Zanzibar

SO i am skipping over last weekends excursion into Masailand and will save that for a Sunday posting. I hopped on the Dar Express for Dar es Salam yesterday morning at 6 am! I caught the last ferry to Zanzibar and am currently typing at an internet cafe (I have 11:30:00 left to write before my money runs out...). It is beautiful here, and the kiswahili is a bit different but I am getting along fine. I have done well in becoming conversant! I have luckily avoided the mtali (tourist) spots. I made it to the darahani market with fresh fruit, veggies, spices!, hanging meat and a fish market. There was one salt water fish being cut up on the ground longer than me, quite amazing. I then hit up the winding markets east of the stone town tourist traps. Many Indian, Arabian and African shops. Luckily (and unluckily with the heat) I wore pants, so was able to go into a local mosque before noon worship. I also walked with a local through a ship building yard. The ships have not changed in hundreds of years and really quite impressive. Finally took a break from the heat here. I hope to find some old men playing Bao this afternoon- would like to learn first hand this very old game. I played it once in Ghana and it was a lot of fun. Pardon any misspellings but with little time, a short stool and Araibic keyboard this is difficult. I hope to post some pics when I return.

Only 3 days until I return home, and so much to see! Hope all is well with family and friends, can't wait to see you all- especially LAURA, CHARLIE & ELLIE!!!!!!!!!!!!!!!!!!!

Tutaonana,
Eric

Out with Captain Fresh Legs

Another national holiday yesterday!















So Bryant and I decided it would be good to mountain bike daily. Sounded good at first. Then we invited Mat Bailey with us (Captain Fresh Legs). We had been going up hills for 4 days and invited this crazy Aussie for another spin. Love biking with him, for sure, but our reserves were low this time. And he hadn't biked in several days.

Mbutwai and Kimane stopped in this am to finalize plans for our trip to their farm- we're leaving Friday afternoon and returning Sunday. It should be awesome.

We ate some toast and then started working on public health. About 1 PM Bailey texts us about a ride. We tune up Bryant's bike, inflate the tires, knock off the mud and go. We are usually gone about 2-3 hrs. Today we went very very very far up.

After about 2 hours we decided to take a very steep pass cutting through the side of a mountain. This went up for about an hour. The incline was about 60 degrees and a lot of bike carrying. We found a duka shop in the small "village" of Oloigeruno for some expensive warm coke and slammed them down. None of us expected such a long day and we didn't have much water. The locals borrowed my bike and we talked with the kids. Then we heard about a waterfall even further up. We hit a very nice grove of evergreen trees that reminded us of Minnesota. Far back into this we hit another slope that ended our climb. The waterfall was very far away and nowhere near us!

We replaced Bryant's back tire and headed down the mountain. Very steep and on either side of slick mud paths are nettles that will cut you if you simply look at them. Bryant took a header over the handlebars into them, and we found an easier slope. Throughout there are bridges of rough cut trees over streams/ravines/etc. Half way back through a small group of Bomas we met Michael, who insisted we come to his small home. It was about 10x20 ft, split evenly into 2 rooms. Entering the door, the first room was empty but very clean. His bedroom barely fit a twin bed and small table (just large enough for a small briefcase). He showed us numerous pictures of random people and his text books for education. He then lead us out of the valley. But as we left he chose paths that went up rather than down and so we departed with the last of our energy.

Overall we saw many spectacular views, met many children asking for money, water, our bikes and are completely exhausted. We just ate an impressive meal of steaks and pasta, probably more than either of us has eaten since arriving.

I am excited to be here, with so many experiences packing the day. But I also can't wait to get home, start residency and especially see my family! Laura and I are looking for places to live and it is an exciting prospect to have some comforts of home and space to stretch out.

Mtasinzia mzuri,
Eric

Easter Ride

Easter Sunrise service was at the Simonson's this morning. They have been working in the NE region of Tanzania for many years, and built a home here in the early 1970's. They have a beautiful large home fashioned after the traditional Masai boma- so it is a round and very open building with an inner circle within the outer wall. An amazing gathering area within with a great loft overhead for sitting. One amazing thing is they have no bars on their windows. Everywhere there are bars, covering all shop enterances, every window, every doorway. It is a necessity for virtually everyone here. They have earned the protection of no bars though, by many years of service. We had cakes and some fruit after the service and I returned down the road with Sarah Wallis.

Later that day... Bryant and I watched the documentary "Darfur Diaries", a documentary I found while reading What is the What (by Dave Eggers). Informative but depressing/infuriating!

Then we jumped on our bikes and got lost up the mountain. There was a lot more mud, a lot more off-roading, and many wonderful sites. I fell off my bike more times today than in +10 years of biking as a commuter. Pausing along one trail next to a stream to take in "I am in Africa. I am mountain biking down a beautiful stream." Amazing. Many times we ride through small villages and are chased by the local kids. We caught a bit on tape yesterday. Of note, I know I don't tan (honest!), but I didn't know I was whiter than white. Can you differentiate my t-shirt from my skin? Cause I can't.

Last evening we made our way up Il Buro to Sarah's home for a bbq. Jose (Argentinian MD working in Mn) controlled the grill and did an awesome job. A great way to end the day- chating, beer and a fire.

Mbutwai & Kimane stopped by today (Monday). We will be going to their place Friday afternoon, returning Sunday. I will move on to Mto wa Mbo (Misquito River) to work with Dr. Friberg hopefully for a week. Things are winding down here it seems!


Eric

A little bit of everything

Water!
Water has been scarce in Arusha/IlBuro/Ngaramtoni area. The short rain season provided less than expected, and now the long rain season is late in appearing. We have just now entered the rains, and it is quite nice. The dust has settled down, making walks and mountain biking much easier on the eyes and lungs. There are powerful rains for a few hours/minutes and then cooler temps and beautiful sunshine.


On Tuesday Dave & Russ left for home, and simultaneously our water tank was fixed. It has been about 3 weeks with only a slow flow from the kitchen sink. Our routines are fairly standard with water here. First you get a bucket and drain some water from the faucet for a shower. Next you grab some water and heat it on the stove so you don't jump from the cold, and when it boils you add it to your bucket. At the same time you can put your cup under the water filter and in about 10 minutes have enough water to drink. A second bucket is taken back with you to the toilet so you can flush.

This doesn't include the water taken to hand wash all our clothes (thankfully Christina does this for us!), or taken for food. It is pretty amazing how reliant we are on easy water, and how much it is taken for granted until it is almost gone. We are fortunate here, our neighbors do not have easy access to water like we do, so even in our “difficult” situation with water we still do not have to walk down the road a quarter mile and back with a bucket on our head. And we can easily heat our water, compared to gathering firewood. So, overall, we are still blessed at Exempla.

Il'Kidinga
Last night Bryant & I grabbed our bikes and headed back up the mountain. We made our way to Il'Kidinga again and stopped at a shop just outside Kionga for some tepid Cokes. I am standing on one side of a valley, Bryant on the other. In the middle was/is a small stream where mzee (old wisened...) women were washing clothes. A Masai warrior was sitting just below Bryant in this pic grazing his cattle. It was, again, an amazing time to see the countryside and meet locals. The ride is beautiful with Meru always in view and great little streams to ride through. We crossed one in particular several times. The photo of the kids (Watoto) is just as we entered the stream.


Maasae Girls Lutheran Secondary School
Last Sunday I joined Ashley & Sarah in a trip to MGLSS. Ashley founded AfricaAid, which I have included in the blog links and Sarah has joined her here these past few months to help. Their organization funds scholarships to Masai girls secondary education. I was introduced to Jean and Marvin Whalstrom, two missionary teachers from Seatle area who have taught at the school for about 8 years. They are terrific people with large hearts for service.

The school is fashioned similar to the boma structures traditional to Masai. There are several dormitories, classrooms, laboratories and administrative offices. Centrally located is the open air chapel, very beautiful and comfortable. Ashley pointed out the beams holding up the roof, they were apparently from I-94 in Minneapolis! The founders of the school (and Selian!), David/Eunice Simonson, collected them when construction was occurring several years ago. Small world!

From numerous perspectives, educating the women of society is possibly the biggest return on investment that people/institutions/churches/organizations can make. Besides the simple point of sexual equality, it has been proven to improve mortality/morbidity surrounding childbirth, control population expansion (more education = fewer children being born), improve sanitation, improve the education level of the whole family, and a lot more that I won't go into. It makes a lot of sense.


UN Rwanda
The kiwis set up a trip to watch UN International Criminal Tribunal for the Rwanda genocides on Thursday. After quickly rounding at Seliani, Jose and I sped home, changed and made the afternoon session with kiwis and Bryant. The genocide in Rwanda is currently being dealt with by the UN here in Arusha. The numerous trials have occurred for past 8 years, and were supposed to be completed this year.

They have 4 courtrooms which run at various times. If the court is open we can watch, with headphones translating the French court. If the trial goes closed we get up and leave. The public gallery is separated physically by a glass wall. The witness was protected, so there was a curtain hiding his identity. There was a 20 minute closed portion of the trial, which we left, and when we returned we only heard mention of the killings/etc he had witnessed/participated in. Such an interesting process here. The focus on the witness was his participation in guarding a camps entrance, whether a particular civilian who was murdered was in a truck, and what was actually witnessed vs hearsay/conjecture. The details were tedious, the lawyer for the defense horrible, the process slow. But still, amazing to see unfold. In reality, justice is not flashy.


Seliani
I spent about 10 minutes with the OB/GYN team before realizing that there wasn't going to be much work for me. I have jumped back in with the medicine team. There are many frustrations that have been difficult to stand by and watch. Last week there was frustration not due to LACK of adequate meds, but proper administration! We would give detailed instructions on patient care, and find the next day that very little has been followed.


Donations
I am beginning to reach out to the community about the donations we would be distributing. Hoping to balance out between public health & medicine/PT. Right now I am coordinating with a few different organizations, and I hope everyone will be happy with the results!


Tomorrow, Easter, we will be going up to the Simonson's home for sunrise service. It will be nice to visit with many of the "movers and shakers" in the area. Peace to all!

Eric

Life back in Minnesota (Laura and Charlie)

As many of you have probably figured out, Charlie and I decided to head home a month earlier than expected. There were a few reasons for that: 1. The work that I (Laura) could do was limited by the fact that I had a 20 month old running around...loved it, but hard to work with other kids when one very adorable kid is demanding my attention. 2. There wasn't much to do with young kids in Arusha besides a swimming pool and play groups. It was a bit isolating. 3. The security issues were still there...better, but still there. 4. I wanted Eric to have the freedom to go off and travel to villages, treating individuals, if he wanted without worrying about us at home. Those were the main reasons. Another valid and fun reason was that my sister just had a baby and this gave me an opportunity to fly to Fairfax, Virginia to see the little guy. He is precious and it was fun to be able to help her out early on.

It has been busy since we have been back. The first week was spent getting over jetlag and visiting my new nephew. The second week has been getting organized. I am in the midst of trying to find a place to live (my parents have lovingly opened their house up to me and Charlie but I am anxious to find a place to call home again), doing taxes, and making a space for Charlie and I to stay in the basement for a while. It is humbling, frustrating and very nice all at the same time...strange but true.

That's it for now. Hope everyone is doing well AND, I too, want to make a public proclomation that Charlie and I miss Eric. We can't wait to see you!!

Mbutuai stops by

I took Tuesday morning off to work on public health and orient a new internal medicine doc to the area. As I returned home in the morning Mbutuai and his brother Kimane stopped by! We had some chai and discussed Mbutuai looking for new employment. He was not being paid by the landlord when we were with him. They liked having pictures taken, so we can pass them along to their family- but I thought I would include them here as well. I'm sitting with Kimane, Bryant is with Mbutuai. If Byrant and I look crusty it is because the water is still out.

The good news is we worked out to visit their farm/home near the serengeti (~4 hr drive) in a few weekends and I finally got his number. It was good to see them again and I look forward to the day I can speak to them in Swahili- it is a real motivator to learn the language.

The new IM doc (Jose) was here last year for 5 weeks. He is originally from Argentina and I will be working with him this afternoon at the medicine clinic. Tomorrow we will be grilling out: Nitapika njema nyama (I will cook good meat)!

Peace,
Eric

Notes from a dusty rider

Just returned from a fantastic mountain bike ride with Mat and the new med student Dave (from New Zealand). We went up the hill quite a distance near a village called Il'Kidinga, and close to where I have done some home visits with hospice. Then we hit a lot of the streams/paths that I had been eyeing up for the past few weeks. There was a lot of incline/downhills and numerous obstacles- very fun. We passed through a weeks worth of touring the countryside in just a few short hours. Our bikes are not great, Dave and I did our best yesterday to tighten everything up. About half way through the ride Daves pedal crank began to make death threats- sounded like a dying cat. By nightfall it was hardly turning, we poured some water on the housing and sped home with haste. We passed many groups, kids chasing us, families coming out of their bomas to say hello, large church parties along the hillside. And a beautiful sunset. It was a great dusty adventure and I know it is something I will miss on my return home to Mn.

This past week at Selian was somewhat short for me, as Laura left Monday and I was at ALMC for clinic Tuesday. I spent the remainder of my time on the medicine wards. There have been quite a few deaths lately to deal with. I had some frustrations with a very old women who was going into shock. Most of my requests for care seemed to fall on deaf ears. I finally got a non-rebreather mask on her to help her breathing and they all wanted to take it off because patients don't find them comfortable! I unplugged from the team after we left her case, as I found myself teetering between apathy and cynicism over the care being provided. By Thursday I was doing well, but there have been several patients who have passed, and many more coming in for what appears to be paliative care. I have started going in on Saturday mornings now to spend extra time at the hospital. A man came in with a large tumor the size of a cantelope- where is the pre-hospital screening that should catch these things before they are deadly? No where to be found. I think primary care development here would save A LOT of lives. Many many different patients this week: an alcoholic (local Konyagi liquor here), TB meningitis, strokes, sepsis, malaria, AIDS, and many more. I plan to spend a week now with OB/GYN, and go from there. I have recently heard from another doctor that I will travel with in late April out into the rural areas, so I am excited to get out. The 2 hospital pics: one of Selian's low-tech ICU and the other is me with the hospice team.

Exempla house has decided to throw some challenges our way. We have been without water for about one week now. We are all getting fairly rank without access to showers and this warm dusty climate. We have a slow flow from the kitchen sink (cold water only). So we can fill our toilet tanks and take sponge baths. Before church today, Bryant and I went to ALMC early and showered for the first time in a long time, it was very cold! It seems they don't have hot water there yet... But it felt good. There is a fairly significant drought here as well, in contrast to the flooding in the midwest currently. It rains very infrequently and the dust is everywhere. The crops are dying and there doesn't appear to be relief in site. Kilimanjaro appears to be fairing even worse. Today at church they ended with an open mic to talk about what verses helped everyone "get through" the day or rough spots in life. It was great to hear the diversity of text being spoken and find what gives people strength.

Two new roommates came in the night Laura left. They are an ortho surgeon and ortho physicians assistant from Stillwater. They spend a great deal of time at ALMC, but we have spent the evenings going to dinner and getting out of the house. It has been great to see Arusha at night, even if only from a range rover window.


And a public proclomation that I miss my family! I don't like Laura and Charlie being away from me for this long! Charlie said his "goodbyes" to friends made at play group.



The simba (lion) was one of Charlie's toys here and keeps me company at night.





Also, just found out we received a nice amount from St Lukes church (our home church) as a donation! We really appreciate everyones support in our work and we will do our best to find an appropriate use for the greatest good.

Eric

PS- Charlie started eating more veggies his last few days here: cucumbers, carrots and green beans. Well, not eat but chew and spit out. It's a start.