Pictures!

Kigoma

Gombe

Arusha/Zanzibar

Dar, Arusha, and Zanzibar

We flew from Kigoma to Dar es Salaam, and checked into EconoLodge. After being in the quiet town of Kigoma for two months, the activity of Dar was a little crazy. I wasn’t quite used to so many cars and people in close quarters! We met up with Molly and Terry, and went out to dinner at Addis in Dar, an Ethiopian restaurant. The food was amazing – and it was nice to sit outside and not get eaten alive by mosquitoes! After a hot shower and a good meal, it felt like I was slowly returning to the real world.

The next day we flew to Arusha, and then the following day went on a one-day safari to Arusha National Park. The morning was great – we went on a walking safari and got very close to a lot of giraffes. We also saw a lot of zebras and wart hogs. The afternoon was a little boring – a lot of driving around and looking at scenery (which was beautiful), but no animals. We found out too late that Arusha doesn’t have any of the big game animas like lions, cheetahs, and elephants. So we were a little disappointed.

The next day we flew to Zanzibar, and we spent a night in Stonetown. The main part of the city is a labyrinth of old white washed buildings. It’s pretty, but very touristy, which I wasn’t really used to. We had dinner at Fondori Gardens – a park where locals set up stands and sell an incredible variety of seafood. Octopus, lobster, squid, several varieties of fish, prawns, and even some meat are grilled. You just point and they serve it up. We ate way too much, but it was cheap and very delicious, especially when washed down with cane juice.

The next morning we took a dala dala up to Kendwa, a beach town on the north coast of Zanzibar. Immediately upon arrival we had a one hour massage, which felt amazing. We spent the next three days lounging on the beach and eating great seafood. One day we did a discover scuba course and dive, where I saw beautiful coral and many different schools of fish. And on our last day we treated ourselves to full body scrubs and massages (very indulgent, but also very cheap), and I think the Kigoma dirt finally got scrubbed off of me.

One more night in Stonetown, a flight to Dar, and one more night in Dar, and then we were on our way home. Our flights were uneventful, and I got home safely on August 7th. Since I’ve arrived home, I’ve been enjoying hot showers (since I can count the number of them I had all summer on one hand), good food, reading Harry Potter, and cherishing all the comforts of living here. I do miss Kigoma and my life there a bit, but right now I’m really enjoying being back.

Checking Out

We paid for our plane tickets today, so it’s official: we’re leaving Kigoma on Saturday. I’m very excited to leave, but a little sad too. Kigoma is a very special place; a small town in a beautiful location. Even though I’m very ready to leave, I’ll always have a soft spot for this place.

We’ve packed up the boxes of questionnaires and handed them off to Dr. Godfrey, finalized the budget, are close to having a clean data set, and will (hopefully) have all the transcriptions in our hands tomorrow. We’re done! It’s a very good feeling, and we feel proud of the work we have done. I’m looking forward to seeing what happens with all the quantitative and qualitative data we have collected.

Our last few days here aren’t that exciting. Tying up loose ends, saying goodbyes. We took Anton (director of Jane Goodall Institute) out to dinner last night, and true to form Gibbs took two and a half hours to get our food on the table after we’d ordered it. We don’t get annoyed at it; it wouldn’t be dinner if you didn’t have to wait a few hours (it’s part of the entertainment here; what else would you do with your evenings?). We had good company: we were joined by the newly arrived conservation specialist for JGI Kigoma and the director of a research program for undergraduates (all sorts of water, fish, and snail projects) who’s been arranging groups of students to come over for research experience for the last ten years. She knows a lot of great facts about the lake, and is an all-around nice person too.

I had my last run in Kigoma, which made me a little sad. There’s great running here, although I won’t miss the dust and exhaust fumes from the cars. Today was our last day, and it was blistering hot; really uncomfortable. I spent the morning at Baby Come & Call and taking pictures of Kigoma. We went up to Hilltop for a lunch of grilled cheese (one of the best things I’ve tasted in a while), and tonight we’re having dinner at Gibbs. Ending our stay in Kigoma the same way we started it. And like that first day, we’re still waiting for our food.

So, we’re flying out of Kigoma tomorrow (Saturday) morning. We fly to Dar for one night, where we have plans to go to an Ethiopian restaurant with Molly and Terry, who are arriving back from Zanzibar that day. The next day we fly to Arusha, and on Monday we’re doing a one-day Safari to Arusha National Park. Tuesday we fly to Zanzibar, where we’ll stay until Sunday. We fly back to Dar on Sunday (fingers crossed the flight doesn’t get canceled!), and then back to SF on Monday. So, this will be my last blog entry until I get back to the US, when I’ll let you know how my travels went.

Almost Done

We’re down to our last few days in Kigoma – thank goodness! The project wrapped up really well. We ended up with 930 completed questionnaires – about double our target so we’re really happy. All the data has been entered, just has to be cleaned up a bit. We need to prepare the boxes of surveys to be shipped back to the States, but that should b finished tomorrow afternoon. During the last two weeks of data collection, we also conducted almost thirty in-depth interviews with mothers, TBAs, and nurse/midwives at the hospital. Last week we held five focus groups with community leaders, TBAs, and health workers. They went really well, and we have almost ten hours of recording from them. What we’re waiting for now is to have all the audio transcribed into Swahili before we leave, so it can be translated into English when we get back to Berkeley. So, needless to say, we’ve been busy busy the last few weeks. But now there’s only a few days left, and we’re itching to go. We really could finish what we need to do in less than a day, but we have to wait for all the transcription. It’s dragging on, and it doesn’t look like we’ll get to leave until the end of the week. It’ll leave us with about a week to travel, and we’re hoping to go to Arusha for a one-day safari and then on to Zanzibar for a few days on the beach. And then, two weeks from today, I’ll be on my way home. It’s hard to believe that the summer is almost over; it’s gone by really fast. I’m happy to be coming home, and I’m really ready to leave Kigoma. With only one restaurant left that hasn’t made us sick, and nothing to do but sit in our room at night, we’re really ready to leave!

7/18: And then there were two...

As July continues to pass by at the pace of a runaway train, things are beginning to wrap themselves up here. Molly and Betsy finished their project on the 10th, and we had a farewell dinner at Gibbs with Dr. Godfrey and the supervisor from their team, Mr. Caliste. It was an enjoyable evening, and it was just unbelievable that they were actually done (which meant we were approaching being done). They did a random sample of 30 houses in 50 villages, ending up with a response rate of 91% and interviewing 1200 women – pretty impressive. I’m really excited to see what their data looks like. It was great having two fellow students working on a similar project to share this experience with, and I’m sure we’ll be in contact in the future (maybe do another study, perhaps? Although I think hiring interns to do data entry is a fabulous idea).

We spent Betsy’s last few days fabric shopping (our favorite pastime, fabric is cheap but it’s adding up in both weight and cost!), and eating at our “favorite places” (aka the only three places in town we can eat). And then on the 12th Betsy left.

I guess her leaving marked the beginning of the end, because a week later Terry and Molly left for Zanzibar. On their last day, Terry and I went for our final run together. We logged 83 minutes, going a little more than 9 miles by our estimate. We ran from AquaLodge through Kigoma, around to the lake and across the bridge to Kibirizi, and then followed the road out of Kibirizi for another half hour. Around the spot we turned around, we were rewarded with an amazing view – a distance shot of Kigoma and the lake. We were surrounded by grass fields and a few mud houses, and groves of palm trees spread out below us and into town. It was one of those “woah, I’m in Africa” moments. I’m kind of used to being here at this point, it all feels kind of normal. But then sometimes it hits me where I am and what I’m doing, and it just feels really unbelievable. We came back from our run feeling pumped and excited, and starving.

All four of us were invited to Caliste’s (Molly and Betsy’s supervisor) house for dinner that evening. He lives in a really nice house – actually the first real house I’ve been in other than mud huts – in what feels like a suburb of Kigoma (we called it Kigoma’s Agrestic – I’ve gotten everyone hooked on Weeds). His wife is beautiful and very hospitable, and cooked us an amazing dinner of noodles, coconut curry vegetables (the first time we’ve had veggies we’ve seen in the markets – okra, eggplant, and peppers!), beans, chicken, rice, ugali, and chipati. For dessert there was perfectly ripe papaya and bananas. It was a feast, and the most delicious meal we’ve had in Tanzania. We’ve really been missing out – the food in the restaurants doesn’t compare. It felt really nice after a month and a half of living in hotels and eating in restaurants to be in someone’s home and have a home-cooked meal, and hang out with a family. Caliste’s triplets (two boys and a girl, almost ten) had arrived the previous day from boarding school, so we got to meet them, which was a treat.

It was really sad saying goodbye to Molly, Terry, and Betsy. It doesn’t feel real that they are all gone. It’s quiet just the two of us, and we miss having other people to share our time and meals with (dinner seriously is the main source of entertainment. Since it takes at least an hour at Gibbs to get your food after you’ve ordered, it takes most of the evening to have dinner – thank goodness or else we’d be really bored!). So now it’s just the two of us, counting the days until we can leave Kigoma and do a little traveling before we come home.

7/15: Observation

I spent today shadowing a nurse-midwife in the maternity ward of Maweni hospital – an incredible experience.

The maternity ward is set up like a shotgun house – each room leads directly to the next, going straight back (so if you fired a shotgun, the bullet would travel through each room). The first room you enter into is the recovery/ward room. 18 saggy old metal beds line the walls. Today every bed was full – women sleeping with a baby wrapped in bright kangas like a present at the foot of the bed or next to them, awake mothers breast feeding, and then the recovering women – laying on their side staring into space, recovering from a c-section or suffering from malaria, the drained and exhausted women recovering from PPH, and the vacant expressions of the women (around 3) where the brightly colored packages were conspicuously absent. Around 12 visiting hours began, and the ward turned into a zoo. Each woman had an average of four women visitors, each carrying kangas, tea, and porridge to fortify the new mothers. They held the baby, bugged the nurses, fed the women, and provided support. It seemed like a very necessary part of postpartum care for these women. A few men came, hanging back and maybe holding the baby. It was obvious that this was women’s territory. When the visiting hour was over, the mass of people went outside to wait for the next visiting time, which explains why there are always groups of ladies with thermoses and kangas sitting in the (open air) corridor outside of the maternity ward.

The next room is the nurses station. It, like the ward, had chipping cream and sea foam painted concrete walls, a concrete floor, a single fluorescent bulb, and a rusty metal fan. It’s a busy room, with people (not just nurses, but patients too since it connects all the rooms of the ward) coming and going. They don’t have a stapler, so they use medical tape to hold patient’s papers together (I’m giving them one when I go to observe again next Monday).

The room beyond that is the delivery room. It has four metal beds with plastic pads on them. When women deliver they put a plastic sheet down, which they reuse wash between patients. There’s also a rusty little box on wheels that they use to hold the babies after delivery. There’s only room for one, so if more than one newborn is present the others have to lay on the weighing table next to wrappers and instruments. Beyond the delivery room is the ANC room, where women who have begun labor but aren’t ready to deliver wait until they were ready. The ward was so crowded when I was there that the overflow stayed in this room.

So today there were over 26 patients – 18 in the ward, 4 in the ANC room who had already delivered, and a few that showed up to deliver. There were five deliveries during the 8 hours I was there (all but 1 were delivered in the last two hours). There was one nurse/midwife and one public health nurse on duty.

I spent a lot of the day alternating between being really bored and being incredibly overwhelmed. When I first arrived, a woman was going in for a c-section. They invited me into the theater, but I declined – didn’t feel quite ready for that. I went back to the delivery room and watched women labor for the next few hours, taking breaks to watch the nurse give transfusions and injections. I saw several vaginal exams – one of them I was instructed to step back during the middle of it, and a few seconds later her water broke flooding the table and the floor. Later I was standing just observing the room, when I got pushed out of the way. I looked back, and a couple feet from where I was standing, a head was emerging. I saw the baby be born, and then the n/midwife took the baby and started cleaning it. She ignored the mom, and when I looked back over my shoulder, I saw another head appearing – twins! I tapped the nurse on the shoulder, and she went back over to deliver the other twin. They had no idea that there were two babies there – no ultrasounds here and archaic methods of listening to heartbeats, so usually twins are a surprise here. The second twin was much smaller, and had to be put on oxygen. Meanwhile, the on-call doctor for the hospital (the one) examined a woman that had been laboring for over 24 hours. He said that the heartbeat on the baby was beginning to change, and he needed to perform a c-section. So I attended a cesarean. They put me in scrubs (not sure if they were clean or not, there was a bit of scurrying to find them) and wrapped my face in gauze (no extra masks). The doctor had me stand two feet from his side, and I watched the procedure. I won’t gross you out with the details, but it was really interesting. The baby had gone into distress, and it’s head was about a foot long from being stuck in the birth canal for so long. They spent ten minutes resuscitating the infant, and thankfully he was fine.

After that, I was done – a long day! It made me realize I definitely don’t want to be a doctor (all that sewing looked really monotonous), and maybe don’t really want to be a nurse either (the operation didn’t bother me, but drawing blood and tying the umbilical cord did). I think I do really want to be a doula, because all I wanted to do during the hours I spent with laboring women (4 at once at one point) was support them and rub their back and help reduce their pain. It was an incredible day, and I’m fortunate enough to be going back for another observation with one of our interviewers who is also a nurse-midwife at the hospital next week.

What amazed me a lot was how self-sufficient the mother's were. There was definitely no coddling involved - in fact the nurse slapped a laboring woman on the but a few times to get her to move. Among the women's belongings were thermoses of tea, and in between contractions they would pour themselves a cup. The woman who had twins barely made a peep during delivery, and showed no surprise when she delivered twins. In fact, she never spoke to the nurses. After delivering the placenta and getting cleaned up, she wrapped herself in a kanga and, without a work, walked into the ward. She looked utterly exhausted, and never asked about her babies. Her mother came in later to retrieve them and take them back to the ward.

7/11: Evil Eyes

Yesterday was another great day in the field. I conducted two in-depth interviews with mothers that had PPH and were treated with miso. Both were great respondents, and we spent about an hour with each woman (and I took about three pages of notes on each!). I give my interviewer a list of prompt questions, and then she conducts the interview in Swahili. This part takes about 20 to 30 minutes, depending on how much of a talker the woman is. Then I have my interviewer review what was said during the interview, and I ask questions about her responses or think of other questions. I had great conversations with both mothers about miso and TBAs, what the problems were and how we could make things better. The women had great suggestions, such as having the community pool together for the TBAs to have a cell phone so she can be reached for emergencies.

I sat and talked with my interviewer for a while after we finished the interviews. There was a woman we really wanted to interview, but we were unable to reach her. I guess when she completed the questionnaire she spoke with this interviewer for a long time afterwards, and her story is great. Even the TBA was disappointed that we weren’t able to get her for in-depth interviews because she has a lot to say. This woman lived in a remote village off of the lake (probably one of the villages I saw on the way to Gombe, where there is only boat access). In her village, at least 5 women die per month due to PPH. She heard from a relative that there was a TBA in this village who had a drug to treat PPH, and so she traveled all the way here to give birth with her. When she heard that there were people coming to the villages to ask women who had had PPH and taken miso questions, she traveled back to the village just to be interviewed, which is when she met my interviewer. She stayed for a week just to be here for the questionnaire administration, and during that time 3 women died in childbirth.

The TBA and her assistant walked us back to the main road when we were done. They asked me questions about where I came from, and had heard of San Francisco before. I asked if they wanted to see pictures, and pulled some out (I always carry some with me, people love them!). I said I had a picture of my house in SF, and my interviewer asked if I had built it myself. I said no, and that I rent, but that didn’t really translate. When I showed them pictures of my roommates, they started pointing very excitedly at Pearl. I said no, that’s not me, I’m on the right. But they kept pointing, and finally my interviewer asked me why her eyes were red. I explained that when people have blue eyes, often the camera makes their eyes look red. She said “oh, ok” and explained that they had all thought that she was evil or possessed, and they were all really worried. They asked to keep one of the pictures to remember me, and they definitely did not want the one with Pearl in it, they took one of my family at Elise’s graduation instead.

7/8: 24 Hours in Paradise

We went to Gombe. At around 11 on Saturday morning, we got a call from Betsy and Molly’s colleague saying that he had arranged a boat from the hospital, and we should meet the driver at noon to make arrangements. We walked into town, arranged for the boat to pick us up at 3pm, paid him, and were set to go. It seemed ridiculously easy after all the work we’d put into going during the week.

At 3pm sharp (the first thing to happen on time ever in Tanzania), the boat pulled up behind our hotel and we loaded it up. The boat was a little rickety – it used to be the TB/Leprosy boat for Maweni hospital – with a only a minor leak that kept one of the crew busy scooping out water for a good half of the journey and filling in minor holes (with wool pounded in using a screw driver and a rock). Since the boat was named Survival and there were life jackets on board, we weren’t too worried. The journey took about two hours, and was beautiful. We passed small little villages on the lake, and watched the landscape turn from the red dirt and palm trees we know so well slowly to forest and then dense forest. We arrived at Gombe and were taken to the Rest House, a small but great green building with an open air wraparound living room (with screens and mesh to keep the baboons and mosquitoes out) and two bedrooms with two big beds each (which felt amazing after sleeping on my smaller than a twin bed for the last month). We made arrangements for our treks the next day, and then Anton, the director of JGI showed up. He welcomed us and insisted on having his cook come and get all of our food to prepare our dinner for us. He’s an amazing man – very accomplished but so calm you always feel very at ease with him. We went for a long walk on the beach and short swim, and then headed up to Anton’s house.

Anton actually lives in Dr. Jane’s old house that she built in 1973 when she started doing research. It’s a really cool open air house (with screens of course) that was completely candle lit when we arrived. Anton showed us a large poster with all the different monkeys of Africa, explaining which ones were located in Tanzania and tons of interesting facts about them. He also showed us a bunch of skulls of wild pigs, monkeys, and baboons, telling us about their teeth and how they are used, the size of their eyes and how you can tell if they have depth perception. We were joined by Mark, a University of Minnesota student who is doing research for six months at Gombe. We drank the wine we had brought with us (an actually decent Merlot from South Africa that’s only about $6) and talking about life in Gombe and Kigoma. Then we had a delicious dinner and said our goodbyes. Before we went to bed, we went out to look at the stars, which were amazingly bright since the moon hadn’t risen yet. I saw a falling star just as we went inside.

We got up bright and early this morning and had breakfast (boiled eggs on bread… yum). Anton was nice enough to give us a thermos of hot water and instant coffee (I’m not sure how much caffeine is actually in it, but it makes the mornings a little easier). The baboons started coming out around breakfast time, and started walking around our little house. It was crazy being so close to them! We saw a cute little baboon hanging onto its mother’s back.

Anton met us and escorted us up to the park office, where we met our guides. Our plan was to hike to a few areas and try to spot chimps, (which is actually a little difficult – a lot of people come all the way to Gombe and never get to see any), then hike up to the waterfall and then further up to Jane’s peak. We started hiking along the forest, which was incredibly beautiful, and stopped at the feeding station. When Dr. Jane first came to Gombe, she had a hard time finding the chimps. Since they were raiding the local food stores and stealing bananas, she figured out that they really liked them. So she built a little house a little ways into the park and laid out bananas so the chimps would come near her, and started observing them that way. The guide was a little ways into telling us this, when the other guide pointed up and said “chimp.” We looked up, and in the tree above us was a small chimpanzee. It was wild! We stood there watching him eat leaves, taking a gazillion pictures, when we noticed an even bigger chimp a little higher up. All of a sudden Anton showed up, and started telling us the names of the chimps, and that they were both males. The smaller one was a younger male who was doing active idol worship – following around the bigger male and imitating him, learning his mannerisms. Then a mother and her child showed up on the other side of us, the mother grooming the baby. The males climbed down from the trees, and the mom and the baby walked across in front of us, and the whole bunch moved down the path. Anton motioned for us to follow them, which we did for a ways. He said that it was a mother and her child, and the mother’s brother. We watched them chill and groom each other. It was very surreal, standing there watching the chimps with the director telling us all about them. Crazy.

Then we hiked up a little farther to watch another family. They were really high up in the trees eating, and we waited for them to climb down, but they never did. We decided to hike for a while and come back later. We hiked to the waterfall, where Gombe stream cascades down for 25 meters before continuing onto the lake. Gorgeous. From there, we hiked for about 30 minutes up to Jane’s peak. This is where Dr. Jane hiked to every morning at sunrise, because you can perfectly see the two valleys below and she could see where the chimps were to follow them. We were amazed that Dr. Jane is 74 years old, and when she’s at Gombe she still hikes up it every day, because it’s a steep climb. She’s an amazing woman, for many reasons. The view from Jane’s peak was incredible – the valley of forest spreading down below us and continuing all the way to the lake, which is so large you can’t see across it. Our guides pointed out a few old chimp nests. We sat up there admiring the view and feeling like the only five people in the world for a while before climbing back down. We tried to find the family that we were waiting for earlier, but they had apparently climbed up to Jane’s peak while we were climbing down, so we missed them. We didn’t really mind, seeing more chimps than most people ever get to see, and very close up, so we hiked back down to camp. Also walking through the park we saw blue monkeys, baboons, and many different kinds of butterflies.

After a yummy lunch of crackers, avocado, and cheese (we found one shop that has what we assume to be very very old cheese, since Tanzania doesn’t have cheese, but that tastes delicious anyways), we all jumped into the lake and swam for a while. The lake is so huge that the water is wonderfully clean, so you feel really rejuvenated and clean when you get out (cleaner than we feel after we take a shower at AquaLodge, where the water is dirty and the water pressure isn’t enough to get your hair completely wet).

We stopped at Anton’s house before we left to say goodbye and thank him for his hospitality. He was very kind to us during our stay, and after such an incredible 24 hours we were really sad to leave. It felt like paradise, or like we had discovered the fountain of youth. We just felt so clean, inside and out, and re-energized. The fresh air, hiking, fresh water, and good food did us all a lot of good since we were a little rough for wear after the last month. The park is one of the most peaceful places I’ve been to in my entire life. We had another nice boat ride home (although we all fell asleep for a while), and came back buzzing from our incredible trip. We felt like the luckiest people in the world, experiencing what few people in the world have experienced, and being lucky to share it together. We went and had a great meal at Gibbs to finish off such a wonderful weekend.

7/6: Weekend Plans

Who would have thought our plans could change so many times within a few hours? We’ve been planning all week to go to Gombe National Park, the park where Jane Goodall set up her institute to study chimpanzees in the early 70s. The trip requires a little planning, though – you have to hire a boat to take you there, make sure you have enough money in US dollars (all the TZ national parks operate on US $), and buy all the food and supplies you need to cook it while you’re there because there’s no food in the park. We managed to take care of the food and the money, but hiring a boat was very difficult.

First we started at the Jane Goodall Institute, trying to see if we could borrow one of their boats, but everyone was out of town. Then Dr. Godfrey said he’d try to arrange a boat for us, but that didn’t work out either. So then we had Betsy and Molly’s colleague call a number they got from some Irish doctors they met in Kasulu that have gone to Gombe. Betsy and I met with him this afternoon (Friday) to negotiate the price. He told us the boat he usually takes to Gombe is gone for the weekend, but he has another boat that we could take. He promises us that it can easily take five people, is safe, and will only take two hours to go to Gombe, but we decide to go and take a look at the boat just to be sure. Good thing we did. His boat was nothing more than a glorified canoe – I didn’t even see a motor on it! I took a picture with my phone so that the other’s wouldn’t think that we were just being picky. We later found out the boat has holes in it too.

With it being 7pm on Friday night, we figured we should just admit defeat and realize we’re not going to Gombe this weekend. It’s Betsy’s last weekend, so we were bummed that she wouldn’t be able to go. But then we were hanging out in our room and saw a boat outside, and thought it wouldn’t hurt to see if we could hire them for tomorrow. After talking with them for a while, they agreed to bring the boat over the next morning, and we could decide if we wanted to take it or not.

Even with this new prospect of going to Gombe, we actually came up with another plan – hiring a car and driving to Burundi, a small country juts a few hours north of here. It would get us out of Kigoma, into another country, and be an adventure. With a new plan in tact, and time to arrange a boat for Gombe the next weekend, we were happy with our plans.

For dinner, Terry had bought a chicken in the village and brought it (still alive) back to the hotel. The kitchen killed it (I’m used to the sound of dying chickens because if I’m near a place that serves food at dinner or lunch time, you hear a lot of squaking for about five seconds and then a big chop!) and cooked it up for us. I had fish but tried a taste – not too bad. It’s a little tough and chewy, and I guess it’s because the chickens are so muscly here from all the running around.

We hung out in our room drinking Zed (pineapple alcohol, we’re not sure what kind) and juice, listening to music, and getting excited about going to another country tomorrow.

7/5: A Day at the Office

We’ve switched to the control area, Kigoma Rural. It’s about what I expected – same mud houses with thatched roofs, now only spaced farther apart and located an hour down a dusty, bumpy dirt away from Kigoma. I went along with the team today to assist one of the supervisors in conducting in-depth interviews. We want to hear about the woman’s birth experience and her perspectives on home vs. facility delivery and PPH.

First thing this morning was a breakfast meeting at 7:30 with Dr. Godfrey to review the project and get the next disbursement of funds. We’re in charge of the day to day finances, paying the interviewers and TBAs their allowances, transport, communication, etc. We asked for the next ten days, and the bank only had 5,000 TSH notes (the highest is ten, so it’s not that small really), so we got a stack of cash about eight inches high (can you imagine $4,000 in $5s? That’s about what we got).

I met the team at the usual spot – Mama’s Best restaurant, and we took our hired Dala Dala to Simbo. Like I said before, it’s located about an hour out of Kigoma along a dirt road. Every time a car came in the opposite direction, everyone would close all the windows to prevent the thick clouds of dust from entering the car. This only partially worked, because I was covered in a film of dust by the time I got Simbo. The dust just cakes on throughout the day, and usually by the time I come home from the villages I hate touching my skin because it’s so gritty from all the dirt. It’s a bright red dirt here, and it stains everything – trees, shoes, clothes, and I’ve just noticed that the tan on my feet isn’t a tan – the dirt has stained my skin!

Mr. Mwamba interviewed two women, and I held our ghetto tape recorder up for him while he interviewed the mother. Of course I couldn’t understand anything that was being said, but at the end of each interview I had him ask her questions that weren’t on the prompt list that we’d created, just stuff I thought of at the time, like “if you got pregnant again, where would you want to deliver and why?”

In the afternoon we drove around picking up interviewers from around the village (it’s really spread out). We waited near the center of the village for a while, where there were piles of coconuts. Boys around ten years old trimmed down the outsides with huge sharp knives using long whacking strokes, and then created a drinking hole on the top. We all had one, and the coconut juice was alright (it kind of tasted like it wasn’t ripe yet). When you’re done drinking, you hand the coconut back to the boys and they grab their huge knives (a little scary seeing such young boys wielding such large knives) and start hacking away at the coconut, breaking it in half and loosening the meat for you to eat – that part was pretty tasty. A deal for 10 cents! Our interviewers also bought long sticks of sugar cane (one was the length of the dala dala; I heard a knocking noise while I was sitting reviewing questionnaires and turned around to find one of the interviewers with a huge knife cutting off a piece. Whereas I need someone to cut up the sugar cane for me, they just take huge bites out of it and spit out the hard outside, something I’m a little to timid to try.

Back home to enter data and organize completed questionnaires, and plan for the next two weeks. It’s crazy to think that we’ll (hopefully) be done at the end of two weeks! We still have approximately 200 questionnaires to administer, 15 in-depth interviews to conduct, and 6 focus groups to hold. We need to get all the qualitative work transcribed and translated before we leave too, along with gathering some basic statistics about the study population – we’ll be cutting it close!

Tomorrow will be another day at the office – I’m going back to Simbo with Mr. Mwamba to conduct more interviews – one with a mother and one with a TBA.

7/1: My Weekend

I think we’re settling into life in Kigoma. This weekend was very pleasant, although not particularly eventful. Friday night we had dinner at Gibbs (the first hotel we stayed at that has the widest selection of food), and only waited two hours this time – last week we waited three.

Saturday was an errands running day for me. I left the hotel early with the mindset of getting everything done and getting back to the hotel before the heat of the day. Didn’t particularly go as planned. I walked the mile and a half from our hotel to town, and dropped off our questionnaire to be photocopied. I realized I forgot to bring the consent form, so I knew I would have to walk back to the hotel and then back to town again at some point that day – bummer. The next hour I spent trying to find a small voice recorder. Apparently, all six places I went had “just sold the last one”, which is Tanzanian for “I had one once and sold it at some point in time, possibly five years ago.” I finally found a small radio/tape player that has a record function which I figured would work (we need to tape in-depth interviews), but then had to search all six stores again for blank tapes, finally finding them at the last one. Phew! Then I walked back to the hotel to pick up the questionnaire and Kristina, and ran into Molly, Betsy, and Terry (the MPH students working on the Michigan survey, and a visiting boyfriend). The five of us went into to town and had lunch at Sun City, where we had tasty pilau (rice sautéed with spices so it turns brown, a big improvement on plain rice) and beans. The best thing about Sun City is your meal comes with a fruit cup – fresh papaya, pineapple, and watermelon, yum! After more errand running I returned to the hotel to nap because being out in the sun for four hours is super draining! At six I met Terry and we had a good run out to the edges of town and back, getting back just as it got dark.

The five of us had big plans to go out on Saturday night. We took a taxi to where we wanted to go, and it was empty. Not just kind of lame empty with one or two people there, but literally empty. We figured Kigoma’s probably the sort of town where there’s certain places you go on certain nights of the week, and apparently Saturday was not the night for this place. So we told the driver to take us to Website Pub, which was pretty busy. It has a big spacious hall and also outside tables. The hall was reserved for a wedding, and we got to peek in and check it out. It was pretty cool – kind of just what you would imagine a Tanzanian wedding to be. We got some food and drank some beer, and had a great time hanging out. We were done by 11, though and headed home.

Today, after a lazy morning at the hotel, the five of us walked into town for lunch at Ally’s Café – again, pilau and beans. The portions are so big that I ate half, was stuffed, and ate the other half for dinner, and was stuffed again (actually, I didn’t even finish it for dinner!). Then we walked around the market, looking at fruits, pirated DVDs, and fabric. Then we headed out to Jacob’s (or as the locals call it, Mzungu) Beach. You have to take a perilous taxi ride their, climbing dirt roads that are meant for four-wheelers in a Corolla (or Corona as their labeled here, I think everything is pirated). It’s a beautiful private beach, and we lounged around in the sun and swam in the crystal blue water. It felt like vacation, and was really relaxing. We shared the beach with monkeys, and had to keep an eye out for them or they would try to look through our stuff. It didn’t help that Betsy had bananas in her bag, so we ended up throwing them to the monkeys so they’d stop trying to sneak into our bags. It was crazy being that close to these cute little monkeys, and I got a few pictures.

Tonight we’re watching pirated movies and going to bed early – a nice finish to a relaxing weekend. It feels good to recharge my batteries because I have a feeling the coming week is going to be a little hectic.

A Couple of Pictures

I actually haven't been great about taking pictures here, mainly because I feel weird taking pictures of random people here. But here are a few that I've taken - some from Dar, some of the training, and a few from time in the field. Hope you enjoy, and I'll try to post more soon!

Tanzania

Mutant Eggs

It’s funny the little things you obsess about when you’re living in a foreign country. For us it’s the eggs. We eat them a lot here – standard breakfast at any hotel is an omlette (nice and greasy, kind of like a fried scrambled egg) with toast, and of course chips mai. We thought it was a little odd when we first got here that they only made egg white omlettes. “How very health-conscious of them” we thought, although we really thought there might be some cultural taboo against eating the yolk here or some such thing.

Then one day we got a hard boiled egg. Cut it open, and, low and behold, the yolk was white! Now this we found fascinating. First thought – albino chickens? No, we’ve seen hundreds of chickens (they are only outnumbered by goats walking around in the street), and they look normal enough, maybe just a little smaller and not as robust as their California cousins (I guess having chickens at home really does pay off). So why on earth are the yolks white? Everyday, when I have my fried egg, I think about it and shake my head. It doesn’t make any sense.

Thankfully, the answer has come. My friend Sabrina has informed me that the chickens are not getting enough keratin in their food to make the yolks yellow. So they aren’t some mutant strain of chicken, they’re just malnourished! Which I can see, given the variety of food here – I’m feeling a little white myself (pun intended).

Africa's Calistoga

I was prepared when I left the US to be a bit bored in Africa; I figured it would be kind of like Barbados – not really much to do for fun. I was right, but didn’t realize the extent of how little there is to do here!

Kigoma is a small town, and is now reminding me more and more of Calistoga. Except, believe it or not, I think Calistoga has more to do for the visitor than Kigoma. At least there’s wine-tasting and spas. Kigoma’s nicest building is the train station built by the Germans in the late 1800s. A pretty building, but empty since the rail line doesn’t reach Kigoma anymore. Town is a single street with “shops”, really just little storefronts where the owner sits behind the counter. We’ve found our favorite with the best cookie selection – a meal here really isn’t finished until you’ve had the full range of carbohydrates, it isn’t very satisfying to only have one or two kinds of carbs, really. The fun thing about the shops is that they are very specialized – there are several stands that sell sundry foods, but the others are very specific. Such as the pirated DVD store, the speaker store (sells nothing but stereo speakers, but sadly doesn’t have computer speakers), the ribbon store, the plumbing store, the electrical store, and the liquor store (selling wine from New Zealand for $8, but I have a feeling it’s been in the hot sun for a few years).

There are several small eateries along the one road in town (no stoplight – Calistoga has a one up on that) that serve the same thing: chips mai (omlette made with fries) and a variety of fried doughs. There is one small restaurant that serves rice and beans. And lastly, there’s Sun City, a restaurant we frequent because we get our food in 15 minutes (more on that later) and there are at least three things on the menu we can order – the same fish with three different sauces, served with three cups of rice. We usually either eat here or at Gibbs resort, which is where we stayed the first four days we were in Kigoma. So, needless to say, the food lacks variety. We tend to get excited about food that’s not necessarily good, but at least different (like the beans with rice – the rice had seasonings added to it, so at least it wasn’t white). We just got through trying to decide where to go for dinner, and none of the three options are sounding too appealing. It’s going to be a long month!

So other than “shopping” and eating, what else is there to do? I go for runs around town which are usually pretty entertaining. As I run along, I get yells of “mzungu!” and “jambo” as I go past, and plenty of giggles and smiles. Sometimes I run into more exciting road companions. Such as the time I looked up (I have to run with my head down so I don’t break an ankle in one of the gazillion potholes) and saw a heard of bull running towards me. Or my last run, where I ran to a small village nearby Kigoma that has a cute little port (lots of little wooden sail boats) and a small market. By the end of the run, I had the entire village of children running after me – at least thirty kids – all yelling and hollering as we ran. That run I did with Terry, the visiting boyfriend of one of the girls from the University of Michigan. The two MPH students are doing a study on women’s utilization of health facility in the rural villages outside of Kasulu, and spend their weekends here in Kigoma. They’re nice girls and we “hang out” (code for talk about how there’s nothing to do) sometimes on the weekend. Terry may be my new running partner, we had a fun time exploring and had a good run.

Unfortunately, western Tanzania is pretty out there (the bush, as Dr. Mbaruku calls it). The road connecting it to other areas aren’t really open all the time, and it’s not like there would be anything there that there isn’t here in Kigoma, since Kigoma is the “big city” on this half of the country. So no weekend trips for us, sadly. Stuck here in good ole Kigoma, watching the fish dry. It’s called dagaa, a local specialty. They’re tiny little fish about an inch long that fishermen lay out to dry in the sand (very hygienic) to dry (fun to watch, like paint) and salt, and are served as a snack or in a sauce with rice or ugali.

And well, that’s about it. There are still the discos to check out, which I think we might do next weekend. We met DJ Super at Sun City, so we’ll see how he spins.

Mzungu!

Going into the villages is quite an experience. It’s the Africa you imagine – kids everywhere, mud brick houses with thatched straw roofs. It’s amazing that this is still considered part of urban Kigoma; I’m interested to see what Kigoma Rural (where the control group is located) looks like.

To reach these areas, we have to travel along crazy dirt roads (our dala dala got stuck today, we all had to get out and push it!). They are groups of houses with small dirt paths tread in the grass. The TBA comes to welcome us – a series of welcome, thank you, thank you, I give you respectful greetings, thanks for your respectful greetings, how are you, I’m fine, how is your morning, good, welcome, thank you, thank you, thank you. This series of exchanges happens with almost everyone you see, and is made even longer by the fact that the response to thank you is also thank you, so you end up in a cycle of asante’s that can last a while. The TBA then leads us through the village to the woman’s house. Usually I am lost in my surroundings, watching where I walk and taking in the environment. So it usually takes me a few minutes to realize that I’m being followed. It starts off with one or two, and then usually builds up to around thirty kids, who follow me through the village. Children that see me start yelling mzungu!, which in Swahili means European but they use it for any white person. The mzungu! Mzungu! Yells follow me wherever I go, and usually when the interview starts the TBA has to grab a stick and start swinging it at the kids to shoo them away. That works initially, but during the interview I notice little heads peering around the yard fence (or should I say mud wall) or little eyes peering through the windows of the house. I feel bad for disrupting the interview, but there’s not much I can do. Whenever I stop walking through the village, the kids crowd around me but usually stay a few feet away.

The really brave ones will come and touch my skin when I’m not looking. The interviewers say they are fascinated by me because they have never seen a mzungu walking around their village before. They have seen them driving around in cars, but never walking from house to house. The TBAs get very concerned that I will overexert myself (as do the interviewers), because they believe mzungu only travel by car or plane; they do not walk. Yesterday James became very concerned because I had a “rash” from too much sun exposure, and told me I needed to bring an umbrella next time. I had to explain that the rash are freckles, and they are there all the time.

It’s an amazing experience being out in these areas, and very humbling to see how they live. It’s a reminder of how poor this country is. I notice it in the markets and restaurants – there’s not really any food to buy, which feels annoying to us but is due to the lack of wealth in the area – but it really hits home when you walk inside someone’s home here. In spite of it, I have to say that Tanzanians are the most welcoming people I have ever met. The women greet us with karibu (you are welcome here), and we have to go through a long cycle of karibu, asante, karibu, asante, karibu, asante everytime we enter or leave. Many women have asked the interviewers to tell me how thankful they are that I am here and doing this work, which makes me feel really good about what I am doing. They also say either they want me to marry their son, or they wish they had a son I could marry, so that I would never leave. Very sweet.

What We Do

It’s been a busy week since I last wrote. I figured you all might want to know what it is I actually am doing here in Kigoma. In 2003/2004 my professor conducted a study here, teaching traditional birth attendants (TBAs) how to recognize postpartum hemorrhage and administer misoprostol, a drug that makes the uterus contract and so stops the bleeding. It was a successful intervention, and the TBAs have continued to use miso since then by themselves. Our project is to interview women who have given birth since the intervention ended (August 2004) to assess the acceptability, feasibility, and reach of TBA distribution of miso.

Since arriving in Kigoma, we have finalized the translation of the questionnaire into Swahili and trained a group of ten interviewers. Each day, an interviewer is paired with a TBA in a neighborhood of Kigoma (it’s called Kigoma urban, although I think their conception of “urban” is a little different than ours – these are more like villages with houses made out of mud and roofs made out of straw, no electricity or running water). The TBA introduces the interviewer to women she has helped deliver, and the interviewer conducts the structured questionnaire. This week, Kristina and I have been rotating following the interviewers to see how they are doing with the questionnaire. Even though we don’t speak Swahili, it’s amazing what we can pick up and have found points of confusion where the interviewers were not asking the questions correctly (the problem with working in second languages!!). At this point, we are pretty confident that they have it down.

So in the mornings we meet at 8am at the hospital and disperse, and then we return around four and people gives their completed questionnaires. We sit at Mama’s Best restaurant and review the questionnaires for mistakes, and clarify questions for the interviewers. Then it’s back on a dala dala (minibus) to our hotel, where we usually go for a run, eat dinner, and then enter the day’s data (35 – 50 interviews). We’re usually done around midnight, and then it’s up to do it all again the next day. Now that we’ve reviewed the interviewers, we can start going once or twice a week and have our days free, which makes us really excited – these long days are starting to wear us down! It’s tough work but we’re really enjoying it.

6/12: Work, Work, Work

As the name of this post suggests, we did a lot of work today. We spent the morning reviewing the Swahili translation of the questionnaire and fixing mistakes. We then went into town with Mr. Ganai and reviewed our changes with him and waited for them to make 15 copies of our human subjects training packet (only 5 pages), which took almost 2 hours. We had a two hour break, and then Mr. Ganai and Mr. Mwamba came over to our hotel and we worked until 8:30 finalizing the questionnaire (this draft anyways!) and going over preparations for tomorrow.

During our break, I went for a quick run around our neighborhood. A little treacherous, given how uneven the dirt road is, but it felt good to be moving. People stopped to stare at me like I was crazy, and little kids just started laughing when they saw me and yelled “hi! Hi!” after me. It added a little fun to my run, and I’m sure it brightened their day too to see a crazy white girl running – why would you want to do that?

6/11: Arrival in Kigoma and Dinner with Jane

On Monday morning, we finally left for Kigoma. We were so excited to finally be on our way, Dar was beginning to feel a little like purgatory. We had to leave our hotel at 7am, which made us a little tired and wasn’t helped by the fact that my first (and I’m sure not last) bout of traveler’s diarrhea kept me up all night. Our flight was on one of those cute little planes I remember from the Caribbean, seating about 25 people and having propellers. Our landing was on a dirt runway, definitely a first for me and a little rough I must say!

Kigoma is a little more what I expected from Tanzania. The dirt roads, which the words bumpy and potholes cannot begin to describe, are a bit of an adventure in the 1980s Corollas that serve as cabs. It’s definitely a small, rural town: tons of kids running around, mud houses, a small market with a thatched roof, and goats and cows for neighbors at our hotel.

After relaxing at our hotel for a few hours, we had a meeting with Dr. Godfrey and Mr. Ganai about the project. As I anticipated, they already have it in their minds how things are going to go, and we’re just along for the ride. I’m totally fine with that, it just means you have to be on your toes and never really know what you’re supposed to be doing. We’re going to have the team training on Wednesday and Thursday, and begin data collection on Friday.

At the end of the meeting, Dr. Godfrey said that the Jane Goodall Institute (JGI) is nearby, and she’s the one that worked with the chimps, and that she’s only in Kigoma one week out of the year and tonight is her last night. He then said that we were invited to go with him to the farewell dinner at our house. We were given five minutes to get ready (what do you wear to meet Jane Goodall?), and headed out to JGI. There was an intimate dinner party set up outside next to the lake, with about 30 or so people there. Dr. Jane (as they call her) ran up to Dr. Godfrey when he arrived and gave him a big hug. He introduced us, and she sat us down at the table next to hers with an American that is volunteering with her organization Roots ‘n Shoots (a youth-led education program). I ate dinner about four feet away from Dr. Jane, totally in awe of what was going on. At the end of the evening, she gave a short speech and finished it with an impression of a chimp calling to another. The head of JGI in Kigoma escorted us out, saying that we were welcome anytime to use their internet or offices (yay wireless!), and we rode back to our hotel in a USAID Landrover. Very surreal.

6/10: Mambo-Poa (Last Day

Our last few days in Dar were spent exploring the last few bits of the city, preparing for our internship, and escaping the heat by watching TV in our room.

We did go explore the “Asian District” (I put Asian in quotes because I didn’t see too much of an Asian influence, nor many Asians). It was much more peaceful than our rough neighborhood, definitely less people around. The one cool thing we visited there were Hindu temples: huge ornate white washed compounds that smelled of incense and had the soft lullaby of bells being struck in the background. It felt like being in another county.

On Thursday afternoon, a shrimpy looking 18 year old knocked on the door. He said “Kristina” and in broken English asked us how we were doing and what we were doing. Having no idea who he was, I was a little vague in answering his questions. After about five minutes of talking, he mentioned Dr. Godfrey and we finally figured out that he was some sort of relative. It turns out he is the brother of Dr. Godfrey’s daughter-in-law in Kigoma. He became our very zealous friend during the next few days, knocking on our door or calling us every few hours either to see what we were doing or to let us know that he was leaving the hotel and coming back later (very informative). He lives in Zanzibar and his name is Abui, and he has 11 siblings (don’t worry, his mother didn’t have all those children, his father has four wives). His brother-from-another-mother, Ifraq, was also in Dar on business (he buys cars in Dubai and Japan and sells them in Tanzania). He, thankfully, is 25 and speaks better English. They took us out Thursday, Friday, and Saturday nights which was really sweet.

My ATM troubles were not over: the ATM near our hotel stopped working after the first day (first it was broken, then under routine maintenance, and then the power was out the whole last day we were in Dar)

On Friday we went to Q Bar, and the description from my guidebook is pretty accurate: popular with locals, expats, tourists, and well dressed prostitutes. That explained why the crowd was about a third white (when we hadn’t seen any other white people since arriving) and the surprising presence of a bunch of ho’ed out women (most women dress very modestly here, and these ladies were showing off a lot of skin and some interesting outfits). After playing pool for a few hours, they wanted to show us the hot new club, Maisha. It would be a really cool venue – a circular dance floor in the middle with a second floor that wraps around it so you can see everything below (kind of like a mini Medjool’s) – except it was pitch black save a few black lights in the corners and one small spotlight that shone straight down on the center of the dance floor. You could barely see anything. We had fun making Abui dance, and were a little surprised to see that guys dance with each other, and kind of close. It was a fun night and a neat insight into the nightlife in Dar.

6/8: Kariakoo (Dar, Day 2)

The ATM across the street from our hotel takes MasterCard. And it looks like the MasterCard system is up and running again, so now I have tons of cash.

This morning we worked on training materials for our project, and this afternoon we visited the Kariakoo Market. It’s only a few blocks from our hotel, and is the largest and most crowded market I’ve seen in my life. Under plastic awnings surrounding the large concrete building, a maze of vendors laid out their goods. Lots of beautiful produce – peppers, onions, cabbage, eggplants, plantains, and fruit I’ve never seen before – shady electronics, random footwear, toiletries – it was all there. It was amazing to see all these gorgeous vegetables, and then find that they don’t serve them in the restaurants. It’s all meat with either rice, ugali (a stiff porrige made of corn and cassavah flours that you roll into balls and dip in sauce), or chips. I hope I have a kitchen in Kigoma so I can have vegetables at some point during this trip!

We really wish we could get out to Kigoma, because we’re a little bored here in Dar. There’s not that much to do but walk around, and it’s all pretty the same. Add the heat, crowds, and pollution, and we’re done!

I’m really starting to feel like I’m in Africa. I think I was in a haze of jet lag for the first two days, and initially I really did feel like I was in the Caribbean. But for some reason, today it really hit me that I’m here. I can’t really describe it, and I wish I could bottle it up for all of you to experience.

6/7: ATM Hunt (Dar, Day 1)

Today was spent mainly in the pursuit of a bank that accepts a MasterCard ATM. At the airport, the ATMs would only take Visa affiliated cards, and I own a MasterCard. Some exploring early this morning (3 banks) found that they wouldn’t take my card either, but the third bank referred me to another bank that would take it. We went into the city center and found the bank. Sure enough, the ATM took MasterCard, but the system was down. We walked the length of the main drag, about a mile, stopping in every MasterCard affiliated ATM, and none of them would take my card. After lunch, we tried the main branch of a bank, and when I told them that the system was down, they told me to go to another bank that was the system headquarters for MasterCard. Another long walk down a dusty, busy road, I arrived at the bank and – hooray! – it accepted my cards. I thankfully have two ATM cards (although right now I’m really wishing one of them was a Visa), so I was able to withdraw from both accounts. So now I’m going to have to visit that bank everyday until we leave for Kigoma, because I’m worried that the ONE ATM in the town will not accept my card. Fun times. I’m really glad I have money again. Thankfully people are very helpful and most speak English, so this process wasn’t as difficult as it could have been. It was a little scary not being able to get any money, though.

In between banks, we walked to the fish market – a compound filled with people selling fresh fish, some of which are huge! It’s smelly and lively, full of activity and people milling around. We were hoping to find some fresh fish for dinner, but in the marked across the road the promising billows of smoke proved to be fried/grilled fish in a preserved fashion (so whole, in stacks, and a weird grey/brown color from the salt), and we weren’t quite brave enough to try it.

We were lucky and found a wonderful little place for lunch across the street from one of the many banks we went to. It was a pretty little garden, cool and shady under the roof made of leaves. It was quite an operation, serving several different dishes and full of people. With no menu, and no clue what things are called, we looked at other people’s plates and pointed questioningly until they told us the name of it. I had chipsi mayai, an omelet with chips (kind of like a Spanish tortilla with French fries instead of potatoes) and Kristina we think had biriani, rice seasoned with spices until its brown with meat and some beans. It was tasty and cheap (less than $2 for both of us), and fun to people watch.

We have three more days in Dar until we can get to Kigoma. We saw about 75% of the town today, so the next few days I suppose will explore the remaining 25%, work on some training materials for our project (which from the sounds of it will begin on Tuesday or Wednesday), and maybe go to a beach a few kilometers from here.

So far I’m loving being here. It actually doesn’t seem that foreign or strange to me. It may be partly due to the fog of jet lag I’m in, but also I’m reminded a lot of Barbados and other places I’ve traveled, which makes me feel kind of at home. Dar is very busy and full of people, and it’s hot and humid so I mainly feel gross and dirty most of the time (although the air conditioned banks provided a nice respite). It’s neat seeing the women carrying large bundles on top of their heads walking down the street, and babies strapped to their mothers’ backs with kangas. There’s people and cars everywhere. I think once I get to Kigoma things will feel very different, since this is Tanzania’s largest city and Kigoma is a small town.

6/6: I've Arrived!

After almost two days of traveling, I’ve arrived in Tanzania. It actually wasn’t as bad as I thought it would be. The plane rides passed quickly enough (10 hours, 7 hours, and 5 hours), and I even managed to sleep on them. The delays were a little painful (7 hours in London and 4 in Dubai), but the Dubai airport is pretty cool. It looks like a fancy mall. We were excited initially, but then realized it contained the same duty free shopping that’s in London so we had nothing to do. Although we could have gone to the spa there I suppose.

Arriving in Dar es Salaam, the customs queue was a little crazy – a huge mess of people with vague formations of lines. We bought our plane ticket to Kigoma, which unfortunately will not be until Monday.

We checked into our hotel and after a blissful shower began exploring our neighborhood. It’s all dirt roads and tons of little shops and restaurants in little shacks. I noticed there were a lot of men hanging around – drinking soda, playing games – but not many women. I wonder where they could be? (Rhetorical question) There were lots of children in the street, and they all smiled at us. We had dinner at a bustling restaurant near our hotel. It had tables inside and on the street, and we had a yummy dinner of bbq chicken (Kristina) and fish (me) with chips. The fish took a good 35 minutes to arrive, so I’m guessing he had to run to a friend’s place to get it. The food came on large tin plates (about 2ft by 1ft) divided into sections – 2 large ones in the middle and 4 around the edges (Amy you’d be so happy – nothing touches!). The chicken/fish and chips were in the two main compartments, and then around the edges were two different sauces (one too spicy and the other that was delicious and tasted like a combination of sweet and sour sauce, hot sauce, and ketchup) and salt. The fish came whole (as in they grabbed a fish and put it on the grill with head, bones, tail everything still attached), which normally bothers me but since it was dark I was ok. Everything was eaten with the hands, so it was my first experience de-boning and eating a fish by hand. It was a little messy, but the waiter brings warm water before and after the meal to wash your hands. By the time the fished cooled a little bit, I was loving it. We were so pooped after we got back from dinner, we passed out at 8:30.

I'm here!

After almost two full days of traveling, we arrived in Dar es Salaam. I have a few blog entries written out on my laptop, but I think they may have to wait until Kigoma to be posted. We only just found an internet cafe, and it's painfully slow. We're stuck in Dar until Monday, which was the first flight we could get seats on to Kigoma. We've already been in contact with Dr. Godfrey Mburuku, who we will be working with on the project, and it looks like we'll be starting on Tuesday or Wednesday. He sounds very eager to start the project, which is good because we are anxious to get things started.

I'm really happy to be here, but very ready to leave for Kigoma. At first, the country really reminded me of being in Barbados, but just with a slightly different feel to it. It was almost comfortably familiar. But now that I've been here a couple of days and the jet lag has wore off, I really feel like I'm in Africa - it's crazy! Dar is full of energy - it's full of people and cars all day long, and the heat and humidity add to the wildness of it. It's so full of energy it seems to suck the energy out of me! We're looking forward to the cooler, and hopefully more tranquil Kigoma.

One Week to Go...

It's hard to believe that I leave for Tanzania a week from today. It still feels like I'm learning about this internship, not about to depart on it. That's probably because I only decided to go six weeks ago!

I'm going to Tanzania to work on one of my professor's projects: Assessment of Postpartum Hemorrhage and Use of Misoprostol. 99% of maternal deaths occur in the developing world, and most of these deaths are caused by excessive bleeding after childbirth, or postpartum hemorrhage (PPH). Misoprostol is a drug that makes the uterus contract, and can be used to either treat or prevent PPH. Since it is relatively inexpensive, stable in field conditions, and does not need to be administered by a health worker, it's ideal for resource-poor settings such as rural Tanzania. Misoprostol has been used for a few years in the region, and along with a fellow intern I will be conducting questionnaires, in-depth interviews, and focus groups with women who have used misoprostol, traditional birth attendants (who have been delivering the drug), and doctors/midwives to learn more about how misoprostol is viewed in the community and by women who have taken it, it's effect on maternal mortality, and barriers to its use.

I'm very excited for this opportunity - it will be my first time working out in the field, which I think will be a wonderful complement to all that I have learned this year. It's going to be an amazing, challenging summer!

I hope you enjoy following my summer in Kigoma, Tanzania through this blog, and please send me emails and comments so I don't feel lonely!