Notes from the Field 2007

Here in Africa I believe people embrace the little blessings of life with more passion and appreciation than in other places. There are three blessings from the past two weeks that I especially want to share with you.

Baraka ya Kwanza: Mvua (First Blessing: Rain)

Last Saturday Minnesota International Health Volunteers (MIHV) inaugurated their project with a huge community celebration. Our guests of honor included the District Commissioner, District Medical Officer, Council Chairman, our Member of Parliament, and local officials. The building was decorated with balloons, draped cloth, streamers, flowers and an inauguration plaque. There was a DJ who played music before and after the 2 ½ hour ceremony – he especially liked playing Marc Anthony’s song “You Sang to Me.” The celebration began with a brass band entering with a large group from the Arusha Tourism College singing and dancing. Shortly after the beginning of the ceremony it began to rain – and we’re in the middle of the dry season! When it rains in Africa you either get a light sprinkle or an incredible downpour – thank goodness this was somewhere in between! Even though we were soaked through and our feet were caked with mud everyone believed the rain meant the project was blessed.

After the rain and some remarks from our Master of Ceremonies we were entertained with drama, musical and acrobatic performances by the ngoma drama troupe. They created drama and songs based on MIHV’s health programs, including a song about our mass media health campaign Afya Moja-Mbili-Tatu (Health 1-2-3). The drama was about a pregnant woman who needed to go to the hospital, but her husband didn’t believe in going to the clinics. Their friends tell them about the importance of seeking care and tips on childhood diseases such as malaria, diarrheal disease and pneumonia. After she collapses on the ground while going into labor, our friend Daniel jumped up from the audience, ran to the scene, and explained he is a MAISHA driver and can take her to the hospital. MAISHA is one of MIHV’s innovative programs to engage taxi drivers in the health of their communities. Taxi drivers will be trained on the three childhood diseases, antenatal care, and maternal and newborn care. Since emergency transportation is scarce, we hope that training taxi drivers in a training-of-trainers model will increase the involvement of men in family and community health. After the drama troupe a group of children from the orphanage sang a couple songs. Contrary to popular belief of orphans in Africa, most of these children have not been orphaned by AIDS. Rather, most of them have been abandoned by their parents who come to Karatu looking for work. Karatu is the major city in the district and includes the only paved road which goes to the national parks. Prostitution is prominent with such a transient population and a plethora of guesthouses.

Baraka ya Pili: Afya (Second Blessing: Health)

Sometimes life here feels like you are living from one crisis to another. From the optimist point-of-view we live from one blessing to another. Our friend Margaret’s nine year old daughter fell while climbing in a tree this past Monday. We took her to the hospital in town, which is the only one in the district. What does someone do when they are hours or days away from Karatu? The x-ray department was closed for the night so the staff admitted her and gave her some pain medication. The next morning the young girl had her arm x-rayed, received a referral to the regional hospital 3 hours away and was discharged without a sling, pain medication, or transportation assistance. We arranged for the local ambulance to take her to the regional hospital and they said they would be right there. Hours later we found out the ambulance never left because no one fueled it up. So, a couple of our staff drove her down to Arusha for care. Good news is that after 36 hours of pain and swelling she received another x-ray and proper treatment. She was hospitalized for 3-4 days and will be alright… a blessing.

Baraka ya Tatu: Mradi Hii (Third Blessing: This Project)

I heard really interesting stories last week during our Traditional Birth Attendant (TBA) training. Some women pull their baby’s baby teeth out to cure diarrhea and fever because they believe that the teeth are false / plastic / poisonous. Another woman from a neighboring town cut her baby’s uvula (the hanging ball thing in the back of your throat) because she thought the mass was making her baby cough. Unfortunately the baby died almost instantly from excessive bleeding. Next, women are starting to compare their sexual experiences and those who have undergone female genital mutilation (FGM) wonder why they don’t feel sexual pleasure like other women. This has led many women who have undergone FGM to move from one man to another in search of sexual pleasure. Other women believe their lack of sexual pleasure must be because their husband is old, so they seek out young men. Although FGM is illegal in Tanzania, people avoid the 30 year prison sentence by practicing FGM on baby girls, which is harder to regulate. FGM is also sometimes believed to be a solution when a baby is itching – but in reality it’s hygienic! These are only a few of the cultural beliefs we have encountered so far. This project will build upon beneficial traditional practices and try to address practices that are harmful to health. By training TBAs, this project hopes to provide the knowledge necessary to make healthy decisions and collaborate with an important group of leaders for mothers and children. Change takes time, but we are looking forward and know that change is possible.

It’s easy to get caught up in the struggles and complexity of life here, as we do with life everywhere. Yes, sometimes we just want to throw our hands up and exclaim our frustration, anger, impatience and exhaustion. That is when we need to count the blessings, even the smallest ones. There is a famous quote on a plaque at the rim of the Ngorongoro Crater that says “It is better to light a candle than to curse the darkness.” Very true - here and everywhere.