Monday, May 11, 2009

Steen: Back in Dar

Hello All!

I have returned to Dar.  Erin and Chow are in Zanzibar tasting delicious spices and relaxing on the white sandy beaches.

Safari was most excellent.  Well, first, I went out to Zanzibar on Saturday in the wee hours of the morning (taxi picked me up at 4am to go to the airport)... got picked up at the airport by a driver, which took me hotel shopping (though I ended up staying at the first one, St. Monica's, as recommended by an ICAP Dr)... then went to Stone Town and enjoyed one of the best breakfasts ever at Passing Show Hotel, which was a cup of chai maziwa (milk tea with masala spices) and this kitubuwa or some kind of really tasty coconut pancake... all for about 35 cents (400 Tshilings).  It was so good. SO good.  Then, Spice Tour from 9 to 4pm or so.. tasted fresh spices and star fruit picked off the tree!..  also had my first taste of Jack fruit and guanabana.. plus some wandering around Stone Town, getting caught by a papasaai who took me all the way from the edge of Stone Town by the water where I wanted to grab a bite, to New Town, tricking me, but leading me on a bit of an adventure.  Eventually made it back to my streetfood by Africa House Hotel.... Sunday, the next morning, was a walking tour of Stone Town.. going through the markets was most excellent.  Got caught by another papasaai on my way to buy spices, but was much better at dealing with him than with the first guy... he wasn't calling the shots.  Then, headed off to airport to go to Arusha.  Oh, also received a marriage proposal and an "I want to be your boyfriend" from two 20something year old Zanzibari guys...  mmmm.. right.  haha.

6 Day Safari with Erin and Chow was great.  Lake Manyara. Serengeti. Ngorongoro.  Oh, and a day with the Masaai.  Serengeti was most awesome -- 100 elephants in one view, the wildebeest migration (wildebeest and zebra as far as the eye can see!)... and other fun things.  Stayed at an excellent tented camp and discovered that lodges have crappy food during the low season (unedible; and this is coming from a foodie who can't stop eating even when she is full.. if it tastes good.. and most things do... sometimes i left most of my plate; so bad). 

Yesterday, flew back to Dar.  Went up to The Slipway for some bargain shopping, which was fun.  Met some characters.  Ate some kiwi ice cream.

Today, office day.  A trip to the tailor for fittings.  Then, will go to city centre at night for dinner.  

Tomorrow, maybe off to Bongoyo Island... having an Ethiopian food craving, so probably going to Addis in Dar.... 

Flight has been delayed a day (they cancelled my Tuesday night flight), so will return to States Wednesday.  Flight leaves Dar at 10:50pm on Wed.. get back Thursday midday.  Yeps!

No pics for now... perhaps later!

Thursday, April 30, 2009

Steen: Quick Update

Friends! Apologies for lack of blogging. Things have been crazy here. Last week was our last full week in Bukoba and we were out and about on Monday and Tuesday with two big fanfare CTC building openings. Wednesday, we worked to finalize our CD4 Collection Study presentation and then on Thursday and Friday was the Annual Regional Partner's Meeting. We presented the results of our study to a room filled with over 130 clinicians, District/Regional medical officers, pharmacists, lab technicians, etc. It was really quite a rush to be able to disseminate the information we found to the people who needed it the most (the people who are collecting the CD4s).

The weekend was busy with going-away activities and we moved to a beautiful bed and breakfast up the road from Kolping. Wrapped up some work and bought a few last minute items. Also made preparations for a Monday celebration where we made Guacamole for the office!

Tuesday, flew back to Dar. Wednesday, we went on a site visit to another CTC in the Pwani region (Dar region) and worked on our final paper. Thursday, went to the tailor and then are still working on our final paper/debriefing. Tomorrow is a public holiday, and I think we will just wander around Kariakoo market and try to get to know Dar a bit.

Saturday, I am headed to Zanzibar for a day plus most of Sunday. Sunday evening, we head out to Arusha for our Safari, which will start Monday and go for 5 nites/6 days. Then, returning to Dar for two days before heading back to the U.S.!

We are turning in our laptops for safekeeping and thus will have even spottier email access during this time, though we may hit up an internet cafe or two along the way. Just fyi!

Hope everyone is doing great!


Sunday, April 19, 2009

Steen: Two Photos

No time to write new blogs since this week is so busies, but here are two photos!

Photo caption: Steen first ride on the back of a boda-boda (motorcycle) in Mbarara, Uganda. One of her newfound favorite activities! There are also piki-pikis (motorcycle in KiSwahili) in Bukoba, but Erin and Steen have not had a chance to ride them there.

Photo caption: Columbia Med Students in Uganda! Erin, Steen, and Jake the morning of our hike up Mt. Sabinyo. Heading to Rwanda and the D.R. Congo! This is before we got all wet and muddies!

Steen: On Secondary School Boys

(written during Week 3)

- This (i.e. secondary school boys coming up to us and introducing themselves) was a point of initial amusement that has become an “Ugh” topic for me. The frequency of a certain rehearsed speech has made me wary of their aggressive, seemingly scammy ways.

- Last Saturday (8 days ago), Erin and I were walking up the hill back to our hotel when we met a boy, about 15, on the grounds of the Lutheran Church situated halfway between the center of town and Kolping. At this point in time, we had become used to random people coming up to us in town and being friendly. This boy, M, seemed like one of those people – friendly, curious, and harmless.

- We had been interested in attending church service in Tanzania at some point, just to see what it was like, and we asked him what time service was on Sundays. 7:30am and 10am. Okay, great, we thought, maybe we’ll see you at church tomorrow then and then went on our ways back home. Sunday came around and it was pouring. Neither of us is equipped with a strong enough umbrella for their storms, so we decided to stay in. 10:30am rolls around and we hear a knock on our door. It’s one of the hotel receptionists, who says “M is here for you.” And we think, M from work who we were hanging out with last night? Oh wait.. no… M the schoolboy. How did he find us? Oh yeah, we’re kind of easy to describe here – White girl, Asian girl (or China (pronounced Chee-nah) as they shout to me here..). We step outside our room and we see him in a tan suit waiting for us, telling us he would like to bring us to church. Having a personal escort to church seems like a sign enough to go and the rain has let up a bit at this point, so we grab our bags and walk with him. Then he says, it’s too late to walk in to church since service is halfway through (this makes sense, we don’t want to be rude), but let me show you some things. Okay, that is fine. We walk past the church and he is like.. let me show my home, do you have time?

- Erin and I are a bit more on guard at this point, unsure how to proceed, but seeing as there are two of us and one of him, out in broad daylight on a Sunday morning, figure it should be okay. We walk down a dirt path past the church and then turn left down another road, where we arrive at a small brick house with a sheet metal roof. M knocks on the door. At first nobody answers and so he heads towards the back of the house. Here, we do not follow. He comes back to the front and eventually the front door opens. Come inside, he indicates. I look at Erin with a “Do you feel comfortable?” look, she looks at me with a similar look. Seems okay to just peek. I step in through the front door, careful to leave the door open in the unlikely, but certainly possible event that M is not as harmless as he looks. Erin is right behind me.

- Inside the house was quite a site. We have gone on numerous site visits at this point and seen many of the houses on the outside, but not once have we stepped inside a home. It’s dark inside with old sofas and lots of yarn doilies. There is a small room maybe 8x10 in the front and then a room that is completely dark in the back. The ceiling has a few wood beams, but otherwise we can directly see the sheet metal. From the back room emerges a boy about 16-17 years of age. This is my brother, M introduces. Another boy walks out of the back room; he looks about 6. This is my younger brother, says M. We shake their hands and say hello, nice to meet you, then indicate that we should leave. M agrees.

- At this point, Erin and I recognize that we have reached the limits of our comfort level and both start indicating that we should get going, we have work to do, etc. M appears disappointed, wondering outloud in broken English when he will see us again. We tell him, next Sunday at church. He says he understands and offers to walk with us back to the hotel. Now M has a brooding, concerned look on his face that this point and he says, “Can I tell you about myself before you go?” We say, okay, and he then goes into this story about how a few years ago he met two Swedish women who became his friends and paid his school fees, but one of them had a husband who died and so she had to return to Sweden and never came back and now, he needs to find a new supporter to help pay for his school fees. You understand, he asks? Ah, yes, I understand what all this has been about now. He pulls out a picture of him sitting with a young Caucasian girl, looks about college age (read: not the old woman “benefactor” I was envisioning who might have a husband who died; this girl looks more like a volunteer who came to the region with whom he happened to take a picture in my cynical view), and says that she used to be his supporter and would we be able to be his supporters now?

- Wow, this made me really uncomfortable. In part, because I don’t believe him, but also because part of me wonders if he might be telling the truth. Regardless, I am not about to pay his school fees by handing him money now, so I say that we are also students and do not work and have to pay our own school fees (all true things), so we cannot be his supporters. He tries to tell a bit more of his story, trying to make sure we understand his predicament, and asking “Do you know anyone at the hotel who could help me?” We do not know anyone else at the hotel, we say (which is true). We are sorry. He looks disappointed, but says he understands and then again offers to walk with us up the hill. Halfway up, M says he should head back to the church and we agree that this is best. He asks for our emails and then goes on his way.

- Back at the hotel, Erin and I discuss. Is he for real or is this a scam? Could we pay for his fees – they probably are not all that much. It’s not a solution though, more just a bandaid. But sometimes, we need bandaids to tie us over. I’m fairly certain there must be some kind of organization/NGO or otherwise that would help students with their fees if that is really the problem; they cannot expect all students to go about finding supporters (i.e. – foreign tourists who happen to be passing through town). On principle, I don’t believe in helping just one if it’s a systemic problem, but Erin brings up a good point in that sometimes people just need a little extra help for a period of time, but then her question is even if we did support the boy, for how long would it go? Just the year or all the way until university? And we both wonder if the way things have been handled here by foreigners is feeding some kind of beggar mentality. What about us makes this boy think that we must be wealthy and can or should ask us for money? I think we both conclude that if he really were in a dire situation, and for some reason there were no local organization to help him, we might be interested in trying to help serve as that bandaid. At the same time, we recognize that we aren’t sure if he’s for real. I personally just don’t quite believe him. Something about him seemed too polished. I certainly did not like his aggressiveness in coming to find us at the hotel or how he was so direct in his request. But, the fact that this boy had a suit, lived in a brick house, despite is darkness and bare-bare bones insides it’s not the wood or mud huts we see along the roadsides, and is currently in school now, makes me less likely to believe his story. I suppose part of me was also just made incredibly uncomfortable because the situation shoves some kind of power and privilege dynamic directly in my face and I feel bad for being so skeptical not wanting to help. Yet, I am unwilling to help, because I feel that if I help this one, it is not being fair to all the other boys who need their school fees paid and it’s really just, again, not a solution to the problem. (if the problem is even real!)

- So… that was last weekend.

- This Saturday around 1pm, Erin and I are walking to town when we and suddenly surrounded by a number of secondary school boys walking home after being let out of class. Habari! Hello! Where are you from? What are you doing in Bukoba? They have a bright curiosity about us and what we are doing in their town and also offer to walk with us towards town. At this point, having experienced M last week, I am a bit more on guard. We do not tell them where we are living (we do not want more visitors at our hotel!) or other specific details about our stay in Bukoba (they often ask how long we are staying as well). This week, however, the boy I was walking with was even more aggressive.

- Meet L. He is fifteen. After talking to me for a few minutes, he asks me if we can be friends. Sure, we can be friends, I say. Since we are friends, can I have your telephone number? I do not have a telephone, I say. (not true, but I don’t want him calling me). I quickly realize that if I do not ask him more questions about himself, he will ask more prying questions of me, so I ask him about school, since he is wearing a uniform. He tells me he is in Form 3 and then goes into an abbreviated version of M’s story with slight variation. I need someone to pay my school fees next year as my father passed away and we do not have money. I tell him the same thing I told Marcus, that I cannot support him because I am also a student, do not work, and have my own school fees to pay. Then we walk a little more and I try to find more benign topics to discuss. He asks me if I own a computer. I tell him that I did not bring one here, no. (Also not true, but I don’t need someone knowing I have a laptop here) I tell him that I use the one at work. He asks, when you leave, can you leave your computer with me? (Who does he think I am? Made of money? Giving away computers left and right?) Now I’m feeling really irritated, because I can see that when he sees me all he sees is dollar signs. I tell him, no, I cannot give him the computer; it is not my computer. Oh, company computer, he says. Yes, I say. I do not have money, I am also poor, I say. Finally, he backs off and another one of his friends comes to chat with me. This boy, I don’t quite catch his name, is much nicer. He teaches me some Swahili phrases and then eventually says he needs to go meet his father in town and says goodbye. A nice guy, I decide.

- On this walk, Erin hears half of a school fees story, but the boy apparently does not speak enough English to really convey the story well. So, by and large, she is able to talk about other things and her walk is a bit more enjoyable and benign.

- Sunday, M comes to visit again, to our surprise, though maybe we should not have been that surprised. This time, we are actually rushing to work, so we say, you can walk with us if you would like, but we are busy. He seems to want to spend more time with us, wondering when we will see him again. At church, we say, if we are in town. On the whole, we suspect that he is harmless, given his age and the reputation of this town as being “safe,” but his aggressive and direct nature, his asking us for money, makes us keep our distance. He walks with us halfway down the hill and then says he needs to head home, which suits us fine. He can just email us if he wants.

- In sum, I now feel like these boys really are nuisances as they are trying to scam me (say they have a specific need when they do not) with the same story. At the same time, I don’t doubt that there are students in this region who cannot pay for their school fees. There is poverty left and right, so it’s completely conceivable that students cannot pay for their fees, and I think this is where the conflict in my lies. If their story is true, then I want to help, but I suspect their story is false. Still, given that the story must be true for some, how do I identify those students and can I really help? What is the best solution? Clearly, I believe a systematic solution is necessary if the problem is so pervasive, but in the absence of being able to provide a systems solution which will take time, is it okay to help individually?

- A few more bits of information. A school teacher randomly sat down with us at lunch at New Rose Café on Saturday afternoon and we asked her about these fees. She says for public school, fees are about 20,000 Tanzanian Schillings (between $15-20) for the year. Private schools cost more. Most families can pay, but not all. A lot of the students who cannot pay receive support from donations from abroad through some of the faith-based organizations, like the Lutheran church. We also spoke with Dr. Bertha, our ICAP mentor, who also said that while orphans often cannot pay for school fees and this is a problem in Kagera, where HIV first started and hit hard some years ago, devastating families, these particularly boys were likely trying to scam us and that there are several organizations in this area that help pay for school fees or whatever basic needs children need. This is not to say that the organizations are perfect as a lot of orphanages are in decrepit conditions where children eat one meal a day and much of the money goes to the administrators instead of for the children and there are students whose families struggle to pay their fees (in contrast to students a generation ago under President Nyerere, who made education free for that generation), so the problems exist, but having foreigners hand out money and encourage begging is not the solution. A sad state of affairs, but I have to agree with her. But how to go about fixing such a big problem?

Friday, April 17, 2009

Erin and Steen: We Are Alive!

Photo Caption: This is Erin, Steen, and Jake (Master Uganda Trip Organizer) on top of the second peak of Mt. Sabinyo. It took us five hours to reach this point from the base of the mountain!

Photo caption: This is Mt. Sabinyo from where we started our ascent in the morning on Saturday. We climbed up to the first peak on the left and then from the first peak to the second peak from the left. The third peak that hikers are given the option to climb is right in the middle and is the tallest (as you can see). Erin and her long legs made it to that one. Steen with her itty-bitty limbs headed down after the second peak; she feels no shame in that though, as she is 6 inches shorter than the next shortest person (Ms. Erin) on this 7 person trip! The tallest person was well over 6 feet!


Apologies for the long hiatus in posting!

Erin and I have returned from Uganda safely and have been super busy in the office with our project with little time for internet. This post is primarily to say that we are alive. We may post some pre-Easter Weekend thoughts soon and then will try to write more about our adventures (of which there have been many!) soon.

This upcoming week is very busy. We have finally done all of the data collection for our CD4 completeness project at four hospital sites here in Kagera region and are now in the thick of analysis and putting together a presentation. Next week will be very busy because on Monday and Tuesday there are two "Launches" for new CTC (Care and Treatment Center) buildings. In other words, ICAP has built two new buildings at two different hospitals where they will be taking care of HIV outpatients patients daily. It is necessary to have a big celebration for the opening of these two buildings in order to make the ICAP name even more well known in the region, to patients and also to district government, medical, and religious officials. On Wednesday, there is some important financial training that the office is involved in and then Thursday and Friday is the annual Partner's/Stakeholder's/Implementer's Meeting where representatives from each of the ICAP Supported Sites (CTCs) come together to discuss the HIV care being provided in the region. Erin and I are trying to put together a presentation of our results for this meeting. SO... busy!

Then, we have one more weekend in Bukoba before we fly back to Dar early morning on Tuesday. Then, a few days in Dar and we are off to our Safari!

Monday, April 6, 2009

Steen and Erin: Will be Away

Hello All!

Just FYI that E and I will be without internet for perhaps the next week.  We are headed out to Rubya Hospital for a few nites and then to Uganda for Easter Weekend!


Erin: How to tie a baby to your back

All women in Tanzania carry their youngest child with them. Most of the babies look quietly content upon their perch. If you want a quiet happy baby on your back, all you have to do is follow these simple steps:

  1. Find your self a kanga or shawl or any piece of fabric that is at least 6 feet long and maybe 2-3 feet wide.
  2. Place the baby on your back. First, bend over at the waist to almost a 90° angle.  Place the baby (or have someone assist you) with its stomach against your back and its legs straddling you. The head should lie in between your shoulder blades. Support the baby’s bottom with your hand to assure yourself that he does not slide off.
  3. Take your kanga or fabric. Place the top of the narrower dimension over the baby’s shoulders. The bottom of the narrower dimension (along with most of the fabric) goes underneath the baby’s butt. Hold one of the ends of fabric over your right shoulder and the other under your left shoulder (or visa versa). You should now be able to sit up, holding on to the longer ends of the fabric, which is supporting your baby as if in a sling. Note: the arms and shoulders should be covered by the fabric (to prevent mischief) but it’s okay if the legs stick out.
  4. Tie the fabric tightly between your breasts with a double knot.
  5. If your baby gets hungry, or needs some face time, just swing him around to your front. The fabric will continue to support him
  6. If you feel uncomfortable trying this with a baby, try it first with a bag of sugar. It’s not as bad to drop a bag of sugar on your first try than your little cousin.
We will work on getting some pics so you can have a better idea of what we're talking about soon!