Heri za Krismas na mwaka mpya!

Merry Christmas!

The Sunday before Christmas, Sandra and I went to the church in Nyangao. Many people from the village attend church (Nyangao has a 60:40 Muslim:Christian ratio) including lots of staff from the hospital, so it's a good place to meet folk never mind the more divine reasons for which one goes to church. Personally, I was also using it as Step 1 of a long game I have planned that ultimately sees me "best friends" with the nuns.

Nyangao Hospital is 60% funded by the government of Tanzania and 40% by the Missionary Benedictine Sisters of Tutzing, Germany. Consequently, there is a convent in the village - many of the nuns have worked as doctors and nurses at the hospital over the years. But these are nuns who know how to live in comfort. Whilst people in Southern Tanzania are some of the poorest in the country, the convent gets fresh milk, grows its own lettuce, makes sour dough bread daily (what I wouldn't do for sourdough bread) and gets water straight from the springs at Ndanda. They live in relative luxury. And I want a piece. So after church, Sandra and I went to the convent on the pretext of introducing me to the Sisters. It went well. Sister Columba (formerly known as Clara) has recently arrived from South Korea - she is a pharmacist too - and will start work at the hospital soon.  We will both have to take the Tanzanian pharmacy registration exam which I have agreed to help her study for. Obviously I am doing this for altruistic reasons, but should I be remunerated with the aforementioned milk, lettuce or sourdough bread (please God), it would be most greatly received. And if, after 2 years in Tanzania I am at a loss of what to do with myself, Sister Tumainde (Big Chief Sister - I'm sure this is what they are called) has said she will pray for me that I will one day become a nun.

Wheeling and dealing done, James, Sandra and I caught a dala dala to Mtwara to start the Christmas celebrations with another group of volunteers. The dala dala is a van/bus - the size varies depending on the destination - the one to Mtwara has seats for 25. There were 50 on board. The journey is 3 hours and invariably at some point you will be holding a baby, a chicken, a baby chicken or will be sat on the lap of another passenger. It's a mobile hell for agoraphobics. 

Nyangao's dala dala stop

Wildlife getting fruity

The bus stops every few miles to squeeze more passengers in but bizarrely no-one ever seems to get off. When you do stop, boys jostle at the windows peddling wares; dried fish, mangoes, cashew nuts, sugar cane, popcorn. If only I could get to my money I would buy your goods however I can't move my arms for the 7 people sat on me. But this time we made it to Mtwara in one piece and were rewarded with a stay in the Mission-owned beach house run by Mama Hilaria. 

A Tanzanian "Christmas" tree - only blooms at Christmas time

Christmas dinner was fairly similar to the usual fare one gets in a Tanzanian restaurant. Mama Mtupa cooked us chicken, chips, rice, vegetables, salad and prawns. It was very pleasant and not unlike the festive cuisine back home, except here we also got prawns (only joking mum).

Kayley, Tim and Louise feeling the Xmas spirits

Christmas lunch Tanzanian style

Three days in Mtwara was a nice break and is the place to stock up on all the produce and Western goods you can't get in Nyangao but I was excited to get home and back to the peace and familiarity of the village. Plus, I was starting to miss morning chapatti's, chai time, my pharmacy colleague's trying to teach me new words (today's: joto sana = it's bloody hot) and the morning medical meetings. Overnight cases - cholera outbreak, malaria, TB, malaria, TB. 

Dr Jankovic took my photo this morning for the Nyangao Hospital website, of which he is the proud designer (at the ripe age of 70, I would guess). I got up extra early to blow-dry my hair. Not much fun when it's already 30^oc outside. Rhian - you would have been proud - I even put on some mascara although it had sweated down my face within 20 minutes. Vanity is indeed an ugly thing.

Happy New Year!

Click here to see the super chic hospital website

A-FREAK-HER

As I exited Dar Es Salaam airport I realised how wrong my priorities were.  I may have a years' supply of toothpaste and Haribo Sour Cherries, but I don't have money, water or any idea who is picking me up. I try to look nonchalant whilst waving away taxi drivers and circling with my 69kg of luggage.

The first three days are in Dar, staying at the ominously named "Econo Lodge". I can vouch for its "econo" status at breakfast the next morning. Day 1: witnessed my first pick-pocketing - the victim, poor Dan a volunteer who came to take me for lunch and show me around. There was a bit of 2 on 1 action, a brief game of footsie and before you knew it, Dan was minus his wallet, bank cards, and $50 cash. He later explained that if you shout "thief" at a pick-pocket or mugger, people will chase the suspect and try and get your stuff back. Sometimes they will beat them up too and it has been known for the mob to set fire to the criminal. Tough justice.

By my third day in Dar I had been issued with the VSO essentials: 18L water filter, Swahili textbooks, mosquito net and packets of condoms. Had registered with IST, the clinic where we get free medical care and meds, had a new phone number and internet dongle. Ready to set off for my new home, I found out I could only take 23kg on the internal flight despite being allowed 69kg on the flight from London. There go the water filter, Swahili textbooks and condoms.

A necessity from IST clinic

My new home is Nyangao Village; population approximately 15,000 although this includes the surrounding areas. The nearest town to be seen on a map is Lindi, 50km (2hrs) away. I am living in a lovely house, a minutes' walk from the hospital, with Sandra a VSO volunteer paediatrician. She has been in Tanzania for 3 months already and has a greater aversion to bugs than me which results in a clean home, free of spiders, scorpions and cockroaches as far as is possible. Sadly, the exception is the fridge where all the ants live. They appreciate the mild temperature in there of 20 degrees compared to the 35 degrees it is for the rest of us.

My new home

One of our house "pets"

Master suite

There is a mango tree in the garden that drops fruit on to the tin roof throughout the day and night; fantastic for breakfast, not so good for a peaceful nights' sleep. James, VSO pathology lab technician lives next door. We went for a "welcome to Nyangao" drink at The Old Trafford, a small shack on the side of the highway, complete with plastic tables and chairs that are dutifully re-positioned outside when they see "Mr Jamesi" crossing the highway to the bar. I had my first chipsi mayai (chip omelette) - not bad for 2000 shillings (80p).

Day 1 on placement (we don't call it a job with VSO) coincided with a surprise visit from the Ministry of Health so the hospital was on high alert. I observed, sat with different folk around the hospital, smiled and gesticulated a lot, observed some more. I really must learn Kiswahili. Each day starts at 7.30am with prayers in the hospital chapel followed by a clinical meeting where the overnight cases are discussed. So far I have seen the x-ray of a man who swallowed a whole mango pip 3 weeks earlier; he needed to have his chest opened to remove it as the only gastroscope we have is broken. And a baby who presented with a skull fracture that the surgeons used a ventouse on to pop the skull back out. In the meeting, James reports on the number of units in the blood bank (total 14 on this occasion) and in future I will report what drugs are out of stock.

In the pharmacy, everyone was very nice to the muzungu (white person) with the pigeon Kiswahili. My first lesson was mfuko (one bag), mifuko (many bags) - clearly important in a busy dispensary. Only a couple of the staff speak any English - another reason to get on with the Swahili practice.

Lunch is rice with beans, rice with vegetables or rice with beans and vegetables, either eaten in the "restaurant" (think laterally) or taken away in a mfuko (see above). I have started to enjoy eating out of a carrier bag. The meal costs 1000 shillings (40p) which works out well with our daily allowance of 12,000 shillings. By 3.30pm the working day is over. Time for a nap, or a trip to the market, or round to James' for coffee, or a frustrating spell trying to connect to the internet.

Two days on placement, 6 days in Tanzania and I am shattered - bring on the weekend!

Happy wall - thanks guys!

Not everyone who wanders is lost

It's official...


The time has come to hang up the Winter coat, cap the green pen and start taking doxycycline.  After 5 months in the planning the bags are packed - my stash of Christmas puddings and I are almost, almost ready for the adventure that awaits.

For 2 years I'll be working at Nyangao Hospital near Mtwara in the south of Tz, not far from the Mozambique border.  With 220 beds, the hospital has medical, surgical, obstetric and gynaecological, paediatric and tuberculosis departments, plus busy outpatient clinics that serve a catchment area of over 250,000 patients. 

http://www.nyangaohospital.com/

It will no doubt be a small change from my old job at the PRUH (I promise I will try and walk slower from now on) and I will miss everyone terribly, but you are all welcome to come over for electives/DAPS/holidays anytime...

See you on the other side.

Kwa Heri xx