Settling in

Charlie and I are settling in quite nicely. The days are slow, routine and filled with enough time to enjoy every moment and take up a few hobbies. Since being here, I have actually cooked on a regular basis (not sure what I was doing at home when I think about it but cooking has never been my forte). I have also taken up knitting. I am definitely not an expert but at least now I can make something like a potholder or scarf and not get so frustrated that my weave is too tight. It flows easier. The only way I can explain how life is here is like a river that is meandering its way downstream. Back home (in Minnesota) life was more like a hurricane... I am not very good at metaphors but that is the best way I can describe it.

Life here has offered a new perspective. Like any drastic change, it sucks at first but you realize somewhere down the road that it has actually taught you something, enhanced life, helped you to understand more about yourself (as a wife, mother, individual). I think it is going to be hard to go back to the pace of life back home but, luckily, I think I have figured out how to ease back into it...we'll see...

A bit about Charlie: Every time I look at him I think, "what a blessing" or "you are soooo amazing!" I feel so humbled by him and love him so much. He is sooooo much fun! Right now he is eating crackers next to me, which he calls "COOOkie" and as he is about to take a bite he says, "Yum!" This morning he woke up at about 6:40am. He stands up in his crib and says, "out!" and then tells me to take his "night night" which is his blanky. I then lift him up out of his crib and bring him to daddy while I make up his breakfast. Lately, all he has wanted to eat is bananas so even though I prepared cereal, he wants a banana. He eats his banana double fisted (banana cut in half) and then, once finished, asks to get down by pointing and the morning routine of changing his diaper, clothes, putting on deet and sunscreen commence.

Then, we play soccer outside together after he insists on putting on his galoshes (boots) because the ants bite and after he has placed my sandals by my feet to get me going. We play for about 30 minutes, kicking the soccer ball around and then make are way around the yard looking for the turtles. We couldn't find them today and since the ants were killer this morning, I retreated us back to the front lawn (where the ants are not) and fill the basin full of water. We pretend to make soup, stirring it with sticks we found in the yard and placing grass, leaves, flowers, toys into the "soup" and say "yum!" He wants to do this FOREVER, so I ablige for about 1-1.5 hours and then take us in to do dishes. He helps me, standing on a chair. His job is to put all the dishes on the right side, on the left side into the basin filled with soapy water while I wash. He insists that I run the water so that he can fill up a cup and unfill it in the meantime and I ablige him because, frankly, it is easier than fighting him on such a small thing. We get done with the dishes and I start on lunch at about 10:45am. Today, I heated up the leftover pasta I made yesterday, cut up some cucumbers and cooked a hot dog for him. He ate the hot dog and cucumbers and drank some water. He knows the routine, so when he says "all done" by saying it and waving his hands back in forth (signing), I take him to bed, change his diaper and read him a few books. Then, I put him in his crib and say "good night" and he slowly falls to sleep.

Charlie has always been really good at nap time so he makes it easy on me. He sleeps while I read my book ( I am hooked! It is called "my sister's keeper" and is very touching which is maybe why I am a bit sappy right now....no, Meagan, I am not PMS'ing). Charlie wakes up enough to see me reading by his crib and stands up. I pick him up and he lies back down on my chest and falls asleep. I pick up where I ended in my book and continue reading. After about an hour (total 2.5 hour nap), he wakes up and we make our way to the kitchen where Christina (our maid who works 3 days/week for 20 dollars a week) is making homemade passion fruit juice from the passion fruit trees outside in our yard and homemade bread is in the oven. This is the life! She makes Charlie some juice and I give him some crackers and...that is where we are right now. Later, I may have a play date with Natasha and her 2 kids, Henry and Elijah..or, I may not. That is the beauty about living here, there are no appointments, no major expectations, just learning to live in the moment...

Oh, and Eric just walked in. It is 3:30 pm...I LOVE IT!

Weekend update

This weekend we moved down to exempla house. It is a great location with a lot more exploring to do in the yard for Charlie and more comfortable surroundings. We have passion fruit, bananas and avacado trees around the yard that are producing right now. Our housekeeper also brought a ton of mangoes in today!

These first pics are from Saturday afternoon. It is Charlie's first shin scrape! He was playing soccer in his rubber golloshes the gravel driveway and fell down. He barely cried though, and went on playing. The reason for the boots is the army of biting ants currently moving through our yard. He got bit a few times in his sandals and refused to go out without his boots. The reason for playing in the gravel driveway is he was scared of the biting ants. He's fallen a few more times but the ants have migrated to more peripheral areas, so he roams the grass more confidently now.

Since the migration, Charlie has ventured around the yard and found the two long term residents of exempla house: turtles! He loves following them and watching them walk/eat grass/retract into their shells. He currently calls them "doggie", but we hope to have him to turtle before he leaves...

He spent Sunday morning before church getting very muddy in the small stream that runs through the yard. He threw rocks into the mud for about an hour and then sat right down and smeared it all over for a finale. Tonight we forgot to give him malarone (anti-malaria meds), so we woke him up with the standard crushed malarone in Nutella- he successfully took down the chocolate easily while remaining asleep.

Today I moved from pediatrics to hospice/adult medicine. Hospice seems to move with spurts of activity so I anticipate a good mix of both. Until noon I basically rounded with the team on the female ward. More frustrations with the health system here as many of the basics are lacking: we had a patient with an acute abdomen who could have a stomach ulcer, or possibly pancreatitis. But they don't do the labs that could diagnose pancreatitis so it is a guessing game. There is also the woman who ingested the unknown pills. Apparently they were Flagyl (a fairly harmless med) and 8 other unknown pills. The problem here is she has depression, but there is no Prozac to give her. That is a safe and cheap antidepressant. There is an alternative, but it has side effects we like to avoid and some dangerous elements for a person who attempts suicide by pills.

On the flip side, this hospital is one of THE best in the country. For all my frustrations with it, it remains one of the best options for care here. So please don't misconstrue my frustrations as directed at the hospital itself, just the situation the health care system is in! It is a sad fact that a great deal better care is possible, as our system and many others have proven, but these people do not have access to it.

One patient that stuck with me today was a 68 year old woman who appears well into her 80's by first look. She is extremely cachectic (emaciated/thin), to the point that I can easily make out the bony landmarks of her skull and skeleton. On abdominal exam there is a large right sided mass about the size of a tennis ball, and it is tender. We are waiting for a diagnosis, but it is likely an intestinal tumor. Why did she wait so long for care? How could she have gotten so far along before seeking medical help? To end today on a positive note I correctly differentiated a fixed vs physiologic splitting of heart sounds! A fixed split is not a good thing, means you have a hole in your heart where there shouldn't be one. A physiologic split is just a ramification on your heart beat when you take a deep breath, which everyone has. A good difference to distinguish and it made me very happy.

To end the day, Mat and I had a very nice mountain biking experience. I would have had a picture too, but the watotos (kids) who asked for a picture ran away screaming when I U-Turned to oblige them! We hit some fairly steep grades and crossed some awesome streams. We left the main "road" for walking paths that are perfect for biking. There appear to be 3-4 road types: one a car could take, one for push carts, one for walking, and the dangerous small ones that get us lost! My bike is not exactly perfect- poor gear shifting and soft breaking which I can easily fix myself. But with that and no helmet it was an experience today. The brakes squeak horribly, so it was funny to come barreling down a hill into somebodies backyard that dead ends into their field. They would come out to see the cause of the noise and find two sweating Wazungus (white people)! We would be chased by several kids and met a lot of friendly people. The great aspect is you leave the population used to seeing wazungu and enter a region where our presence is a novelty and not one where we are constantly asked for money or some such silliness. It was a beautiful countryside and nice to know I can easily get away from the hectic streets into the countryside. As it approached dark on our return, we passed a church holding choir practice, and it was a peaceful moment to hear the songs reverberate as we went by.

The nightly neighborhood dog fight has begun, which means it is time for bed.

Cheers!
Eric

Habari! (How is the day?) Nzuri! (The day is good!)

Adding to Laura's safari post, I will insert some pics about the trip. We collected several, and I will try to put together a slide show some time as the landscape and animals were truly amazing to be around. I noticed that once you are out of Arusha the country side opens up a good amount with great expanses of land and large mountain ranges. Masai in their colorful plaid blankets roam the land near their bomas (homes) with their cattle. It is peaceful out there and I will try to get out and see what I can. I hope to visit the settlements with a worker from Selian who performs health assessments once Laura returns to the states.

On safari the lions were amazing, although I did not realize what a brutal life they must lead until I looked through our pictures and saw how banged up they get! We saw a small pride attack a water buffalo, and as they attacked several were trampled and rolled on their backs. The last lion standing gave one last effort by grabbing the buffalo's tail, but in the end it got away. It was great watching them come into the valley and slowly surround the 3 buffalo.

As many of you know, Charlie loves chasing birds. My two favorite of the trip- the superb starling and this white/black/orange variety were at our picnic lunch. I tossed them a crumb since I was still not feeling quite well in the stomach and the starlings went nuts on the other bird! Needless to say, you can see Charlie's response!

Today at Selian I worked with the pediatric team again. We have one patient with a kidney disease (nephrotic syndrome) who we just aren't seeming to help. We are hoping to treat schiztosomiasis, a tropical urinary infection, but the drug is out of stock (surprise!). It is a best guess right now anyway. We are treating the syndrome with the usual steroids, and diuretics to help him lose water weight. It is a waiting game right now but frustrating as we don't seem to be helping him.

During lunch, some of the Swedish medical students rotating at Selian mentioned 2 women in outpatient clinic who had attempted suicide by ingesting pills. The first was a young woman who downed some rat poison (warfarin- an anticoagulant, makes you bleed). The other woman had overdosed on unknown pills and was given activated charcoal to help remove the toxins. Outpatient clinic is run by house officers, who are not trained physicians. For all their good intentions they do not have the training for complicated patients. We left lunch for the outpatient ward with an Australian ICU doctor named Matt (pic at his house in a previous post). The story given was that this woman had been seen by a young boy taking unkown pills, and now she was unresponsive. In the small triage room, this woman was out on a bed. She had a coma scale of 3- as low as you can get. It was frustrating because people like this should not get charcoal as they can aspirate it into their lungs. It was also frustrating because she needed a respirator, cardiac monitoring and appropriate labs. The best she would get were IV fluids and an oropharyngeal tube so she wouldn't choke on her tongue. In spite of this it was good to see where I might be more useful in the future as a trained emergency medicine physician and help Selian improve their ability to care for patients like these.

On the way out of the ward Libby noticed the girl who had taken the rat poison. She was sitting in the waiting area waiting for discharge. It was a good catch by her because the girl needed to be admitted for observation and given a shot of vitamin K to counteract the warfarin!

Tonight we decided to consolidate all the Selian volunteers into the exempla house down the road. The recent break-ins around Il Buro have ruffled some feathers. We quickly packed up our house as the electricity had been shut off and it was getting dark. The place is really nice, although it was hard for us to leave MButuai (our guard). We are going to try and stop by to see him after the move. While we waited to go he brought out a book on Masai and we talked through the pages. We discussed his traditions a bit and he brought out his Rungu (a 1.5 ft heavy wood club with a small ball of metal on the end), which he can use as a weapon. It was pretty awesome.

We ended the night unpacked and tired. I got bit by a large ant while unloading and will try to get a pic of one sometime as they are impressive. It is amazing what you can see on the ground at night with a headlamp. Endless activity amongst the ant hills as hundreds of ants attacked nightcrawlers coming out in the night!

Eric

ps- Charlie is becoming proficient at: habari! and this goes far while walking around Arusha.

Safari/time with family and friends

Okay, family (Whatley family!)...I hear you...I will try to write more often even though 1 week is not that long. Eric is the expert at putting in the pictures and videos so he will do that when he has some spare time.

Things are settling down here. Right before our safari there was some concern about the security in the area so it was a good time to get out of dodge for a little bit until the Jacobson's and towns people were able to clear things up. The Jacobson's have lived here for 30 years and are well known in Il Boro. Mark started the Selian hospital and Linda, his wife, works as a music teacher, social coordinator for all the volunteers coming to Selian and raised their children here. Since coming back from the safari, security has increased and the town leaders have been connecting to make sure the police are cooperating to keep Il Boro safe. Eric and I have also decided to move into the house down the road with other students so we are not alone in one house and the landlords/gate keepers have been notified to be extra vigilent. SO, we are feeling much better now.

Now about the safari! Bryant's girlfriend came to visit this week so we decided to reduce costs and all go together. We started out by driving about 2 hours out of Arusha to a campsite near Lake Manyara. This was no ordinary campsite. The tents were equipped with actual mattresses and had bathrooms with running water and showers. Eric, Charlie and I were offered the guest house for no extra cost...it pays to bring an infant along! The scenery was also amazing. We were on a mountain, surrounded by trees and greenery, the sky was clear and the weather was dry and about 80-85 degrees! We dropped off our bags and headed to Lake Manyara in a Land Rover with a pop up top (incidently, the Land Rover has no seat belts and no car seat, but that is not abnormal in these parts). :) Once in the park, we were almost arms length away many times from baboons, cape buffalo, giraffe, zebras, elephants, many varieties of birds, water buck, impalas and wart hogs. We will post some pictures soon. Back at the campsite, they made us a "western meal" consisting of fried fish, potatoes, and a veggie casserole (Indian style). Charlie, of course, did not eat any of it and feasted on corn flakes and peanut butter bread.

In the morning, we left at 6:30am and drove about 2 hours to Ngorongoro Crater. It was awesome!! We saw 12 lions and a group of lions attempt an attack on a cape buffalo. The perfect scenario, all the action but no kill! We got it on video tape so will try to download it later if possible. We also saw all the animals we saw the day before except elephants and giraffes. The terrain did not accomodate the vegetation needed for giraffes and elephants. There were many, many water buck and baby water buck. Supposedly, the babies are easy kill for lions, cheetahs (we saw 2!) and cape buffalo. We spent all day in the crater, ate lunch by the hippo pool. Hippos are not very interesting. All they seem to do is laze around in the water and only occasionally roll or bring their head out of the water. Their skin is very thin and so they stay in the water and roll in the mud to protect them from the sun.

We spend our last day of the safari at the Terengetti. It didn't have many animals since many had already migrated but we did see some fascinating birds and the scenery was peaceful. Charlie did great! No major tantrums, was interested in the animals and sat on our laps the whole time. I am speeding up this entry because he is now awake and getting very busy. I will write more later...maybe when he takes a nap. :)

ROL

ROL= Rank Order List.

My list has been certified for residencies- meaning that I have put all the programs I interviewed at this winter in order and hit the submit button. Now we wait a month (for March 19) to find out where we match to! One more step complete.

We had our first real power outage here too, a night of candle light and then the power was back up!

And to celebrate, here is a pic of Charlie with chocolate milk and a picture of some cheetahs we recently saw. I know, random right? But it's midnight here...

Eric

A few pics worth 1000 words

We've had quite a day here. I thought I would just add a few pictures that helped us through:

Charlie at playtime today (choose your own caption on this one):














Yesterday, MButuai (our guard) was trying to ask me something and I couldn't put it all together. Today I figured it out- he wanted to get some pics with us and Charlie in his traditional Masai clothes (with his brother, Kimane) as well!










































We are unexpectedly off on safari tomorrow morning through Monday evening! Bryant & his girlfriend Brooke are headed out and we are tagging along to split the costs for all of us. We should have some great pics/stories for you all then.





And every night ends well when Charlie has a shower!










Until Monday, take care and keep us in your thoughts- Eric, Laura & Charlie!

Funny thing happened today...

So, I was reading through my former posts and realized that they all sound a bit depressing. Sorry about that...I feel the tide has changed and life here is actually really nice in many respects. The weather here is beautiful, you can't get better than this...sunny, mid-80s during the day and drops down to 60s at night with a few rain showers here and there. I have also met some wonderful people. I attend a play group for Charlie on Wednesdays and Fridays which has been lovely (I feel like I am talking a bit like a Brit since being here since I am hanging around many of them).

The play group consists of ex-patriotes (mostly Europeans) and many cute little kids. The play group on Wednesday is at a woman's house who is an elementary/pre-school teacher during the days. She has a nice set-up where kids can paint, play in the sand-box, jump on a trampoline, play with toys, explore their surroundings. The play group on Fridays is similar but not as well equiped with all the "goodies" but is definitely good conversation. The play groups have been really nice for Charlie and me...Charlie gets to play with people his own age and I get some adult time and understand more about life in Tanzania (I promise to take pictures next time and post some).

Many of the ex-patriotes are committed to staying 3 plus years working at the international school or due to their husband's job (computers). They are all very realistic about how they feel about living here stating that they have their ups and downs. The upside is that a mom can stay at home and live a relatively comfortable life taking care of the kids, the weather is fantastic, and the people are warm and friendly. The downside is that there really isn't much to do with the kids besides a swimming pool at the Il Boro Lodge and outings like play group. One can feel quite isolated if you don't plan get togethers weekly. The moms all have cars which they say has been a life saver and really helped in getting adjusted and acquainted with their surroundings.

The slower pace is becoming much easier to handle...and I quite like it now. Lazy mornings, playing with Charlie, long walks with Charlie on my back, scheduled lunch and nap times, when Charlie naps I read or take a nap with him. It is quite luxurious. On Tuesday and Friday mornings I go to Step by Step, on Wednesdays and Friday afternoons I have play group, every other Thursday I have bible study. These activities have come to be enough for me to easily settle in and really start enjoying life here. I have met a few regulars on my morning walks with Charlie too! I realized after talking to one man that owns a shop along the road that his main goal was to find a white woman to marry and wanted to know if I knew any of them and if I thought it were possible. Now that was a loaded question! I wasn't quite sure how to answer him without crushing his dream. The thought of an American woman marrying a man that happens to be of the Masai tribe which historically do not treat their women well is hard to digest. The Masai men tell the woman what to do and the woman does it, she has no free will as I understand it (my information given to me from a friend that has lived here for 30 years and has worked with the Masai). If the man dies, the wife has no way of supporting her family and is lost. SO, you can imagine my difficulty in answering the question but basically I left it open ended....and eventually gave him Sarah's number...ha ha ha. I mean, who knows, I could be surprised. Life is often not what it seems to be...

A bit about Charlie: Charlie is getting to know our gate keeper well (Mbutuai), saying "hi" and even letting him pick him up periodically. Charlie is very independent playing inside the gate but once we step out he is reaching up for me to hold him. In the beginning of our walks he is in my arms clinging to me as little Tanzania boys and girls come up to him, try to touch him and say "jambo toto." As we walk further he gradually wants down but holds onto my hand and after about 15 minutes he is walking on his own and I am having to tell him not to chase after the dogs or chickens. He is talking a lot too! He says all gone, all done, goat, dog, please, thank you, chalk, mommy, daddy, okay, lets go, chocolate milk (hard to understand but we know what he is saying), juice, book and the list goes on. He is also pointing to all of his body parts without help (ie. where's your eye...and he points to his eye). Charlie LOVES to play in the dirt, moving dirt from one pile to the next. He loves to throw rocks, read books, and chase after mommy and daddy. Charlie and I have had fun singing songs and performing the actions (the itsy bitsy spider, hokey pokey, etc) and follow the leader (bear walks, stomp your feet like an elephant, wave your arms like a monkey, jump like a frog, run like a leopard, walk slow like a turtle, arch your back like a cat and so on). He and I have lots of fun!