7/30/10 Crayons, coloring books, and more soccer

Today is Friday and we had a 10am appointment to bring our mosquito net coloring pages and crayons that we so laboriously brought to Tanzania. We made 500 copies of the coloring book and brought about 55 lbs. of crayons in our luggage. The school experience was fun but kind of sad at the same time. Since we have limited materials, we decided to involve the 2nd, 3rd, and 4th grade of two local primary schools. The general purpose of this event is to promote mosquito net use among children in a fun way. We would first have our translator explain that malaria is caused by mosquitoes, nets help prevent mosquito bites, and then briefly explain each of the 6 images in the coloring packet. Then we had the children write their names on the packet and color one chosen page. We then collected the packets back because we are taking them home to judge which student has the best colored photo and then award them a prize, probably a mosquito net, on Monday. Then on Monday we will also give them back their packets and also donate 3 crayons per child.
The sad part about visiting the schools is seeing the condition of the classrooms and education system. One of the teachers told us that there were 700 kids and 12 teachers which means about 1 teach for every 60 students. Each grade would consist of 50-100 kids crammed in one classroom probably fit for 30 children. The kids would share a small desk and wooden bench with up to 4 children per desk. The room is very bare with no fun posters, colorful art, or educational materials. None of the kids had their own crayons, markers, scissors, or anything near that. The teachers didn’t seem to have much chalk either. I thought it was incredibly sad that some classrooms full of an entire grade of students had no teacher. It seems like the teachers actually rotate between classrooms. We left at about noon for lunch and the kids returned at 2pm and we returned at 3pm and the 4th grade class did not seem to have a teacher that entire time before and after the lunch break. There was also nothing on the chalk board like some of the other classrooms indicating that they were working on some sort of lesson. A lot of children and teachers seemed to be missing. The number of students that we prepared materials for based on the total estimate given by the headmaster was significantly less than the children present today. The good thing was that they kids that were there really enjoyed the coloring and crayons. They were all so sweet and for the most part well behaved. I can’t wait to visit the second primary school and return to this one for prizes on Monday. Wish me luck on judging, its too difficult!!
At about 5pm today, I went back on the field sans translator but had the accompaniment of Melody and Louisa. Louisa is a German medical student that recently moved into the SHED hostel. She was smart enough to bring a full size soccer ball. I’m pretty sure all the secondary school kids really wanted to play with her golden soccer ball. We returned to the same spot where Pili, Melody, and I had played handball the day before with a tiny bit of soccer. Today was amazingly fun as well. Louisa, Melody, and I played handball for a long time with the girls. We then switched to soccer. Somehow I managed to organize teaching some soccer basics with no Swahili or Luo knowledge (and very limited soccer skills too). But all the girls lined up and we did dribbling, passing, heading, chesting, and stopping the ball. It was going amazing but then some girls had to leave and then a bunch of the secondary school boys started to join and hogged the ball showing off their juggling and long kicks. Today we had so many more girls than the 7 from yesterday, we must have had like 15-20 girls. It was so awesome, some of them started calling me friend and sister. I’m so thrilled to have local rafikis. The girls were so inviting and funny. Even though there was a huge language barrier, there were still general gestures that you can understand in any language. The girls were so amazing, they learned the basic soccer skills so fast and they were totally playing in their skirts the entire time and most were barefoot or wearing flip flops! They want us to return tomorrow and I want to continue this girl soccer building!! I am definitely loving it here in Shirati, I’m not ready to go anytime soon and am so sad that I basically only have 1 more week. I really wish I could stay a few more months, I’m entirely too happy here but learning so much at the same time.

7/29/10 Girls Soccer

The beginning of the day was slow to begin with since we were following up with a bunch of different houses and nobody was home. As Pili and I were walking home around 4:30pm, a bunch of secondary school boys asked us to play football (soccer) with them and we just walked by. I decided when I got home that I wanted to at least watch and maybe join so that we could get more information about how their team works and how we could use their setup to start a girl’s soccer team. I brought Melody and Pili back and really glad we had Pili to translate since everyone spoke mostly Swahili and Luo. We were watching the boys try-outs for about 15 minutes and then spotted some girls playing with a ball at the other end of the field. Pili said that they were playing handball, a sport I have not heard of, where there is a team of 7 and you throw the ball like basketball but there is no bouncing. There is a tall circular hoop to score. I haven’t totally gotten the game down, but those are the basics. First we sat down and watched the game then I decided to join in and try some passing. It was really fun passing the ball back and forth. The ball was funny enough a soccer ball. At some point, the local girls and I started kicking the ball instead of throwing it like hand ball. Soon we were all laughing and kicking the ball. I’m pretty sure that there have been very few times that the girls have played soccer or used their feet to kick a ball. Once the boys started seeing us kick a ball around, they felt a need to walk over and join in. The boys are so much better with football since they were able to juggle, dribble, and pass without any issues. Soccer is way more emphasized in boys than in girls. The day was so amazing. One girl promised that she would go back to her secondary school and write down the names of all of the girls that are interested in playing. The 7 girls there seemed very interested and thought that other women would want to join also. The cold shower felt so good today after my sweaty workout.

7/27/10 For Better For Worse

The title is just a play on words. With any trip, there is positive and negative. I feel like I’ve experienced some negative today revolving around mosquito net distribution. Melody and I started our surveys in the subvillage of Yakina and decided that we would give an appropriate number of nets to each family as we deemed it fair and also not give any nets to families which show that already have a sufficient number of nets. We also decided to replace nets that were very worn with lots of holes. Let me tell you, nets are quite a coveted item in the entire area since they are expensive for local residents and a nice commodity for comfortable sleeping. So we gave nets to cover every person in the family in Yakina. There were 3 instances where we were “double dipping” which is when Melody or I would give a person a net and survey them and then the other person would visit them and accidentally re-interview the same person since we did not have a full list of our participants at all times. Of course the double dipped people did not say anything about another group interviewing them since they knew that they would be getting nets. The situation is certainly our fault for not being in better communication about the names we visited, but we were still upset about the dishonesty. Furthermore those that we interviewed twice claimed that they had old tattered nets and never mentioned the new ones they got.

So the blog title comes from Better Owour. Pili and I first interviewed this single man with no children of his own but lived in a homestead with his other family members. He showed me 4 tattered nets so I decided to give him 2 nets. Melody and Enock came a few days later and re-interviewed him on accident and decided to give him 1 net. I obviously was not pleased when we learned about this but had to return to Better’s house for evaluation. On the survey, he told us that in the 4 households on his property, they were using the new nets. When I went to observe the 4 different bedrooms, there were 4 nets hanging above the beds, but none were ours. I also saw other brand of nets that were new in bag, so it seemed like Better had about 8 nets in total and left the ones we gave him in the bag. I was pretty angry since he took advantage of our net distribution and took away nets from families that could have really used them. He was pretty quiet during the interview and sheepishly brought back one of our nets to give to his sister-in-law in front of Killion and I.

Its has been interesting to see our shift in attitude. In the very beginning we were optimistic and idealistic and felt that everyone should get as many nets per family as needed. Now after seeing the desperate net situation in Bwiri and some selfishness in Yakina, our attitudes have shifted a bit. I feel like I used be more inclined to give a net for someone that would tell a story about how they have extra nieces or nephews moving in or if there was one child not sleeping underneath the net, but now I feel like I have to weigh their story against a family of 5 or 7 in Bwiri that uses no nets at all. In an ideal world, I want every person to be covered underneath a net including parents and grandparents, but with limited resources you have to ration. Sometimes free government nets that are intended for children under 5 years are used for the parents only while the kids that are most vulnerable to severe malaria sleep without a net. I feel like this experience has shown me the realistic side of giving free things and how so much thought has to go into distribution while realizing the gratefulness of some recipients and the greed of others.

7/26/10 The 2 Week Countdown

Today is the start of the last two work weeks in Shirati. Melody and I have so much to do and I am definitely hoping that it can be done. We are doing evaluation in Yakina for the rest of this week. Towards the end, we really want to bring the crayons and coloring books to some local primary schools and have a coloring contest of our mosquito net images. We will also have to return to Bwiri the last week we are here to evaluate. Its been challenging trying to figure out if anyone wants to help us start the first girl’s soccer team, we would need a coach and another foreign student to make sure it gets implemented. Finalizing our ride back to Nairobi on August 8^th and booking a hotel in Egypt seem pretty necessary too. Today was the first Monday that we did not head to the weekly market, we were tired today. Melody and I each surveyed 8 households in Yakina and then proceeded to bake peanut butter cookies with Hershey’s kisses on top for Daudy’s birthday tomorrow. At the end of the night we celebrated the birthday and had some people over our hostel. Apparently our hostel is the “nice” place since its one of the few in Shirati to have running water, showers, and electricity most of the time. I know that I was expecting to shower in lake water with limited electricity here, but its really quite nice. Our accommodation fee also covers a cook that makes us all of our meals, laundry service, night watchman, cleaning in the hostel, and Dasani water bottles. So despite the cockroaches, bats, and other critters we room with, the hostel is pretty awesome.

7/25/10 Bless the Rains in Africa

A bunch of us were going to go hiking today but it started raining. I also played the “bless the rains in Africa” song because the rain totally reminded me of that song haha. Josiah also came over the hostel and we worked out some more details with sponsoring Babou, the orphan kindergartener that we met. His aunt Suslia was willing to take him in and his grandma was happy about the idea. Melody and I will share sponsorship of Babou and probably pay around $50/month for his school, food, clothing, and other necessities. Before we leave, we intend to buy him a bed with mattress and clothes as well. Since we have been so incredibly busy in Bwiri and not coming back until 6pm, its been difficult to visit Babou or Junior in the Yakina village. Its incredibly hard to believe that we only have 2 more weeks in Shirati which is quite insane actually. Sue also got about 60 lbs of donated soccer equipment from a local NJ girl’s soccer team and it includes soccer balls, uniforms, and shin guards. The only issue is that it costs $350 to ship here and probably won’t arrive before we leave. At first I was thinking that we could use the equipment for an established team or something, but then realized why not start the first girl’s soccer team in town!? There is basically no female recreation activities here, so it would be pretty awesome. The only thing is to recruit enough girls, funding for a team, borrowing a soccer field, and a coach. Melody and I are thinking about who we can entrust to start the team. We got a suggestion from someone to maybe donate the things for a secondary school to start a girl’s team. We would of course need at least 2 teams so they could scrimmage each other. I totally wish I didn’t have to go back to the U.S. and stay to make this happen. I remember how fun and amazing doing soccer in high school was and to be able to start a revolutionary girl’s soccer team here would be incredible!

7/24/10 Halfway point at 131 houses

For the past two days, we’ve been spending long days in Bwiri. Its so beautiful up there, but the houses are pretty spread apart so we have to hike a lot to get around. I think we must walk about 5 miles each day. We usually arrive at 10 or 11am and then leave at 5pm with lunch on the field. It does seem like a lot of people missed out on free nets from the last government campaign and many of those with nets have very tattered nets that really reduce protection. Today, David, a Dutch medical student followed up us along and had some medical use. He took a look at a back injury and wrote a medication for a boy with a really bad fungal infection that was eating away at his scalp. During our first survey day in Bwiri, we met a toddler with a broken right femur and it was being held together by a local bone setter’s wood contraption that looked like a big bracelet. I was pretty horrified at the sight since the little boy started screaming when his mom moved his leg. David got to take a look at that boy, but unless his parents want to and can afford to bring him to the hospital, its really hard to do anything. We finally finished doing baseline surveys and interventions in Bwiri. Between the two villages that we’ve been surveying, we have a total of 131 households after 3 weeks of work! Woohoo we exceeded our goal of 125 total houses!!

7/22/10 Need more nets in Bwiri

Today we completed our third visit to Bwiri. This time instead of the nice SUV that we had the last two days, we got a land cruiser from the 70s. When you open the back door to get in, there are just two benches with no seat belts and a metal floor. It was quite an interesting off-roading adventure today, I felt like I was on a safari. In Bwiri, we saw a good number of households. I chose a bad day to wear a white skirt and flip flops. We ended up doing some hiking, passing through corn fields, and minor rock climbing to get to some remote houses in Bwiri. There is still a great need for nets in Bwiri. In the other village we surveyed called Yakina, nearly everyone had mosquito nets and were educated on the basics of how malaria is transmitted through mosquitoes. In Bwiri, the majority of people did not have even a single net. They also had different ideas of how malaria is spread: cold wind, water, person-to-person, etc. Melody and I would love to provide more free nets since its one of the most effective and affordable ways to prevent malaria, a major killer of kids under the age of 5. If you would generously consider donating, please Paypal my e-mail sunkissedsteph@gmail.com and we will use the money to buy nets here to give out to Bwiri.

When we got home, Melody and I also baked an oatmeal cake from scratch for Pili’s birthday, she’s our translator that is turning 21. Tanzanians don't really celebrate birthdays and when they do, they slaughter a goat. Haha fun fact of the day.

7/21/10 Funny stuff about living in Tanzania

Living in Tanzania has its share of funny moments especially when you are a mzungu learning for the first time. Everything tends to run on Tanzania time. So when I request a driver at 8am, I can expect him to show up at 9:30am or even 11am. The architects here building a new clinic find that their electrician is worse. He arrives 1 week and 4 hours later than scheduled, so I guess I have it good. Swahili and Luo are the main languages spoken in this area. Some students learn a bit of English in primary school. I love it when I walk down the street and young kids ask “What is my name?” and I look confused and ask back “I don’t know what is your name”. It happened like three times before I realized they were asking about MY name not theirs haha. Some funny but horribly dangerous situations often involve the independence of children. Today I saw a 2 year old with a machete just playing with it and chopping at a tree. Other days I see kids that look about 4 years old carrying their baby sibling on their back. I’ve also had almost marriage proposals or talks of possible engagement. Dowry is accomplished by giving cows. I estimated that I’m worth about 200 cows (estimated $4,000 USD). Some guys just ask about how many cows it would take to marry a mzungu. The bad thing is that the more cows you get, the more work you are expected to do once married. Another random thing I find amusing is that people in the area wear a lot of clothes that have been used from America. So far I’ve seen a polo that says Retail Manager of Cracker Barrell, numerous college tshirts, Blockbuster employee shirt, and men wearing shirts that are very obviously designed for a woman. Bugs and critters take an entire different meaning here. So far in our hostel, I’ve seen 1 scorpion, 2 bats, 1 gigantic spider, a rainforest colorful frog, cockroaches, brown geckos, and tons of ants. There’s all kinds of wildlife in this area, but I’ve been handling it well except for the tarantula sized spider in the living room that ran faster than I did.

I like comparing lifestyles in U.S. to Tanzania. I never realized how much of babies we Americans are. Its extremely rare to own a car in the area unless you are extremely wealthy so almost everybody takes piki pikis (motorbikes), bicycles, or walks. They are also pretty good at cutting down waste. Whenever you buy a soda or beer, the shopowners are adamant about you bringing back the bottles. Apparently Coca Cola pays these shopowners to return the glass bottles which are then sterilized and rebottled. Tanzanians also cut down on plastic waste by giving you the bare minimum plastic shopping bag. There is no such thing as doggy sweaters, gem studded collars, or pampered pets here. Dogs and livestock all have a purpose to herd the farm or be part of it. I realize that giving birth is way over-hyped in the U.S. Shirati women pop out babies, breastfeed, wrap a cloth diaper, and carry their babies on their backs with this colorful long cloth. Baby monitors, strollers, playpens, baby showers, teething rings are all completely unnecessary. Apparently babies grow up just fine without Babys R Us.

7/20/10 Exploring Bwiri

Today is the first day in Bwiri, a new village that is 14km away from Shirati. We are surveying the other half of our households here since a malaria director said that Bwiri is hard to reach due to its bad roads leading up to the village and that the many government handouts of nets and education might not have reached there. The roads are pretty bad, our car drives at 45 degree angles at some points, crossed a small stream, and drives on lots of huge rocks. Its like riding on a safari or off-roading at some points. When we arrived, we met with the village chairman and secretary, pretty standard procedure before interviewing members of a new village. Since it appears that many people in Bwiri never received nets, we decided to prioritize our surveys and free nets for families with a child under 12 months. We only have about 100-150 nets left so we knew that we could not cover the 600 families in the area. At first I had my hesitations for coming all the way to Bwiri, a 40 minute drive, and paying money to do so with transportation and all. But the need for nets and education in the village is very great. Unlike the other village we have been surveying called Yakina, not every household had a net in possession. Melody and I would have preferred to give more than 1 net to families or cover all families, but we have such a limited number. I am pretty excited to see the rest of the village and see the impact that our intervention can have on this village. Its also so gorgeous here, its higher up in the mountains and there are tons of big scenic rocks.

7/19/10 Quiet Tuesday

Today the USC, Boston U, and Western med students all left. There were about 15 other people living in the hostel with us for a bit but now they left for a safari then back to the U.S. It’s a bit quiet and strange but sort of nice. I am SO glad that we are staying for 5 weeks because if left now after 2 weeks, the entire trip would seem so short. I am pretty content with the food here and its been really nice getting away. Melody and I still have so much surveying to do and a new village to explore tomorrow I hopes of capturing different types of net usage.

7/18/10 Monday Market Madness

After surveying a few houses about 2 miles out in Yakina, Melody, Enock, and I went to the weekly Monday market where many gather from surrounding towns and even Kenya to buy stuff at the huge market. Its quite a spectacle. There are tons of stands selling used clothing, fish, produce, etc. The last time I went to the Monday market, Melody and I bought fish, tomatoes, peanuts, and dahga (its like anchovies) for Babou, an orphan, and his grandma. This week, we decided to buy clothes for Babou. Apparently bargaining does not work here if you are a mzungu. Nevertheless, we got a bunch of clothes for less than $5USD. We bought Babou three shirts, two pairs of pants, one pair of shorts, and shoes. When we got back from the market, we listened to a talk from Dr. Machaga, the regional malaria director. He was describing how they will do indoor residual spraying for the entire area since the government is paying for it. This type of spraying involves using pesticides on the inside of households to eliminate mosquitoes. I think the process is quite expensive and spraying only lasts 6-9 months before it needs to be re-sprayed. During the lecture, I learned a lot about malaria control and mosquito elimination using different methods. I’m really glad to be doing our mosquito net behavior usage study since malaria is a top killer of children in the area and long lasting insecticide nets seem to be an effective way of not getting bit while sleeping. Education certainly plays a huge role for people to understand how malaria is caused and how to properly use nets to maximize protection.

7/17/10 Evaluation

Our first day of evaluation went really well. We were supposed to go to Bwiri today but couldn’t get plans to go through at the last minute, so are instead returning to the Yakina village to evaluate those that we gave nets to. Visiting some of our participants was really rewarding. It seems like some of the people we had completed the education intervention with had their nets hanging down and tucked in during the day, answered correctly on how often they should wash nets, and even had our laminated education tags hanging! Our control households which we did not give the intervention to, seemed to possess the same knowledge as before so we know that those that received the education did not diffuse knowledge. After the evaluation survey, we then gave the education to the control groups. Our education intervention consists of telling the participants about the cause of malaria, how it can be severe in young children, describe the net we give them, to wash the net only 4-5 times a year, never wash it in the lake, dry it in the shade not direct sunlight, and to leave the net hanging down and tucked in all day to avoid any mosquitoes at night. Beyond the verbal part, we also have a laminated card that looks like a big bookmark with a hole in the middle to hang with a net…its like an instruction card. We also offer to help hang any nets and show them how to properly tuck them in. While designing this project, I wasn’t sure whether people would necessarily adopt the new behavior after 10 minutes of explaining, but it seems to be working some of the time!

7/16/10 Birthday

I turned 23 today! I decided to spend it doing manual labor for the first time in my life haha. My day started out with Melody leaving me the sweetest post-it notes and letter, one of the nicest anyone has ever written me! She also got me a beautiful necklace from a local shop and my favorite chai tea brand..sooo incredibly thoughtful and sweet. There is a clinic in Roche which is 28km away from Shirati. The Village Life Project has been working on building a new health care clinic which will serve the remote area. Our friends Emily, Richard, and Bryant have been working up there to build this clinic with local workers. Melody and I spent the first part of the day measuring where gravel and dirt would be poured then we were put in charge of hammering mud bricks to break them down into gravel sized pieces. I admit that was pretty fun destroying bricks but I soon realized that I had 2 blisters on my hand and managed to cut myself against a rusty metal post (good thing I got that tetanus booster just a bit ago). The best part of the day was when we got to go to a water committee meeting. We got to meet with members of the village while Bryant led the meeting on how the water system would be created at the clinic using rain and well water that would be collected in tanks and then a solar panel would heat up water. The system definitely seems environmental as well as great for limited resources in the area. The committee also talked about how they started teaching village residents of Roche how to use a slow sand filter that was introduced by Village Life. Its really fascinating since muddy and dirty water would be poured through layers of sand and the protozoa in it would destroy harmful bacteria as well as sift out the mud to create “maji salama” or clean water. I definitely learned a lot today and have a whole new appreciation of construction work and manual labor. When we got back to Shirati, it was really sweet, my translators got me small gifts. Enock got me this awesome bracelet that has woven into it the colors of the Tanzania flag. The green stands for vegetation, gold for the mineral wealth, black for the people, and blue for the adjoining sea. A few people went with me for some chai tea at the local bar then headed to drink at the Freedom bar afterwards. I’m a fan of $1 Tanzanian beer and $2 flask of Conyagi which is a Tanzanian hard liquor that tastes like rum. All in all, I had a great birthday celebration from the construction site, meeting, friends, and night.

7/15/10 Boring data entry day

It’s the last day that I will be 22 and today is also Dr. Esther’s birthday. Dr. Esther Kawira is the US trained doctor that resides in Shirati with her husband. Today is a slow day just another data entry day. We are waiting on our head translator to be freed of his other duties with translating for the Sota clinic so that he can ride out 10km to Bwiri, his home village where there may be a lot of people without nets. I might try to go to Roche tomorrow as well which is a 40 min. drive away but a new clinic is being built there and it sounds pretty awesome.

7/14/10 Typical Day

We went back today to survey the locked up boy’s mother since she had requested a net on Monday. It was a tense interview, but we got to see the inside of her home and we did ask if it was ok if we kept visiting her son. He went outside when we came and liked playing in the backyard. Today was a hot day and we only surveyed 3 households. I remembered that I have these tiny star stickers and they were a total hit with all the local kids. After surveying, we went down to the lake by the pier which is about 7km away. The view from the lake was really nice and I finally got to use my DSLR. We also randomly met volunteers from Spain also in the Shirati area. I also finally got my blackberry to pick up 3G internet on my Vodacom SIM card so I’m pretty excited to have super slow internet. At night, we went back to a local bar where we had a table and cold beers, which is a rarity at bars in this area. I feel like everyday is new and interesting whether I find out that the med students bough a goat, a world cup watching party is happening, or exploring uninhabited islands. Its pretty amazing that we’ve been here for about a week and a half. It feels like so much longer but no in a bad way. I really like being out here and away from life in the U.S. I truly do feel that people in Shirati are much happier as a whole than people in the U.S. despite their lack of money, resources, and technology.

7/13/10 Thoughts on the child

It is Tuesday and Melody and I are deciding to take a day off from surveying to finally catch up on data entry. We talked to Dr. Esther and Dr. Feifer last night about the mentally handicapped boy we saw naked and locked up. They concluded that the mother was trying her best as a single mom with 4 children and that she has no other choice nor resources to give her son a better life. His image of crying naked on the floor or against the barred windows is still engrained in my head and haunts me. I don’t want to think about it, but is this going to be his life for another 10 years? What will they do when he becomes a teenager and grows bigger? Will he roam around the town alone like many other people with disabilities? I guess this is where I realize how young and naïve I am. I want to try to fix this situation by working with his mom or throwing money at the situation. I keep wanting to see if we can pay for him to go to an expensive special needs school in Dar es Salaam which is the capital and a few hours away. And I keep thinking about how many are like him in this town, this country, and other countries. Its just so hard to walk away from this and forget about it and accept the fact that until he dies he will be lonely everyday and locked up treated worse than the goats and dogs around here. I plan on visiting him as often as I can, his home is about a half mile walk from our hostel. I have a ball to give him, but am hoping to find more safe toys but Shirati does not exactly have a toy store and most kids play with worn down soccer balls, rolling tires around, or bottle caps.

7/12/10 An all around tough day :(

Mondays never start out right, but today seemed especially draining. The morning began amazingly, Melody and I followed the nurse and physician assistant in our group to distribute their crayons, stickers, and notebooks to kindergarteners. The kids were so cute and very excited about the stickers, Frisbees, and blow up balls. They also taught me how to count to 10 in Swahili and I taught them how to in English. We left the school and met up with our translators. Pili and I were following up with a household that had an old lady that took care of her grandson sine she had requested a net a few days ago. We knew that this older woman was widowed and her son had died so she was left with her grandchild whose mother had also ran away. Halfway through the interview, Babou, the cute kindergartener we saw just an hour ago comes running in. He was super excited to see me. In primary school which is paid for by the Tanzanian government, kids are provided with uniforms. Once Babou got home, he switched into his regular clothes which were shorts that were so torn that his arms and buttocks were exposed. When we went inside the grandmother and Babou’s mud hut home, we saw that their bed consisted of ripped pieces of mattress, a fire cooking pit, and very worn ragged items. Monday is known for its weekly market a few towns away. The grandmother said that she walked all the way to the market to beg and managed to get a few oranges and a cabbage. She said that the boy is hungry and she had oranges for him since the school does not provide many meals. She also said that she would probably have relatives care for Babou. Just seeing this site made me want to change it. I decided right then that I want to pay for Babou to go to secondary school which is an unattainable task for the poor.
Moving from that heartbreaking moment, we went to another household. It looked abandoned since there was a nice brick house but half of it was exposed to the outside and a dead thorny bush was covering this open space. The only reason I decided to proceed forward was because they had a few small rows of corn which meant somebody had to have lived there. Pili knocked on the door and we heard a noise that sounded like a cat but more like a person. We knocked again and then looked into a window. To my horror, there was a boy inside naked and on the bare mud floor in the fetal position looking back at us. It was clear that he had serious mental disabilities since he looked about 7-8 years old and could not speak at all, he just muttered sounds. We started walking away after being shocked about finding this boy and he started to cry until we returned. The door was locked from the outside, clearly not wanting the boy to go outside. There was no couch for him to sit on and he was next to the thorns growing into the room. The windows were barred and the entire setup looked like a jail since he had no toys, bed, clothes, or food there. This was the most horrifying thing I have ever seen for a child, especially one with a developmental disability. A neighbor then came by and opened the door to where the boy sat. She explained to us that the boy was normal until the age of 2, his mother would leave him from early morning to night, he stays alone in the house, and that she would occasionally give him porridge when she came over. We thanked her for the information and left completely shocked and speechless. I had to fight back tears seeing this skinny boy locked up in what was like a jail cell and neglected so badly that he cried when strangers left him…all of these circumstances just because he was mentally handicapped.

Pili and I decided to survey one more house before lunchtime. This household did not hold any happier times. The man that we interviewed had a very bad leg that did not function well for walking. During the survey, we found out that he only had one tattered net, 6 children, 3 of which had malaria, he could not afford to buy nets, and he has had 2 children die of malaria in the past. He also said that for his three sick children with malaria, we went to buy an inexpensive drug at the store. The translator told me that this was no more than a pain reliever. I told him that I would try to get some of our med students to his home if I could. At this household, we gave 3 nets in total hoping to replace the current ragged net and cover all 9 people living in that household. The man was extremely grateful for the nets and the rough time hanging them up was completely worth it.

By the time lunch rolled around, I was so emotionally drained from the 3 households. I told Melody about the situations and she felt equally as shocked and compelled. We started to talk to one of the SHED members who is Dr. Kawira’s husband about the situation with the orphaned Babou living with his grandma. He gave us such constructive advice and is basically helping us set up a sort of scholarship for him to ensure that he has food every day and has the opportunity to go to secondary school through donations. I felt so much better about Babou’s future since without secondary school, he would have no chance of breaking out of poverty. Melody and I also went to the large Monday market and with about $5, we purchased bananas, peanuts, large fried fish, anchovies, tomatoes, and onions. The market was so vibrant and so full of people from different regions. We then gave the food out to the grandma and Babou and attempted to give food to the boy who was locked up. The grandma appreciated the food and when we headed back to the mentally handicapped boy, nobody was home. The boy seemed excited to see us and lept on the window bars and was biting down on them. We tried to give him a banana through the window bars but he did not seem to understand how to eat the banana. We further investigated his situation with another neighbor. The boy’s name is Julio I believe and he is actually 10 years old though he looks much younger. His mother is a widow that works all day with 3 other children. Apparently he is left naked since he takes off all of his clothes when he has them on. The neighbors explained that the door is locked from the outside since he runs away. We started walking back since it was about dinner time and ironically ran into the boy’s mother. We gave her the rest of the food and told her that it is intended for Julio. She explained her situation and it sounded much like what the neighbor was saying. I think a part of me wants to be angry with her for leaving this poor special needs child locked up for 10 years and then another part of me realizes that what were her alternatives. There are hardly any special needs schools or programs in the entire country, no special ed teachers, and money is always a barrier. I still can’t get the disturbing image of the naked boy sitting on the bare floor crying out of loneliness. Even if he does not have full mental capacity, he still has feelings and is a human being.

7/11/10 Uninhabited islands

Its been nice having a weekend break from the long days of surveying though I absolutely love going out into the village and learning about how the village residents live. Today we went in a large group to a supposed uninhabited island that the SHED foundation may purchase and use for a tourism boost. We drove for about an hour and then took another hour boat ride to the island. Funny thing about the isolated island that nobody ever stepped foot on…it has like an entire subvillage haha. Dr. Esther was so funny since she claimed that we would be exploring this new territory that was totally settled. One little baby cried when he saw me and all of us mzungus, he probably never saw anybody like us before. One of the island village guys was wearing a USC t-shirt which of course all of us Trojans found to be awesome. We hiked to the top of a small mountain slash hill and the view was so incredible. After the hike, we went to a small red sand beach briefly and then went back on the boat home. I kind of wonder if SHED is still going to claim this island as their own even with the entire subvillage there.

7/9/10 Research time

The research has been going well so far. I really enjoy walking into the Yakina subvillage and going house to house to complete our questionnaires. So far we have had nearly 100% participation, this is an unheard statistic in the U.S. Every participant seems to answer our questions and even let us observe their bed nets in their bedrooms. A lot of expectations that I had of mosquito net use are different. In this subvillage, everyone seems to know that malaria is caused by mosquitoes and that bed nets help prevent this. Nearly everyone we survey has at least one net, though usually old and torn. Melody and I have been giving nets to those that need it. It is sort of a sad situation, literally everyone has had malaria multiple times in the entire area…even our educated translators that always sleep under nets. Many of our participants have lost a child, brother, or friend to malaria. It is sort of a way of life, getting malaria is equivalent to getting a cold in the U.S. Ironically even though parents know that malaria tends to severely affect their children more so than adults with immunity, we have found that many households that have limited nets will have the parents sleep under it and leave out the children. Perhaps one of the way to make net usage more effective especially if you want to cover the children would be to provide enough nets for everyone in the family. News travels pretty quickly, everyday it seems like people approach us and let us know that they need a net if we have not visited them. I really love the swarms of young kids greeting us mzungus and absolutely delighted with my digital camera. The funniest thing happened the other day. This pack of kids that looked about 4-5 years old followed us and I took a picture of them and showed it to them and they started rolling with laughter and were content and just ran off. Seeing so many roosters, hens, and chicks also amuses me. I just need to learn more Swahili to be able to communicate more than just hello, thank you, and goodbye!

7/8/10 So far away from LA

Its pretty amazing that exactly 7 days ago I was in my LA apartment where my room is much larger than some families’ huts that fit 5 people, where cable TV is a staple not an unattainable luxury, and everyone owns a car rather than walk for miles each day. Although I think that most people think of poverty-stricken African communities as lacking so much, I feel like they also have more than some of the richest people in the U.S. It is true that everyone pretty much gets malaria at some point in their lives in Shirati and that many residents live on less than $1 a day and rely on catching or growing their own food. At the same time, it seems like they are sometimes happier and more content that wealthy people that I know. Instead of stressing about money 24/7, being angry all the time over something, fixated over material things, or worrying about life, many of the residents are super friendly and laugh easily with strangers. You would never guess unless that some of these generous families have lost young children to malaria until you ask this on a questionnaire.

7/7/10 First Impressions of rural Shirati

I just completed my 2nd full day in Shirati. To give you a quick rundown on what it is like here… I am living at a hostel which is like a dormitory style living built by the SHED Foundation. My roommate is Melody and we arrived with about 7-8 other med students. The electricity here is supposed to be reliable about 50% of the time. The bathrooms definitely require shoes and there is a toilet and sink. In between the toilet and sink, on the ceiling, there is a shower head that shoots out only cold water. I am so grateful that a well was recently installed since before this well, all students showered in lake water that sat out in the sun. Melody and I use our mosquito nets religiously of course. For $20 a day, our stay at the hostel is included as well as 3 delicious meals a day, unlimited bottled Dasani water, and apparently a laundry service. In the hostel, we’ve seen some amazing creatures. In our room we’ve noticed some mosquitoes, spiders, and a huge beetle. The net is totally keeping everything out and I love it. Some of the med students have found a scorpion under their clothes while another discovered an orange rainforest-looking frog in the toilet tank. There’s never a dull moment.

The town of Shirati is accessed by dirt roads which create huge dust clouds whenever they are driven on. Unfortunately for me, there is no ATM. More interestingly, I learned upon arriving in Nairobi that Kenya and Tanzania do not accept $100 USD that are older than the year 2000. Literally, there is no vendor, money exchanger, or bank that will accept these bills. Let’s just say that I have a lot of them so I was a little concerned about money for a bit. Shirati is rural near Lake Victoria, which is a huge lake full of fish. The town consists mainly of farmers and fishers. There are a few stores but they are sort of like wooden stands that sell small items. The nearest bank for international people is 2 hours away by the border. Internet cafes, wireless internet in general, bars, and cable are almost nonexistent. I’ve been a bit out of touch but attempting to get a SIM card and modem to re-connect. So far, I haven’t really minded it. Its been refreshing getting away from constant Blackberry updates, e-mails, IMs, and facebook checking. I thought that I might have a difficult time adjusting to millions of critters, cold showers, lack of internet, time change, food shift, avoiding any tap water, etc. but its been totally fine.

The people that are here in Shirati with me are also fantastic. My partner Melody is super sweet and compassionate. She’s been to so many places and has put a bajillion hours into volunteering, its pretty inspiring. The med students from USC and BU are all so unique and interesting. I love hearing about their travel experiences, life lessons, and jokes. I don’t know what I’m going to do when they leave in less than 3 weeks. There are also about 3 independent volunteers that I’ve met in Shirati. One is an MPH student as well from UPitt and she’s doing interviews with cancer patients in the area. The other two are architecture grad students and they are entirely in charge of building this huge new medical clinic 40km away.
Tanzania and Africa in general is so beautiful. The sunrises and sunsets are the most incredible I have ever seen in my life. The skies are basically purple and pink during these times and the sun is red. Being less than 100 miles away from the equator, I definitely feel that beating of the afternoon sun. I would say LA sun feels 3x’s as strong as NJ while Africa feels 4x’s as strong as LA sun. Melody and I put on DEET, picaridin, and other insecticides like nuts to avoid mosquito bites and malaria. My wardrobe here is nothing like what I wear in the U.S. I have culturally appropriate clothes such as knee length skirts, khakis, and shirts in mostly neutral or white colors to avoid tse tse fly bites. I basically look like a school teacher and was actually called one the other day.

The two translators that Melody and I are using are basically our lifelines and the only way we can complete our research study. Killion is the head translator that has worked on medical translations for a long time. He speaks English, Swahili (a major language in Africa), and Luo (a local tribal language). His 20 year-old daughter, Pili, has a great sense of humor and also speaks those 3 languages. She is currently on summer break from “high school” which is the equivalent of a community college in the U.S. Everybody in Shirati seems to be so friendly and so laid back, its really welcoming. We briefly trained our translators and then started walking out to the villages. On our way to the first household, a swarm of little kids ran up to us foreigners and smiled. One cute little girl held my hand and walked with me for awhile. The kids also shouted out “mzungu” which is the equivalent of “gringas” in Spanish…it means foreigners or most often white people.

Life here seems very relaxed. We usually don’t start or meet people at scheduled times. All the med students finish their clinic work by 2pm, an early end. Then for the rest of the day we play with local kids, walk around the area, talk endlessly, and then watch the world cup at Dr. Esther Kawira’s house. She is the American physician that lives here and sets up the SHED foundation med school program. She has also been a tremendous help in my research project. She also is one of the few households with TV and internet. So far, its only been 2 days and I totally feel like I’m adjusted to living here.

7/5/10 Ride from Nairobi to Shirati

We had a 10 hour ride from Nairobi, the last third of the trip consisted of large pot holes in the road which shook our van like a mechanical bull haha. It was pretty amazing to see 5 giraffes roaming around 1 hour outside of Nairobi. We made a quick stop overlooking a mountain peak. There was one local man that that was wearing a Lycoming Warriors sweatshirt! How random is that, a Lyco sweatshirt on another continent…my undergrad consists of 1,500 people total and a lot of people in PA don’t even know of the college!! The village of Shirati has about 5,200 people. The main road is a dirt one and all of the stores are kind of like shanty shops. An amazing thing about Tanzania, like Kenya is that there are cell phone provider signs virtually everywhere. The main ones are Zain, Safaricom, and Vodafone. The long ride also taught me some lessons. When we stopped at the border, some of the med students were handing out stickers to children. Once you hand out something, not only do the kids want more, but they also bring their friends so you always have to be wary of how many items you have and that you have enough to give out to everyone fairly. The next thing we kind of observed was sad. I did not personally witness it, but a car had hit a woman and she died. Her village members were surrounding her dead body lamenting and waiting for a police report. This tragic event reminds me of Dr. Paul Farmer’s accounts in Haiti. Before I traveled internationally, I never realized that systems such as efficient law enforcement and traffic regulations could prevent so many deaths and that poorer nations did not have this luxury.

Hectic time in Nairobi, Kenya

Our 3 short days in Nairobi have not exactly passed by without a few major glitches. When we first arrived on July 2nd, a Friday night, after 22 hours of flights only my luggages showed up in baggage claim. Melody anxiously went the next 2 days without her luggage or any idea from the airlines about where in the world it would be. Her luggages like mine, collectively held 50 lbs of surveys, 55 lbs of crayons, necessary insecticides, and culturally appropriate clothing.

When we went to meet with my Nairobi correspondent about obtaining our PermaNet brand LLINs on Saturday morning, we were surprised to find that they office closed until Monday morning at 8am. The problem is that our van to Shirati is leaving at 6am sharp on Monday so waiting until 8am was not an option. I was able to track down the representative's cell phone and arranged for her to arrive in the Nairobi office. We placed an order for 250 LLINs which had came from the generous donations of our friends and family. Well, at that point, we learned that the cash in USD they had requested also had to have $100 bills no older than 2000. When they counted our money, they would not accept $400 worth of $100 bills since they were old. Funny thing, apparently the entire country of Kenya and Tanzania both do not accept bills older than 2000 or 2003 in some cases. So Melody & I had to trade these "bad old bills" with our personal money to pay for the nets. The next mishap was that the nets were not at the office and we had to meet someone at 8:30pm. Next thing you know, 8:30pm rolls around and the guy does not show up. Of course we are a little nervous that we handed them an insane amount of cash, but confident the company is legit. The delivery guy shows up at 10pm and delivers 250 nets...they were HUGE and so heavy, about 400 lbs. in total. All is perfect except when we open up one of the nets, they are white and we specifically ordered blue. The reason having blue is so important is because research studies have shown that in rural areas, colored nets are used more often and washed less often than white nets which tend to show dirt very readily. After some time the next day, we were finally able to get the blue nets exchanged. Phew.

Melody did finally get her luggage on our last day at this guest house, any later and she might not have luggage in Shirati for 5 weeks, yikes. The last mishap that we still have to deal with is that we looked through our $100 bills that we are essentially living off of since credit cards are not readily accepted in this part of Africa and we have limited amounts of cash. Apparently a large sum of those were older than 2000, rendering them completely useless in Tanzania & Kenya. We might have to try to convince the bank to take them, convert them at terrible rates, borrow someone's money, or hang onto the money until we get back home.

I definitely think these last few days, which thank god in the end worked out pretty nicely, have taught me how to be flexible. Nothing goes exactly as planned but you have to be creative and come up with persistent solutions. I find this true about life and traveling abroad in general. Lets see what our project in Shirati is going to hold! On a more pleasant note, there are giraffes that just freely roam on the side of the highway in Nairobi!! How cool is that since the only ones I have ever seen were at zoos! Also, Nairobi is quite industrial and there are so many Americans and Europeans here it was surprising at first. The next update I'll have will be in Shirati!!

What brought me to Africa

Originally written on 7/1/2010 on a plane

I'm on my way to London then Nairobi and eventually Tanzania. It is so nice having a spare minute since the last few days have been so intense. I feel this nervous rush and am surprised that I'm awake after having little to no sleep for 3 days straight. I just can't believe that the day that I have been dreaming about since I was 16 is finally here. Here is my chance to travel to Africa and engage in meaningful work. I think its funny that I've traveled internationally before, but have not been this anxious.

I can't help but reflect on the circumstances that motivated me to travel to an impoverished rural village, design a public health intervention, and live in the area for a large part of the summer. I suppose it all began with TV. I think that a majority of the population is able to watch depressing news and move on unlike myself. When I was a teenager I started becoming aware of disadvantaged populations and the realities of the world, especially what is portrayed in the media about poverty in Africa. It was only recently in my masters program that I learned about the extent of income inequalities in the U.S. and the world. I started to wonder how is that those of us in richer nations are able to spend more money on a single purse than a family of 6 earns in a third world country. Was there a conscious decision somewhere in history to determine that Americans nowadays succumb to deaths due to lifestyle choices such as poor eating habits leading to chronic diseases while starvation is still an issue in some countries. In sub-Saharan Africa, it is normal for a mother to have a child die in her lifetime; in fact, its almost expected that their baby will die due to diarrheal diseases, malaria, or parasites by the age of 5. Can you realistically imagine accepting this as a norm?

I think that my motivation to first-handedly work with developing countries stems from my perceptions of social injustice and simply how we are all humans and yet our lives are not valued fairly. To introduce my project for those that do not already know, I am traveling to Shirati, Tanzania to complete a research study on mosquito net usage in the village. Dr. Mull is my advisor as well as a USC professor and physician. He founded the SHED Foundation (Shirati Health, Education, Development Foundation) and graciously allowed me to travel with his group of med students this summer to Tanzania. The USC Institute for Global Health is also funding part of my travel and research expenses, I am forever grateful or else I would not be able to afford to go. My dear friend, Melody, and I will be in Shirati for 5 weeks. We want to figure out whether or not education can encourage villagers to properly use nets. Millions of mosquito nets are distributed every year but some residents tend to use the nets for fishing, chicken fences, or wedding veils rather than their intended purpose. It makes sense though, if you were given antibiotics and were not told about how to use them or why you should, there is a high chance that you will either use them incorrectly or not at all. In addition to our house-to-house survey of net usage, Melody and I are planning a community intervention to diffuse this information village-wide. We brought a lot of coloring pages and crayons with net instruction images for the kids. We also want to ask community leaders how to encourage net use and demonstrate to the village proper net usage. I'll keep you updated on how it goes!