World AIDS Day 2012

A little behind schedule but check out this link to a video I put together from our World AIDS Day/Teen Club event held December 1st 2012

http://www.youtube.com/watch?v=C6nK4xlUJ54

(for some reason blogger/tanzania won't let me put the video directly into my blog...just go with it...)

tragedy.

Over the past few years, I've tried to stay positive in my sporadic blogging. People know life is hard here and sometimes bad or sad things happen. But that hasn't ever been the purpose of my blog and I haven't really felt the need to share those hard times until now. 

On January 4th as Baylor was reopening after the holiday break, my counterpart and I got word that one of our teens whom we both knew well had been admitted to Bugando Hospital. We heard that her condition wasn't good, and went to see her in the ward. It turned out that 'wasn't good' was an understatement. She was literally unrecognizable, starving to death, and suffering from a massive infection in her leg that had yet to even be examined by a doctor at the hospital. After an initial breakdown, I tried to pull myself together and figure out what to do. I couldn't leave her there, laying in sheets that hadn't been changed in days, full of blood, puss, and urine. I spoke to a few other women in the room only to find out there was no one taking care of her, only two young men who were allowed to come in the mornings and evenings during visiting hours - her brothers. It was clear no one was taking care of her, advocating for her, or simply being with her during this time and I know you all know me well enough to know that wasn't something I was going to walk away from. Since that day I've hardly left Hafsa's side.

Literally shaking, I went to three different wards to find clean sheets. I changed her clothes and gave her her first bath in weeks. I started to build relationships with the nurses and get more information about what happened, what was being done, and what I could do. I started pulling every doctor I saw into her room. She had been neglected by her doctors and I needed to know who I was supposed to be talking to to get her treated. A few friends who are doctors at Bugando came to see her and made recommendations, but as I learned more and more about the politics and bureaucracy of the hospital I began to realize there was little any of them could do without direct consultations from her doctor.

I spent those first two nights at the hospital, trying to get her re-hydrated and to hold some food down. Her IV hadn't been changed and no one was monitoring her fluids, or changing them at this point until I asked them to. After all these hours at the hospital I noticed she wasn't receiving her medications, antibiotics, pneumonia prophylaxis, etc. It seemed like no one really cared to help her get better, and I felt incredibly alone. Becoming the primary caregiver for a person who was by all assessments dying was one thing, but life in the ward was icing on the cake. Huge rats scurried around, women moaned and cried in pain, two in her room died. Nurses took naps and made chai while patients laid scared and alone in their beds, doctors made rounds twice a week with no follow up and seemingly no drive to help their patients recover.

I won't go into all the details about what the next two weeks entailed, they are kind of all a blur. Every time it seemed like we were making some progress and celebrating small victories like holding some liquids down, finally finding a surgeon to put a central line in her, getting her catheter changed, something worse would happen - her central line would come out, she would vomit for hours, or I simply couldn't find a nurse to show me how to help her use a bedpan. I felt like Hafsa and I were making tiny steps forward and big steps backward. I began to accept that she probably wasn't going to make it and that my role was simply to make her comfortable, and make sure she didn't die alone.

Baylor finally stepped in and started to help, first by advocating for her and transferring her to be looked after by a different doctor, and second by raising funds for her to get a "simple" cleaning on her leg that should have been done weeks ago. Had the cleaning procedure been done when she was first admitted, the infection could have been contained and they probably wouldn't have had to amputate her entire leg, which they had to do on Saturday January 12th. Try holding a 16 year old girl's hand while a nurse tells her that her leg was amputated, it was heartbreaking. I felt that with the infection in her leg gone and working with a Bugando doctor that finally seemed to care about his patients, the rest of her body could finally have a chance to heal, things were looking up and she was going to make it. But after a few days of not being able to hold any fluids or food down they inserted a feeding tube (which she pulled out hours later after being left unattended for a short time). The second procedure on her leg was too much and last week her doctor informed me that he was afraid she had entered into multiple organ failure. After a long fight that she was determined to win, her body finally couldn't handle it anymore and she died early last Thursday morning.

Throughout all of this I've seen things that I couldn't have imagined happening in a hospital, blatant negligence and disregard for patient rights and human life. Every day brought a new challenge or the return of an old one, we simply couldn't keep up. I was completely exhausted mentally, physically, and emotionally, trying my best to take care of myself while at the same time making sure Hafsa's last few weeks were spent fighting for her care and her life, not sitting back and watching her dignity slip away. The last few weeks and her passing has been incredibly hard on me, but the support Baylor staff has provided has been amazing. I am resuming my responsibilities at work slowly this week, and spending time with Hafsa's brothers and her 1 year old son. I know that only time will heal, but the hardest part was that this was all preventable if a few people would have just done their jobs from day 1.

life in Mwanza.

Returning to Tanzania after 5 glorious weeks of yoga, turkey sandwiches, happy hour, Minneapolis, and friends and family was tough but I was ready. I was eager to settle in and start in my new position as Program Assistant for Adolescent Programming at Baylor Children's Center of Excellence for Pediatric HIV* care and treatment (very wordy, I know, you should hear me try to say that mouthful in Swahili...) I'm still with Peace Corps, as a third year extension volunteer, but have been 'seconded' (one of my many new vocab words) to Baylor to work with adolescent programming.

Baylor staff at the annual team building retreat at Shafiq Beach in Mwanza, Tanzania

As soon as I got here to Mwanza I hit the ground running. I started to figure out where I could be most helpful and learned how much potential this program has. The main program within adolescent program is called "Teen Club"** and is a psychosocial support group for our clients starting at the age of 13. Teens come together at the clinic on the first Saturday of every month for Teen Club to play games, have a life skills lesson, and to just spend time with their friends. I've been working closely with a few of our staff and my newly appointed assistant and Teen Club rock star to adapt curriculum from Botwana's Teen Club and to create our own. The past few months our themes have been grief & bereavement, risky behavior, and a World AIDS Day reflection writing activity. Every month is different and I'm using my experience teaching Life Skills with my students in the village to know what works and what doesn't.  We've had on average 95 teens come to the past few Teen Club days and the numbers keep growing. Every time they get together whether it's in a large group on a Teen Club day or in smaller groups doing other activities I'm continually inspired by how incredible these programs are in the lives of our kids. To have a safe place where they meet friends who are going through similar challenges, without having to pretend to be someone their not, and to learn how to be a good friend by being involved in such a supportive community is truly life changing.

Playing a circle game to start out Teen Club in October		Teen Club and Baylor staff before running the 5km run in the Rock City Marathon

Teens listen to a staff member teach about the importance of good adherence to their meds

My roomie, Liza, who is another volunteer with Baylor gets the teens pumped up before the run		Teens repsond to questions about whether a behavior is 'risky', 'low risk', or 'no risk' by moving to stand behind the respective sign

Aside from helping organize Teen Club each month, I've also been working with smaller groups of our teens who have expressed interest in "extra curricular" activities. Soon after I started, we met with an organization called Mwanza Youth and Children's network. We developed a partnership and recruited some teens from Teen Club who were interested in media to start a Media Group. MYCN began training this group of 18 teens in everything from the basics of media and why it's important to using tape recorders and practicing interviewing skills. After a few trainings, a few teens were ready and went to try out to have a part on MYCN's radio spot. They made the cut and before we knew it we were live on local radio! 

Teens volunteer answers during a Media Training facilitated by Mwanza Youth and Children's Network		Teens practice interview skills and using a recorder during a Media Training

At Metro FM radio station with Mwanza Youth and Children's Network about to be live on the radio!

Another group I've been working closely with is called Stitch x Stitch. Earlier this year this group was formed by girls from Teen Club who were interested in sewing and starting an income generating project. Baylor hired them a mentor to teach them sewing basics, and Baylor staff has been working with them to develop business skills and financial literacy. The program made a lot of progress recently thanks to Candace and her marketing background by helping the girls develop a marketing plan and get organized. They have new orders almost weekly, with most of their products being purchased by Texas Children's Hospital. 

Well enough about work. Mwanza really is a whole different world from the life I've been living in Tanzania so far. From early morning rooster wake up calls and days of fetching my water on my bike in Sepuka to Monday happy hour at our neighborhood bar (yes I realize this is the second time I've mentioned happy hour in this blog) and going dancing on the weekends (sometime during the week too...), my days and weekends are spent much differently than before. I have good friends and two great roommates who are actual people instead of my previous company of termites and scorpions and I'm so lucky to have them (the people ones). It's not better or worse than the way I was living before in a small village in the middle of nowhere, it's just different. I still have bad days in Tanzania where I just wish I could be home sitting at my parent's kitchen table eating mango salsa and grapes, but I love my job, and this is exactly where I'm supposed to be.

*http://www.bipai.org
**http://tanzaniateenclub.wordpress.com

last days in singida and goodbyes to those who made it all worth it.

As I began to count down the days left in my village, our pit latrine project was coming to a close. The walls were going up, the roofs were being poured, and with a coat of paint we'd be done. I was so proud of everyone that had been apart of this project and stuck with it through the end. I wanted to do something special for my head craftsman, Lisu, who worked day in and day out for months. He was reliable, responsible, totally involved in the project, and was definitely proud of the work him and his assistants had completed. I had hoped that we would have some left over money and I could buy him a goat as a bonus for how incredibly hard he worked but no such luck. Instead I printed all the pictures I had taken throughout the project and assembled a photo album for him. When I gave it to him after we'd finished we went through it picture by picture and with a huge grin on his face he said, "this is the best present you could have given me, better than any money, even a goat!" He said he couldn't wait to show his wife and children, and for the first time he had a portfolio of his work from beginning to end, "now my children will always remember me and my work."

Lisu pictured here on the left and below on the right with me in front of our finished latrines

We opened the pit latrines at the first market day in July. Our project committee met together for the opening and after a few words from our Ward government officials we had celebratory soda. (I then proceeded to climb on top of the rocks nearby to see how many people would use them over the next hour or so...)

On the homefront, we pounded out our last sunflower harvest (they worked, I ate sunflower seeds) and I made one last cake with my neighbor Lafa (who I eventually grew kind of fond of. kind of.) Saying goodbye to my neighbors and villagers was much different than I thought it was going to be. I was ready to move on, and although there were many people I grew close to, it had become such a challenging and somewhat toxic place for me, that it was time to go. There was no goodbye celebration like they said there would be, and my neighbor didn't even get off her mat on the ground to wish me a safe journey. I was truly disappointed by many people when I left, but the ones that really mattered, my neighbor kids, the women who cooked Kiki and I lunch almost everyday, my fundi Lisu, and Mama Pendo made sure I knew I'd be missed and that I mattered to them. 

But the goodbyes didn't end there - the celebrations had actually just begun. Justin hosted a goat roast at his house to celebrate those of us who were also finishing up (dana, fink, me, and duncan), and my fellow singidites threw a party for me complete with cinnamon rolls, balloon trivia, and an entire bottle of Konyagi. Then I headed to Duncan's village for a few weeks as he finished up his massive water project. But the festivities would not be complete without one last trip with the whole gang. We all met up in Dar and ferried over to Zanzibar where thanks to the incredible generosity of one delightful Dutchmen, we were able to afford spending 3 days at a luxury resort on the beach and then ventured to Stone Town.

Everyone left for the states in the days following, officially finishing their Peace Corps service and headed to a land full of ice cubes and internet. I boarded a plane shortly after to spend 5 amazing weeks with family, friends, food, and one of the best inventions ever - happy hour.

two years in tanzania.

Two years ago today I stared out the window of the airplane at giraffes and elephants frolicking in the plains below and became overwhelmed by the realization that my dreams of living and working in Africa were finally coming true. I knew little about the roller coaster ride I was about to embark on, but with a group of 40-some other people knowing just as little as I did, we stepped out into the suffocating humidity and heat of Dar es Salaam and into a country that would change us all.

Two years later I look back at the places I've been, the people I've met, the things I've seen and done, and I'm at a loss of words at how to sum it up. If you would have told me two years ago that I would be teaching 7th graders how to use condoms, building toilets in the middle of nowhere, holding a conversation with a tailor about how he no longer supports Obama because of his stance on gay marriage - in Swahili, or unwrapping an umbilical cord from a newborn baby's neck helping him to take his first breath, I would have told you you've lost your damn mind.

Two years ago if I would have known I would go through some of the things I've experienced here I'm not sure I would have gotten on the plane. But I am thankful everyday that I did; that I've experienced everything that I've experienced, learned everything that I've learned - good and bad, beautiful and heartbreaking. When I was very serious about throwing in the towel if one more fly landed on me, I had friends and neighbors to turn to who knew exactly how I felt and who helped me put things into perspective and remember why I'm here.

I've been pushed to my limits - in good ways and not so good ways - and learned that there is absolutely nothing I can't do. Peace Corps has taught me that, Tanzanians have taught me that. And for that I am thankful.

Here's to all of you in our health and environment training class of 2010 who have strived everyday (well almost everyday...) to make a positive difference in the lives of others. Here's to ugali and mlenda, obnoxious kondas, unforgettable sunsets, drunk bibi's, village runs, that rooster who woke me up every morning at 4:30, a shy student asking for help getting birth control, bats/cockroaches/rats/scorpions, fetching water, no privacy, volleyball, tanzanian buses, call to prayer, climbing the boulders with neighbor kids, and all of the other things that will forever remind us of our time in Peace Corps Tanzania. we did it!

work. or something like it.

I'm sure a good number of you are wondering what in the world I've been up to other than roaming around Tanzania and/or sitting in my courtyard reading The Clan of the Cave Bear. Well here's a quick look at some of the projects we've been cookin' up...

In rural Tanzania, people have little access to a place where they can purchase everyday household items and foodstuffs. Most villages have small shops where they can find salt, soap, and other little things, but many areas rely heavily on the traveling markets that set up show in the village every few weeks. In my village, Sepuka, our market days happen twice a month and people travel up to a half day by foot, donkey, or bike for access to everything from new dishes and fruits/vegetables, to beds, bikes, and livestock. A rough estimate by the Ward District Council in my village puts an average market day attendance at around 1,000 people. The market in Sepuka Ward is the largest in the area and provides more selection than any other small market.

The village government approached me In June of last year with concerns about the health and well being of community members, especially those traveling to the market and those living in the surrounding area. Due to the lack of public latrines in the market area, villagers who attend the bi-monthly market openly relieve themselves in the surrounding area resulting in the contamination of a nearby uncovered water source and the spread of dangerous illnesses.


So we got down and dirty to try to clean up the market and provide the people with a much needed basic amenity...toilets.

The village government helped me to put together a Project Development Committee consisting of one man and one woman from each of the three sub-villages the market directly serves. Together with this group of six selfless individuals, a village government official, a nun, and the health extension officer from the village, we designed a project that would provide the market area with two, four-stalled pit latrines and help educate the community about communicable disease and the importance of proper sanitation. We wrote a PEPFAR (President's Emergency Plan for AIDS Relief) Grant and with the village contributing 25% of the total cost, we finally broke ground for the construction of the pit latrines in April of this year. (By the way, condensing 7 months of work into one sentence doesn't really do it justice, but for your sake I'll spare you the gruesome details.)

The construction of the latrines has progressed swimmingly. The two 10'x5' and 12' deep holes were dug within the first 10 days and as of yesterday the holes have been lined with cement blocks, covered with a cement slab/flooring, and the walls are going up. We hosted a Water, Sanitation, and Hygiene seminar last Saturday where the health extension officer, the Medical Officer from our village health clinic, and myself taught committee members the ins and outs of the importance of proper sanitation, communicable disease, and water contamination. But the learning doesn't stop there! After practicing some peer education skills, I've asked the committee to go forth and talk with their peers about how to protect themselves and prevent illness that destroys so many families. It is incredible that simple adherence to using a proper pit latrine or hand washing can literally save lives but it's true...42% of the children who die before they are five years old are in sub-Sahara Africa*. Their main killer? Infections and disease: many that can be prevented by basic education and tangible behavior change.

Along with building toilets an training these peer educators, I've also been working with our health clinic's 'mobile clinic' that travels to five remote villages each month to provide monthly weighing and routine vaccines to children under five, birth control, and prenatal check-ups to communitites lacking health facilities. This mobile clinic and I have a slightly unhealthy love-hate relationship that'll put the latest chick-flick to shame, but here are some picture of our latest mobile clinic in a village called Kaugeri...

No matter how long and bumpy the drive out to the middle of absolutely nowhere is...disregarding the fact that 50% of the time we return in the middle of the night starving and thirsty...forget how uncomfortable it is to translate a sentence through 2 people to tell someone they've tested positive for HIV...it's worth it if we can provide a young mother with birth control pills that will allow her to gain some footing before having yet another baby...or if we can give a three month old baby a vaccine that will give them a fighting chance against an otherwise deadly infection. I always come back with some story that made the trip worth it, reminding me of why I joined Peace Corps.

With our Close of Service conference behind us, our training class that arrived two years ago is in the home stretch. Two months of our Peace Corps service left to go means finishing up projects, spending as much time with neighbors and friends, taking pictures of the places many of us might never see again, and preparing for what's next.

I decided some time ago that I wasn't quite finished here and applied to extend with Peace Corps for a third year. A few weeks ago I was offered an extension position beyond my wildest dreams and just couldn't turn it down. After finishing up in Sepuka in the end of July and taking a month of Home Leave to travel back to the states, I'll be starting as a Program Assistant with the Baylor International Pediatric AIDS Initiative in Mwanza, Tanzania. Most of my work will be focused on working with adolescents living with HIV/AIDS through the program's Teen Club and I'll have the opportunity to expand on what this incredible program is doing all across sub-Sahara Africa (specifically in Botswana and Lesoto) and adapt it for Tanzania as well as work in outreach and peer education. For more information on the Baylor International Pediatric AIDS Initiative and Teen Club check out these links...

Teen Club - http://tanzaniateenclub.wordpress.com/

Baylor International Pediatric AIDS Initiative - http://www.bipai.org/

That's all for now, thanks for checking in on what's going on with me lately!

*stat from UNICEF Progress for Children, 2004

february photo-a-day...(in march)...

i saw this a while ago and thought it could be a cool way to teach you all a little bit about my life here in tanzania. 

(and yes, i realize it is no longer february)

ps. i skipped some that i thought were dumb.

1:your view today.

fairly self-explanatory. rainy, gloomy, but i sure was glad i'm not the one trying to mop up the mud floor.

2:words.

this is my friend Ditrik. he is HIV positive and isn't afraid to shout it from the rooftops if it means reducing stigma and educating people. we went to see Tanzania's president, Jakaya Kikwete, speak in a nearby village and he brought this homemade sign listing what's wrong with how Tanzanian's deal (or don't deal) with HIV/AIDS and stigma and what can be done to lower the HIV rate.

he's not afraid to use his words, and his actions to bring change.

3:hands.

these hands find their way into my ever-growing collection of crayons and coloring books almost everyday.

4:a stranger.

waiting for the bus on the side of the road, i snapped this of a man heading into town to sell charcoal. by foot and by bike, people travel from remote villages to sell their goods in the main market in town.

5:10am.

drop everything it's chai time. after almost two years i'm still not tired of chapati and chai in the morning.

6:dinner.

not my dinner, thank you very much, but brandon handled this duck like a pro.

8:sun.

an incredible sunset from my courtyard after a big rainstorm.

9:front door.

one way in. one way out.

10:self portrait.

living once again in the land of sunflowers.

11:makes you happy.

duncan ewing is a source of great happiness for me. he is always pushing me to be better, to do better, and to love bigger.

12:inside your closet.

not much of a closet i realize...

14:heart.

i've never met anyone with a heart like maria's. her love for jemsi was unmatched. although she was only the housegirl for his mother, she treated jemsi as if he were her own. she lived with the unique kind of selflessness and unconditional love we rarely see in others. i strive to have a heart like maria's.

15:phone.

living with no electricity, charging my phone can be quite the task. this dumb light/charger is on it's last leg but has been a faithful companion for almost two years (as long as there is not even a hint of a cloud and that pen is jammed just the right way between those two cords...we're charging)

16:something new.

no one knows 'something new' better than mama sauli. new babies that is. as the primary midwife at our health clinic, mama sauli has been delivering babies for over 20 years. she estimates she's delivered over 1,000 babies in all her years as a nurse. working with her in the delivery room is one of my favorite pastimes. she's taught me a few things, maybe i'll follow in her footsteps one day.

17:time.

the meeting is at 9:00 am. okay i'll be there at noon. time is not of the essence here. waiting for hours for meetings to start is the norm. what is that crazy american doing trying to get us all together on time? doesn't she know we have extended family to greet and unruly cows to gather?

18:drink.

with no running water, i resort to fetching my water from a local well or catching rain water. rain water is good to go, but if it's well water it can take up to 8 hours of filtering before it's drink-ready. i filter my water extensively, but the majority of my villagers use it as-is.

19:something you hate to do.

hate. hate. hate. fetching water. pulling my bike out to head down to the local water hole and collecting 50 liters of muddy, grass and feces-infested water for drinking, bathing, washing dishes and clothes is one of those activities that i will not miss. 

20:handwriting.

a song written for kiki and i from mama menga talking about how grateful they are for our work and welcome we are into their villages, homes, and families.

21:a fave photo of you.

attending the traditional muslim wedding of my counterpart's sister, this picture was taken by my counterpart as i present the bride with a gift.

22:where you work.

most of my favorite teachable moment have not happened at the clinic or in the classroom but right here in my village center. whether it's over an extremely awful cup of coffee or buying tomatoes, the informal setting of everyday life sparks up the best conversations (topics have included gay marriage, whether there is corn in america, condom use, polygamy, and the origin of skyscrapers to name a few)

23:your shoes.

most tanzanians who see these shoes would like them not to be my shoes, but their shoes. daily they see me fording the 'river' that flows briefly after a rain, running quickly away from children, and passing worry-free across the boulders...and they are jealous. i was once offered 3 goats for them.

24:inside your bathroom cabinet.

who needs fancy mirrors with doors and hinges to qualify for a bathroom cabinet? not i. 

this shelf located conveniently above the hole in the ground i call my toilet, has sufficed as my bathroom cabinet and offers my neighbors the freedom to explore foreign objects (such as those kept in the box on the right) without having to worry about the hinges creaking on the cabinet.

25:green.

green. literally and figuratively. as the main cash crop in tanzania, corn provides tanzanians (and poor peace corps volunteers) with their staple food, ugali. if a family is lucky enough to have a large farm, good rains, and not too many hungry mouths, they might be able to make a profit by strategically waiting to sell the maize until the price goes up.

26:night.

when first arriving in tanzania i was shocked by all the fires at night. i thought the whole village was burning down and didn't understand why no one was panicking. turns out before preparing their lands for planting, many farmers resort to burning their fields to finish cleaning up last year's harvest. a hazardous practice that have cost people their houses and can be very harmful to the environment.

27:something you ate.

mlenda. one of my least favorite dishes. eaten with ugali, this green goop is a common side dish in my village. with a quick snap of the wrist, getting the mlenda sufficiently wrapped around the clump of water-flour mixture is a skill that will have my neighbors clapping...once i get it right...

28:money.

this is the 10,000 shilling bill, the largest that exists in Tanzanian currency. 

Its USD equivalent is about $6.50.

29:something you're listening to.

my site mate and I walked to a neighboring village for a celebration of traditional dancing and singing...just for us.