Views of Mwanza and Driving

I've been slowly collecting city photographs over the past few weeks. Here is a collection of shots from our drive from Nyakato into Mwanza proper and some downtown Mwanza pictures as well... Mwanza is the 2nd largest city in Tanzania but the scenery just outside town changes from urban to rural very rapidly. Jeans to goat herds. Small "shops" are very common, such as where the man is sitting under the umbrella selling small wares. These may be fruit, small tools, or t-shirts. We also noticed a huge quantity of Coke brand (Coca Cola, Fanta, Dasani) ads, painted on buildings and homes, as sun umbrellas, and even painted on boulders jutting out of the hillside.

Most of the roads in Mwanza city are paved, with the obvious exception of "rough" street. Roads outside town, except the highway, are not paved. Apparently the Japanese paved these roads as a (successful) strategy of generating new customers for Japanese cars. However, people prefer to sweep and splash water on walked areas to keep the dust and debris down. People commonly walk alongside the highway as well as ride bicycles or push/pull carts. The traffic can move pretty fast when the road is empty but it can get very congested and people don't frown on passing using the opposite lane even in heavy traffic. People just kind of shift out of the way. Honking is not very common and angry yelling is even less so; almost never, actually. Driving LOOKS very hazardous but I have yet to see a single auto or pedestrian collision (knock on wood).

1) not REALLY from Texas...
2) View from the road just outside Mwanza city.

3) A look out of the back of our Land Rover onto Rough Street.

4) A typical store on the side of the road.

5) A view of the lake from Mwanza city, not far from the center.
6) The rice is drying on the side of the road in Mwanza suburbs. Lots of rice farming here.
7) Central roundabout in Mwanza. The "sick fish" fountain as Paula calls it.
8) A typical Coke stand. Lots of those.


9) A taxi stand in front of a secondary school. Way in the back, you can see the large brown building. This is Bugando Hospital.

10) My favorite children's store in the WORLD. Note it says "BABY" behind the thing with the ears... Oy.

Days 13-14: Observing Procedures!

I shadowed Dr. Jones in clinic this week and observed both diagnostic interviews and 2 surgical procedures. The clinic can only accommodate local anesthesia, so I stood in on an adult circumcision and a simple suturing procedure for a boy with a deep upper lip injury. Watching the surgeon perform the procedures and simultaneously train the clinic staff was fascinating. It really brought home the importance of good lighting and hygiene even in a small suburban/ rural clinic. One stitch in poor lighting can make a huge difference in a person's life.

Feral Dogs, Cats, and Butterflies

The wildlife here is almost overwhelming. The most entertaining "neighbors" have been this feline family. They're wild but not shy about strolling by just after breakfast to see if you might leave some food out. Paula and Denny are not fans of these cats because they hunt the birds and of course likely have fleas. I caught one napping by the screen door near the kitchen. This is the mama-cat. Possibly pregnant...

I also saw this pack of wild dogs just across from the clinic on my way from work. They are a good example of the Tanzania Terrier, as the locals call them. I don't know if the breed is named officially but this is what all dogs here look like. I think I'm lucky these didn't eat me...

On the walk from the bungalow to the clinic, there is a spot where I always see the same butterfly. Here it is...

Days 11-12: Busy Clinic

Monday was crazy. The main registration/ billing person was out sick so I had to learn pretty fast and assist the head nurse as we managed the influx of people. Not only did we have a lot of walk-ins, but 2 local schools decided to bus in their students for check-ups. The school pays for the students' consultation fee.

Here I am with Miriam (to my right) the head nurse who knows everything there is to know about the clinic and who paaatiently taught me reg. and billing procedures (as well as some Swahili) on Monday and Victoria, a physician here at the clinic, to my left.

Tuesday was a little lighter in terms of patient flow but I was still busy as I pushed to finish my patient records project. This is a shot of me and Mariam, the Queen of Registration and Billing (she does more work in a day than most of us in a week) after I FINALLY finished re-alphabetizing the old charts. The charts themselves are to our right in the boxes; what you see is about a third of them. The clinic opened in 2006 and so far there are 24,500+ patient records on file.

To our right at the top is a picture of current President Kikwete and to the left, the older gentleman, is Julius Nyerere - the first leader of Tanzania after the country gained independence. Many offices in TZ display both photos as Nyerere is on their currency as well. The interesting thing about him is that, as President, Nyerere was outspoken about trying to make sure his family did NOT follow him into politics and pretty much prevented his son from running for national office. This was in order to protect Tanzania from "big man" politics that has infected so many other newly independent African states.

Next I worked a little in the diagnostic lab (the clinic runs HIV, pregnancy, urinalysis, stool, and blood sugar tests, among others plus pelvic and abdominal ultrasound exams) and called it a day. Not many people seem to get HIV tests (a small handful a day, at most)... may have something to do with the fact that they have to announce they want the HIV test done and pay for it in front of all the other patients. The clinic is too small for private conversations with the patients and written forms are not the norm because of the high illiteracy rate among patients in low-cost healthcare settings. So, the norm is loud - and very public conversation.

Day 10 - Sunday Dinner at Dr. Bon's

Dr. Bon (as in Boniface) invited the volunteers for dinner at his home in Mwanza. He lives up on a hill that would be a hiker's dream. His brother drove us. We had the local fare (beef stew, fried fish, rice, cabbage, cucumber salad) plus the best drink I've tasted EVER. A fresh pineapple + avocado smoothie. We polished off two jugs of it in the first 10 minutes. His wife is gorgeous and the kids charming. I was definitely not that good as a teenager. Dr. Bon is an avid soccer fan and (apparently) like most of the men in Tanzania is waiting for FIFA World Cup 2010 (in South Africa) with the game calendar neatly folded behind his TV. His wife is not an avid a fan, shockingly.

On our drive to Dr. Bon's, we saw the ONLY jogger in Mwanza making his way up the road. Poor guy...everyone seems to know him and everyone kind of laughs. :/

Day 9 - Saturday Trips to Lake Vic and Dancing Rock

Clinic is open half day on Saturdays so we put in the hours; it was busy! Afterward, however, Mboto and Dr. M took us out for some sightseeing in Mwanza! Here is a view of the lake from the road:







1) The pier (like a fisherman's wharf type of thingy) at Lake Victoria. Smelly smelly but amazing birds and views.













2) Park overlooking the lake It was peppered with some cow patties but otherwise beautiful. You can see some locals behind me doing their laundry on the right. We try to not take pictures of the local people unless it's unavoidable (i.e. they walk into the shot) or they give their permission. Not only is it rude to objectify them like that but you may get yelled at or cursed by a Maasai. Not cursed AT, mind you...cursed as in "abracadabra." So, anyway..this is me at the park.

Some likely schistosomiasis vectors at the beach (3 feet from swimming locals)








3) Dancing Rock!

The drive up to "Dancing Rock" in Mwanza was so scary I had to look away. Below is a picture of the road to give you an idea of the drive. You have to hold on because otherwise you will whack your head on the window or fellow passenger's noggin. Saw many goats and even piglets in the homes we passed. The horse is a dashboard bobblehead. I have no idea either...





The Dancing Rock itself is a complex constellation of enormous boulders that peak to a vista overlooking Mwanza as well as the Lake. My picture with Yelena really doesn't do it justice, the view was so so vast. I will upload other pics when I get them from the fellow volunteers.
On the other side of the vista there is a HUUUUGE boulder. The only person with ballz to climb it was a teenage girl (WIN). It's difficult because there are no footholds and you kind of have to scamble like a gecko. We cheered her on and she was shaking with giggles the whole way up. Here she is at the top. Good job!!
After the trip we were hungry and tired and decided to go to a highly highly recommended local restaurant. Well, it sucked. We sat for 3 hrs looking at this:
Tai Five restaurant is ass, don't go there. I never got my Ughali either. >:/ Separate Eugi from her food and she shall FLAME you!

The Party Scene is so NOT off the hook... :) Pool Bar and Rockman Pub

Went to Rockman Pub with the 3 fellow volunteers, a new and relatively spiffy local establishment. We were served Vladimir Vodka (distilled in Tanzania) and Fanta. They don't pre-mix your cocktails, just bring the ingredients. I mostly chatted with Mboto, who is the IHP driver extraordinaire and was so patient for hauling us there and back. FYI, I am NOT drunk, I'm just squawking directions for the person taking the shot on where the "big button" is. :D

That is a carrier pigeon on my shirt, if you're curious.


A few days earlier, we had stopped by the Pool Bar here in the village (I don't think it's an official name - just that the little lodge has a pool table and a clean quiet bar) where Y and I were pretty entertained by the very correctly dressed woman on the Toilet sign.

Note the covered up knees and shoulders! (Jeanhee, I can hear you laughing from here...I couldn't help myself, okay?!)

Day 8 - Family Planning Clinic and Village Market

Instead of work today I joined Paula on a trip to Mwanza.

We visited the city Family Planning Center where the Nyakato clinic and others like it receive their contraceptive supplies. In order to receive a batch, the clinic must supply a report of how the previously-received batch was used. I'm assuming this is to prevent overpurchase and resale of supplies...









After that, we had to drop my housemate and fellow volunteer R at the airport but before we let her go we had lunch at one of the outdoor spots just by the airport building.

We each got a HUGE plate of (local) rice, plus beans, tomato sauce, spinach, and I ordered fish.They served tilapia from Lake Victoria. Even though you can't swim there, the tilapia is too good to pass up. Don't ask me why I'm making my rabbit face. I confuse "hungry" with "rabbit" for some reason...

Day 7 - 5/20

Picked up dress from the tailor. Looks good (will add picture, don't worry). Also after dinner saw the Big Dipper. It's upside down here!

Days 5-6: Work and Mwatex

The Nyakato Clinic where I am working is located on a plot of land bordering a textile factory called MWATEX. No scrubbers to clean the smoke and the chimney is fairly low, given the density of the smoke and the amount of crap the chimney pukes up every day.

Here's a taste. This is a view from the clinic. Where sick people are breathing.... And yes, lots of respiratory illness cases at the clinic. Just a random correlation, I guess!View from the worksite at the Patricia Ward (under construction), on a different day. As the ward is being painted inside you can literally see the soot settle on the first coat of paint.
The funny thing is they sell the fabric mostly in India, so local ideas to boycott the textile factory have pretty much died out.

Working out at the Bungalow

WOD:
x10
1 min burpees
1 min squats
1 min jumping jacks

[+100 V ups ]

My luxury gym facilities. My overjoyed face.

I better make it up Kilimanjaro dammmmmit!

Day 4 - Mon 5/17

Worked in clinic all day, at the registration/ records/ billing office. My project is to review/ re-alphabetize the files in a-z order. The system is kind of multifaceted. Removing duplicates and making sure med histories are complete and easy to find. More than 20,000 records at the clinic and it's only been open since 2006! Many new walk-in patients daily...

Lots of upset kids, but clinic does dental extractions and circumcisions so I hardly blame them. Finished up around 4, only done w/ about 25% of the files, but covered in dust and bug poo from the file cabinet.

After work, went to the local tailor in the village. It's about a 15min walk. Tailor shop is next door to fabric shop. Each is basically a room. I now have a very accurate mental image of what a sweat shop is. :D There was mucho sweat, literally and figuratively, in those shops. Anyway, I got a large swath of fabric and ordered a dress. Total cost for everything - $7.

Here is a picture of Y and me with the tailor shop staff. They are fantastic and super friendly. If you are in Nyakato, you MUST go spend your shillings there. :)

Day 3 - Sun the 16

First real weekend day. Jet lag made me get up way early so I did some chores. Chores are therapeutic (Frank stop reading now lest you get any ideas) around here. Loads of laundry, sweeping and taking out the trash - 3 cans: one of burnables (paper etc) to the burn pit, one of plastic/metal to the bury pit, and one of perishables (i.e. food) to the compost pile. National brand (Kilimanjaro) beer and plastic water bottles (Dasani) are kept for return to manuf. for a refund.

Was peeling potatoes in the kitchen and saw a family of mongooses sniffing around front yard. There are snakes around here they eat and also bugs, obviously.

L, Y, and M, other volunteers, arrived from safari today. They were thrilled with the trip.

Just before bed, finished my first book started here: "Adventures of the Hunt Sisters" or something. It's okay but has this quote that I can't get out of my head: "...hope is neither false nor true but a kind of happiness in itself, a fuel that carries us towards our dreams."

Day 2 - Saturday - Worked at Clinic

Got a tour of the clinic on Sat (busy) and worked the day in registration, filing patient records. There are 3 different filing systems and over 20,000 records. Looks like patients have the option of keeping their original record with them or leaving it at the clinic. Interesting, from the perspective of privacy...

Chief complaints seem to be malaria and typhoid, with lots of suspected malaria. some reluctance to get HIV tests, but without outreach to encourage and de-stigmatize it, I'm not entirely surprised. I WAS surprised to learn that condom use is believe (locally) to do very little for preventing HIV transmission and MORE surprised to learn that this is true, because someone came up with the bright idea of reusing the condoms instead of buying them time and time again. Tell me again about why the free market is better than subsidized access to certain health care needs?? ;) Clinic does (and plans to do more) outreach and education to local students, although resources are scarce. Clinic also does dental extractions.

Overall - very very busy, but patients are tremendously patient. Service appears affordable but not free. Groups of children come in from nearby schools and orphanages. Info about the clinic was originally advertised in town (Mwanza) but now mainly spread by word of mouth by distributing flyers to women at the local markets (seems more effective).

More later...

Day 1: Working on the Patricia Ward

I spent Friday painting a suite in the new Patricia Ward for clinic patients. Right now the clinic is outpatient only, trying hard to expand (nearest hospital is at 120%-140% capacity).

I had neither ventilation nor a mask, so please excuse my paint-huffed crazyface. The electrician who took my picture was laughing. But I learned words from the other workers - nusu is half (i.e. I need another half a bucket of paint, yo) and nzuri is good (i.e. good job finishing the painting without passing out).

P.S.: Note how much the gloves have helped ensure I don't get any paint on myself. Yes, that white splotch in my hair is paint, shuddup.

Fire Ants for Breakfast

This is near the end of the rainy season in Tanzania. The day I arrived saw some rain. The ants don't like the rain because it floods their little ant caves and their little ant babies get the sniffles. Or something. So they "migrate" something around 10 feet to a lightly higher elevation (i.e. out of the mud puddle). Of course, the 10 feet they choose are exactly across the path from my bungalow to Paula's house, i.e. my breakfast trail. Uuugghh...

Did I mention fire ants can eat your freakin' leg off? So yeah, I BROAD JUMPED my butt over those guys. I must have set some kind of record for "jumping over fire ants en route to breakfast." Tough day. (Second pic is zoomed in. They way bigger than regular ants!)

Paula's Garden

The wildlife here is kind of breathtaking... Even for a non-bird-watcher and a non-flower-sniffer like me. This is just in the FRONT of Paula's garden. I literally turned 30 degrees and went snap snap snap with my camera.

First Night in Nyakato

Finally getting tucked in. Okay...the roosters were crowing all dang day and this first night the dogs barked and howled and barked and howled. And then the crickets. And then the birds. I mean...great that there are no airplanes like there are in Arlington but the decibels are comparable.

So, I got bored and looked out the window and what do I see?....

(and ZOOMED IN?!)


This is the dead Geico mascot! The one on commercials is a robot?!?

........Daaaaamn, Nature - YOU SCARY!

Nyakato - International Health Partners. Ze Accomodationz.

Arrived! I am staying at a "bungalow" although this is really just a big house. 3BD, 2BA but lots of bunk beds so sleeping spaces = 10. Fantastic, except showers tend to run cold. Here is my room. I'm on the lower bunk. So far the room is all mine until more volunteers show up.

Cows on my bedspread FTW!!!! :-)















This is a look at the front of the bungalow. About the gated entrance: there is a gate to the yard, as well as a gate before the door to the house on the picture. It stays locked whenever we're out. The house is patrolled 24/7 by guards; at night, the guard has a dog (his name is Nyoko! Yes I met him and totally made friends. He tried to play with me, much to the guard's embarrassment, hee hee.). The small building you can almost see on the left side of the photo is the guards' quarters where they can wash up, have tea, nap, etc. They're very friendly and help me practice the Swahili greetings...patiently. The day guard's wife brings him lunch and comes with the baby in the kick-ass sling on her back to hang out while he eats - it's the sweetest thing.

Here is the back yard (with the red flower). Note the clothesline - yay for handwashed linens! We can give our linens to the cook weekly for washing but so far I've been doing it myself. It's kind of fun and reminds me of being a kid when I had to wash my own socks in the common washing up area in the "pansionat" in Barnaul (Are you reading this Mom?? Yes I remember! Thank you for instilling in me some serious sock-washing skills, they are coming in extremely handy right now!)...and no I am not just putting the sock onto the faucet like I did when I was 5 :)

Arrival in Mwanza and Trip to Nyakato

Arrived in Mwanza airport (it's a hallway and a room, but works) Thursday. Met by Paula Lofstrom and Mboto, the driver. Paula is absolutely charming (she lives here with her husband Denny and pretty much runs the place) and so is Mboto. He told me on the drive in that Mwanza is known as "Rock City." I said "oh...rock'n'roll?" and shook my hands like I was at an AC/DC concert. Mboto looked at me like "well...uh..crazy woman" and explained that the terrain is unusually rocky, wih big boulders popping up everywhere - I noticed this after a few minutes into the trip. Note to self - do not assume the presence of "rock'n'roll" just because you're delirious with jetlag and excitement. Self control, Eugenia....*sigh*

We drive through Mwanza city, which is a bit like downtown Nicosia in terms of size, but in some places it looks like a bomb went off. Very little urban repair... Driving seems hazardous, but it was actually okay because people are generally careful even if it seems like they're about to careen into you. No cops, but lots of parking attendants. No seatbelts on anyone... But the bumpy road keeps the speed to a minimum.

We stopped at a post office for Paula to check her mail (many ppl here traditionally have P.O. Boxes because they live on a land plot without a street address) as well as a pharmacy run by the Ladhani brothers. Indian expats seem to run lots of businesses here.

Drove out of Mwanza city to the suburb of Nyakato, where the clinic compound is located (clinic itself, buildings in progress, housing for staff, etc.). Road had a stream parallel that ran down to Lake Victoria. Stream contained rubbish from local residents as well as wastewater from uphill. No swimming in Lake Victoria. Many stray dogs walking around but Paula was pretty clear that I cannot pet them and make them my friends. *saaaaaaad face* Did I mention I miss Dave?! (and Frank too, calm down hubby)

Will upload pictures of where I'm staying in the next post.

Kilimanjaro - Mwanza

Flight from Kilimanjaro to Mwanza was pretty uneventful and quick. Except for the spider in the REAL window seat. He was between the two panes and had woven an elaborate web. To catch what? Crazy vagabond...
I was also surprised that we got a snack and drinks during the 80 min trip, here is a taste:Saw this beautiful thing out the window, just before we crossed over the Serengeti. I think this is part of the highlands where Ngoro Ngoro Crater is located.

The Flight In: Volcano, Yellow Fever, and the Maasai Dog

Volcano: Flight to Amsterdam became flight to Detroit, then Amsterdam - leaving 2 hrs earlier. This was inexplicably due to the volcanic ash from the Angry Sister in Iceland. Mmkay. Had to scramble to leave. B/c of the delays, and upon the advice of both my mom and a very maternal Delta agent, took both bags as carry-on. Didn't empty the bag initially intended for checked luggage. Got stopped by gigantic red headed TSA agent called Kinner who proceeded to remove everything out of said bad and confiscate bug block and contact lens solution. :( Best part: I packed ink cartridges+ flavored salt + electric plug adapter/ converter into a neat little box that apparently looks exactamundo like a bomb from the scanner. So it was not one but 3 guys digging through my underwear. They tested the salt. Took a half hour. F#%^ volcano.....

Yellow Fever: 19mins to landing in Kilimanjaro. My neighbor in window seat suddenly curses and discloses that she forgot her yellow fever vaccination card. Me too. Frank - you have to mail me this unless you want me to stay in Tanzania. Please.

Maasai Dog: Landed in Kilimanjaro and took shuttle bus (with removable "Ambulance" sign) to KIA Lodge. Gorgeous little hut. Hot shower kicks ass.

Hut inside:

View out in the morning:

Crazy bird in breakfast cafe:


Breakfast was in an outdoor cafe. I have never seen this variety and quantity of birds. Apparently something like 70% of all birds in East Africa are in Tanzania - or so I was told. I believe it. This bird had been zooming around all morning. Wild blue color. Like a giant bluejay with an orange/red chest. Fearless little thing.
















On my way to breakfast and while I was waiting for the shuttle back to airport to catch my last flight (to Mwanza) I met the "Lodge Animal." The cutest dog ever (except Dave.) Name is something like Katika. Attitude is something like dalmatian on meth. As I tried to take a pic with her and the Maasai working at the lodge as porters/greeters, she kept trying to play.

Maasai dog!!!

(P.S. Check out the dude behind me to my left. Bad Maasai, baad!)