the other safari car pulled away and made room for him to pull up close next to the bush – cheetah!! She was laying there in the shade, protected by the huge spines of the thorny bush of hell (same plant that almost took my arm off had it not been for my maasai warrior). She was soooo beautiful! I was in awe! And we were ridiculously close. Duma was just laying there, her head up watching us curiously, or more likely annoyed, that we were disturbing her. got some great photos of those red eyes staring directly into the camera. It was incredible to see such a beautiful animal so close. I need to hunt down one of my favorite childhood movies about a cheetah, the reason I named my favorite stuffed animal duma, which I didn’t realize at the time means cheetah (it’s a snow leopard – oops :) ok, that’s definitely an over-share in this blog…anyway, we were very lucky to see duma so close, and even luckier when we got to see another duma tomorrow!! cheetahs are impressive animals.
clouds – im including this in the list of cool things we saw because the clouds in the Serengeti on this day were the most amazingly epic clouds I have ever seen in my entire life and there was a moment when I thought I might actually end up with more photos of the sky than photos of animals :) (am I overdoing it with the smiley faces or what? but really, this safari was perfect, I can’t stop smiling when I think about it, we got soooo lucky!!)
simba- yup, we stumbled upon more simbas, a few females this time, very VERY close and out in the open. one walked over and laid down and mohammed drove us right up next to it for photos. I was having sensory overload because nearby was the first herd of elephants we had seen and there were many and they were so beautiful and I love elephants, especially after getting to ride them in Thailand, and I was so excited to see African elephants. Anyway, my photos are all over the place – lion, elephant, lion, elephant, lion and elephant, elephant, lion… you get the idea. SO COOL! ok, quick story… so our safari car was awesome, and the fact that we survive the trip without a trip was pretty remarkable (you see the safari cars changing flats alllll the time), but it was older and a little bit falling apart. The first day, if he idled for too long looking at an animal (so pretty much everything we stopped for) it would die. Mohammed would patiently get out, fix the loose connection, get back in and start the car. the thing is, when we stopped next to the lion to watch it and take photos and remark on it’s blood stained legs and paws, the car definitely died. So it came time for us to leave the lion and peace and mohammed’s all ‘so guys, who wants to get out and fix the engine?’ just casual and sarcastic. And we all laugh because it was funny but the thing is it was only so funny because we were actually stuck. You can’t get out of the car, pop the hood, and fiddle with the engine when you’re parked 5 feet from a huge female simba, with blood stained fur nonetheless!! So we’re all just twiddling our fingers wondering what the next move is… waiting it seemed. Fortunately, another safari vehicle had gotten wind of the lazy lions and pulled up behind us. mohammed yelled something in Swahili out the window and yup, you guessed it, the safari car, with a rev of the engine, moved forward and nuged us about 20 feet past the lion, giving us enough speed to get the car started. We’ve had a lot of fun with the ‘hey guys, remember that time the safari truck died when we were parked next to a huge lion?’ ‘oh yeah, good times’ :)
black kite eagle – saw lots of cool eagles and hawks and vultures. Actually the bird life is so diverse and they’re all really beautiful. The crazy birds might have been one of my favorite parts of the safari.
secretary bird – HUGE and very odd looking. We saw a lot of these, I liked them beaucoup :)
love birds – these really pretty little green birds that we would occasionally see in flocks.
Ostrich – possibly the ugliest bird ever created. The first time we saw an ostrich we actually saw two males outside of the park, near one of the maasai boma tourist traps. Mohammed joked because the one male was doing a mating dance and he said he must be confused because the other bird was male too. at this point we didn’t realize how different the males and females look. We thought maybe the one male was just practicing. Later we realized that the males are the typical black and white that you think of when someone says ostrich. The females are a neutral brown color that makes them even more ugly. Their wings hang down at their sides, seemingly weighed down by all of the feathers that cover their body, making them look quite disheveled. Their featherless pink necks are gross, and when they’re eating lizards or whatever you can see the lump get swallowed down their long throat. They are HUGE birds and we saw a lot of them throughout the safari. the feathers really do sway and fluff like a massive, thick boa or something. ok fine, ostrich is a cool bird, just soooo absurdly unusual looking!
giraffes :) I love giraffes. I learned there are three types – masai giraffe and rothschild giraffe – both of which im pretty sure we saw and im hoping I can distinguish between in photos since I’ve educated myself. there’s also a reticulated giraffe that would be soooo cool to see but I don’t think it lives in east africa. ill have to review my photos just to be sure we didn’t see one. fun giraffe fact! – those loooonnnggg giraffe necks have the same number of cervical vertebrae that we do! yup, only seven in such a long neck. Really cool! it would’ve been kinda awesome to see a giraffe skeleton (in a messed up sort of way) – we did see what im pretty sure was an elephant skull. There was also a really big rib cage another day. you spot horns and random bones every so often on safari.
hyaena – asleep by the water. This is the animal avy wanted to see most and I have to admit I was pretty into the hyaenas as well. A very interesting creatures, so aggressive. Amy was reading about them and what the book said was that they’ll eat pretty much anything, including humans, and have been known to ‘tear the face off a human sleeping in the open’ – what?! and the canadians also passed on a story from their safari (thank goodness they told us once we returned) about a hyaena coming into a tent and killing a woman. They do just look like mean, grumpy animals capable of incredible violence. I think they were well portrayed in the lion king (oh, we saw pride rock by the way, er, several of them. when the volcano exploded creating ngorogoro crater the rocks landed in the Serengeti so there’s random huge boulders everywhere, and sometimes the piles make a perfect pride rock :)
sausage tree!! – ever since hearing about this when we went to arusha national park I’ve wanted to see a sausage tree – mostly because of the humor of the name. fear not, I took many photos. It’s a pretty funny tree… the fruit or whatever the ‘sausage’ is cannot be eaten by humans but a lot of the animals in the Serengeti eat it.
that’s about it for day one on safari. we were ridiculously dirty after only one day, with no intention of trying to shower at the campsite. We stick with the homeless showers using baby wipes we’d turn brown with a single swipe. My hair was caked with dirt and I had a neat outline of my sunglasses on my dirt smeared face. but let’s be honest, who doesn’t love being the dirty kid every now again? ;) we got to the campsite and set up our tents alongside several others from various safaris. They’ve really got the system figured out. prosper got straight to work in a kitchen crowded with all of the other cooks. I would pick him out at first by his shirt, which said ‘go commando’ and had a picture of a cartoon guy running with his underwear behind him. we helped set the table for dinner, and got everything put in our tents, as the sun set quickly on the horizon. It was possible one of the most epic sunset I have ever seen and again, the number of photos I took probably rivals my animals photos for the day. clouds and beams and glowing orange and red. I kept getting distracted as I helped set up the tents. Huge canvas tents plenty big enough for three people (though they usually only stick two in a tent, we opted to only set up two and save the time and effort). They provide sleeping mats, sleeping bags, and pillows. I was more than thankful for my sleeping bag liner – im guessing the sleeping bags get washed, oh, never!
dinner was incredible. we were served tea and popcorn (yes, a mt kilimarjaro of popcorn) as we watched the final sunset…
ok, pause, im typing this in the hostel, it’s the second to last day of our trip and thu and amy are both passed, I’m guessing it’s not ten p.m. yet, but we’re on a wayyyy early schedule after safari. anyway, point of this is that there’s something living in the attic of centre house hostel and it’s BIG! And it just went scurrying across our ceiling and I can hear the claws and it sounds huge enough to fall through the thin and poorly constructed ceilings and we only started hearing it two weeks ago but I hear it almost every night and it freaks me out that some huge, nocturnal, clawed beast is running around over our heads all the time. I just have to tell myself it’s our last night in a sleeping bag, mosquito net tucked neatly around us (that reminds me, I need to take my malaria meds), and soon I will be home in my soft amazing bed. creatures in the night on safari, ok… creatures in the night in your hostel, not so ok.
back to dinner, now I will describe in detail our delicious food: popcorn has never tasted better – and no microwave! How do they do it?! ;) amazing cucumber soup from scratch (I watched him make it), avocado noodles and vegetable medley and I think something else im forgetting and then all sorts of fruit for dessert, particularly the most delicious pineapple ever. we were all stuffed and happy and praising prosper for his amazing culinary skills.
we had to team it to the bathroom as it really isn’t safe to walk around alone or in small numbers. Mohammed emphasized again and again that if we had to pee in the night we were not to walk to the bathroom but inside, shine our flashlight out first, and then quickly take care of business right next to the tent, then get back inside asap. I made a mental note to stop my water intake and ensure I would not need to pee in the night. I slept like a rock. was expecting to hear the sounds of the serengeti, and so I fell asleep with my music in. it was funny because when I woke up in the night my music was still going and I was sure I heard all of the crazy loud noises of the animals over my music so I quickly removed my headphones and… and…. Silence. No animals? but we had heard there would for sure be crazy animal noises. I was back asleep in a snap and before I knew it amy’s alarm was going off…
Wednesday, August 18, 2010
Friday, August 13, 2010
african safari
spending the evening at blue heron with the canadians. a million stars tonight and live music :)
leave in the morning for safari and we cannot wait!!
ngorogoro crater and serengeti - camping with the wild animals :)
back tuesday then home wednesday!
where has summer gone?! can't wait to finish it off in home sweet oregon!
miss you all and can't wait to see everyone!!
xo
~L
leave in the morning for safari and we cannot wait!!
ngorogoro crater and serengeti - camping with the wild animals :)
back tuesday then home wednesday!
where has summer gone?! can't wait to finish it off in home sweet oregon!
miss you all and can't wait to see everyone!!
xo
~L
O.R. hopping
last day in surgery! can’t believe it. we brought in the end of our supplies as well. it has been so wonderful to be able to bring in supplies each day we work, distributing everything where we see the need. I’ve said it many times before, but thank you again to everyone who contributed!! mt. meru hospital and the staff and patients here, are all so grateful!! and amy, thu and I cannot thank you more for your help and support!!
the O.R. was fairly eventful today and I was jumping from minor to major theater and back again to make sure I didn’t miss a case. I entered dr. lee’s theater just as he was starting an operation. it was one of those moments where I walked in too late to ask about the procedure, and all I could tell was that there was a growth on the back of the patient’s head. because I wasn’t sure if it was a growth, or something else, I opted to remain back, though I could have easily approached the table for a better look. this turned out to be a wise decision. a few cuts in and there was an explosion of pus that shot across the room. it was a sebaceous cyst. moral of the story: if you see something that looks like it might be under high pressure it’s best to be cautious.
next was what the schedule identified to be a ‘cystic mass at R clavicle’. that was an interesting procedure to watch and for once I felt comfortable that the doc knew what he was doing. he used a lot of blunt dissection as he was very near an area with critical veins, arteries and nerves. his caution around such delicate anatomy was not something I have seen here, and I appreciated that he shared with the large group observing the reason he was being so careful – some teaching in the O.R.! wonderful!
we watched dr. lee remove a calcium deposit from the distal part of the fifth metatarsal. from what I understood it had maybe formed after trauma to the area. he attempted to numb the hand by injecting lignocaine around the brachial plexus, unfortunately for the patient he wasn’t very successful and the poor guy was grimacing in pain through much of the procedure.
next was one of the cancelled amputations from tuesday – the 70 year old man with a gangrenous leg. it was dreadful! the smell was horrid and this poor man was so old and weak. apparently back in may he had been hit by a bicycle and it seems that the site of injury has been getting worse from that day forward. he had a gapping, oozing wound in his upper left thigh. the leg and foot were hypertrophied and shriveled. there was no bone, it had essentially rotted away and yet again we were watching this gumby leg get manipulated before our wide-eyed gaze. I was jumping between this procedure and what the schedule said was an exploratory laparotomy to check for a gastric ulcer (the schedule is handwritten and nearly illegible) – I think. basically they had the patient’s entire abdomen open and a vast majority of the guts, yup, im calling them guts, were pulled out of his body as various hands worked their way along the intestine checking for any perforations. these two procedures were quite overwhelming to watch and we called it a day once they were done. did I mention the power kept flickering out throughout the day? things I won’t miss about this place…
talk about going out with a bang! what a day to have as our final day in surgery. can’t believe we only have tomorrow in the hospital and then we’ll take off on safari. we’re very excited!! wish us many rare and wild animals :) and no rabid bats.
the O.R. was fairly eventful today and I was jumping from minor to major theater and back again to make sure I didn’t miss a case. I entered dr. lee’s theater just as he was starting an operation. it was one of those moments where I walked in too late to ask about the procedure, and all I could tell was that there was a growth on the back of the patient’s head. because I wasn’t sure if it was a growth, or something else, I opted to remain back, though I could have easily approached the table for a better look. this turned out to be a wise decision. a few cuts in and there was an explosion of pus that shot across the room. it was a sebaceous cyst. moral of the story: if you see something that looks like it might be under high pressure it’s best to be cautious.
next was what the schedule identified to be a ‘cystic mass at R clavicle’. that was an interesting procedure to watch and for once I felt comfortable that the doc knew what he was doing. he used a lot of blunt dissection as he was very near an area with critical veins, arteries and nerves. his caution around such delicate anatomy was not something I have seen here, and I appreciated that he shared with the large group observing the reason he was being so careful – some teaching in the O.R.! wonderful!
we watched dr. lee remove a calcium deposit from the distal part of the fifth metatarsal. from what I understood it had maybe formed after trauma to the area. he attempted to numb the hand by injecting lignocaine around the brachial plexus, unfortunately for the patient he wasn’t very successful and the poor guy was grimacing in pain through much of the procedure.
next was one of the cancelled amputations from tuesday – the 70 year old man with a gangrenous leg. it was dreadful! the smell was horrid and this poor man was so old and weak. apparently back in may he had been hit by a bicycle and it seems that the site of injury has been getting worse from that day forward. he had a gapping, oozing wound in his upper left thigh. the leg and foot were hypertrophied and shriveled. there was no bone, it had essentially rotted away and yet again we were watching this gumby leg get manipulated before our wide-eyed gaze. I was jumping between this procedure and what the schedule said was an exploratory laparotomy to check for a gastric ulcer (the schedule is handwritten and nearly illegible) – I think. basically they had the patient’s entire abdomen open and a vast majority of the guts, yup, im calling them guts, were pulled out of his body as various hands worked their way along the intestine checking for any perforations. these two procedures were quite overwhelming to watch and we called it a day once they were done. did I mention the power kept flickering out throughout the day? things I won’t miss about this place…
talk about going out with a bang! what a day to have as our final day in surgery. can’t believe we only have tomorrow in the hospital and then we’ll take off on safari. we’re very excited!! wish us many rare and wild animals :) and no rabid bats.
ants in your pants…
will make you do the boogie dance. I have a thing for cemeteries. I know what you’re thinking, how did we go from boogying in ant-filled pants to graveyards, but trust me, it’ll all make sense after this story. it’s wednesday here, WEDNESDAY!! are we all registering the substantiality (is that really a word?) of this statement?! wednesday in arusha means in exactly one week we’ll be headed back to the states. wait, it’s too much to process, I don’t want to talk about it… back to the story:
post-hospital we headed to check something off of my to do list for the trip: visit a local cemetery. I think this is becoming a trend, that when I travel I need to find a local cemetery. yes, this is odd, I realize, but allow me to explain. rather than thinking of a graveyard in the literal sense of a place where many dead people are buried, I prefer to wrap my mind around all of the history that’s embodied in the grave stones and lives of the people buried there. it is interesting to contemplate. all of things accomplished and seen and experienced by these people, many who lived in a world so different than my own, so different than the world that exists today. yes, it may seem morbid to a lot of people out there, but I suggest looking at it from a different perspective and experiencing cemeteries as a place that holds so much history, endless secrets, things you can never know. awesome, right?
I was really excited to get to walk around the overgrown graveyard we had seen in passing several times when we ventured to the other side of town. amy, thu and kurt were all good sports and came along to make sure I didn’t get too lost, or kidnapped by ghosts or whatever. I was photographing one particularly ambiguous gravestone when I heard amy’s voice ‘uh, linds, there’s an ant crawling on your shoe.’ she said it so calmly that I stood up from my crouch and made to look at my shoe. when I glanced down, before my gaze made it to my shoe it fell upon a creeping, crawling, thick line of HUGE ANTS!! so many ants that I went into panic mode on the spot. not sure if ill be able to paint the appropriate picture here but imagine my scream, true terror scream, coupled with a really awesome ants-in-my-pants dance, stomping around and desperately asking the others if any ants were on me. nope, that description doesn’t do it justice, im going to have to reenact it when I get back. my stomping tribal, get-out-of-my-pants dance worked, and when amy and thu finally convinced me to stop moving so they could look for ants we only found one on the tip of my shoe. I had escaped the fiery death bite and successful shook all ants from my pants. took me a good 15 minutes to come down from the sympathetic response though… we had a pretty good laugh about my ridiculous reaction to amy’s calmly stated comment ‘lind, you have an ant on your shoe’. amy would also like to point out that I came over to dance next to her, snuggle with her as she says, as if it would help the situation. in hindsight I totally did do that, like being near her would make the ants run away or something, not exactly sure what logic was running through my head. fight or flight will make you do crazy things!
our afternoon consisted of finalizing safari plans (we’re so spoiled :) and shopping for mzungu safari companions at the maasai market. the more of us there are, the cheaper the safari is, so we thought the best place to look for willing mzungus was at our favorite souvenir shopping spot. unfortunately, pretty much everyone we creepily approached had already been on safari. regardless, we made some new friends and have some leads for potential safari companions. the worst is when you approach a mzungu to ask about safari and they say ‘im a lifer’ meaning that they live here always and find no thrill in safari because they’ve been on far too many and could probably safari for free if they wanted to. how embarrassing. gotta watch out for those lifers.
to fill our evening we did henna. kurt had found some henna at a local supermarket and we had been sketching potential designs all week. I set to work on his back last night with thu’s help. hours later he had a spinal column drawn down his back with massive wings fanning off out to his shoulders so that the feathers lifted when he lifted his arms. pretty sweet. I’ve decided if I ever change my mind about medschool I’ll pursue a career as a tattoo artist. there’s something very satisfying about decorating someone’s body. we drew all over our arms and stayed up way too late working on these henna masterpieces. however, we wouldn’t have been sleeping otherwise as a group of korean students is here and are way to noisy and obnoxious extremely late as well as early in the morning. no respect!! apparently kurt got up to ask them several times this morning between 5 and 6 a.m. if they could lower their voices and stop slamming doors, no concept of being courteous, they still kept us up from about 5:30 a.m. on…glad to see them go today.
post-hospital we headed to check something off of my to do list for the trip: visit a local cemetery. I think this is becoming a trend, that when I travel I need to find a local cemetery. yes, this is odd, I realize, but allow me to explain. rather than thinking of a graveyard in the literal sense of a place where many dead people are buried, I prefer to wrap my mind around all of the history that’s embodied in the grave stones and lives of the people buried there. it is interesting to contemplate. all of things accomplished and seen and experienced by these people, many who lived in a world so different than my own, so different than the world that exists today. yes, it may seem morbid to a lot of people out there, but I suggest looking at it from a different perspective and experiencing cemeteries as a place that holds so much history, endless secrets, things you can never know. awesome, right?
I was really excited to get to walk around the overgrown graveyard we had seen in passing several times when we ventured to the other side of town. amy, thu and kurt were all good sports and came along to make sure I didn’t get too lost, or kidnapped by ghosts or whatever. I was photographing one particularly ambiguous gravestone when I heard amy’s voice ‘uh, linds, there’s an ant crawling on your shoe.’ she said it so calmly that I stood up from my crouch and made to look at my shoe. when I glanced down, before my gaze made it to my shoe it fell upon a creeping, crawling, thick line of HUGE ANTS!! so many ants that I went into panic mode on the spot. not sure if ill be able to paint the appropriate picture here but imagine my scream, true terror scream, coupled with a really awesome ants-in-my-pants dance, stomping around and desperately asking the others if any ants were on me. nope, that description doesn’t do it justice, im going to have to reenact it when I get back. my stomping tribal, get-out-of-my-pants dance worked, and when amy and thu finally convinced me to stop moving so they could look for ants we only found one on the tip of my shoe. I had escaped the fiery death bite and successful shook all ants from my pants. took me a good 15 minutes to come down from the sympathetic response though… we had a pretty good laugh about my ridiculous reaction to amy’s calmly stated comment ‘lind, you have an ant on your shoe’. amy would also like to point out that I came over to dance next to her, snuggle with her as she says, as if it would help the situation. in hindsight I totally did do that, like being near her would make the ants run away or something, not exactly sure what logic was running through my head. fight or flight will make you do crazy things!
our afternoon consisted of finalizing safari plans (we’re so spoiled :) and shopping for mzungu safari companions at the maasai market. the more of us there are, the cheaper the safari is, so we thought the best place to look for willing mzungus was at our favorite souvenir shopping spot. unfortunately, pretty much everyone we creepily approached had already been on safari. regardless, we made some new friends and have some leads for potential safari companions. the worst is when you approach a mzungu to ask about safari and they say ‘im a lifer’ meaning that they live here always and find no thrill in safari because they’ve been on far too many and could probably safari for free if they wanted to. how embarrassing. gotta watch out for those lifers.
to fill our evening we did henna. kurt had found some henna at a local supermarket and we had been sketching potential designs all week. I set to work on his back last night with thu’s help. hours later he had a spinal column drawn down his back with massive wings fanning off out to his shoulders so that the feathers lifted when he lifted his arms. pretty sweet. I’ve decided if I ever change my mind about medschool I’ll pursue a career as a tattoo artist. there’s something very satisfying about decorating someone’s body. we drew all over our arms and stayed up way too late working on these henna masterpieces. however, we wouldn’t have been sleeping otherwise as a group of korean students is here and are way to noisy and obnoxious extremely late as well as early in the morning. no respect!! apparently kurt got up to ask them several times this morning between 5 and 6 a.m. if they could lower their voices and stop slamming doors, no concept of being courteous, they still kept us up from about 5:30 a.m. on…glad to see them go today.
the pt is falling off the table
words that should never have to be spoken in the O.R… particularly during a routine minor procedure. then again, what we consider a minor procedure in the states can quickly turn into something major and complicated here, as we saw today when the doc attempted to remove a small lipoma from the back of a young maasai man.
this procedure was interesting to watch for several reasons: 1. the lignocaine was given using, I’ll say, an interesting technique. 2. the initial incision was massive, aka unnecessarily large, aka absurd by u.s. standards! 3. there was a point during the removal when the doc said ‘it looks like lung tissue’ though they were superficial to the rib cage… excuse me? 4. there was massive blood loss for a procedure that should have been very minor and no one seemed very concerned. and then, oh that’s right, 5. the patient started falling off the table mid-procedure and I had to be the one to point it out, though this poor maasai boy was surrounded by docs, nurses and medical students. what’s worse is that the reason he was falling off the table is because he was writhing uncomfortably in relative pain during the procedure. guess that interesting technique for giving the lignocaine wasn’t all that effective…
other reasons the O.R. here often makes us cringe… the first procedure of the day was supposed to be a plastics case. oddly enough it was on dr. lee’s schedule as he is probably the doc at mt. meru hospital most qualified to do this scar revision. when you have an ortho surgeon doing the plastics cases you have to ask yourself if… actually never mind, you get the idea, this shouldn’t be happening. point is the patient is on the table this morning and one of the local docs comes in and begins discussing other options for reducing the scar. aren’t alternatives to surgery supposed to be discussed before the patient is actually on the table prepped for surgery?! silly me, that’s apparently far too reasonable. this poor patient was lying there as the one surgeon was saying ‘maybe steroid can make this better’ and dr. lee was saying ‘non-surgery option is best, please try other options, I don’t know plastic surgery well but I could make this better if she needs surgery’ – ultimately they decided to try steroid injections for two weeks before resorting to surgery. go mt meru, we’re making good decisions on occasion at least! (even if it is done is a roundabout and time-inefficient manner).
next we’ve got a few knarley time filler cases – mostly leg injuries from motor vehicle crashes, and some crazy open wounds!! there was also a tiny boy with a badly broken arm. when they went to knock him out I jumped in, eager to help, and turned his head away from the injection and tried to distract him. he was so stinkin’ cute and I comforted him until he was out. the kids here are too much, ridiculously adorable (and unlike the maasai children they aren’t absolutely terrified of mzungus). kurt and I always joke about distracting the parents and taking the kids away :) instead we make them paper airplanes and give them pens (awesome, right? not really, but they’re usually pleased). as much as I love kids, I cannot stand seeing them in pain – no thanks to peds for me. it’s easy to know how to interact with kids (too many years as a nanny, and I did two rotations in peds last year), but I can’t handle watching them suffer. and you should have seen the way they manipulated this arm before casting it (very different than what we think of as a cast in the states, by the way, they call it plaster of paris – POP – and it looks like a second grade art project when they finish)…I was certain they were going to dislocate his tiny shoulder in the process the way they were yanking on his forarm and putting counter traction on his rib cage – spells disaster. hope the poor kid’s ok, he’s definitely going to wake up with a very sore arm.
next on the schedule we have two amputations. both are necessary because the patients have gangrene, both sound like they’re be above the ankle, one is on a 75 yo male, the other on a 100 yo female. what?! unfortunately (that sounds morbid, but you know what I mean), one of the patients backed out last minute and the other had a Hb that was too low to safely do the procedure. too bad, kurt was with us in the O.R. today and we were lookin’ to get him in on some wild procedures. there’s always thursday…
a few things I will miss about arusha:
-being able to walk everywhere (though I’ll be happy to be home in a place where I can walk around safety at night)
-having fruit stands everywhere that sell the most delicious fruits and veggies for ridiculously cheap (our favorite veggie stand lady today gave us green beans, a cucumber, two carrots, an eggplant and a zucchini all for the equivalent of 75 cents.)
-walking down the street past a guy with a bunch of sugar cane tied to his bicycle, giving him 200 tzs (about 15 cents) and having him cut off and skin a piece two feet long, then create chops in it so that it’s easy to bite, then just chewing on and sucking the amazing juice out of fresh sugar cane as an afternoon snack.
-not having to rush anywhere… ever.
something I really will not miss:
-people staring at you, greeting you, talking to you, wanting to shake your hand and know about you everywhere you go. I am sooo excited to be anonymous!! it’s going to be amazing to walk around and not stand out, to just be an average person able to blend in and to be ignored. I’m realizing I would make a terrible celebrity. who knew anonymity was such a luxury?!
this procedure was interesting to watch for several reasons: 1. the lignocaine was given using, I’ll say, an interesting technique. 2. the initial incision was massive, aka unnecessarily large, aka absurd by u.s. standards! 3. there was a point during the removal when the doc said ‘it looks like lung tissue’ though they were superficial to the rib cage… excuse me? 4. there was massive blood loss for a procedure that should have been very minor and no one seemed very concerned. and then, oh that’s right, 5. the patient started falling off the table mid-procedure and I had to be the one to point it out, though this poor maasai boy was surrounded by docs, nurses and medical students. what’s worse is that the reason he was falling off the table is because he was writhing uncomfortably in relative pain during the procedure. guess that interesting technique for giving the lignocaine wasn’t all that effective…
other reasons the O.R. here often makes us cringe… the first procedure of the day was supposed to be a plastics case. oddly enough it was on dr. lee’s schedule as he is probably the doc at mt. meru hospital most qualified to do this scar revision. when you have an ortho surgeon doing the plastics cases you have to ask yourself if… actually never mind, you get the idea, this shouldn’t be happening. point is the patient is on the table this morning and one of the local docs comes in and begins discussing other options for reducing the scar. aren’t alternatives to surgery supposed to be discussed before the patient is actually on the table prepped for surgery?! silly me, that’s apparently far too reasonable. this poor patient was lying there as the one surgeon was saying ‘maybe steroid can make this better’ and dr. lee was saying ‘non-surgery option is best, please try other options, I don’t know plastic surgery well but I could make this better if she needs surgery’ – ultimately they decided to try steroid injections for two weeks before resorting to surgery. go mt meru, we’re making good decisions on occasion at least! (even if it is done is a roundabout and time-inefficient manner).
next we’ve got a few knarley time filler cases – mostly leg injuries from motor vehicle crashes, and some crazy open wounds!! there was also a tiny boy with a badly broken arm. when they went to knock him out I jumped in, eager to help, and turned his head away from the injection and tried to distract him. he was so stinkin’ cute and I comforted him until he was out. the kids here are too much, ridiculously adorable (and unlike the maasai children they aren’t absolutely terrified of mzungus). kurt and I always joke about distracting the parents and taking the kids away :) instead we make them paper airplanes and give them pens (awesome, right? not really, but they’re usually pleased). as much as I love kids, I cannot stand seeing them in pain – no thanks to peds for me. it’s easy to know how to interact with kids (too many years as a nanny, and I did two rotations in peds last year), but I can’t handle watching them suffer. and you should have seen the way they manipulated this arm before casting it (very different than what we think of as a cast in the states, by the way, they call it plaster of paris – POP – and it looks like a second grade art project when they finish)…I was certain they were going to dislocate his tiny shoulder in the process the way they were yanking on his forarm and putting counter traction on his rib cage – spells disaster. hope the poor kid’s ok, he’s definitely going to wake up with a very sore arm.
next on the schedule we have two amputations. both are necessary because the patients have gangrene, both sound like they’re be above the ankle, one is on a 75 yo male, the other on a 100 yo female. what?! unfortunately (that sounds morbid, but you know what I mean), one of the patients backed out last minute and the other had a Hb that was too low to safely do the procedure. too bad, kurt was with us in the O.R. today and we were lookin’ to get him in on some wild procedures. there’s always thursday…
a few things I will miss about arusha:
-being able to walk everywhere (though I’ll be happy to be home in a place where I can walk around safety at night)
-having fruit stands everywhere that sell the most delicious fruits and veggies for ridiculously cheap (our favorite veggie stand lady today gave us green beans, a cucumber, two carrots, an eggplant and a zucchini all for the equivalent of 75 cents.)
-walking down the street past a guy with a bunch of sugar cane tied to his bicycle, giving him 200 tzs (about 15 cents) and having him cut off and skin a piece two feet long, then create chops in it so that it’s easy to bite, then just chewing on and sucking the amazing juice out of fresh sugar cane as an afternoon snack.
-not having to rush anywhere… ever.
something I really will not miss:
-people staring at you, greeting you, talking to you, wanting to shake your hand and know about you everywhere you go. I am sooo excited to be anonymous!! it’s going to be amazing to walk around and not stand out, to just be an average person able to blend in and to be ignored. I’m realizing I would make a terrible celebrity. who knew anonymity was such a luxury?!
Tuesday, August 10, 2010
supporting and empowering women
I’ve found the most wonderful thing today… I explored the gift shop at the blue heron, our fav restaurant, and found a bag that I took a liking too. here’s why I had to buy it, there is an inset that explains the name of the brand – SEW – and this is what it says:
SEW – supporting and empowering women – is a development project that employs HIV+ women in arusha, tanzania. in africa, it is almost impossible to find a job once infected with HIV/AIDS, because of the stigma associated with it. as such, SEW acts as a stepping stone for self-employment. while making these bags, the women learn valuable business skills which help them develop their own enterprise. these carry bags are made from a mix of recycled and environmentally friendly materials. the women are paid a fair wage and all profits are re-invested back into the project. for more information email SEW at sew.tanzania@gmail.com
so cool right?! two things I’m wayyy keen on: empowering women and protecting the environment!! I was thrilled to be able to support such causes :)
the girls and I have been very aware this entire trip of the importance of empowering the women. I am confident that with education, a life skill as a way to make an income, and a greater sense of equality, the empowerment of women could bring such positive change to arusha. we actually make a point of purchasing our souvenirs from the women at the market rather than the men. it’s wonderful to know that other people are acknowledging the importance of this and creating groups and organizations to give strength to the women here. they are the workforce as well as the homemakers and their empowerment is key to reducing the total fertility rate, bringing up the poverty line, bringing down the rate of HIV and STIs, and improving the standard of living in the country as a whole. the women here pretty much kick butt, sadly, they aren’t given the respect or power they deserve and societal standards reinforce their inferiority, making it difficult to bring about the positive change that the empowerment of women can lead to.
SEW – supporting and empowering women – is a development project that employs HIV+ women in arusha, tanzania. in africa, it is almost impossible to find a job once infected with HIV/AIDS, because of the stigma associated with it. as such, SEW acts as a stepping stone for self-employment. while making these bags, the women learn valuable business skills which help them develop their own enterprise. these carry bags are made from a mix of recycled and environmentally friendly materials. the women are paid a fair wage and all profits are re-invested back into the project. for more information email SEW at sew.tanzania@gmail.com
so cool right?! two things I’m wayyy keen on: empowering women and protecting the environment!! I was thrilled to be able to support such causes :)
the girls and I have been very aware this entire trip of the importance of empowering the women. I am confident that with education, a life skill as a way to make an income, and a greater sense of equality, the empowerment of women could bring such positive change to arusha. we actually make a point of purchasing our souvenirs from the women at the market rather than the men. it’s wonderful to know that other people are acknowledging the importance of this and creating groups and organizations to give strength to the women here. they are the workforce as well as the homemakers and their empowerment is key to reducing the total fertility rate, bringing up the poverty line, bringing down the rate of HIV and STIs, and improving the standard of living in the country as a whole. the women here pretty much kick butt, sadly, they aren’t given the respect or power they deserve and societal standards reinforce their inferiority, making it difficult to bring about the positive change that the empowerment of women can lead to.
saved by god
I am not personally much of a religious being, however, I respect the beliefs of others and I think religion often has great influences on people and how they choose to live their lives. that said, there are also times when religion manipulates people in negative ways, or when it is downright confusing and nonsensical. today we saw more of the latter… here’s my story:
a typical day in casualties: head wound here, sloppy stitches to be removed there, cerebral palsy patient on this bed, woman post-miscarriage on that bed, maasai being carried in lifeless and limp, car accident victim being asked to clear the bed for another patient, lady without detectable bp or palpable pulses… you know, the usual.
I’m taking it all in, trying to be helpful where I can, practice starting IVs and such, when in comes a group of three people struggling to carry an apparently unconscious young woman to one of the beds. I take her head as they heave her down and try to straighten her stiff body. I immediately check for a pulse – strong… I look for breathing – regular and unlabored. then I went to check her eyes – I wanted to know if her pupils were equal round reactive and if she had a pupillary response – but she was actively closing her eyes, scrunching them tight together and I could see nothing (clue one). the others were taking bp, listening to her heart and lungs, checking muscle tone. we worked quickly on the preliminary exam but it was soon apparent that her vitals were all normal (clue two).
the brit student who had started in casualties this week was concerned. he was a bit of a mr. know-it-all (damn medical students, think they know everything ;) and annoyed me from the start. his plan was to treat her for malaria until proven otherwise. at this point I had had the opportunity to exam her further and I wasn’t so convinced – her muscle tone was suspicious, as if she were actively flexing her arms, legs and neck (clue three). to me it seemed like something psychological, as if she was doing this to herself, and that, had I wanted to, I could lay on the bed next to her and mimic her every behavior. am I as jaded as a seasoned ER doc or what? I kept this opinion to myself as the nurses and docs hustled around her, tending to other patients. they didn’t seem too concerned with her, though she was unresponsive. with vital signs that stable, they decided simply to give her fluids and wait (pretty much standard treatment in the casualties ward here).
we continued to observe her and debate what it might be. finally I said what I was thinking: that I know it’s not a conclusion we should jump too, but we should definitely consider that this might be self-induced. kurt was pretty shocked that I’d suggest this patient was faking it, he was as concerned as brit-boy, but I can’t blame him, he’s still in college ;) sorry kurt! anyway, before long this woman, who still appeared to be tensing as many muscles in her body as she could muster at once, started to breath very rapidly. fast onset tachypnea with no aggravating factors you say? sounds…interesting. the brit was super concerned, I couldn’t figure out how he didn’t see that it was her forcing the hyperventilation (clue four). just as quickly as she started, she stopped (clue five). ‘she’s not breathing!’ he said frantically – I think I actually rolled my eyes – ‘look at her abdomen, she’s breathing, just subtly’… who is this guy? no, I promise, im not such a cynic that I think every patient is faking, there were just a lot of signs with this patient that pointed to something aside from a physiological illness. at this point I was voicing my skepticism even more openly (one of the nice things about being in a setting like this is that I don’t make the call – we’re all allowed to make our best guess and whether we’re right or wrong the patient is treated the same, the docs do their thing here regardless of our opinion – so no harm, no foul in proposing that she’s faking).
it wasn’t long before her eyes opened, but despite a slightly crazed look, and a refusal to respond to the doc, she seemed lucid. I went over to her and checked her pupils – perfectly normal. I also noted that she was looking around, unable to fake the glazed, incoherent stare of someone truly out of it. she also couldn’t fight the urge to blink when I moved my fingers quickly before her eyes. janet, the doc we’ve been shadowing, gave me a smile and walked away, she was on the same page. just as amy, thu and kurt were starting to come around to the idea that this might simply be a case of crazemia (brit-boy would have already given her the malaria meds if he had it his way), she sits straight up in bed with boisterous energy and begins yelling loudly the same swahili words over and over again. we were all a bit startled, though I had to laugh because anyone able to yell so articulately is obviously in relatively decent health. we asked janet what she says (janet was sitting at the desk scribbling notes, unconcerned with this behavior), she shook her head as she chuckled and said ‘the woman repeats that god has saved her’.
the nurses and docs alike were now leaving this woman to her thing. when she would start ranting they would look up, make eye contact with one of us, then laugh shaking their heads. I don’t know how they were so light-hearted about it, guess you have to find entertainment where you can get it. the waiting room was absolutely packed and it was bothering me that this woman was taking up a bed. t.i.a. I started talking to kurt about the things I had noticed early on that had clued me in that this woman might not be so sick after all. he was happy to hear my reasoning, he said he had been concerned when I jumped so quickly to that conclusion. ultimately, we laughed at the situation too… you would have had to see this woman in action. can you blame her? I mean, god did save her after all…
a typical day in casualties: head wound here, sloppy stitches to be removed there, cerebral palsy patient on this bed, woman post-miscarriage on that bed, maasai being carried in lifeless and limp, car accident victim being asked to clear the bed for another patient, lady without detectable bp or palpable pulses… you know, the usual.
I’m taking it all in, trying to be helpful where I can, practice starting IVs and such, when in comes a group of three people struggling to carry an apparently unconscious young woman to one of the beds. I take her head as they heave her down and try to straighten her stiff body. I immediately check for a pulse – strong… I look for breathing – regular and unlabored. then I went to check her eyes – I wanted to know if her pupils were equal round reactive and if she had a pupillary response – but she was actively closing her eyes, scrunching them tight together and I could see nothing (clue one). the others were taking bp, listening to her heart and lungs, checking muscle tone. we worked quickly on the preliminary exam but it was soon apparent that her vitals were all normal (clue two).
the brit student who had started in casualties this week was concerned. he was a bit of a mr. know-it-all (damn medical students, think they know everything ;) and annoyed me from the start. his plan was to treat her for malaria until proven otherwise. at this point I had had the opportunity to exam her further and I wasn’t so convinced – her muscle tone was suspicious, as if she were actively flexing her arms, legs and neck (clue three). to me it seemed like something psychological, as if she was doing this to herself, and that, had I wanted to, I could lay on the bed next to her and mimic her every behavior. am I as jaded as a seasoned ER doc or what? I kept this opinion to myself as the nurses and docs hustled around her, tending to other patients. they didn’t seem too concerned with her, though she was unresponsive. with vital signs that stable, they decided simply to give her fluids and wait (pretty much standard treatment in the casualties ward here).
we continued to observe her and debate what it might be. finally I said what I was thinking: that I know it’s not a conclusion we should jump too, but we should definitely consider that this might be self-induced. kurt was pretty shocked that I’d suggest this patient was faking it, he was as concerned as brit-boy, but I can’t blame him, he’s still in college ;) sorry kurt! anyway, before long this woman, who still appeared to be tensing as many muscles in her body as she could muster at once, started to breath very rapidly. fast onset tachypnea with no aggravating factors you say? sounds…interesting. the brit was super concerned, I couldn’t figure out how he didn’t see that it was her forcing the hyperventilation (clue four). just as quickly as she started, she stopped (clue five). ‘she’s not breathing!’ he said frantically – I think I actually rolled my eyes – ‘look at her abdomen, she’s breathing, just subtly’… who is this guy? no, I promise, im not such a cynic that I think every patient is faking, there were just a lot of signs with this patient that pointed to something aside from a physiological illness. at this point I was voicing my skepticism even more openly (one of the nice things about being in a setting like this is that I don’t make the call – we’re all allowed to make our best guess and whether we’re right or wrong the patient is treated the same, the docs do their thing here regardless of our opinion – so no harm, no foul in proposing that she’s faking).
it wasn’t long before her eyes opened, but despite a slightly crazed look, and a refusal to respond to the doc, she seemed lucid. I went over to her and checked her pupils – perfectly normal. I also noted that she was looking around, unable to fake the glazed, incoherent stare of someone truly out of it. she also couldn’t fight the urge to blink when I moved my fingers quickly before her eyes. janet, the doc we’ve been shadowing, gave me a smile and walked away, she was on the same page. just as amy, thu and kurt were starting to come around to the idea that this might simply be a case of crazemia (brit-boy would have already given her the malaria meds if he had it his way), she sits straight up in bed with boisterous energy and begins yelling loudly the same swahili words over and over again. we were all a bit startled, though I had to laugh because anyone able to yell so articulately is obviously in relatively decent health. we asked janet what she says (janet was sitting at the desk scribbling notes, unconcerned with this behavior), she shook her head as she chuckled and said ‘the woman repeats that god has saved her’.
the nurses and docs alike were now leaving this woman to her thing. when she would start ranting they would look up, make eye contact with one of us, then laugh shaking their heads. I don’t know how they were so light-hearted about it, guess you have to find entertainment where you can get it. the waiting room was absolutely packed and it was bothering me that this woman was taking up a bed. t.i.a. I started talking to kurt about the things I had noticed early on that had clued me in that this woman might not be so sick after all. he was happy to hear my reasoning, he said he had been concerned when I jumped so quickly to that conclusion. ultimately, we laughed at the situation too… you would have had to see this woman in action. can you blame her? I mean, god did save her after all…
Monday, August 9, 2010
today is a day for venting...
…some more. met an interesting person yesterday in casualties, a doc I haven’t seen before. for some reason he quickly took a liking to me, I wasn’t thrilled, I prefer to fly more under the radar here. from the moment he met us the lecturing began:
…this country’s anthem is ‘we are poor, we are poor’ but it is not true. there are naturally resources and we get aid, it is just what we do with the aid, there is corruption high up in the government, the majority of the people suffer as a result…
he was fairly articulate and I understood most of what he said, losing only a few words to his thick african accent. I know what he speaks of, but what can I say? I listen intently and nod sympathetically. i reinforce that we are aware of these problems and we went to help. but we’re only first year... well, going on second year, medical students. how much can we do? we’ve repeated over and over how helpless we feel here. but he was relentless in his preaching and he went on:
…you see these beds, they have blood stains on them. you see the sinks, they don’t work. you see me, I have no place to sit, no table to write on. this patient, he must stand because there is no room or bed to put him in. these curtains, they have never been washed, they are used as hand towels and tissues and they are never cleaned…
before I know it he has swept me away into an exam room. I glance back with a final, pleading look toward amy and thu. they are standing there and shrug as if to say ‘good luck sucka!’ as I turn and follow him obediently. our first patient is an old woman, we take her bp. he instructs me all wrong but I can’t correct him, im a woman, and more than ten years his junior. I bite my tongue and report her bp to be 128 over 68. it was easy to hear and I was sure of my precision. he writes 120/60. we round, he tells me… ?! your rounded skills need to brushed up on! I think, frustrated, and bite my tongue again. next thing I know the bebe is out of the room, some arbitrary prescription in her hand, and he is asking me to close the door and sit. what is your cell phone number, he wants to know. I retrieve my local cell and he takes it from my hand. dang it! I thought I put it on silent earlier but a text came in and there was a quiet ring, no hiding the fact that I have a cell on me… he exchanges the numbers, then satisfied, the lecture begins anew:
… the reason here we are allowed cell phones in the work place is because we must take care of ourselves. no one will call our work if something bad happens at home. in the US you think it is rude, unprofessional, here it is the way it must be. if something goes wrong, I need people to be able to get a hold of me…
this makes sense I suppose. I’ve discussed the lack of cell phone etiquette here and several times during our conversation his phone would ring and he would answer it. usually I think he would say he’s busy and ask them to call back later, a short conversation, then hang up, but often it would ring again almost immediately, and even mid-sentence, he would answer it without an apology to me for the interruption.
a new patient enters. a woman 25 years old. she complains of left sided abdominal tenderness. we lay her on the dirty, rusted, sheetless exam table. he palpates abdomen then invites me to do the same. I rub my hands together attempting to warm my icy fingers before I place them on her stomach. he looks at me appalled. she is not a baby, he says. I laugh because to me, it doesn’t matter weather she cares or not if my hands are cold, the polite thing to do is to try to warm them; it is the same courtesy I’d want paid to me were I in her situation. we emphasize bedside manner so much in the states, it is a huge part of medicine and I really value that. he scoffed at me for even this tiniest effort to make the patient more comfortable. there’s something wrong with that. such differences in what is valued when it comes to healthcare. Sure enough her spleen was very enlarged. unfortunately, he prefers to preach on the adversities in tanzania and not explain so much about the medicine, so she was sent away without me getting to ask questions about her condition. nonetheless, it was cool to feel a spleen, usually you cannot palpate it. pt is out of the room and again I find myself closing the door and finding a seat. I’m starting to get exasperated. this time he wants to tell me a story:
…when I first started working here seven years ago I was approached by a woman from the UK. she wanted to offer me a 13 week course in a medical school in her home city, she said she would pay half the price. she emailed me again and again with the offer, she wanted to help me. when I asked the administration at this hospital they said no. you have only been working for a few months, they said, and already you want to take leave for more school, we cannot allow it…
I started to get an idea of where this story was going. he sees me, a mzungu, and all he sees is dollar bills and a ticket to the U.S.
…I know you are only a medical student, and you do not have money, but you know people, you can ask at your school, I am only asking for three months, please, lindsay, you are different, I can tell, I am begging you, please, can you help me?…
it went from a simple story I was having to focus very hard to understand, piecing together what words were unclear or improperly used. it turned suddenly to a plea for help, a demand for me to make a promise I cannot possibly keep. who am I going to talk to at OHSU? do we even have exchange programs for physicians like this? I don’t think so… grants for these people? doubtful, my school’s in the gutter! I tried to explain to this doctor, all I can do once im back is ask, but I cannot make him any promises. I’m not even sure my school offers what he is looking for, it is very small and… he says again:
…please, lindsay (he kept using my name and it was starting to annoy me), you can help me. I am asking for this small favor, please tell me you can talk to someone…
again I tried to explain. I’m not sure he was getting what I was saying… ugh, language barrier. I was also getting a little fed up and tired of being so polite. this was obviously his prerogative from the beginning. why’d he have to pick me? um, can I please switch places with one of the work the world brits? they’d give him a piece of their mind. instead I sat quietly and listened as the preaching continued, it was an annoyance, but a unique experience as well… he must’ve finally been satisfied with my response because he moved on:
…your teeth are very white (uh oh, here we go! weren’t thu and I just having a convo this morning about all of the tea here turning our teeth yellow?!)… the people here, their teeth are stained, it is from the fluoride in the water. because the water comes from mt. meru, from killimanjaro, both dormant volcanoes, the fluoride content is so high. it makes it difficult for the body to use calcium properly, there are problems with bones, joint pain, muscle pain, the teeth develop problems. the people do not realize it is all from the water they are boiling to drink (in my head im thinking, wait a second, I’ve been drinking boiled water this whole trip! and my tongue instinctively rubs against the front of my teeth, searching for decay), I tried to collect information on the fluoride content of the water and the water people would not tell me, the people have a right to know!…
at this point it had been almost three hours of preaching and I was starting to wonder what he should be doing, since obviously the hospital does not pay him to lecture me. also I was itching to see the cool cases outside I kept glimpsing when nurses would come in and out of the room. finally a patient entered, rescuing me! the smell was familiar before I saw the young maasai woman walk into the room. she carried a tiny bundle of dirty blankets, I didn’t think twice about it and started to leave the room, make my get away when… ‘lindsay!’ crap, not fast enough, I turned defeated and stepped back into the room. that’s when I saw it, a very tiny baby on the young woman’s lap. ‘uh, thu, amy!’ I heard my voice quiver, they came quickly. we all stared. the baby would have easily fit into the palm of my hand, (and for those of you who know me, I have very small hands, so that’s saying something). it was so tiny and frail, it looked like a shrived little old man. and to add to the shock of it all, apparently this baby was six days old! knowing what we do of the maasai, it could have taken them that long to get to a hospital. he admitted the baby and asked us to take the family to the preme ward. no problem, get me outta here!
I had enough for one day. now im torn between wanting to observe and help more in casualties, and wishing to avoid that doc and his long-winded sermons on everything that is wrong with the healthcare system and tanzania as a whole. as I told amy and thu about all of the things he had said to me, they both couldn’t believe I had tolerated it for so long. it’s funny because I was very fed up with his preaching, but as soon as they started to bad mouth him I felt suddenly defensive. take our frustrations, as visitors, with the hospital and then imagine if you were an employee and you had been dealing with these problems every day for the past seven years. I cannot even fathom the aggravation he must feel working within a system where he doesn’t have professional support, the correct supplies, adequate facilities, and so on. you would want to voice your irritations to anyone who will listen as well, particularly well-to-do mzungus who find themselves in your department with judgmental looks on their faces they aren’t good at hiding. when he would speak to me today I would try to push away my irritation and instead acknowledge it as an interesting experience, to hear how this local doctor really feels about the situation. I respect the fact that he needed to vent. more importantly, I truly admire him for what he does, despite not approving of everything. you can only do so much when you have so little. the fact that he still comes to work under such conditions is commendable in and of itself and I don’t think it is my place to judge him for needing to preach to an open ear.
did get to see a few other cool cases. a guy with many deep head wounds, he said he had been attacked by a thief, and they did they same thing, removed the thick sutures though the wounds were still open and bleeding. there was a young girl so frightened she wet herself while sitting on her father’s lap – lucky him. they pretty much just spread the urine around on the floor to make it dry faster – so cleanly :) a young woman came in unresponsive and foaming at the mouth. that was interesting. two older women brought her in and neither of them could explain what had happened. it was almost as if she were seizing – drug overdose? she had huge sweat marks on her shirt, which was on inside out and backwards. they did the sternal rub and got nothing. her eyes were closed but you could see them flittering beneath her lids. then, like the snap of fingers, she came to, and was fairly oriented, though she also could not explain what had happened. a few minutes later they were asking her to stand and walk out of the room, they needed the bed for a guy who we think just had his appendix burst. when we left to take the baby to the preme unit, the girl was nowhere to be seen, the guy was being wheeled to surgery (we hope) and two other men covered in leaves were laying unconscious, one on a bed, one in a wheel chair, and no one really knew what had happened to them either, the docs didn’t seem too concerned… is this place for real?!
on a happy note it is a gorgeous saturday and we’re enjoying a restful day of doing pretty much nothing. finished two loads of hand-washed laundry yesterday, so im feeling good (and smelling much better ;) when I went running yesterday a random local guy joined me and proved to be great company with a stride to match mine. tried saffron ice cream today and I’m hooked. went to our favorite fruit and veggie lady (we go to the same woman every week and she loves us!!) and she picked us out the best pineapple I have ever tasted. last night was live music and the blue heron and it was a great band, a beautiful starry night, and all of our friends were there. the hospital can be frustrating for sure but it’s memories like these that remind me of how much im going to miss this place.
…this country’s anthem is ‘we are poor, we are poor’ but it is not true. there are naturally resources and we get aid, it is just what we do with the aid, there is corruption high up in the government, the majority of the people suffer as a result…
he was fairly articulate and I understood most of what he said, losing only a few words to his thick african accent. I know what he speaks of, but what can I say? I listen intently and nod sympathetically. i reinforce that we are aware of these problems and we went to help. but we’re only first year... well, going on second year, medical students. how much can we do? we’ve repeated over and over how helpless we feel here. but he was relentless in his preaching and he went on:
…you see these beds, they have blood stains on them. you see the sinks, they don’t work. you see me, I have no place to sit, no table to write on. this patient, he must stand because there is no room or bed to put him in. these curtains, they have never been washed, they are used as hand towels and tissues and they are never cleaned…
before I know it he has swept me away into an exam room. I glance back with a final, pleading look toward amy and thu. they are standing there and shrug as if to say ‘good luck sucka!’ as I turn and follow him obediently. our first patient is an old woman, we take her bp. he instructs me all wrong but I can’t correct him, im a woman, and more than ten years his junior. I bite my tongue and report her bp to be 128 over 68. it was easy to hear and I was sure of my precision. he writes 120/60. we round, he tells me… ?! your rounded skills need to brushed up on! I think, frustrated, and bite my tongue again. next thing I know the bebe is out of the room, some arbitrary prescription in her hand, and he is asking me to close the door and sit. what is your cell phone number, he wants to know. I retrieve my local cell and he takes it from my hand. dang it! I thought I put it on silent earlier but a text came in and there was a quiet ring, no hiding the fact that I have a cell on me… he exchanges the numbers, then satisfied, the lecture begins anew:
… the reason here we are allowed cell phones in the work place is because we must take care of ourselves. no one will call our work if something bad happens at home. in the US you think it is rude, unprofessional, here it is the way it must be. if something goes wrong, I need people to be able to get a hold of me…
this makes sense I suppose. I’ve discussed the lack of cell phone etiquette here and several times during our conversation his phone would ring and he would answer it. usually I think he would say he’s busy and ask them to call back later, a short conversation, then hang up, but often it would ring again almost immediately, and even mid-sentence, he would answer it without an apology to me for the interruption.
a new patient enters. a woman 25 years old. she complains of left sided abdominal tenderness. we lay her on the dirty, rusted, sheetless exam table. he palpates abdomen then invites me to do the same. I rub my hands together attempting to warm my icy fingers before I place them on her stomach. he looks at me appalled. she is not a baby, he says. I laugh because to me, it doesn’t matter weather she cares or not if my hands are cold, the polite thing to do is to try to warm them; it is the same courtesy I’d want paid to me were I in her situation. we emphasize bedside manner so much in the states, it is a huge part of medicine and I really value that. he scoffed at me for even this tiniest effort to make the patient more comfortable. there’s something wrong with that. such differences in what is valued when it comes to healthcare. Sure enough her spleen was very enlarged. unfortunately, he prefers to preach on the adversities in tanzania and not explain so much about the medicine, so she was sent away without me getting to ask questions about her condition. nonetheless, it was cool to feel a spleen, usually you cannot palpate it. pt is out of the room and again I find myself closing the door and finding a seat. I’m starting to get exasperated. this time he wants to tell me a story:
…when I first started working here seven years ago I was approached by a woman from the UK. she wanted to offer me a 13 week course in a medical school in her home city, she said she would pay half the price. she emailed me again and again with the offer, she wanted to help me. when I asked the administration at this hospital they said no. you have only been working for a few months, they said, and already you want to take leave for more school, we cannot allow it…
I started to get an idea of where this story was going. he sees me, a mzungu, and all he sees is dollar bills and a ticket to the U.S.
…I know you are only a medical student, and you do not have money, but you know people, you can ask at your school, I am only asking for three months, please, lindsay, you are different, I can tell, I am begging you, please, can you help me?…
it went from a simple story I was having to focus very hard to understand, piecing together what words were unclear or improperly used. it turned suddenly to a plea for help, a demand for me to make a promise I cannot possibly keep. who am I going to talk to at OHSU? do we even have exchange programs for physicians like this? I don’t think so… grants for these people? doubtful, my school’s in the gutter! I tried to explain to this doctor, all I can do once im back is ask, but I cannot make him any promises. I’m not even sure my school offers what he is looking for, it is very small and… he says again:
…please, lindsay (he kept using my name and it was starting to annoy me), you can help me. I am asking for this small favor, please tell me you can talk to someone…
again I tried to explain. I’m not sure he was getting what I was saying… ugh, language barrier. I was also getting a little fed up and tired of being so polite. this was obviously his prerogative from the beginning. why’d he have to pick me? um, can I please switch places with one of the work the world brits? they’d give him a piece of their mind. instead I sat quietly and listened as the preaching continued, it was an annoyance, but a unique experience as well… he must’ve finally been satisfied with my response because he moved on:
…your teeth are very white (uh oh, here we go! weren’t thu and I just having a convo this morning about all of the tea here turning our teeth yellow?!)… the people here, their teeth are stained, it is from the fluoride in the water. because the water comes from mt. meru, from killimanjaro, both dormant volcanoes, the fluoride content is so high. it makes it difficult for the body to use calcium properly, there are problems with bones, joint pain, muscle pain, the teeth develop problems. the people do not realize it is all from the water they are boiling to drink (in my head im thinking, wait a second, I’ve been drinking boiled water this whole trip! and my tongue instinctively rubs against the front of my teeth, searching for decay), I tried to collect information on the fluoride content of the water and the water people would not tell me, the people have a right to know!…
at this point it had been almost three hours of preaching and I was starting to wonder what he should be doing, since obviously the hospital does not pay him to lecture me. also I was itching to see the cool cases outside I kept glimpsing when nurses would come in and out of the room. finally a patient entered, rescuing me! the smell was familiar before I saw the young maasai woman walk into the room. she carried a tiny bundle of dirty blankets, I didn’t think twice about it and started to leave the room, make my get away when… ‘lindsay!’ crap, not fast enough, I turned defeated and stepped back into the room. that’s when I saw it, a very tiny baby on the young woman’s lap. ‘uh, thu, amy!’ I heard my voice quiver, they came quickly. we all stared. the baby would have easily fit into the palm of my hand, (and for those of you who know me, I have very small hands, so that’s saying something). it was so tiny and frail, it looked like a shrived little old man. and to add to the shock of it all, apparently this baby was six days old! knowing what we do of the maasai, it could have taken them that long to get to a hospital. he admitted the baby and asked us to take the family to the preme ward. no problem, get me outta here!
I had enough for one day. now im torn between wanting to observe and help more in casualties, and wishing to avoid that doc and his long-winded sermons on everything that is wrong with the healthcare system and tanzania as a whole. as I told amy and thu about all of the things he had said to me, they both couldn’t believe I had tolerated it for so long. it’s funny because I was very fed up with his preaching, but as soon as they started to bad mouth him I felt suddenly defensive. take our frustrations, as visitors, with the hospital and then imagine if you were an employee and you had been dealing with these problems every day for the past seven years. I cannot even fathom the aggravation he must feel working within a system where he doesn’t have professional support, the correct supplies, adequate facilities, and so on. you would want to voice your irritations to anyone who will listen as well, particularly well-to-do mzungus who find themselves in your department with judgmental looks on their faces they aren’t good at hiding. when he would speak to me today I would try to push away my irritation and instead acknowledge it as an interesting experience, to hear how this local doctor really feels about the situation. I respect the fact that he needed to vent. more importantly, I truly admire him for what he does, despite not approving of everything. you can only do so much when you have so little. the fact that he still comes to work under such conditions is commendable in and of itself and I don’t think it is my place to judge him for needing to preach to an open ear.
did get to see a few other cool cases. a guy with many deep head wounds, he said he had been attacked by a thief, and they did they same thing, removed the thick sutures though the wounds were still open and bleeding. there was a young girl so frightened she wet herself while sitting on her father’s lap – lucky him. they pretty much just spread the urine around on the floor to make it dry faster – so cleanly :) a young woman came in unresponsive and foaming at the mouth. that was interesting. two older women brought her in and neither of them could explain what had happened. it was almost as if she were seizing – drug overdose? she had huge sweat marks on her shirt, which was on inside out and backwards. they did the sternal rub and got nothing. her eyes were closed but you could see them flittering beneath her lids. then, like the snap of fingers, she came to, and was fairly oriented, though she also could not explain what had happened. a few minutes later they were asking her to stand and walk out of the room, they needed the bed for a guy who we think just had his appendix burst. when we left to take the baby to the preme unit, the girl was nowhere to be seen, the guy was being wheeled to surgery (we hope) and two other men covered in leaves were laying unconscious, one on a bed, one in a wheel chair, and no one really knew what had happened to them either, the docs didn’t seem too concerned… is this place for real?!
on a happy note it is a gorgeous saturday and we’re enjoying a restful day of doing pretty much nothing. finished two loads of hand-washed laundry yesterday, so im feeling good (and smelling much better ;) when I went running yesterday a random local guy joined me and proved to be great company with a stride to match mine. tried saffron ice cream today and I’m hooked. went to our favorite fruit and veggie lady (we go to the same woman every week and she loves us!!) and she picked us out the best pineapple I have ever tasted. last night was live music and the blue heron and it was a great band, a beautiful starry night, and all of our friends were there. the hospital can be frustrating for sure but it’s memories like these that remind me of how much im going to miss this place.
Saturday, August 7, 2010
half the battle
so many thoughts in my head now that we’re back at the hospital. it was interesting to make the transition from some vacation time (where you see fancy resorts and wealthy travelers) to working at mt meru, where the need is so great and you feel tremendously helpless. thursday was rough, we spent the day in casualties (again, what a terrible name for the ER dept, am I right?!) and there was never a dull moment. first thing we see is a guy come in with a huge cut on his face that they had sutured closed with massively thick sutures (for faces you should always use the very thin sutures). they work with what they have. The woman removed them with a scalpl, which looked so precarious I kept fearing she was going to cut right through his skin! not that it mattered, the wound was still completely open, hardly healed, and when the sloppy sutures were removed the skin just splayed apart and you could see the deep anatomy of the face. what. the. heck?! She put some gauze and tape over it and sent him away. That will be a disfiguring scar if he manages to avoid infection.
next was a guy post-draining of a huge abscess under his chin. he said it had been grapefruit sized and showed us with his hands. when they removed the bandage it actually looked really good, aside from the gaping hole larger than a quarter on the understand of his chin. here you could really see the muscles, fully exposed and partially eaten away from the infection. wild. thu and I were all up in it trying to see everything up close and the guy was a very good sport about it.
we had another man come in wearing handcuffs, apparently he is accused of theft but the trail is pending and in his statement he claimed that the police beat him. he showed the doc a swollen knee, ankle and side of his face. I always feel conflicted about these cases because until you really know the entire, true story, it’s hard to decide your opinion… we learned something interesting though, apparently the prisoners here who are given long sentences, if they behave well, are allowed some freedom (with restrictions of course) toward the end of the their sentence. as long as they are in their orange uniforms they are allowed to walk around. that’s the gist of what we understood, does explain why you see people in the orange prison uniforms wandering around unsupervised. not exactly comforting.
the one doc we were shadowing was very young, only 25, and he actually extremely immature. his feet would literally be kicked up on the window sill as he spoke to the patients, and I got the creeping feeling he was flirting with all of the young female patients. professionalism has a whole different meaning here, though I suppose with a salary so comparatively small, and facilities so poorly maintained and supplied, what do you expect? part of me gets angry and frustrated, can’t they see they’re part of the problem?! but part of me understands that they are not the ones at fault… conflicted, im often conflicted here.
I glance into the waiting room. it is packed. no obvious injuries at the moment… except… not another burned child. It is so sad, and far too common. this mtoto, so young and in such great pain, crying on a woman’s lap, holding his arm tenderly out from his body, almost his entire left side is covered in fresh burns. his dark skin is peeled fully off, exposing tender pink flesh that is weeping without the protective epidermal layer. I cannot imagine the pain. and to make matters worse the woman is trying to cover him, as if she is embarrassed, and the khanga against his raw skin makes him cry out in excruciating pain. I try to tell one of the nurses to instruct the woman not to touch his open wounds, she tries, and the khanga comes off for a moment, but then it is instinctively draped back over him and he cries yet louder. it hurts me to watch so much torment… this baby is brought in, I can hardly take my eyes off his suffering.
beside me a guy is removing a bloody bandage from his finger. he’s in a lot of pain too and keeps wincing as he tenderly unwraps the bandage. he finishes, revealing a smashed finger, the bone exposed and shattered, the fingernail almost completely detached, swollen and bleeding. I peel my eyes away in time to see a many carry in a young girl, she has a makeshift case around her leg, made of cardboard and cloth, a terrible break from the looks of it…
it goes on like this, until we’re exhausted and can’t take much more. fortunately, on this day dr. lee had told us that there would be a talk at 1 in the church, so we left just before then to meet him. a projector was set up, the small korean computer displayed the powerpoint created by one of the local docs. here’s a summary of what we learned. It’s a little outdated, but definitely interesting…
-life expectancy of tanzanians – M: 54, F: 56.
-they recommend 4+ antenatal visits, only 64% of women here make that (I think it’s lower based on what we’ve seen)
-only 46% of births are assisted by a skilled healthcare worker
-cesarean section rate is only 3% compared to the WHOs recommended 5-15%. a lot of women die from what is called CPD – cephalic-pelvic disproportion.
-only 1,311 sites throughout the country offer some sort of PMTCT services – preventing mother to child transmission. very important for HIV+ moms and those with certain STIs.
-postnatal care: only 13% of women were examined within 2 days of giving birth as is recommended for childhood immunizations and checking the mother
-only 20% of women use a family planning method (this is mostly the fault of the men, what they say goes)
-between 8,000 and 13,000 women die here each year in pregnancy related deaths.
-major causes of maternal death are HIV, hemorrhage, eclampsia, self-induced abortion, severe anemia, sepsis, complicated malaria…this list goes on and on.
-53% of women deliver outside of a healthcare facility. very dangerous for the mother.
-main reason is that it is too expensive (often they are responsible for buying their own supplies) and very far to get to a hospital (also costs money, need to wait for husband’s permission before they leave, no transportation options)
-other challenges faced by the women:
no money
high fertility rate (5.7 children per mother)
poor nutrition
inadequately trained staff and supplies (we were surprised he acknowledged this)
he definitely touched on the poor attitudes of the staff at the hospital saying that they do not take a humanistic approach to the care of their patients.
there is a big problem with inadequate management of obstetric emergencies, no protocol, not the proper training or supplies
so many reasons that maternal mortality is this high here
there are also delays in the care of the women:
-as I mentioned, she has to wait for her husbands approval to go to the hospital and often he is rarely home
-bad transport system – too expensive
-the theater is occupied or the doc isn’t in…
they need to work on standardized protocols for treatment of emergency situations.
the neonatal mortality rate is a whopping 32/1000 live births. this is through the roof!! absolutely unacceptable… and there has been no improvement over a decade. tragic.
even though im aware of a lot of these adversities, I’ve studied them in college, seen them firsthand here, it doesn’t take away from the shock factor when these facts are reiterated. it is frustrating, but at the same time a bit of a relief to know that one of the local docs is willing to acknowledge these statistics and issues. often it seems like everyone here turns a blind eye… admitting there’s a problem is half the battle, right? except that from what I’ve seen there’s a lot more than half the battle left to be fought….
next was a guy post-draining of a huge abscess under his chin. he said it had been grapefruit sized and showed us with his hands. when they removed the bandage it actually looked really good, aside from the gaping hole larger than a quarter on the understand of his chin. here you could really see the muscles, fully exposed and partially eaten away from the infection. wild. thu and I were all up in it trying to see everything up close and the guy was a very good sport about it.
we had another man come in wearing handcuffs, apparently he is accused of theft but the trail is pending and in his statement he claimed that the police beat him. he showed the doc a swollen knee, ankle and side of his face. I always feel conflicted about these cases because until you really know the entire, true story, it’s hard to decide your opinion… we learned something interesting though, apparently the prisoners here who are given long sentences, if they behave well, are allowed some freedom (with restrictions of course) toward the end of the their sentence. as long as they are in their orange uniforms they are allowed to walk around. that’s the gist of what we understood, does explain why you see people in the orange prison uniforms wandering around unsupervised. not exactly comforting.
the one doc we were shadowing was very young, only 25, and he actually extremely immature. his feet would literally be kicked up on the window sill as he spoke to the patients, and I got the creeping feeling he was flirting with all of the young female patients. professionalism has a whole different meaning here, though I suppose with a salary so comparatively small, and facilities so poorly maintained and supplied, what do you expect? part of me gets angry and frustrated, can’t they see they’re part of the problem?! but part of me understands that they are not the ones at fault… conflicted, im often conflicted here.
I glance into the waiting room. it is packed. no obvious injuries at the moment… except… not another burned child. It is so sad, and far too common. this mtoto, so young and in such great pain, crying on a woman’s lap, holding his arm tenderly out from his body, almost his entire left side is covered in fresh burns. his dark skin is peeled fully off, exposing tender pink flesh that is weeping without the protective epidermal layer. I cannot imagine the pain. and to make matters worse the woman is trying to cover him, as if she is embarrassed, and the khanga against his raw skin makes him cry out in excruciating pain. I try to tell one of the nurses to instruct the woman not to touch his open wounds, she tries, and the khanga comes off for a moment, but then it is instinctively draped back over him and he cries yet louder. it hurts me to watch so much torment… this baby is brought in, I can hardly take my eyes off his suffering.
beside me a guy is removing a bloody bandage from his finger. he’s in a lot of pain too and keeps wincing as he tenderly unwraps the bandage. he finishes, revealing a smashed finger, the bone exposed and shattered, the fingernail almost completely detached, swollen and bleeding. I peel my eyes away in time to see a many carry in a young girl, she has a makeshift case around her leg, made of cardboard and cloth, a terrible break from the looks of it…
it goes on like this, until we’re exhausted and can’t take much more. fortunately, on this day dr. lee had told us that there would be a talk at 1 in the church, so we left just before then to meet him. a projector was set up, the small korean computer displayed the powerpoint created by one of the local docs. here’s a summary of what we learned. It’s a little outdated, but definitely interesting…
-life expectancy of tanzanians – M: 54, F: 56.
-they recommend 4+ antenatal visits, only 64% of women here make that (I think it’s lower based on what we’ve seen)
-only 46% of births are assisted by a skilled healthcare worker
-cesarean section rate is only 3% compared to the WHOs recommended 5-15%. a lot of women die from what is called CPD – cephalic-pelvic disproportion.
-only 1,311 sites throughout the country offer some sort of PMTCT services – preventing mother to child transmission. very important for HIV+ moms and those with certain STIs.
-postnatal care: only 13% of women were examined within 2 days of giving birth as is recommended for childhood immunizations and checking the mother
-only 20% of women use a family planning method (this is mostly the fault of the men, what they say goes)
-between 8,000 and 13,000 women die here each year in pregnancy related deaths.
-major causes of maternal death are HIV, hemorrhage, eclampsia, self-induced abortion, severe anemia, sepsis, complicated malaria…this list goes on and on.
-53% of women deliver outside of a healthcare facility. very dangerous for the mother.
-main reason is that it is too expensive (often they are responsible for buying their own supplies) and very far to get to a hospital (also costs money, need to wait for husband’s permission before they leave, no transportation options)
-other challenges faced by the women:
no money
high fertility rate (5.7 children per mother)
poor nutrition
inadequately trained staff and supplies (we were surprised he acknowledged this)
he definitely touched on the poor attitudes of the staff at the hospital saying that they do not take a humanistic approach to the care of their patients.
there is a big problem with inadequate management of obstetric emergencies, no protocol, not the proper training or supplies
so many reasons that maternal mortality is this high here
there are also delays in the care of the women:
-as I mentioned, she has to wait for her husbands approval to go to the hospital and often he is rarely home
-bad transport system – too expensive
-the theater is occupied or the doc isn’t in…
they need to work on standardized protocols for treatment of emergency situations.
the neonatal mortality rate is a whopping 32/1000 live births. this is through the roof!! absolutely unacceptable… and there has been no improvement over a decade. tragic.
even though im aware of a lot of these adversities, I’ve studied them in college, seen them firsthand here, it doesn’t take away from the shock factor when these facts are reiterated. it is frustrating, but at the same time a bit of a relief to know that one of the local docs is willing to acknowledge these statistics and issues. often it seems like everyone here turns a blind eye… admitting there’s a problem is half the battle, right? except that from what I’ve seen there’s a lot more than half the battle left to be fought….
enough travel to make you puke
breakfast at our cute hostel in stonetown, and then we set out on foot, weighed down by our backpacks, determined to master the maze and find out way to the ferry. success. we made it onto the ferry just as the rain started coming down. a storm blew over the whole island and followed us most of our way back to the mainland. it was a choppy sea and the huge waves made for a wild ride that pushed the majority of the ferry passengers to grab the plastic vomit bags and let loose. it rivaled the ferry ride in southern thailand where almost every passenger was puking as huge waves overtook the windows on either side of the ferry. as for the three of us, thu was asleep (not new, that girl can sleep through pretty much anything), I was digging the wild ride (big waves are fun and I like the rocking feeling that stays with you after) and amy was mustering everything she could not to spew everywhere. she was taking such deep breaths I couldn’t decide if I was more concerned she was going to vomit or pass out from hyperventilating. luckily, she made it, and we all stepped uneasily onto solid ground. we decided to walk to a hostel we had heard was not far from the ferry dock – the YWCA (not to be confused with the YMCA). they had one three bedroom (complete with bathroom) left and we got it!
dar es salaam is a crappy city. I see no reason to visit it and I’d like never to go back, though we’ve heard from a local that it can be sweet if you have the right person to show you around. as we saw it, we were staying in a hostel so ghetto it felt like welfare housing in one of the poor inner cities in the U.S. – take your pick. the city noises were so obnoxious, loud honking and the screeching of brakes, yelling, animals, cars, pollution… not my cup of tea.
we wanted to explore so we hopped a bus out of town to a place where we had heard there’s a maasai market (as if we haven’t already gotten enough of that, but we didn’t know what else to do). it was maybe a 45 minute bus ride standing and trying not to fall over. we made it, and eventually found the market after some struggle and asking directions from about half a dozen people. the market was fun and I picked up a few gifts to bring home.
as I was walking to the next booth I noticed an ominous cloud overhead. my mom and I always say it’s possible to smell when rain is coming. I could definitely smell it. I looked around and realized that suddenly the market had become frantic, the stall owners were running into their shops, grabbing plastic and hastily trying to hang it at the entrances. I turned to look over my shoulder for amy and thu and there was the sheet of rain about to overtake me. I ducked into a shop just as it hit with such force and so suddenly I wasn’t sure the plastic would withstand the wind and rain. I stood there with a few locals trying to hold it down and keep the rain out, then retreated deeper into the dark shop, careful to avoid the leaky spots in the roof. the rain was thunderous and coming down so hard I couldn’t take my eyes off the street outside. I asked how long it would last – two hours, the woman calmly replied. two hours?! I had no idea where amy and thu where, I was trapped by the downpour in a tiny shop with a guy, who confessed he was only 19, and kept offering to give me an umbrella and carry me to the stand where I soon realized amy and thu had taken cover across the way. he was about a foot short than me and I politely declined. eventually the rain let up enough that we could walk in it without getting too soaked. lucky we’re oregonians used to such weather. we went on a hunt for the bus back home, got lost, tracked down by one of the rasta men who I had bought earrings from and who had given me free bracelets earlier, and he led us to a bus and directed us onto it saying ‘one love man’. where do these people come from?!
back at the YWCA we met up with kent, our friend from stanford who had stayed at centre house with us and who was headed home after his summer working on making ice from sun (yes, he’s an engineer and their current project is solar powered fridges – pretty cool to hear him talk about). we were relieved to have a guy around, and one who knew the city a little. we went to dinner with him and three canadian law student guys we had met at our hostel in stone town. kent told us the story over dinner about matt, his friend who we had also met at the hostel, and the bat bite incident they had on safari. here’s the gist of it:
matt and kent’s first night on safari they were having dinner outside. matt noticed something moving in his pants and started freaking out, he did the ‘get out of my pants’ dance until a small bat can tumbling out of his pant leg. he wasn’t sure if it had bit him, but he definitely had open wounds on his legs from bug bites and often bats’ teeth are so small you can’t feel the bite, plus it was behaving strangely so they caught the little creature and proceeded to try to explain the severity of the situation to their safari guides. the guides weren’t really getting it, but eventually agreed to drive them to a middle-of-nowhere clinic that night. the doc there wasn’t too helpful either. they walked in, bagged bat in hand, and explained what had happened. She grabbed gauze as if you to bandage the non-existent wound, and then suggested she give him a tetanus booster. not gonna cut it. they got a hold of a doc in the states who said who said they needed to hunt down the rabies vaccine. Luckily matt had great travel insurance and a woman was able to track down the closest vaccine – unfortunately in nairobi. she booked him a flight and told him when he needed to arrive at the airport. they decided to part of the next morning’s safari – kent was into it all like ‘matt! check out the zebras!!’ while matt was basically rocking back and fourth nervously, thinking ‘im going to die, im going to die’. poor kid
they set off that afternoon for the airport, (their safari car was going on without them since there were other passengers). first they bummed a ride with some random africans, but when they got to the gate where they needed to pass out of the park and had no american cash. they took matt’s credit card and tried to pay – cash only. is there a cash machine nearby? no. they literally resorted to begging from other safaris, asking the people to let them borrow $100 US and saying they’d pay it back in arusha. finally they found some guy who cruised up in a pimped out safari luxury vehicle, just him, who offered to loan them the money and drive them part of the way. lucky! they eventually made it to the airport, only 40 minutes before the flight left. there were so many complications at the airport, they needed to buy kent a ticket as well, the place only accepted cash again, the money machine was outside and they had to come back through security once leaving. the plane was held about 15 minutes after departure time for them but they made it. talk about an adventure!
when they finally arrived at the hospital in nairobi the doc went to give the vaccine. He was going to give it IV and apparently matt wasn’t a little unsure about this so he called the doc back home and the doc said ‘whatever you do, don’t give it IV’ so at the hospital the doctor there was like, hm, ok, and gave it IM. oh boy. anyway, so matt is prophylaxed and not going to die of rabies and he’ll have a great story to boot! but poor guy…
we made it home to arusha safe and sound after wayyy too long on a bus – about ten hours. with a bathroom stop that involved the men going to the right and the women to the left and just squatting in the bushes on the side of the road. I was glad to be wearing a long skirt. we had pukers on the bus too… way too much vomit for one journey. the triple bumps of death coming into arusha were almost too much to bear in the back of that bus. we are relieved to be back at centre house and excited for the hospital tomo. back in action!
dar es salaam is a crappy city. I see no reason to visit it and I’d like never to go back, though we’ve heard from a local that it can be sweet if you have the right person to show you around. as we saw it, we were staying in a hostel so ghetto it felt like welfare housing in one of the poor inner cities in the U.S. – take your pick. the city noises were so obnoxious, loud honking and the screeching of brakes, yelling, animals, cars, pollution… not my cup of tea.
we wanted to explore so we hopped a bus out of town to a place where we had heard there’s a maasai market (as if we haven’t already gotten enough of that, but we didn’t know what else to do). it was maybe a 45 minute bus ride standing and trying not to fall over. we made it, and eventually found the market after some struggle and asking directions from about half a dozen people. the market was fun and I picked up a few gifts to bring home.
as I was walking to the next booth I noticed an ominous cloud overhead. my mom and I always say it’s possible to smell when rain is coming. I could definitely smell it. I looked around and realized that suddenly the market had become frantic, the stall owners were running into their shops, grabbing plastic and hastily trying to hang it at the entrances. I turned to look over my shoulder for amy and thu and there was the sheet of rain about to overtake me. I ducked into a shop just as it hit with such force and so suddenly I wasn’t sure the plastic would withstand the wind and rain. I stood there with a few locals trying to hold it down and keep the rain out, then retreated deeper into the dark shop, careful to avoid the leaky spots in the roof. the rain was thunderous and coming down so hard I couldn’t take my eyes off the street outside. I asked how long it would last – two hours, the woman calmly replied. two hours?! I had no idea where amy and thu where, I was trapped by the downpour in a tiny shop with a guy, who confessed he was only 19, and kept offering to give me an umbrella and carry me to the stand where I soon realized amy and thu had taken cover across the way. he was about a foot short than me and I politely declined. eventually the rain let up enough that we could walk in it without getting too soaked. lucky we’re oregonians used to such weather. we went on a hunt for the bus back home, got lost, tracked down by one of the rasta men who I had bought earrings from and who had given me free bracelets earlier, and he led us to a bus and directed us onto it saying ‘one love man’. where do these people come from?!
back at the YWCA we met up with kent, our friend from stanford who had stayed at centre house with us and who was headed home after his summer working on making ice from sun (yes, he’s an engineer and their current project is solar powered fridges – pretty cool to hear him talk about). we were relieved to have a guy around, and one who knew the city a little. we went to dinner with him and three canadian law student guys we had met at our hostel in stone town. kent told us the story over dinner about matt, his friend who we had also met at the hostel, and the bat bite incident they had on safari. here’s the gist of it:
matt and kent’s first night on safari they were having dinner outside. matt noticed something moving in his pants and started freaking out, he did the ‘get out of my pants’ dance until a small bat can tumbling out of his pant leg. he wasn’t sure if it had bit him, but he definitely had open wounds on his legs from bug bites and often bats’ teeth are so small you can’t feel the bite, plus it was behaving strangely so they caught the little creature and proceeded to try to explain the severity of the situation to their safari guides. the guides weren’t really getting it, but eventually agreed to drive them to a middle-of-nowhere clinic that night. the doc there wasn’t too helpful either. they walked in, bagged bat in hand, and explained what had happened. She grabbed gauze as if you to bandage the non-existent wound, and then suggested she give him a tetanus booster. not gonna cut it. they got a hold of a doc in the states who said who said they needed to hunt down the rabies vaccine. Luckily matt had great travel insurance and a woman was able to track down the closest vaccine – unfortunately in nairobi. she booked him a flight and told him when he needed to arrive at the airport. they decided to part of the next morning’s safari – kent was into it all like ‘matt! check out the zebras!!’ while matt was basically rocking back and fourth nervously, thinking ‘im going to die, im going to die’. poor kid
they set off that afternoon for the airport, (their safari car was going on without them since there were other passengers). first they bummed a ride with some random africans, but when they got to the gate where they needed to pass out of the park and had no american cash. they took matt’s credit card and tried to pay – cash only. is there a cash machine nearby? no. they literally resorted to begging from other safaris, asking the people to let them borrow $100 US and saying they’d pay it back in arusha. finally they found some guy who cruised up in a pimped out safari luxury vehicle, just him, who offered to loan them the money and drive them part of the way. lucky! they eventually made it to the airport, only 40 minutes before the flight left. there were so many complications at the airport, they needed to buy kent a ticket as well, the place only accepted cash again, the money machine was outside and they had to come back through security once leaving. the plane was held about 15 minutes after departure time for them but they made it. talk about an adventure!
when they finally arrived at the hospital in nairobi the doc went to give the vaccine. He was going to give it IV and apparently matt wasn’t a little unsure about this so he called the doc back home and the doc said ‘whatever you do, don’t give it IV’ so at the hospital the doctor there was like, hm, ok, and gave it IM. oh boy. anyway, so matt is prophylaxed and not going to die of rabies and he’ll have a great story to boot! but poor guy…
we made it home to arusha safe and sound after wayyy too long on a bus – about ten hours. with a bathroom stop that involved the men going to the right and the women to the left and just squatting in the bushes on the side of the road. I was glad to be wearing a long skirt. we had pukers on the bus too… way too much vomit for one journey. the triple bumps of death coming into arusha were almost too much to bear in the back of that bus. we are relieved to be back at centre house and excited for the hospital tomo. back in action!
stone town
today I fell in love. stone town is unquestionably one of the most amazing cities I have ever visited. we took the hour long cab ride with sam and court this morning and ended up at a hostel called manch lodge, not far from the haven hostel we stayed at our first night here. the white washed paint on the building is chipped from the salty sea air and the sheets are festive tropical flowers, bright and charmingly mismatched. we threw our bags in the room and made to explore.
the city is a maze but we were determined to do stone town in a day and that meant mastering the narrow alley ways and winding streets as soon as possible. we set out sans map and headed in what we believed to be the direction of the ocean. it was hot and humid and my choice of a black shirt and black skirt, though very culturally appropriate, was making my body damp with sweat. no complaints, I thrive in the heat and humidity and the occasional breeze offered some relief. we walked down the narrow cobblestone streets that seem to be placed arbitrarily, joining others in random places and dead ending without warning. there is absolutely to rhyme or reason to the layout of the city and that adds to the charm.
ok, I have to say that as im sitting in the hostel room typing this, I left the door open. big mistake. there is a guy standing in the door as I type and right now he is asking me about the law of segregation… er now he’s on to evolution. what is going on?! he doesn’t get the hint at all that I’m busy and I’m not in the mood to drop what I’m doing and answer the standard serious of questions thrown at us everywhere we go – where are you from? what is your name? how long have you been here? you are volunteer? and so on…. I’m still typing as he talks, only partially aware of the conversation, saying a lot of ‘ahh’s and ‘aya’s (we learned that one in arusha) and ‘oh’s… now he’s talking music, I think. how the heck did we get from talking chromosomes to this topic? he is apparently a fan of linkin park, ha. no really, what is going on?!! sometimes I feel like all of these men have aspergers. you can be completely ignoring them, hardly paying attention, sending signals of disinterest so strong any normal human being would taste it, and yet he stands there, chatting away, as if I were hanging on his every word. we’ve decided this phenomenon is rooted in the way society is structured here. the women are inferior, their opinion doesn’t matter, so whether we’re interested or not, the man will talk to us if he wants to.
this is getting annoying like you wouldn’t believe. last night around the bonfire I just wanted to sit in peace and stare at the fire – a favorite summer pastime of mine. this little twerp comes, sits next to me, and despite me explaining that I’d like some peace and quiet, he starts talking to me. the funny thing about it was, and he’s lucky I found this comical, that he talked at me for a good 8 minutes and 47 seconds without taking a single breath or pausing for so much as a second. it was actually quite impressive. I understood maybe every 11th word of what he said, and even the words that I believed were english, and somewhat distinguishable, I was tuning out. as far as I could tell there was no topic of conversation, rather a random stream of consciousness monologue being performed for me by this borderline bipolar 21 year old dude. yes, at some point in his speech I heard something about him being 21, I think it’s when he was confessing his love for the ‘chinagirl’ aka thu or something like that. being anonymous back in the states is going to be sooo wonderful :) ok, finally, he’s gone, back to stone town…
by the end of the day we were turning down streets, pausing, and taking a vote on our next move. which way do we turn? did that door look familiar? yes, of course, we’ve seen a thousand like it today, but have we seen that one? have we passed by that shop before? most certainly, I recognize the khangas… or do I? but that building, paint chipping and clothes hanging from the balcony, that is definitely something we know… I think. navigating this place is like playing a game, only if you make the wrong turn it doesn’t matter. eventually you’ll find something you recognize and before you know it, between the three of you, you’ll find your way back to the hostel.
we succeeded at this game three times today, once in the dark. the first time we set out for the ferry to confirm our ticket for tomorrow. piece of cake! it helped that we had stayed here for a night before and had a handful of brits, who knew the area, as our guides. for what a labyrinth the city is, it doesn’t take all that long to figure it out. next we headed to the spice market. an outdoor… or rather, covered in orange tarps that give everything a strange orange hue, market that offers every spice we learned about on our tour and more. I stalked up, the prices were quite affordable, and the quality is unbelievable! fresh spice mixes from zanzibar? I might just have learn how to cook when I get home.
we stopped for a coconut from some guy on the side of the road. nothing like quenching your thirst with fresh coconut milk then downing the coconut calamari to fill your stomach. what am I going to do back home when there are no guys with machetes and coconut tree climbing abilities?!
next it was every vegetarian’s nightmare… the meat market. i’m not talkin’ the beaches of nungwi littered with bronzed europeans (ok, bad joke) but really, this was a building with stands lining each side that literally wreaked of death. there were bloody carcasses hanging from the booths on either side, everything from large slabs of meat to whole skinned goats to heads of bulls. yeah, that one confused me too but it’s as if they make a clean cut just behind the horns and straight down through the head and then i suppose you can purchase that head for your dining pleasure? flies were swarming and the smell was suffocating. there were definitely goats being let into that place and you can only imagine their fate. we didn’t stick around to watch, i’m way to fond of goats.
the fist market was more bearable, mostly because selfishly I love seafood and will eat anything from the ocean cooked or not, so it was pretty much my paradise. I was imagining everything sautéed or barbequed and got really excited for the night seafood market. we have eaten seafood at every meal here and it’s not even starting to get old. it has been completely mouthwatering every time and I will definitely miss the variety back in arusha, where we wouldn’t dare eat seafood anything.
we stumbled upon another market, more khangas and scarves, and we couldn’t help but make several purchases. when you can get scarves for two for 5000 tzs it’s just too good to pass up. by this point all of the wandering and shopping was making us hungry and thu and I had been dying to try to roadside grilled corn. yes, we’re at that point in the trip where we’ve gone so long without getting sick (I’m doing some serious knocking on wood right now), that we’ll eat pretty much anything. we got two ears of corn, grilled over a fire and covered in lime and chili and salt. reminded me a lot of elote in mexico though not nearly as good. something about the way they cook the corn, wasn’t quite what we were expecting. the kernels pop off and are hard and chewy. it’s like something between grilled corn and a corn nut if that makes sense. the flavor is great, and nice and spicy, but after eating about a third of the ear we were stuffed and ended up pawning off the rest on some locals who were extremely pleased with their free treat. I also bought a piece of naan that is possibly the best carb I ever eaten in my entire life. the food in zanzibar has some been some of the best we’ve had. then again, as I mentioned before, I tend to think that every meal I eat is better than the last.
next it was time to hunt for the chicken market. we had done the spice market, walked the fish market (and seen them cutting up some huge shark creature, the fin was three feet long and the organs were ginormous!!), cringed in the meat market, and now the vegetarian was bound and determined to see the kuku market I had heard about from a friend. I found a local to lead us there. the smell was probably worse than all the other markets combined. wait, no, I take that back, the fist market smelled terrible! and the flies were unbelievable! the meat market just smelled like blood. so the chicken market was dark and the chickens were kept under these woven baskets. it was packed with cats as well, I suppose cleaning up the leftover pieces. I asked the guy where they cut off the heads. thu and amy were extremely entertained that the vegetarian was the one seeking out the place to watch chicken decapitations. he eagerly lead us through the chicken coups and to a place where guys were quite literally slitting chicken throats and de-feathering them while standing in a pool of chicken blood and chicken carcass. It was one of those affirming moments where I was so pleased to be a non-meat eater.
we also toured the anglican cathedral and old slave market. it was an overwhelming experience. you are able to go underground into the holding chambers where they used to keep the slaves, overpacked, starving, and suffocating, before bringing them to the market to be sold. there were photos and information about how big the slave trade was in zanzibar, and in some places there were still shackles. the alter of the beautiful cathedral is quite literally built on top of the location where the whipping post used to be. it was extremely distressing to learn about and see, but it is a part of history that needs to be acknowledged despite the tragedy of it. eerie being down in those chambers, a reminder of a very devastating past and the cruel potential of the human race. but there are also reminders of the people who worked to end slavery and that was uplifting to learn about. all in all a great experience.
we walked for miles today, sampled many a local cuisine item, and mastered this maze of a city. it was time to get cleaned up, because lets be honest, after a day running around in the hot and humid sea air, you stink. once semi-presentable we headed to the night seafood market. I got almost instantly distracted when we left the hostel and set out on the dark streets (talking about testing our navigation skills!). we passed some men enjoying this strange looking gooey mixture of I-didn’t-know-what. so I approached them and asked about it. they said it was fruit and I instantly said ‘like a smoothie’? and they nodded, though im pretty sure they have no idea what is smoothie is and were just agreeing with the silly mzungu. ‘where did you get it?’ I asked eagerly, and one of the men pointed. there was a dimly lit shop across the alley. I walked over and invited myself inside and behind the counter to try to point out what I was looking for. I explained my need and asked about the contents of the drink. the guy showed me some huge buckets of different colored liquids. brownish – banana. yellow – mango. easy enough. fruit chunks... uh, what’d you call it? some pink stuff... ok? and when I started eating it, anther surprise, peanuts? the first peanut I got I thought had maybe fallen in by accident, but then there were more and more and it worked so well with the flavor I started getting excited to find more peanuts in my fruit drink combo mixture of goodness. peanuts were definitely not in there by accident – genius. I enjoyed every last drop of that thing. I still have only a very vague idea of what a few of the ingredients were but when something tastes that good you don’t question it. this is another one I’m going to have to bring back to the states… the only problem, how to figure out the ingredients. I might need to have it again for breakfast in the morning :)
after my short detour we were on our way again. the nigh seafood market is possibly the most awesome collection of food ever in the history of the world. the featured drink is made from sugar cane (pressed on location), lemon and ginger. delicious. the food is anything and everything from the sea and then some. more delicious. the people are nice and friendly (overly friendly as always) and willing to bargain a little… not so much delicious, but definitely fun. we started off with some clams and fish. everything is on shish kabobs and when you order they take it back to a communal grill shared with neighboring stands and bbq it for you. we had more of the amazing naan, tried barracuda and kingfish, and then sat digesting as we contemplated our next item. thu and I wanted shark, it was pretty good, not what I was expecting. we had lobster with masala seasoning that was ridiculously tasty. I ended the night with a banana nutella ‘zanzibar pizza’ that pushed my into the painfully full category but it was worth it. zanz has had the best food of any place we’ve traveled and this night was the icing on the cake. I’m gonna miss having every type of seafood ever only a few thousand shillings away.
tomorrow we head to dar then back to arusha the next day. it will be good to be home but definitely bittersweet as this vacation part of our trip has been so amazing. We’re excited to get back to the hospital, though, and pleased to be staying at centre house for the rest of the trip.
the city is a maze but we were determined to do stone town in a day and that meant mastering the narrow alley ways and winding streets as soon as possible. we set out sans map and headed in what we believed to be the direction of the ocean. it was hot and humid and my choice of a black shirt and black skirt, though very culturally appropriate, was making my body damp with sweat. no complaints, I thrive in the heat and humidity and the occasional breeze offered some relief. we walked down the narrow cobblestone streets that seem to be placed arbitrarily, joining others in random places and dead ending without warning. there is absolutely to rhyme or reason to the layout of the city and that adds to the charm.
ok, I have to say that as im sitting in the hostel room typing this, I left the door open. big mistake. there is a guy standing in the door as I type and right now he is asking me about the law of segregation… er now he’s on to evolution. what is going on?! he doesn’t get the hint at all that I’m busy and I’m not in the mood to drop what I’m doing and answer the standard serious of questions thrown at us everywhere we go – where are you from? what is your name? how long have you been here? you are volunteer? and so on…. I’m still typing as he talks, only partially aware of the conversation, saying a lot of ‘ahh’s and ‘aya’s (we learned that one in arusha) and ‘oh’s… now he’s talking music, I think. how the heck did we get from talking chromosomes to this topic? he is apparently a fan of linkin park, ha. no really, what is going on?!! sometimes I feel like all of these men have aspergers. you can be completely ignoring them, hardly paying attention, sending signals of disinterest so strong any normal human being would taste it, and yet he stands there, chatting away, as if I were hanging on his every word. we’ve decided this phenomenon is rooted in the way society is structured here. the women are inferior, their opinion doesn’t matter, so whether we’re interested or not, the man will talk to us if he wants to.
this is getting annoying like you wouldn’t believe. last night around the bonfire I just wanted to sit in peace and stare at the fire – a favorite summer pastime of mine. this little twerp comes, sits next to me, and despite me explaining that I’d like some peace and quiet, he starts talking to me. the funny thing about it was, and he’s lucky I found this comical, that he talked at me for a good 8 minutes and 47 seconds without taking a single breath or pausing for so much as a second. it was actually quite impressive. I understood maybe every 11th word of what he said, and even the words that I believed were english, and somewhat distinguishable, I was tuning out. as far as I could tell there was no topic of conversation, rather a random stream of consciousness monologue being performed for me by this borderline bipolar 21 year old dude. yes, at some point in his speech I heard something about him being 21, I think it’s when he was confessing his love for the ‘chinagirl’ aka thu or something like that. being anonymous back in the states is going to be sooo wonderful :) ok, finally, he’s gone, back to stone town…
by the end of the day we were turning down streets, pausing, and taking a vote on our next move. which way do we turn? did that door look familiar? yes, of course, we’ve seen a thousand like it today, but have we seen that one? have we passed by that shop before? most certainly, I recognize the khangas… or do I? but that building, paint chipping and clothes hanging from the balcony, that is definitely something we know… I think. navigating this place is like playing a game, only if you make the wrong turn it doesn’t matter. eventually you’ll find something you recognize and before you know it, between the three of you, you’ll find your way back to the hostel.
we succeeded at this game three times today, once in the dark. the first time we set out for the ferry to confirm our ticket for tomorrow. piece of cake! it helped that we had stayed here for a night before and had a handful of brits, who knew the area, as our guides. for what a labyrinth the city is, it doesn’t take all that long to figure it out. next we headed to the spice market. an outdoor… or rather, covered in orange tarps that give everything a strange orange hue, market that offers every spice we learned about on our tour and more. I stalked up, the prices were quite affordable, and the quality is unbelievable! fresh spice mixes from zanzibar? I might just have learn how to cook when I get home.
we stopped for a coconut from some guy on the side of the road. nothing like quenching your thirst with fresh coconut milk then downing the coconut calamari to fill your stomach. what am I going to do back home when there are no guys with machetes and coconut tree climbing abilities?!
next it was every vegetarian’s nightmare… the meat market. i’m not talkin’ the beaches of nungwi littered with bronzed europeans (ok, bad joke) but really, this was a building with stands lining each side that literally wreaked of death. there were bloody carcasses hanging from the booths on either side, everything from large slabs of meat to whole skinned goats to heads of bulls. yeah, that one confused me too but it’s as if they make a clean cut just behind the horns and straight down through the head and then i suppose you can purchase that head for your dining pleasure? flies were swarming and the smell was suffocating. there were definitely goats being let into that place and you can only imagine their fate. we didn’t stick around to watch, i’m way to fond of goats.
the fist market was more bearable, mostly because selfishly I love seafood and will eat anything from the ocean cooked or not, so it was pretty much my paradise. I was imagining everything sautéed or barbequed and got really excited for the night seafood market. we have eaten seafood at every meal here and it’s not even starting to get old. it has been completely mouthwatering every time and I will definitely miss the variety back in arusha, where we wouldn’t dare eat seafood anything.
we stumbled upon another market, more khangas and scarves, and we couldn’t help but make several purchases. when you can get scarves for two for 5000 tzs it’s just too good to pass up. by this point all of the wandering and shopping was making us hungry and thu and I had been dying to try to roadside grilled corn. yes, we’re at that point in the trip where we’ve gone so long without getting sick (I’m doing some serious knocking on wood right now), that we’ll eat pretty much anything. we got two ears of corn, grilled over a fire and covered in lime and chili and salt. reminded me a lot of elote in mexico though not nearly as good. something about the way they cook the corn, wasn’t quite what we were expecting. the kernels pop off and are hard and chewy. it’s like something between grilled corn and a corn nut if that makes sense. the flavor is great, and nice and spicy, but after eating about a third of the ear we were stuffed and ended up pawning off the rest on some locals who were extremely pleased with their free treat. I also bought a piece of naan that is possibly the best carb I ever eaten in my entire life. the food in zanzibar has some been some of the best we’ve had. then again, as I mentioned before, I tend to think that every meal I eat is better than the last.
next it was time to hunt for the chicken market. we had done the spice market, walked the fish market (and seen them cutting up some huge shark creature, the fin was three feet long and the organs were ginormous!!), cringed in the meat market, and now the vegetarian was bound and determined to see the kuku market I had heard about from a friend. I found a local to lead us there. the smell was probably worse than all the other markets combined. wait, no, I take that back, the fist market smelled terrible! and the flies were unbelievable! the meat market just smelled like blood. so the chicken market was dark and the chickens were kept under these woven baskets. it was packed with cats as well, I suppose cleaning up the leftover pieces. I asked the guy where they cut off the heads. thu and amy were extremely entertained that the vegetarian was the one seeking out the place to watch chicken decapitations. he eagerly lead us through the chicken coups and to a place where guys were quite literally slitting chicken throats and de-feathering them while standing in a pool of chicken blood and chicken carcass. It was one of those affirming moments where I was so pleased to be a non-meat eater.
we also toured the anglican cathedral and old slave market. it was an overwhelming experience. you are able to go underground into the holding chambers where they used to keep the slaves, overpacked, starving, and suffocating, before bringing them to the market to be sold. there were photos and information about how big the slave trade was in zanzibar, and in some places there were still shackles. the alter of the beautiful cathedral is quite literally built on top of the location where the whipping post used to be. it was extremely distressing to learn about and see, but it is a part of history that needs to be acknowledged despite the tragedy of it. eerie being down in those chambers, a reminder of a very devastating past and the cruel potential of the human race. but there are also reminders of the people who worked to end slavery and that was uplifting to learn about. all in all a great experience.
we walked for miles today, sampled many a local cuisine item, and mastered this maze of a city. it was time to get cleaned up, because lets be honest, after a day running around in the hot and humid sea air, you stink. once semi-presentable we headed to the night seafood market. I got almost instantly distracted when we left the hostel and set out on the dark streets (talking about testing our navigation skills!). we passed some men enjoying this strange looking gooey mixture of I-didn’t-know-what. so I approached them and asked about it. they said it was fruit and I instantly said ‘like a smoothie’? and they nodded, though im pretty sure they have no idea what is smoothie is and were just agreeing with the silly mzungu. ‘where did you get it?’ I asked eagerly, and one of the men pointed. there was a dimly lit shop across the alley. I walked over and invited myself inside and behind the counter to try to point out what I was looking for. I explained my need and asked about the contents of the drink. the guy showed me some huge buckets of different colored liquids. brownish – banana. yellow – mango. easy enough. fruit chunks... uh, what’d you call it? some pink stuff... ok? and when I started eating it, anther surprise, peanuts? the first peanut I got I thought had maybe fallen in by accident, but then there were more and more and it worked so well with the flavor I started getting excited to find more peanuts in my fruit drink combo mixture of goodness. peanuts were definitely not in there by accident – genius. I enjoyed every last drop of that thing. I still have only a very vague idea of what a few of the ingredients were but when something tastes that good you don’t question it. this is another one I’m going to have to bring back to the states… the only problem, how to figure out the ingredients. I might need to have it again for breakfast in the morning :)
after my short detour we were on our way again. the nigh seafood market is possibly the most awesome collection of food ever in the history of the world. the featured drink is made from sugar cane (pressed on location), lemon and ginger. delicious. the food is anything and everything from the sea and then some. more delicious. the people are nice and friendly (overly friendly as always) and willing to bargain a little… not so much delicious, but definitely fun. we started off with some clams and fish. everything is on shish kabobs and when you order they take it back to a communal grill shared with neighboring stands and bbq it for you. we had more of the amazing naan, tried barracuda and kingfish, and then sat digesting as we contemplated our next item. thu and I wanted shark, it was pretty good, not what I was expecting. we had lobster with masala seasoning that was ridiculously tasty. I ended the night with a banana nutella ‘zanzibar pizza’ that pushed my into the painfully full category but it was worth it. zanz has had the best food of any place we’ve traveled and this night was the icing on the cake. I’m gonna miss having every type of seafood ever only a few thousand shillings away.
tomorrow we head to dar then back to arusha the next day. it will be good to be home but definitely bittersweet as this vacation part of our trip has been so amazing. We’re excited to get back to the hospital, though, and pleased to be staying at centre house for the rest of the trip.
just another day in paradise
zanzibar is amazing. my description won’t do it justice- such a perfect tropical paradise, warm and a little humid with nights just as comfortable, incredible food, pristine beaches… the buildings and mosques of crumbling stone, eaten away by the salty sea air, are rustic and beautiful, whitewashed to match the sand on the beaches and covered in thatched roofs. paradise doesn’t get better than this…
if I could pick a way to spend my days for the rest of my life, here’s one option I would choose. i’d sleep in, but not too late, and wake up without an alarm. i’d have breakfast outside, and someone would serve me fresh fruit and other foods I find delicious and i’d have endless tea and coffee just the way I like it. the weather would naturally be beautiful - warm, but not too hot, with a few clouds to keep the sky interesting. I would gather my things: sunscreen, a good book, my ipod with all of my favorite music, and i’d make my way to the beach. this would only take me a minute or two, because in my perfect day I would have slept the night in a place only a stone’s throw from the ocean. I would lay out in the sun and read, listening to music, and when I got too hot I would retreat to the cool ocean water. I would wade in the water, the smooth white sand beneath my feet, and once I was deep enough I would lay there, floating on my air mattress of salt water. I could almost fall asleep i’d be so relaxed just bobbing with the small waves. later I would play volleyball, there would definitely have to be some beach volleyball involved on my perfect day, I mean, what’s a day at the beach without volleyball? and I would play with friends and we would have a great time and play until we were tired and thirsty and covered in sand from head to foot. then I would make my way to the grocery store – it’s on the beach of course, so I don’t have to leave my sunny paradise, not even to buy a drink. I would get the ginger ale, real ginger ale, so strong with the smell and taste of ginger that it burns your tongue a little bit as you drink it. I would savor that soda as I lay on the beach, reading more of my good book. I would finish my book and feel satisfied. then I would decide I’m hungry so I’d opt for a lunch of fruit: an orange, banana with peanut butter, and a coconut fresh cut from the tree and chopped open for me to enjoy with a spoon made of the skin so that I can eat the ‘coconut calamari’ inside. I’d stroll back down to the beach, full and happy and ready for a swim. I’d take off against the current, stroke after stroke, a relaxed journey along the beach. I’d swim in that perfect, turquoise water until I was tired… though I never get tired of water, or swimming, so rather I’d swim until I was ready to float and then I’d roll onto my back, close my eyes, and drift some more, the warm afternoon sun heating my face and toes. I’d eventually swim back, find a place on the beach next to one of the friendly stray dogs, and sit there with him, petting his soft ears and watching the sunset. if I could pick a way to spend my days for the rest of my life, that’s pretty much how I’d do it. now if I could arrange for family and friends to join me during this day, I definitely would, and then it would be truly perfect. pretty much the only thing that could make me happier after such an amazing day as this would be dark chocolate :) what kind of an island, or country for that matter, doesn’t have dark chocolate?! I suppose you can’t have everything... zanzibar, you are a wonderful paradise, thanks for the holiday. to everyone back home, wish you were here!!
if I could pick a way to spend my days for the rest of my life, here’s one option I would choose. i’d sleep in, but not too late, and wake up without an alarm. i’d have breakfast outside, and someone would serve me fresh fruit and other foods I find delicious and i’d have endless tea and coffee just the way I like it. the weather would naturally be beautiful - warm, but not too hot, with a few clouds to keep the sky interesting. I would gather my things: sunscreen, a good book, my ipod with all of my favorite music, and i’d make my way to the beach. this would only take me a minute or two, because in my perfect day I would have slept the night in a place only a stone’s throw from the ocean. I would lay out in the sun and read, listening to music, and when I got too hot I would retreat to the cool ocean water. I would wade in the water, the smooth white sand beneath my feet, and once I was deep enough I would lay there, floating on my air mattress of salt water. I could almost fall asleep i’d be so relaxed just bobbing with the small waves. later I would play volleyball, there would definitely have to be some beach volleyball involved on my perfect day, I mean, what’s a day at the beach without volleyball? and I would play with friends and we would have a great time and play until we were tired and thirsty and covered in sand from head to foot. then I would make my way to the grocery store – it’s on the beach of course, so I don’t have to leave my sunny paradise, not even to buy a drink. I would get the ginger ale, real ginger ale, so strong with the smell and taste of ginger that it burns your tongue a little bit as you drink it. I would savor that soda as I lay on the beach, reading more of my good book. I would finish my book and feel satisfied. then I would decide I’m hungry so I’d opt for a lunch of fruit: an orange, banana with peanut butter, and a coconut fresh cut from the tree and chopped open for me to enjoy with a spoon made of the skin so that I can eat the ‘coconut calamari’ inside. I’d stroll back down to the beach, full and happy and ready for a swim. I’d take off against the current, stroke after stroke, a relaxed journey along the beach. I’d swim in that perfect, turquoise water until I was tired… though I never get tired of water, or swimming, so rather I’d swim until I was ready to float and then I’d roll onto my back, close my eyes, and drift some more, the warm afternoon sun heating my face and toes. I’d eventually swim back, find a place on the beach next to one of the friendly stray dogs, and sit there with him, petting his soft ears and watching the sunset. if I could pick a way to spend my days for the rest of my life, that’s pretty much how I’d do it. now if I could arrange for family and friends to join me during this day, I definitely would, and then it would be truly perfect. pretty much the only thing that could make me happier after such an amazing day as this would be dark chocolate :) what kind of an island, or country for that matter, doesn’t have dark chocolate?! I suppose you can’t have everything... zanzibar, you are a wonderful paradise, thanks for the holiday. to everyone back home, wish you were here!!
our maasai goodbye
day 4 with the maasai
we’ve joked a lot about there being many men in lengasti in search of more wives. gladness will playfully ask how many cows we’re asking and we always say some absurdly high number it would be impossible to come up with. That’s how they do it here, if the men can offer the number of cows the woman (or rather girl in most cases) is asking, then they will be married. can you imagine if that were the way marriage happened in the states?!
breakfast was as filling as every. they make a variation of chipati for the morning that has more egg in it, very much like a crepe, and it is delicious!! we also had my new favorite treat, they cut these small, buttery avocados in half, fill the middle with honey straight from a hive nearby, and you eat it with a spoon. an unlikely combination that could not possibly taste better! I think I’ve broken my ability to feel full. we eat breakfast outside, im comfortable in my fleece and the day looks like it’s shaping up to be sunny. gladness pulls up her truck and starts blasting some local music to wake us up. we’re eating breakfast with the maasai warrior who saved my arm and I smile at him so frequently I think he’s a little creeped out. gladness eats meat for breakfast, pigeon, two to be exact. we saw the birds alive last night, the ladies who work in the kitchen buy them from the children who catch them for fun. I finish my avocado and feed the leftovers to simba, the small dog that lives at gladnesses. she’s pretty cute and ironically tiny to be named lion, but she has a fierce personality :)
poor jennah’s been feeling sick. she hasn’t traveled much and has shown no caution when it comes to eating the food here. not that we really have, but three of us have traveled enough that our bellies are used to insult – at least so far. thu and I are shocked we have yet to feel even remotely strange after all of the crap we’ve eaten here, street food and all, and amy’s had a few tough stomach days but for the most part has done well.
after breakfast we head out on our final mission… we walk out to one of the bomas, past donkeys and cows and goats (some with plastic plates tied to their bellies to prevent them from mating – it’s pretty interested and confused us at first, but gladness says some of the goats are not meant to make sex with the other goats). if you want to cause a frenzy in a maasai village, here’s what you do… walk to the center of one of the larger bomas carrying several non-descript bags filled with candy. just being mzungu will draw attention of the children and adults alike, so when they come over to investigate have your maasai speaking translator (in this case gladness), tell them there’s lots of candy in the bags and it will only be handed out once the children have been gathered from all of the nearby bomas. it also helps if you show some of the candy, and maybe hand out one piece or two to whatever lucky child happens to be bold enough to approach you. it shows you mean business, and you’re not bluffing about the goods. this is what we did today and I have never seen children run so fast. their tiny, tattered shukas streaming behind them, they split off in every direction to spread the word.
we stood abandoned, making eye contact with each other that could only say ‘what have we gotten ourselves into?’. it was like the calm before the storm. everyone gathered on the front step of one of the nicer huts, preparing for the children to return. I moved away from the group and stood atop the front hitch of a wagon to take in the chaos that was about to ensue. And sure enough, the children returned in force, outstretched hands desperate for a piece of mint or buttermilk candy. I had grabbed a large bag of lollipops and held it hidden between myself and the wagon. the children hadn’t really noticed me standing a distance away, and I would take out a piece at a time and hand it discretely to any child who passed by. they would in turn go whisper to a friend or sibling, and the next child would come to receive a piece. It took longer than I thought for word to spread to the point where I was being swarmed, but soon I was relieve I had chosen to stand on the hitch, it gave me some advantage on the crowd and endless outstretched hands below. In the beginning I tried to remember the faces of the children I had given candy too, but soon I couldn’t tell which had went with which child, and I was trying to make sure everyone got some, especially the littlest, their hands overshadowed by the taller, stronger children. it was good, clean mayhem and I was having a fine time being the mzungu candy ferry.
unfortunately the men did not feel the same way and soon stepped in to assist. here’s what happened next, and I couldn’t do a thing about it except keep handing the candy in such as way as to try to put the children in the least danger of getting hit. yes, he started beating at the crowd with his wooden stick. that damn wooden stick that all the men carry around, I hate that stick. I saw the children disperse frantically before I realized he was beating blindly into the crowd. he would violently grab the wrist of a child and pull it forward for me to set candy in the hand. you could tell the children are used to be being threatened and beat with these sticks, they swiftly and skillfully avoided the blows, for the most part. one young girl approached with her lip split and I gave her extra candy, I felt so bad, filled her hands with more than she could carry. leave it to the men here to ruin a fun time. what was interesting, however, is that the children were so desperate for the candy that they were willing to risk a beating just for a piece. they would keep an eye on the stick, dive in for a handful when they thought it was safe, then retreat quickly, trying to avoid a blow. as the chaos died down it became more of a game. the feeling of terror settled and the man who had decided to take control of the situation began laughing as he flicked playfully at the children who had returned for seconds and thirds one too many times. they do the same thing with the candy that they did with the pilau, but this confused me even more because, though they don’t seem to have pockets, just as fast as you’d place some wrapped candies in their hands, it would disappear and they’d reach again with empty palms. some came up with mouths so full they couldn’t close their lips, other had stashed the candies somewhere on their person, and we had to be carefully not to give a majority of the candy to a few of the very tricky candy hoarders.
once all the children had more candy than they could stuff in their mouths and carry, we moved on. we knew there were other kids who hadn’t received the candy memo. we walked from boma to boma handing out candy. the children are mostly scared of us because they haven’t seen wzungus before. we would have to wave the candy around as a peace offering to convince them to allow us to approach. kurt was having a blast with it, he would see some kids in the distance and sprint over with such speed that they would literally cling to each other in terror or cower onto the ground, horrified at what this mighty mzungu might do to them. then he would come to an abrupt stop and offer candy and they’d realize he’s a rafiki and follow him around for the rest of the day. I kept giving seconds to the kids who had already gotten candy, and I would give it to the women too (it’s well known that women have a sweet tooth :) there was this one little boy who walked cautiously over to me, hand outstretched, I reached out to give him the candy at the last second said ‘psych!’ and pulled it away playfully. but as went to immediately place it in his hand after, he was already crying and running away so fast I didn’t know what to do. kurt, who had been next to me and had seen the whole thing, was laughing so hard he was almost on the ground. I felt so bad, but couldn’t help laughing too, I walked after the boy and handed him extra candy. understandably, candy distribution is no joking matter here.
we gave out candy until it was gone, hoping we had reached as many children as possible. it was a good time to be sure, despite the men getting involved. after, we headed to see an old bebe (that’s what they call grandmas here) who was allegedly 104. not sure how accurate this is, but she’s definitely old. they don’t have birth certificates and mothers never remember when their children were born. gladness has no idea what her birthday is. she knows the year based on her mother telling her that remembers being pregnant during some particular event, and she knows the season because her mother remembers the weather, but that’s about it, so she arbitrarily picked a date in november. It’s this way with almost all of the people in the village. so this bebe was sitting in her hut, quite plump for her age. she can’t see but she can talk, is what gladness told us. we stepped inside and were instantly overwhelmed with the terribly thick smoke. my eyes were watering and I was choking despite doing everything in my power to act like it didn’t bother me. we took in what we could see of the hut. it’s so dark, and with the smoke and black tar covering the inside of the roof (an indication of what their lungs must look like), you can’t see much. the window is about the size of a small cup, and there is no chimney. miserable! it was absolutely miserable and I hardly lasted three minutes inside. my eyes and lungs are still burning. I cannot imagine living in such terrible conditions for 104 years!! how she is still alive baffles me.
that pretty much sums up our time with the maasai. our long trip back to arusha was bumpy to say the least, but im happy to have a warm-ish shower, less food being shoved in my face, and a climate that is less dusty and dry. it was an unforgettable experience and I feel fortunate to have experienced a culture so very different than my own. staffing the clinic was also a great opportunity, and I hope we’ve helped at least some of the children we saw. there’s so much that needs to be done to improve the quality of life of these people, fortunately they have gladness and dr. lace working to make their lives better. we hope to do more in the future with the lengasti and we will certainly send next year’s students to dr. lace to help out.
we’ve joked a lot about there being many men in lengasti in search of more wives. gladness will playfully ask how many cows we’re asking and we always say some absurdly high number it would be impossible to come up with. That’s how they do it here, if the men can offer the number of cows the woman (or rather girl in most cases) is asking, then they will be married. can you imagine if that were the way marriage happened in the states?!
breakfast was as filling as every. they make a variation of chipati for the morning that has more egg in it, very much like a crepe, and it is delicious!! we also had my new favorite treat, they cut these small, buttery avocados in half, fill the middle with honey straight from a hive nearby, and you eat it with a spoon. an unlikely combination that could not possibly taste better! I think I’ve broken my ability to feel full. we eat breakfast outside, im comfortable in my fleece and the day looks like it’s shaping up to be sunny. gladness pulls up her truck and starts blasting some local music to wake us up. we’re eating breakfast with the maasai warrior who saved my arm and I smile at him so frequently I think he’s a little creeped out. gladness eats meat for breakfast, pigeon, two to be exact. we saw the birds alive last night, the ladies who work in the kitchen buy them from the children who catch them for fun. I finish my avocado and feed the leftovers to simba, the small dog that lives at gladnesses. she’s pretty cute and ironically tiny to be named lion, but she has a fierce personality :)
poor jennah’s been feeling sick. she hasn’t traveled much and has shown no caution when it comes to eating the food here. not that we really have, but three of us have traveled enough that our bellies are used to insult – at least so far. thu and I are shocked we have yet to feel even remotely strange after all of the crap we’ve eaten here, street food and all, and amy’s had a few tough stomach days but for the most part has done well.
after breakfast we head out on our final mission… we walk out to one of the bomas, past donkeys and cows and goats (some with plastic plates tied to their bellies to prevent them from mating – it’s pretty interested and confused us at first, but gladness says some of the goats are not meant to make sex with the other goats). if you want to cause a frenzy in a maasai village, here’s what you do… walk to the center of one of the larger bomas carrying several non-descript bags filled with candy. just being mzungu will draw attention of the children and adults alike, so when they come over to investigate have your maasai speaking translator (in this case gladness), tell them there’s lots of candy in the bags and it will only be handed out once the children have been gathered from all of the nearby bomas. it also helps if you show some of the candy, and maybe hand out one piece or two to whatever lucky child happens to be bold enough to approach you. it shows you mean business, and you’re not bluffing about the goods. this is what we did today and I have never seen children run so fast. their tiny, tattered shukas streaming behind them, they split off in every direction to spread the word.
we stood abandoned, making eye contact with each other that could only say ‘what have we gotten ourselves into?’. it was like the calm before the storm. everyone gathered on the front step of one of the nicer huts, preparing for the children to return. I moved away from the group and stood atop the front hitch of a wagon to take in the chaos that was about to ensue. And sure enough, the children returned in force, outstretched hands desperate for a piece of mint or buttermilk candy. I had grabbed a large bag of lollipops and held it hidden between myself and the wagon. the children hadn’t really noticed me standing a distance away, and I would take out a piece at a time and hand it discretely to any child who passed by. they would in turn go whisper to a friend or sibling, and the next child would come to receive a piece. It took longer than I thought for word to spread to the point where I was being swarmed, but soon I was relieve I had chosen to stand on the hitch, it gave me some advantage on the crowd and endless outstretched hands below. In the beginning I tried to remember the faces of the children I had given candy too, but soon I couldn’t tell which had went with which child, and I was trying to make sure everyone got some, especially the littlest, their hands overshadowed by the taller, stronger children. it was good, clean mayhem and I was having a fine time being the mzungu candy ferry.
unfortunately the men did not feel the same way and soon stepped in to assist. here’s what happened next, and I couldn’t do a thing about it except keep handing the candy in such as way as to try to put the children in the least danger of getting hit. yes, he started beating at the crowd with his wooden stick. that damn wooden stick that all the men carry around, I hate that stick. I saw the children disperse frantically before I realized he was beating blindly into the crowd. he would violently grab the wrist of a child and pull it forward for me to set candy in the hand. you could tell the children are used to be being threatened and beat with these sticks, they swiftly and skillfully avoided the blows, for the most part. one young girl approached with her lip split and I gave her extra candy, I felt so bad, filled her hands with more than she could carry. leave it to the men here to ruin a fun time. what was interesting, however, is that the children were so desperate for the candy that they were willing to risk a beating just for a piece. they would keep an eye on the stick, dive in for a handful when they thought it was safe, then retreat quickly, trying to avoid a blow. as the chaos died down it became more of a game. the feeling of terror settled and the man who had decided to take control of the situation began laughing as he flicked playfully at the children who had returned for seconds and thirds one too many times. they do the same thing with the candy that they did with the pilau, but this confused me even more because, though they don’t seem to have pockets, just as fast as you’d place some wrapped candies in their hands, it would disappear and they’d reach again with empty palms. some came up with mouths so full they couldn’t close their lips, other had stashed the candies somewhere on their person, and we had to be carefully not to give a majority of the candy to a few of the very tricky candy hoarders.
once all the children had more candy than they could stuff in their mouths and carry, we moved on. we knew there were other kids who hadn’t received the candy memo. we walked from boma to boma handing out candy. the children are mostly scared of us because they haven’t seen wzungus before. we would have to wave the candy around as a peace offering to convince them to allow us to approach. kurt was having a blast with it, he would see some kids in the distance and sprint over with such speed that they would literally cling to each other in terror or cower onto the ground, horrified at what this mighty mzungu might do to them. then he would come to an abrupt stop and offer candy and they’d realize he’s a rafiki and follow him around for the rest of the day. I kept giving seconds to the kids who had already gotten candy, and I would give it to the women too (it’s well known that women have a sweet tooth :) there was this one little boy who walked cautiously over to me, hand outstretched, I reached out to give him the candy at the last second said ‘psych!’ and pulled it away playfully. but as went to immediately place it in his hand after, he was already crying and running away so fast I didn’t know what to do. kurt, who had been next to me and had seen the whole thing, was laughing so hard he was almost on the ground. I felt so bad, but couldn’t help laughing too, I walked after the boy and handed him extra candy. understandably, candy distribution is no joking matter here.
we gave out candy until it was gone, hoping we had reached as many children as possible. it was a good time to be sure, despite the men getting involved. after, we headed to see an old bebe (that’s what they call grandmas here) who was allegedly 104. not sure how accurate this is, but she’s definitely old. they don’t have birth certificates and mothers never remember when their children were born. gladness has no idea what her birthday is. she knows the year based on her mother telling her that remembers being pregnant during some particular event, and she knows the season because her mother remembers the weather, but that’s about it, so she arbitrarily picked a date in november. It’s this way with almost all of the people in the village. so this bebe was sitting in her hut, quite plump for her age. she can’t see but she can talk, is what gladness told us. we stepped inside and were instantly overwhelmed with the terribly thick smoke. my eyes were watering and I was choking despite doing everything in my power to act like it didn’t bother me. we took in what we could see of the hut. it’s so dark, and with the smoke and black tar covering the inside of the roof (an indication of what their lungs must look like), you can’t see much. the window is about the size of a small cup, and there is no chimney. miserable! it was absolutely miserable and I hardly lasted three minutes inside. my eyes and lungs are still burning. I cannot imagine living in such terrible conditions for 104 years!! how she is still alive baffles me.
that pretty much sums up our time with the maasai. our long trip back to arusha was bumpy to say the least, but im happy to have a warm-ish shower, less food being shoved in my face, and a climate that is less dusty and dry. it was an unforgettable experience and I feel fortunate to have experienced a culture so very different than my own. staffing the clinic was also a great opportunity, and I hope we’ve helped at least some of the children we saw. there’s so much that needs to be done to improve the quality of life of these people, fortunately they have gladness and dr. lace working to make their lives better. we hope to do more in the future with the lengasti and we will certainly send next year’s students to dr. lace to help out.
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