Unwind

A joint effort for our last post! Here is Priyanka, with a word from Stone Town.

Stone Town, the largest city in Zanzibar, is a place of sensory overload. Each winding alley brings you face to face with bustling bazaars, mosques, and beautiful carved wooden doors. The labyrinth of streets makes it almost impossible to find the same place twice, but that is half the fun. Not only is Stone Town appealing to the eye but the abundance of fresh tropical fruits and locally grown spices are a treat to your taste buds. When we tired of wandering the streets of Stone Town we indulged in fresh coffee spiced with locally grown cinnamon, cloves, and cardamom, passion fruit juice, homemade chapattis, and some of the most delicious freshly caught fish. While we enjoyed wandering and exploring my favorite part of Stone Town was our final Saturday morning. Up early we dressed conservatively and went to Ben Bella Secondary School for the Students for Students International Health Seminar.

Students for Students International is a non-profit organization whose mission is to create educational opportunities for high-achieving students in the developing world, with the belief that education is essential to community leadership and a country’s development. Based at the University of North Carolina-Chapel Hill, Amit and I began working with S4Si during our first year of college in 2004. There were countless hours spent in meetings, recruiting volunteers, planning educational events, and so much fundraising. During undergraduate I was inspired by the idea of helping to fund the education of female students. But across an ocean and continent, I had no idea what the reality of the S4Si scholarship was, until a few weeks ago.

You can imagine how excited I was to meet the infamous S4Si scholars who I had worked with for 4 years but never actually seen. We began the morning discussing nutrition but quickly launched into female reproductive anatomy. Despite the lack of a projector, the makeshift chalkboard drawings did the trick and we continued the morning with a discussion of pregnancy and sexually transmitted infections. With a few snack breaks, before I knew it the morning had flown by and it was time for the girls to go home. The health seminar was a success! I was amazed by the intelligence of all the scholars and their prowess of the English language. It is hard to describe in words how wonderful it was to see with my own eyes that the work we had done for many years was really and truly making a difference in the lives of these remarkable young women. To learn more about S4Si you can check out the website: http://s4siunc.org/

Alright, time to let Priyanka take a break. Amit’s your guide on a vacation in Matemwe.
After two months of toil and trouble in Tanzania, three days of nothing but laziness was not something I was going to feel guilty for. A ride on a one hour dala dala, the local transport van, was a guaranteed cultural experience in itself. Open air and bumping all the way to Matemwe, our rear ends were happier than ever to switch from the barely cushioned benches to the soft beach sand typical of the eastern coast of Zanzibar. Here, the finest whitest sand one may ever see forms an endless strip separating the brilliant blue waters from the overhanging palms of the coastline. The mornings are restful, the afternoons are relaxing, and the evenings are breezy. Matemwe is both an idyllic getaway for travelers and a fascinating home for locals. After treating ourselves to fresh squeezed juice, Spanish omelets and toast we would walk the ten yards to the beach, our home until the stomachs indicated it was time for lunch. The morning view was always dotted by women wrapped in multi-colored kangas making their seaweed collection rounds. With the tide low, the women were able to wade knee-deep to their collection site. Hours could easily tick by just watching the work progress. Women would come with empty hands and leave hours later with dressing gowns of seaweed trailing behind them. On afternoon walks we would notice the same seaweed hanging from makeshift clotheslines connecting the palms. Curiosity was certainly peaked by this practice, but in honor of “pure physical and mental relaxation”, I never did figure out what the purpose of harvesting all that seaweed was. Regardless, the fascination remained and I watched from morning to afternoon.

Once the tide came in we were free to wash away the morning heat before returning to the bungalows for some casual reading. And each evening ended with an incredible meal of the catch of the day, grilled and curried with stir-fried vegetables and rice. If ever in Tanzania, I am happy to provide a personal guarantee that you will not be disappointed with Sele’s Bungalows in Matemwe!

And now I'm back in the states just four days away from the start of year 2. Thank you all for reading and writing! Hope you had a great summer and enjoyed the blog!

Outside the Lines

Seven weeks have already passed since I first stepped off my Precision Air flight into Mwanza on June 2nd. It's hard to believe that I have been working here at IHP's clinic for that long, but now that I stop to think I notice the small things that indicate I am no longer a new presence, but a part of the usual circle. Zefaniah, our favorite guard, greets me as cheerily as always, but so kindly lies through his teeth, “Ohh Amiti, very good, you are speaking Swahili now, it is very good!” Bibi, our clinic grandma, doesn't hesitate to ask me to start an IV, granted I still defer to Jimmy. Lucy, chef extraordinaire, knows chapattis and french fries at dinner are guaranteed to make my day.

Work here has been very rewarding, as I have learned a great deal about tropical diseases and medicine, become more comfortable with blood draws than I could have ever imagined, and had the opportunity to share time with people that laugh their way through any setback. One aspect of work that truly stands out, are the general health education presentations we have done in the local schools. The initial idea was to determine where there might be a void in health education and how we could fill it. Upon asking educators and students if there was anything they needed us to present on, one answer always found its way to the top of the list: STD's and sex education.

Last Wednesday, this seemingly benign concept led me to find myself with my friends and fellow medical students from IHP (Courtney – girl, Priyanka – girl, Natalie – girl, Sarah – girl), at the front gate of the Loreto Secondary School for Girls, ready to do a presentation on women's health, to include: reproductive anatomy, the menstrual cycle, UTIs, yeast infections, and more. In a relatively conservative setting, this situation made me wonder what in the world I was doing there. Pepsi in a Coke culture, I was trouble.

Beyond the gates, past the guard tower, and under the archway, the grounds opened out into a beautiful landscaped courtyard flanked on all sides by concrete education blocks. My mind didn't want to give in that I was actually nervous about this, but my involuntary physical changes yanked the cloak: erector pili muscles pulled my arm hair to attention, temperature notched up a couple, and palms became clammy. I dipped my head into the room filled with almost a hundred Form 3 girls in uniform. As we walked in and it became apparent to the Loreto girls that I was the only male presenter, the giggles and whispering began. I busied myself setting up the computer and projector, counted to ten, and looked up. This was going to be special.

Fortunately, Priyanka began the presentation and introduced reproductive anatomy and the menstrual cycle before time came for me to talk more in depth about ovulation, fertilization and dysmenorrhea. I started off strong. Ovulation and fertilization no problem. On to dysmenorrhea. “One risk factor of dysmenorrhea is having a positive family history.” Blank stares. I continued, “this means if you have a parent or a sibling who has experienced dysmenorrhea then you are more likely to have it.” Blank stares. My clammy palms had lost sensation, the room was shrinking, and sweat was forming on my receding hairline. “You know siblings, as in sisters or brothers...or, haha, obviously not brothers.” All I could do was laugh, run my hand through my hair, and look to Sarah and say, “I think it's your turn.”

Making a mistake always makes it easier. Having butchered dysmenorrhea, everything else seemed better and the rest of the presentation went smoothly. We fielded numerous questions that shall not be repeated and were asked to come back the next day for more. After two days, I am confident the girls had a much better understanding of STD's, how their body functions, and how they can, both protect themselves and receive the care they need. Having survived Loreto, the presentations in Zanzibar should be a breeze!

On a side note, Priyanka and I decided to write two completely different blogs about different aspects of our work here because we realize we cheated some of you out of different entries with our last joint post about the safari. So, to read a fabulous description of life in the clinic from both the student and patient perspective, hop on over to http://priyankarao.blogspot.com/

Tanzania tidbits:

1. I find it sad to report that, while the harmless act of yawning is contagious in the states, the not so pleasant act of in front of your face nose-picking is contagious here. While at the tailor the other day, we noticed one lady start, and then two more follow in suit. This is an observation that can be corroborated by several volunteers here.
2. An “i” is added to the end of almost every name. Amit = Amiti. The name, Martin, given to me by our driver, Mboto, actually equals Martini.
3. The collection of pumpkin foods we have consumed thanks to Paula's love for pumpkins is now: pumpkin pie, pumpkin bread, pumpkin bread pudding, pumpkin soup, boiled pumpkin with butter, and pumpkin cookies.

Safari!!!

One week has already passed since we left on our safari, but all the details are still fresh.

Friday, 8:30 AM anxiously awaiting the arrival of our already half an hour late vehicle we begin to wonder if we have crossed the threshold of African Standard Time. Urged to call our agent, Amit reluctantly agrees to drop 300 of his remaining 600 shillings in order to find out the ETA of our driver, Vincent, and cook, Bosco. Minutes later the souped up excursion sized, Landcruiser arrives: massive tires, three rows of paired captain seats, a built in fully powered mini-fridge, electrical outlets that don’t work, and best of all, the type of sunroof that would make a convertible jealous. Stocked with M&Ms, our saving grace, we’re off!

Crossing the gates into the western Serengeti, the landscape quickly changes from rows of Coca-Cola and Sprite faced buildings to endless straw shaded fields. We are all excited by our first sightings of zebras, wildebeests, and gazelles, but soon grow anxious to see the rarer animals. Priyanka’s wish list: 1. baby elephant, 2. male lion, 3. lots of giraffes. The landscapes are incredible. Herds of wildebeests are everywhere as the timing of our safari happens to coincide with their annual migration through the western Serengeti. Interestingly, just like humans trying to escape the heat, they often cluster in groups in the shade of some of the bigger trees that happen to spring from the occasional spot in the otherwise flat plains. Midday, they group directly under the trees, but as the sun looks sideways in the late afternoon, the groups slowly seep out from under the branches in pursuit of the slowly elongating shadows.

Only three hours past the western gate we happen across a water source, and with it a gathering of animals. In dry season, the dwindling number of rivers and streams funnel the herds in. Perfect bait for hungry lions. Just seeing the lions is a gift, but Vincent believes they may be preparing for an attack, so the engine is turned off and we become part of the scene. Female and cub arise from their slumber, ears point, shoulders tense, head lowers. Such a contrast, from our six bobble-heads, looking every which way trying to grasp what she senses. We click away knowing something is amiss, and then she shoots out from under the tree, through the brush and around towards the back of the car. Within seconds her jaws are clenched around the neck of a wildebeest and she is joined by the regal male, all of us had failed to even notice. The site is astounding. Just ten yards away from our vehicle. Male, female, and cub, with dead wildebeest are all that are left of the scattered herds.

We were more than spoiled on our first day, but nonetheless continued to be awed by the beauty of the landscapes. The grandeur of fifty plus elephants controlling their stomping ground and families of giraffes careening their necks to enjoy their balcony view over all the action were only a couple of the memorable sites. And interspersed throughout the weekend, lion spottings never failed to spike the adrenaline. On our last night we even enjoyed a special visit from the neighborhood elephant. Tired from a long day we had gathered at our campsite expecting only a mix of tents, tired safari goers, and a peaceful evening. Instead we found a crowd gathering near the fenced in cooked stations. Word was that one of the older wiser elephants had figured out how humans keep their water year round. Having departed from the toil of finding water in ever changing streams, he had made it a habit to just take a stroll in our campsite over Ngorongoro for a daily sip from the communal reservoir, haha!

By Priyanka and Amit

Mambo!

Wrinkled, swimming pool fingers typing away on a Sunday afternoon. Washing dishes is one of the many new skills we learn living the day to day here in Mwanza. Preparation: tub 1 with hot water, dish detergent and chlorine crystals, tub 2 with hot water and chlorine crystals, and tub 3 with more of the same. In the “man’s kitchen” Dan filters the flow of dirty dishes into tub one and assures that they get a good scrubbing. From there he goes for the no look pass I have come to expect. The soap suds are pulled in by tub 2 and the now virtually clean plate is dropped into tub 3 for the final step. Round three of chlorination takes care of the typhoid, salmonella, and whatever else may have otherwise been looking to hang on for the ride.

Father’s day in Mwanza led Paula, the director here at Nyakato, to cook a feast not to be forgotten: eggplant parmesan, spaghetti, fresh baked bread, balsamic droplets in a puddle of olive oil, ice cream, and lemon cookies. The Tanzania everyone expected, right? Two days ago I even had pumpkin pie for breakfast, lunch, and dinner. Here at Nyakato we are beyond lucky to be surrounded by amazing food, great weather, and wonderful people.

It’s Wednesday now. Internet went out last Sunday so the blog was put on hold, but now I am free to begin typing once again. Still wrinkled fingers, no worries. Just finished a stack of dishes again. Today is my miscellaneous day, a nice break in a strangely hectic drawl that equals life here. Each day comes to a close before one is ready for it. Stopping to think, though, I realize how much all the little quirks of living in Africa add up. Hanging clothes on the line to dry, soaking fruits and greens in chlorine water, waiting the flip of an hourglass for a webpage to load, charging electronics when the power is working, knocking shoes before slipping the feet in, doing dishes in three tubs, and warding off mosquitos, all while broiling away your energy under the inescapable steady stroll of the sun above… Every bit is worth it. It’s worth slowing yourself down and stepping away from the independent individualism of life at home.

There are currently ten medical students here (five from UNC, four from Mayo, and one from Iowa). The bulk of us live in the “bungalow” a nice two bedroom bunk-bed filled house with a kitchen, living room and a couple of bathrooms. We are constantly bumping into each other, but it works. In the clinic we rotate through a schedule that involves three lab positions (doing blood draws, measuring blood sugars, hemoglobins, and whatnot, conducting tests for malaria, typhoid, HIV, etc.), a couple rotations with doctors where we practice our physical exam skills and gain mostly tropical medicine knowledge, and finally triage and pharmacy. Aside from the clinic we occasionally outreach to local schools to give health presentations mainly focused on sexual health and STD’s because those are the topics most frequently requested.

Outside of the daily wanderings, one of the most memorable sights from our first couple of weeks was a trip to Dr. Msengi’s dancing rocks. I wish you all could meet Dr. Msengi, one of the physicians we work with and the man who led us on our adventure. In three words he’s expressive, high-pitched, and old-fashioned. A one hour spine reorienting ride led us to what looked like a mountain of misshapen boulders rising behind a typical African village. Unfolding below the other side, however, was an amazing view of lush countryside, stone schoolhouses, and Lake Victoria. A whole afternoon could easily be spent on those rocks, a speck on the horizon.

Whenever we can catch a free afternoon and are able to overcome the desire for shut eye, we venture on one of the multitude of splitting dirt paths leading us to either the village or the basketball courts. A trip to the village equals walking to the beat of a chorus of Swahili greetings from curious onlookers. Shouts of “Mzungu! Mzungu!” (Foreigner! Foreigner!) remind me of my morning walks in Ghana, where I for the first and potentially only time in my life was called a white person (Abruni! Abruni!) haha. A response in Swahili sometimes leads to the full test. If you can make it through all the greetings (Habari – Nzuri!, Mambo vipii – Poa!, Kazi – Kazi Nzuri) you are sure to get some very satisfied smiles and maybe even fall headfirst into a full out conversation you have no chance of keeping up with. Turning the corner into the village we come across the tailors who whip together African print scrubs in the matter of days, the cell phone shop for phone cards, and then our usual destination, a place we like to call pool bar. Basically, our one spot for a cold Coke and chance to watch some World Cup!

A stop by the basketball courts is usually motivated by our secret weapon and varsity athlete Jade. If she is successful at pulling at least three of us out of slumber we can usually represent. Although, I find it virtually impossible to hit anything on the humbling double rims, basketball is always fun and there is usually a good group of people welcoming us to play. The best memory was of thirteen year old Jeffrey from our first outing. After following through layup and shooting drills, we split into two teams with a couple subs. Sitting out at the beginning, I noticed little Jeffrey changing out of his shoes and pulling his polo over his head. Drills and no basketball? Jeffrey said he wasn’t aloud to play yet. The older guys owned the court and Jeffrey was still the little sibling. Not upset at all though, he smiled and watched. He said he would always come out for the drills, even if he couldn’t play in the games, because “Practice makes perfect.”

P.S. Since Priyanka and I are both here for the summer we thought we would include you on both of our writings. Read more about Nyakato and life in Tanzania here: http://priyankarao.blogspot.com

Off to Tanzania!

Hey Friends. I just got to Tanzania a couple days ago and will be here for the summer! That means that the blog is getting an epi shot to the thigh and will hopefully find its way back into business soon. Internet access is very limited, but I will do my best to post as regularly as possible. For the first six weeks I will be in Mwanza, Tanzania, working at a clinic with International Health Partners Tanzania and conducting health education presentations in local schools. Then I will fly across to the island of Zanzibar for two weeks of health education work with the scholars of Students 4 Students International! S4Si is a completely student run non-profit based out of UNC that provides scholarships for girls to attend secondary school in Tanzania. I was lucky to work with S4Si for four years as an undergrad and can't wait to finally meet the scholars!

Breakfast time and off to work!