running in circles, chasing our tails

huge apologies to those of you wondering where I’ve dropped off the face of the earth to, it has been so long since I’ve written an update.

to be honest, it’s because I haven’t had lots to write home about. I mean, I could’ve easily written about the severe diarrhoea I’ve had off an on for the past couple of weeks and the very intimate relationship I’ve had with the toilets in my house (sorry, oversharing is caring), but I’m pretty sure that’s not what you want to read about. bit just a little on that topic, this is now my sixth month in africa, and seventh month away from home, I can’t believe I’m still dealing with such a temperamental stomach. someone please remind me to enquire about an entire gastrointestinal transplant when I get home. one of my friends I made volunteering in kenya, richard (who’s a fellow aussie), uploaded an instagram picture and used the quote “used my butt as a trumpet filled with soup” when he and a mate were sick. it couldn’t be more true.

okay sorry, enough ‘toilet talk’. but being sick and confined to either my bed or a toilet has made time absolutely fly – I’ve already been in tanzania for a month now.

for a couple of my weekends here, I’ve spent my saturdays helping a really lovely girl alice, from england, help build a new house for a mama she met here in arusha when first volunteering in 2010. I got in contact with her through the tanzania volunteer group on a facebook when I was still in kenya as she was asking if anyone wanted to help out on their spare weekends. figuring I’d have not much else to do when I’m not at work, I let her know I’d be keen. long story short, I’ve been for two of the saturdays that I’ve been in tanzania helping with whatever needs help with at the house. god it is strenuous work, I don’t know how alice has been doing it at least six days a week for the last five or so weeks. incredible.
things we’ve helped to do include excavating existing dirt and clay that was piled up after digging the 12m hole for the squat toilet, hacking away at the existing clay retaining wall behind the new house, scrape off concrete from the newly installed doors and window frames, sanding down said doors and window frames with a piece of sandpaper and a machete and a steel wire brush, painting the doors and window frames… it has been amazing to be a small part of such a huge project. click here to check out alice’s website for a much more detailed re-cap of all she’s achieved.

work at my clinic has still been quite interesting, including a day of working solely with a midwife doing fundal height measurements and listening for a heartbeat with an archaic tool that looks like a funnel, as well as spending time doing ‘growth and monitoring’ on bubs, which occurs every month until about the age of 4 years. it’s a bloody great system – they have a scale suspended from the ceiling (like you see in the fruit and veggie shop) and all the mothers hand make these little jumpsuit things that has a loop that hooks onto the scale, so their bub is suspended (which most of the kids hate) but it’s fast, efficient and easy. I’d then record their weight on a brochure like piece of paper and any serious abnormalities compared to the last time they were weighed, I had to report to the midwife. luckily there were no bubs on this day who were malnourished or weighed significantly less than they did a month prior. africa might be behind in a lot of things, but this is advanced to the max.
also gave polio, tetanus, and rotavirus meds/injections to newborns and as much as it was awful making them cry, at least these kids are getting vaccinated like we all were.

I really love living at the volunteer house now, obviously I didn’t when I first got here, but it’s buckets of fun and the bunch of people living here now are a great group and we all get along really well. just took a bit of getting used to living with 20+ other people. it’s so nice coming home to friends asking how your day was, as well as asking how everyone else’s days were. we all have such different experiences at our respective workplaces. I would love to visit a couple of orphanages while I’m here, apparently they’re really well orchestrated here in arusha – including a baby orphanage that I’m really looking forward to hopefully visiting.
also couldn’t be happier that I decided to buy a ukulele when I was in germany, it’s getting a good workout here in tanzania – sitting around the outside fire pit of an evening with a few beers having a singalong is probably my idea of heaven… glad there’s a scottish bloke called iain who is more than happy to join in so I’m not singing all alone. we’ve treated everyone to a rendition of “the four chord song” by axis of awesome (you should youtube it) and added extra songs in as well. but it’s making me really miss my guitar.

okay i guess now that I’ve written all that, I did have stuff to write home about. apologies for being slack.

it’s hard to believe I’m on the home stretch now, about 5 weeks until I’m back on australian soil. christmas looks like it will be loads of fun here, about 10 or so other volunteers spending the holiday in arusha – see what happens when it arrives! can’t believe I got to africa on the 30th of june and now it’s december. if anyone needs a reminder of how fast time goes, do volunteer work… it flies.

time is like the ocean, you can only hold a little in your hands

thoughts, part IV.

(if you’re new to these “thoughts” posts, it’s basically little things I’ve written down that intrigue me and I feel the need to share with you lot)

on one of my last weekends in kenya, my host family had a huge party at home. about 50 people came over for a late lunch where they’d eat the two goats that were freshly slaughtered that morning. preparations started the night before when makena, her aunt and her grandmother sat in the kitchen peeling potatoes. then the next morning when I woke up, there was an army of kenyan women in the kitchen; rolling dough for chapati, slicing (what looked like) a million bunches of kale to be eaten, cutting vegetables, preparing what would be lunch for about 50 people that day. I felt a bit homesick actually, because I love it when my big dysfunctional family gets together. and it felt like that, except there was no alcohol at this party… something that’s never missing from my family shindigs.

seeing evelyn, the principal at little ray of hope give the rest of her lunch to one of the smaller kids one day brought tears to my eyes. I have never met a more selfless person.

it gets me down when you see people purely ‘existing’ here. I mean that in the sense that some kids just don’t have the same opportunities to grow up and be who or what they want to be; that they have to sell fruits and vegetables by the side of the road so they can merely survive. not many of them get to dream as big as we do.

I find it hilarious that kenyans drink guinness, and a lot of it, regardless of how old or pregnant they are, because it would “keep their skin nice and evenly black”. because nobody wants uneven skin colouring.

arriving in africa, I was told to dress somewhat conservatively so as not to offend anyone. I complied for much of my stay, understanding that you have to cover up in certain areas in africa to be respectful – however everyone can go get fecked if they think I’m going to wear neck to toe coverage when it’s this bloody hot. okay, I get that wearing a crop top and short-shorts would be offensive to the many muslims here in tanzania (and I wouldn’t do it anyway), but if my “pasty white” shoulders offend you, which by the way they are no longer pasty and white, avert your eyes. it’s too goddamn hot to be polite anymore. rant over.

a very wise person once told me “you can’t grieve over everything you see here, otherwise you’d never stop grieving” (that was norwegian anna by the way). it’s so true. seeing men carrying “bunches” of chickens strung together by their feet on the dalla-dallas shocked me, initially. same with seeing men dragging goats across a road by a rope tied around their neck. or seeing baby chickens tightly crammed into cardboard boxes on the side of the road waiting to be sold. I hate animal cruelty but here, this is life. this is how people survive. I think I’ve come to terms with it a bit easier than some other people I’ve met and maybe it’s because of the “farm girl” attitude I’ve been raised with through my grandparents and my parents. I hate that people can’t handle the fact that a “cute baby animal” had to die for that delicious juicy steak or an amazing pork chop they’re eating for dinner. where did you think it came from? of course the cute things are the most delicious. (just writing about steaks is making my mouth water, I would do anything for a big bit of meat right now… I don’t know how vegetarians do this shit). you have to eat to survive. here, nothing goes to waste and nothing is more obvious for some than the will to survive.

I hate that regardless of how well practised you are – and I’ve had four and a bit months worth of practice – when using a squat toilet, if you’re a girl, you will piss on your feet. it’s inevitable. and it sucks.

the fact that it takes me almost an hour to get to work at my clinic here in tanzania. dat shit cray. in kenya, our workplaces were always within walking distance. and how I get to the clinic is as follows: get on a yellow coloured dalla dalla (matatu), ride for 20-25 mins into town, get off yellow dalla, walk 15 mins to get to red coloured dalla, ride for 20 mins, get off red dalla and walk 5 mins. but I’m not alone, this is done with about 15 other people crammed into the back of the van, most of whom are women who have done their market shopping for the day so are carrying bags of vegetables and/or dried fish and/or dead animals. delicious.

this week I got on a by motorbike for the first time since my accident. no there was no helmet, no I wasn’t wearing any protective clothing (I was only in a dress), yes I’m an idiot… I already know that, but I was lost and the dalla I got on to go home went the wrong direction and it was almost dark and I needed to get home ASAP. needless to say it won’t be happening again, I was shaking like a fool the entire ride and for about 20 mins afterwards, as well as being so sweaty, I hated the entire ride. never again. but I did it. I conquered a fear… sort of.

speaking of dalla dallas, I can safely say that before I got to tanzania, I had never before been asked to purchase a bra from a woman sitting behind me to “help support her family”. lingerie sales in the back of a public van. sorry love, but I like to try before I buy.

people like us, we don’t need that much

my first week in tanzania was really interesting. obviously, you all read about my severe “homesickness” from kenya, which I should let you know I am almost over. I still miss the kids at little ray of hope like crazy, and I really miss my host sisters, but I don’t feel as upset about it as I was 11 days ago. but I am going back to nairobi for a weekend visit in my couple of weeks… I just spoke to anna and vicky and makena, and I miss them all so much, I will happily spend money on buying another visa to re-enter kenya, and then to re-enter tanzania. I might be crazy, in fact I know I am, but it’s only 250km away.

anyway, tanzania. I have been placed in a clinic called kijenge RC dispensary, RC stands for roman catholic. so there’s usually a few church songs playing in the background during the working hours, which definitely make me feel like I’m in a gospel choir or something (that’s my ultimate dream, to be a gospel singer. I’m just not a good singer nor am I black enough… one day). there’s two huge (and I don’t mean tall) nuns who run the show who I’m waiting for them to start singing “oh happy day”. the clinic is quite nice, they don’t need for much. I’ve had a look in their pharmacy and it’s stocked to the brim – they obviously have great sponsorship.
my first couple of days there were relatively observational, which I expected, and to be honest, it’s really captivating as people just don’t go to the doctor in australia for these sort of things. I sit in with the doctor (who is also my supervisor) as he does consults , and some really interesting cases have come through over the past week. the doctor is awesome, he includes me in the consults and asks my opinion, as well as translating to me what the patients say and what he thinks they have and what he will prescribe, and asks if patients in australia would receive the same treatment. I’m not completely up to date with what diagnoses require what medication, but a few things I recognised and could say yes or no. obviously we don’t have malaria cases back home.

the doctors office; the wall I sit and look at while he chats to the patients

things that came through the clinic last week include (but certainly not limited to):
– 3yo girl with malaria
– 25yo female with hypertension (220/150 on both arms)
– 6yo boy with mumps
– HIV positive woman for medication to prevent spread of disease to kid (niverapine)
– 25yo guy with cut finger
– 6yo boy with UTI
– 30yo female for stitches removal post caesarean
– 8 month old baby boy with otitis media
– 18yo girl with malaria
– 14yo girl with mumps
– baby with facial skin rash whose mother is HIV +
– 8yo boy and his 30yo dad with amoebiasis (a type of gastro) – treated with flagyl (metronidazole)
– 18 month old girl with bronchitis
– 5yo boy with productive chesty cough
– 3yo boy with malaria
– 5yo boy with huge abscess behind right ear (lidocaine before lancing, hardly done at all kid screamed the whole time, lots of shit (obviously not a medical term) came out)

hand washing facilities in the treatment room… yep, gross.

I spent one day working alongside a midwife doing antenatal checkups; learnt how to measure fundal height (basically measuring how big a women’s pregnant stomach is… that’s a very lay person description) and how to listen for a heartbeat with an archaic tool that looks like a weird mini-trumpet but not before harassing the baby through mum’s tum to figure out where the head is, therefore where the chest/heart might be (I’m still practising this new and difficult skill).

some of the things in the treatment room, apparently anything inside the silver tins is sterile. yet to see a steriliser though

some awesome things I learned this week:
– all malaria tests and treatment are free; children just don’t die of malaria here anymore as treatment is free (provided they can make it to a clinic)
– all tuberculosis tests are free
– all HIV testing and treatment are free

I still can’t wrap my head around the fact that we had three mumps cases in the clinic. for those of you who don’t know, mumps is one of the things that we’re all vaccinated against in the big MMR injection (measles, mumps and rubella) at 12 months of age and (I think) the booster is at 2 years. mumps is a viral infection that usually causes painful swelling of the salivary glands, but can cause other serious problems including encephalitis (swelling of the brain), which can lead to permanent brain damage and/or deafness.

I was dumbfounded. like measles, isn’t mumps ‘extinct’? I mean obviously nothing is ever completely extinct – except dinosaurs- as these patients had it. even things like the bubonic plague (the black plague) have surfaced in madagascar and the middle east in the past few months. crazy stuff. I guess because I’ve not seen it in australia, and I know I certainly don’t have an extensive work history due to only just finishing uni, but I’ve never heard or seen anyone being diagnosed with mumps, at least not my age or younger. even though vaccines are pretty much readily available here in east africa (as far as I’ve seen), there are many factors that prevent kids being vaccinated against things that we’ve all been vaccinated against – unless you’re one of those crazy people who believes there’s a correlation between receiving certain vaccines and developing autism. don’t even get me started on that, that’s a topic for another day and a lot of wine… moving on… one website writes about the challenges of getting kids vaccinated here; i) lack of medical personnel to administer the vaccines, ii) lack of vaccines, iii) inability to store refrigerated vaccines in rural areas, iv) inability to transport refrigerated vaccines and v) poor record-keeping (reference: east africa partnership). I’ve seen all of these things, even to the point of only being able to have certain vaccines at the medical camps I worked at in kenya.

beautiful baby girl with the awful skin rash on her face, likely correlated to being HIV+

the baby girl who had the facial skin rash was such a beautiful little kid, I managed to take a picture (obviously after checking it was okay with her mum and the doctor). she wasn’t the patient, but the doctor and I obviously noticed something was wrong. her mum was coming in for more HIV anti-retrovirals (ARV’s) and the doctor mentioned that the baby’s skin rash is almost 100% indicative that she is also HIV+. I’ve done a lot of google-ing about rashes that relate to HIV and haven’t seen many that correlate to the same rash as the baby, but her mum didn’t consent to having her daughter tested on the day. the frustrating part of our job; you can’t force anybody, even when it’s in their or their child’s best interest.

it’s been really eye opening. and I’ve learnt a lot. not in terms of clinical skills, and by no means are they improving, but I’m learning a lot about patient care and how important it is for patients to feel like they’re being listened to. picking up on small cues about how certain medical professionals look at and/or speak to (or don’t) their patients; I know how much they drummed it into us at uni that you need to give patients eye contact so they aren’t feeling ignored. I thought it might have been a culture thing, but now I don’t, because patients are constantly looking at the doctor or midwife, hoping for some sort of interaction, yet they rarely receive it.

on a side note: I’m totally and utterly exhausted. I had no idea how tiring this volunteering thing would be, and I think I’ve been chronically tired since mid-september. dragging myself out of bed some days has been really difficult, I’m really sick of not showering (when the power goes off here in tanzania, so does the power, so you have to get water out of the well in our front yard to bathe with), I’m so so sick of eating carbs and carbs and more carbs (dinner the other night was spaghetti and mashed potato), I’m so tired of having irregular bowel movements and getting ‘travellers diarrhoea’ on a regular basis (yes that’s an overshare but I don’t give a shit) and spending every fortnight sick like I am now.
but it’s made worth it by a lot of little things – including an elderly gentleman who paid for my bus ride home from town yesterday to thank me for what I’m doing for his community. this guy was so unbelievably old (I always say that africans always look young, until they hit a certain age, then they look 150 years old), and had hardly any teeth left, and spoke terrible english, but I felt so humbled by how generous his gesture was. or by the kids and how they have to run their hands over your skin to admire how different the colours are… or pull your arm hairs out.

I’d be lying if I said I wasn’t counting down until my holiday in zanzibar, only 27 days until I’m lying on a beautiful, idyllic, crystal clear beach and actually relaxing. bring it on, baby. I’ll be so ready for a break by then!

now my feet won’t touch the ground

getting to tanzania was an experience, to say the least. with my emotions already shot to buggery, I got the bus from nairobi, kenya to arusha, tanzania. getting out of kenya and into tanzania with new visas etc. was actually pretty easy and self explanatory (thank god because there was no one to help explain anything); until we got a flat tyre, didn’t have a spare and waited almost 45mins for our drivers mate to come and save the day with his spare tyre. in the desert, under the blazing sun. dis is africa.

how many Africans does it take to change a bus tyre?

arrived at the bus stop in arusha and called angella, one of the directors of TVE (tanzanian volunteer experience, the equivalent of NVS in kenya), to let her know I’d arrived. someone was there to pick me up in about 15mins, but not before a million guys come up to me greeting me with ‘mambo!’, which is kind of like ‘what’s up?’ and then asking if I need a taxi ride. so now that I’m totally fluent in kiswahili (that is such a lie, but I’m better than the volunteers who also started with me in my orientation here), I respond with ‘poa sana’ which kind of means ‘not much, everything’s good’… sorta kinda. that made these guys think I was fluent; they kept asking if I was a kenyan, I was like mate do I look like a bloody kenyan? I’m not that dark. until I realised it was my kenyan bracelet that was giving it away, now I have a tanzanian one as well – just to confuse people. anyway these guys started chatting to me in swahili – yeah nah mate, I can say hey and what’s up, and I can understand a bit but don’t get me to speak it back. it would take years for me to get that good.

got picked up by a guy called jimmy and a woman called aichi, who turns out to be the house manager of the volunteer house I’m staying in, in sakina, arusha. there was a guy from the US, matt, already in the car as well as a girl from israel, arielle, who just got released from the army. we picked up another guy from spain, pepe, and then all got taken to our respective volunteer houses. this is so unbelievably different to my kenyan experience; the house I’m staying in is called ‘new new house’ and fark me, it’s a modern mansion! sleeps about 30 people plus the two house mamas and our house manager, hot showers that don’t give you an electric shock, flushing toilets with supplied toilet paper, supplied drinking water, really cool outdoor living area, we get served three meals a day every day, there’s no curfew, there’s no rules on alcohol… incredibly different to living with my host family in kenya. but not necessarily better. more on that after.

my room, sleeps 14

the boys doing some DIY BBQ meat

the new new volunteer house – bigger and more modern than my home in australia

thursdays in arusha are what they call ‘social night’, where all volunteers can go and have a huge BBQ dinner at the old house (meaning that it was the first volunteer house TVE had, since then they’ve now got two more, including new house and new new house, which is mine). because TVE volunteers are only placed in arusha, it’s pretty easy for everyone to come together and to get picked up from wherever they’re staying. maybe about 35-40 volunteers in total had dinner, everyone sitting outside and hanging out. now I’m really looking forward to this every week because I’ve met some awesome people who I don’t live with, that I’ll now see each thursday (plus the dinner is amazing, last week I ate so much I felt sick… that’s what I’m like now, I see delicious food and I can’t stop myself. that’s what eating unexciting bland carbs for 4 months does to ya!)

it was so weird being on the other side of what I normally am; in kenya, I was that volunteer who knew all the tips and tricks and could give the advice because I’d been there so long. whereas this time, I was eagerly listening for anything that could help out in this slightly familiar yet really strange place. there are also some lovely girls from new zealand though, especially rebecca and savannah…. there’s just something about people from that part of the world. wink wink.

friday was my orientation day, and that was so bloody different to my last orientation. my kenyan july 1 orientation had 99 volunteers, my tanzanian november 1 orientation had only 9 volunteers. ha, how times change. the orientation was different to what I was used to in kenya as well; while I should have only gone to one (my own), anna and I ended up going to about 3 or 4 as we were trying to organise our medical camp and chat to marcus about it. no singing “jambo bwana” at this orientation in tanzania and the staff of TVE are all women, some of the new things in this new country. did a walk around the city, tried to get my bearings but lord knows it will probably take my entire time here to feel as comfortable as I eventually did in nairobi.

I feel really nostalgic to my time in kenya, in the grand scheme of life it was only 4 months but it seemed like a lifetime almost. when I was brought to the volunteer house on thursday afternoon, one of the volunteers told me about a girl who came to arusha after being in kenya for 2 weeks, stayed here in arusha all of 24hrs before going straight back to kenya. being completely honest, I’d by lying if the thought of that didn’t excite me. my first couple of days here I really struggled. I think it was a combination of loving what I was doing in kenya as well as loving the people I spent my time with. I know moving to a new place is daunting, and while part of my struggle to assimilate was due to that, a lot of it was because it wasn’t kenya. I’d become so used to living in a slum, to having a shower that gives me an electric shock, to walking down my dirt road to school every day, to avoiding ugali night at home, to sneaking in bottles of wine to my house where alcohol wasn’t allowed – and then finally graduating to just going down to the closeby bar mixing with the locals for beers, to fending for & protecting myself in a way I’ve not had to before, to finally learning the kids names at school (over 50 kids in 4 months, it’s no easy feat). I spoke to mum and dad over the weekend who reckon I’m going through culture shock, which sounds like a bloody joke as I’ve only moved down one african country. but it makes sense. I might still be in africa but tanzania seems like ‘the ritz’ compared to the budget hotel that kenya is… and I’m all about the ‘budget hotels’. I knew it would be difficult once I got home, just not this soon!
but now it’s time for a new experience, as much as I miss kenya I know I’ll be back there and back with the kids before I know it.

next posts – random thoughts over the past few weeks as well as my new workplace here in tanzania, the kijenge RC (roman catholic) dispensary and the weird medical stuff I’ve already seen in my first week. the new part of my adventure has started, and it’s actually medical. #nursinginafrica