We are half way through our stay and time is flying by. There are several projects to be finished and in some ways it feels we should be here several more months, but we hope to be back next year to continue our work.
This past week was spent in the field in an area called Mang’ola. The landscape is very different there. The elevation is lower, perhaps 4,000 feet instead of the 5,000 feet we are used to here in Karatu. In Mang’ola the temperature is warmer and the rainfall less. There is a large spring nearby. The water is pumped up to reservoirs, and then allowed to be diverted to different areas as irrigation water. This gives the contrast of scrub plants surviving in dry areas, next to lush irrigated fields of corn and red onions. The latter are shipped all over Tanzania, Kenya, Uganda and other countries.
Mang’ola is smaller than Karatu town, and challenging to reach because of the road leading to it. There is no electrical service, although a few of the businesses use small solar panels to power a few fluorescent lights. Most use kerosene lamps. The nights were spectacular because the streets are so dark so the visible stars are so numerous and bright. The guest house we stayed in had all the wiring, switches and outlets necessary, even a TV satellite dish. However, it is all useless because the power grid doesn’t include the town.
As with so many experiences, being on location has much more impact than reading about what life is like there. We continue to be in awe of what MIHV has accomplished in just two years. As we drive through remote areas, people eagerly greet us because the staff has made such a strong investment in building relationships and training. Add the factor that we two white people are in the car along with staff, and we sometimes felt like we were celebrities in a 4th of July parade in America, with kids running out to wave and yell friendly greetings.
The challenges to improving the health of mothers and children under five are daunting. For example, in one village about 23 kilometers/14 miles from Mang’ola, an hour’s drive, we found a young mother who had been bitten by a poisonous snake the day before. She went to a traditional healer to get medicine, who didn’t have the right one. The woman was told not to go to the hospital in Mang’ola because they would simply cut off her leg. When we arrived she wasn’t doing well. The staff convinced her that the hospital wouldn’t cut off her leg. While two staff people were meeting with other village members, our driver took the woman to the hospital, got the right medications and brought her back, leg intact.
We were told about another incident when complications developed for a woman in labor. The plan was for her to deliver in the village with a traditional birth attendant, but it became apparent she needed to be taken to a hospital. There was no vehicle available, so she was carried on the backs of village members six hours throughout the night. The result happily was a successful, healthy birth.
MIHV seems very skilled in dealing with the wide range of education found in the villages. In one training session, the participants ranged from an individual with no formal education to one who spoke eight languages, including very good English.
The focus of this trip was training specific village members on why and how to collect data on pregnancies, illnesses, births and deaths. Data can be a powerful tool, helping to identify the causes of health problems that can lead to a course of action. The government is keenly interested, but doesn’t have all the necessary resources, so MIHV in cooperation with the district authorities is helping. In one case the data they collected was turned over to the Karatu District Medical Office. They described the problem and presented the supporting data to a local business who pledged to fund a program to help solve it.
The people we met fascinated us. The afore-mentioned man who spoke eight languages was an engaging conversationalist. Tanzania has at least 130 different tribes, and such individuals as this gentleman have learned to converse in a surprising number of the traditional languages. As we said in a previous blog entry, given our poor performance in Swahili and previous language efforts, it is humbling. We’ll have more to say about education here in a future blog update.
We also met a 75 year old shaman/traditional healer, dressed in her tribe’s traditional clothing. Although she spoke no English, she was eager to learn a few phrases.
The week also helped reinforce the need to be patient and take things as they come. In the town and the various villages we visited there is no electricity. The roads are difficult, and in some areas will be impassable during the rainy season. Fortunately, mobile phones have revolutionized communications because there are almost no land lines.
Even with the mobile phones, scheduling these sessions is extremely difficult. Because of the roads it is a little difficult to know when we will arrive. Participants have the demands of family, farms and other responsibilities. So, something that is planned to start at 9:00AM may not begin until 11:30. Emergencies such as the snake-bite incident can pull us away from what has been planned.
In our last blog entry we mentioned a Valentine’s luncheon put together by MIHV for leading women in Karatu. The goal was to listen to their views on what should be done to help women and children in the district build income-generating activities. It was a wonderful success, with most pledging money, training and other support and deciding to meet monthly to make solving the problems an ongoing effort. It is impressive to see how government, organizations like MIHV and community members are working together.
This next week we will be in the office. We have developed some training materials for Excel and will be using them in sessions with the staff, along with members of another non-governmental organization. We will also continue working on a marketing training program for staff so they can train the village women.
We hope all is well with all of you.
Monday, February 16, 2009
Sunday, February 8, 2009
Our Third Week (such imaginative titles)
Today (Sunday) we went to Ngorongoro Crater, called by "A Thousand Places to See Before you Die" the Garden of Eden of Africa. It is the largest intact volcanic caldera not filled with water in the world (don't you love all the qualifiers?), over 12 miles in diameter. The lakes, grasslands, swamps and forests make it an ideal environment for a wide variety of animals. The steep sides help discourage migration for many but not all. The edge also provides wonderful vistas in all directions.
We took four staff members with us along with the three-year old son of one, who was a little afraid of us, perhaps wondering what was wrong with two people who had lost all their color.
We saw wildebeest, zebras and water buffalo by the thousands. A lake had tens of thousands of flamingos. Also for our viewing pleasure was a rare black rhino, hippos, elephants, serval (a small cat), waterhogs, eland (a large deer-lake animal), various gazelles, hyenas, jackal, monkeys, baboons, ostrich, various storks, egrets and cranes. We also saw a number of lions. At one location was a wounded water buffalo, hunkered down in a hollow with several lions waiting. The next time past the buffalo was dead and the lions were feasting. It was an incredible day.
Saturday we went to a large open market on the edge of town. This happens on the 7th of each month, and is aimed at Tanzanians. There is an animal auction, varieties of foods to buy, handicrafts, watches, and nearly anything imaginable. Clothes? Chances are items you donate to ARC or the Epilepsy Foundation get bundled up and sent overseas, ending in markets such is this. It was being unbaled on the spot. Every kind of used clothing seems to be here, from Columbia jackets to underwear. There is also a profusion of the colorful fabrics women and sometimes men wear.
As for our work, this last week we spent our time in the office getting prepared for future activities. Jolene, the-ever creative country director, is inviting the leading women in the Karatu community to a nice lunch on Valentine’s Day and we are assisting with that. She is always looking for ways to generate ideas from the community and collaborate in the process of improving health. Everything MIHV does here needs to be sustainable, continuing past the time the project ends.
We are continuing with activities aimed at developing income generation for the Survive and Thrive Groups. This includes creating a marketing training program for staff so they can train the village women. There has also been a lot of brainstorming on what items can be made that will appeal to tourists.
This week we will be in the field again with staff, who will be recording data and doing training. One of the stops will be in an Hadzabe village. They are a hunting-gathering tribe whose lifestyle is being impacted by modernity.
Time is flying by and we continue to be fascinated by the people and places.
We took four staff members with us along with the three-year old son of one, who was a little afraid of us, perhaps wondering what was wrong with two people who had lost all their color.
We saw wildebeest, zebras and water buffalo by the thousands. A lake had tens of thousands of flamingos. Also for our viewing pleasure was a rare black rhino, hippos, elephants, serval (a small cat), waterhogs, eland (a large deer-lake animal), various gazelles, hyenas, jackal, monkeys, baboons, ostrich, various storks, egrets and cranes. We also saw a number of lions. At one location was a wounded water buffalo, hunkered down in a hollow with several lions waiting. The next time past the buffalo was dead and the lions were feasting. It was an incredible day.
Saturday we went to a large open market on the edge of town. This happens on the 7th of each month, and is aimed at Tanzanians. There is an animal auction, varieties of foods to buy, handicrafts, watches, and nearly anything imaginable. Clothes? Chances are items you donate to ARC or the Epilepsy Foundation get bundled up and sent overseas, ending in markets such is this. It was being unbaled on the spot. Every kind of used clothing seems to be here, from Columbia jackets to underwear. There is also a profusion of the colorful fabrics women and sometimes men wear.
As for our work, this last week we spent our time in the office getting prepared for future activities. Jolene, the-ever creative country director, is inviting the leading women in the Karatu community to a nice lunch on Valentine’s Day and we are assisting with that. She is always looking for ways to generate ideas from the community and collaborate in the process of improving health. Everything MIHV does here needs to be sustainable, continuing past the time the project ends.
We are continuing with activities aimed at developing income generation for the Survive and Thrive Groups. This includes creating a marketing training program for staff so they can train the village women. There has also been a lot of brainstorming on what items can be made that will appeal to tourists.
This week we will be in the field again with staff, who will be recording data and doing training. One of the stops will be in an Hadzabe village. They are a hunting-gathering tribe whose lifestyle is being impacted by modernity.
Time is flying by and we continue to be fascinated by the people and places.
Monday, February 2, 2009
Our Second Week
Our second week has been a wonderful mixture of nature and culture. We started with a day safari to Manyara National Park, about ½ hour from our place. We saw baboons, different kinds of monkeys, gazelles, giraffes, hippos, water buffalo, wildebeest, zebra, elephants, and lots of birds, including storks, egrets, hornbills, flamingos and many more. It was a great day.
On the culture side, an integral part is languages. Swahili is the lingua franca, with most people having a local/tribal one as their first language. It seems nearly everyone speaks two languages, quite a few three (including our coworkers who speak English), and some four or more. Given how little progress we have made in our poor attempts at other languages (Japanese, Spanish and Swahili), we are truly humbled.
The other issue with language is how it limits our understanding of our surroundings. Our coworkers are wonderful, but there is only so much they can convey in trying to translate what we are experiencing. As we wander through the open markets and the town of Karatu alone, fumbling with our limited Swahili, our experiences are obviously filtered through our lack of language, Midwestern perspectives, the relatively small part of Tanzania we are seeing, and the short time we are here. So, we offer the following and future information with the knowledge that the slice of life we are experiencing is very limited, and we will make corrections later if new information changes that perspective.
With that, here goes. This last week has mostly been spent in two villages. In both cases staff was building Survive and Thrive Groups (see 9th paragraph from our previous entry). This involves two days of training with traditional birth attendants (TBAs) and a third day with the TBAs and young mothers. (We will try to limit acronyms to only two – MIHV for Minnesota International Health Volunteers, our host organization, and TBAs as above).
The TBAs are truly remarkable women. To put this into perspective, we had to drive between 45 and 60 minutes to get to each village, which is only 20-23 miles away. The roads are unpaved, often rutted, rocky, very rough, and should only be driven with a decent size four-wheel drive vehicle. Ours is a Toyota Land Cruiser. When the rainy season comes, some villages become isolated as the roads become impassible.
The village homes are widely spread out among fields, with sub-villages. In the second village we visited there was no electricity and we didn’t see a car or truck. Cell phones work everywhere, but to get anyplace, people generally either walk or use a bike, the latter being beat up versions of the old bikes we grew up on. Even with a mountain bike, the roads would be extremely challenging.
Although the Tanzanian government and MIHV are working hard to encourage women to get to clinics for deliveries, for many of them this is impossible. The reasons include the roads, long and sometimes difficult distances to clinics, needing to plan ahead for the delivery and hoping the due date is accurate, along with the impossibility of leaving family behind.
The TBAs are not paid for their work, expect if the delivering mother and family can afford to offer a chicken or other goods. Sometimes the TBA is buying supplies from her own funds. Some have even been known to take in a young mother and child if the woman is unmarried and the family is not able to care for her. As you might imagine, TBAs often have to go long distances, sometimes in the dark of night where wild animals could present a danger. Add to this that they teach women of all ages before and after delivery on health and safety issues, and their roles are challenging.
Traditionally, TBAs’ knowledge was passed on from one woman to another within the village. It is obvious they are eager for the training they receive, and happy they can bring more tools to their work. Some have limited literacy or less than adequate Swahili, yet they show incredible motivation to learn.
The TBAs we saw have already received training from MIHV on antenatal, delivery, neonatal and maternal care. What we witnessed was additional education and help in starting their Survive and Thrive Groups. The latter will help unmarried mothers learn more about care for themselves and their children. The mortality rates for both are high, with a large percentage of them preventable. For children under five, 51% of deaths are from acute respiratory infections/pneumonia, 31% from malaria, and 3.6% from diarrheal disease. The education provided by the government, MIHV and other non-governmental organizations can eventually reduce the numbers dramatically.
As mentioned last time, MIHV wants to introduce a system for income generation in these groups. By doing so, the young mothers will be able to help support their families, hopefully help TBAs cover their costs, employ good health practices and encourage the mothers to stay in their villages rather than seek their fortune in Karatu town. The income generation aspect of the Survive and Thrive Groups is the focus of our time here.
Karatu is the gateway for Ngorongoro Crater, the Serengeti and other famous parks nearby, with an estimated 500,000 tourists each year. The town has only about 15-20,000 people, and most of the handicrafts sold in the tourist shops come from Kenya. The women of Karatu District produce traditional crafts, including baskets and bead work that can be sold to visiting tourists. The goal of MIHV is to develop skills in the groups to perfect the crafts, help the women start agricultural projects or small animal husbandry, provide the knowledge to manage these small businesses, and have the enterprises self-sustaining. Our hope is to contribute to that effort.
On the nature side, next weekend we go to Ngorongoro Crater, which is said to have the largest concentration of mammals in all of Africa.
We are having a wonderful time.
Now, for all of you in the northern climates of the US, a weather report. The temperatures here have so far been nearly perfect, with low humidity. Days can be like that perfect summer weather in Minnesota. In the evenings we sometimes have to put on a light fleece. Sleeping temperatures are just right.
The down side is precipitation. Karatu didn’t get the rains expected in November and December, so it was dusty. The soil here is a burnt orange color, and when the winds blow, the dust rises and delivers a fine coating on everything.
A few days ago the rains started, usually in the latter part of the day and sometimes at night. Then the soil turns to a slick mud because of all the clay. Riding in the Land Cruiser feels like being on a winter road in Minnesota, slithering along. And of course the mud is quick to grasp our shoes and not let go.
However, 90% of the people here live off agriculture and need the rain, so the combination of sunlight during much of the day and needed rain later is just what they need. And, we do love the temperatures.
On the culture side, an integral part is languages. Swahili is the lingua franca, with most people having a local/tribal one as their first language. It seems nearly everyone speaks two languages, quite a few three (including our coworkers who speak English), and some four or more. Given how little progress we have made in our poor attempts at other languages (Japanese, Spanish and Swahili), we are truly humbled.
The other issue with language is how it limits our understanding of our surroundings. Our coworkers are wonderful, but there is only so much they can convey in trying to translate what we are experiencing. As we wander through the open markets and the town of Karatu alone, fumbling with our limited Swahili, our experiences are obviously filtered through our lack of language, Midwestern perspectives, the relatively small part of Tanzania we are seeing, and the short time we are here. So, we offer the following and future information with the knowledge that the slice of life we are experiencing is very limited, and we will make corrections later if new information changes that perspective.
With that, here goes. This last week has mostly been spent in two villages. In both cases staff was building Survive and Thrive Groups (see 9th paragraph from our previous entry). This involves two days of training with traditional birth attendants (TBAs) and a third day with the TBAs and young mothers. (We will try to limit acronyms to only two – MIHV for Minnesota International Health Volunteers, our host organization, and TBAs as above).
The TBAs are truly remarkable women. To put this into perspective, we had to drive between 45 and 60 minutes to get to each village, which is only 20-23 miles away. The roads are unpaved, often rutted, rocky, very rough, and should only be driven with a decent size four-wheel drive vehicle. Ours is a Toyota Land Cruiser. When the rainy season comes, some villages become isolated as the roads become impassible.
The village homes are widely spread out among fields, with sub-villages. In the second village we visited there was no electricity and we didn’t see a car or truck. Cell phones work everywhere, but to get anyplace, people generally either walk or use a bike, the latter being beat up versions of the old bikes we grew up on. Even with a mountain bike, the roads would be extremely challenging.
Although the Tanzanian government and MIHV are working hard to encourage women to get to clinics for deliveries, for many of them this is impossible. The reasons include the roads, long and sometimes difficult distances to clinics, needing to plan ahead for the delivery and hoping the due date is accurate, along with the impossibility of leaving family behind.
The TBAs are not paid for their work, expect if the delivering mother and family can afford to offer a chicken or other goods. Sometimes the TBA is buying supplies from her own funds. Some have even been known to take in a young mother and child if the woman is unmarried and the family is not able to care for her. As you might imagine, TBAs often have to go long distances, sometimes in the dark of night where wild animals could present a danger. Add to this that they teach women of all ages before and after delivery on health and safety issues, and their roles are challenging.
Traditionally, TBAs’ knowledge was passed on from one woman to another within the village. It is obvious they are eager for the training they receive, and happy they can bring more tools to their work. Some have limited literacy or less than adequate Swahili, yet they show incredible motivation to learn.
The TBAs we saw have already received training from MIHV on antenatal, delivery, neonatal and maternal care. What we witnessed was additional education and help in starting their Survive and Thrive Groups. The latter will help unmarried mothers learn more about care for themselves and their children. The mortality rates for both are high, with a large percentage of them preventable. For children under five, 51% of deaths are from acute respiratory infections/pneumonia, 31% from malaria, and 3.6% from diarrheal disease. The education provided by the government, MIHV and other non-governmental organizations can eventually reduce the numbers dramatically.
As mentioned last time, MIHV wants to introduce a system for income generation in these groups. By doing so, the young mothers will be able to help support their families, hopefully help TBAs cover their costs, employ good health practices and encourage the mothers to stay in their villages rather than seek their fortune in Karatu town. The income generation aspect of the Survive and Thrive Groups is the focus of our time here.
Karatu is the gateway for Ngorongoro Crater, the Serengeti and other famous parks nearby, with an estimated 500,000 tourists each year. The town has only about 15-20,000 people, and most of the handicrafts sold in the tourist shops come from Kenya. The women of Karatu District produce traditional crafts, including baskets and bead work that can be sold to visiting tourists. The goal of MIHV is to develop skills in the groups to perfect the crafts, help the women start agricultural projects or small animal husbandry, provide the knowledge to manage these small businesses, and have the enterprises self-sustaining. Our hope is to contribute to that effort.
On the nature side, next weekend we go to Ngorongoro Crater, which is said to have the largest concentration of mammals in all of Africa.
We are having a wonderful time.
Now, for all of you in the northern climates of the US, a weather report. The temperatures here have so far been nearly perfect, with low humidity. Days can be like that perfect summer weather in Minnesota. In the evenings we sometimes have to put on a light fleece. Sleeping temperatures are just right.
The down side is precipitation. Karatu didn’t get the rains expected in November and December, so it was dusty. The soil here is a burnt orange color, and when the winds blow, the dust rises and delivers a fine coating on everything.
A few days ago the rains started, usually in the latter part of the day and sometimes at night. Then the soil turns to a slick mud because of all the clay. Riding in the Land Cruiser feels like being on a winter road in Minnesota, slithering along. And of course the mud is quick to grasp our shoes and not let go.
However, 90% of the people here live off agriculture and need the rain, so the combination of sunlight during much of the day and needed rain later is just what they need. And, we do love the temperatures.
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