Haraka-haraka, habina baraka!*

*Speed-speed, is without blessing (I don't think the dala dala drivers know this).

I'd like to start by thanking some new friends for their sustained efforts in supplying me with an enormous stash of beer bottle tops, which I have used to create a self-professed work of art. Their gallant act of drinking copious amounts of beer (not entirely against their will) has done VSO proud. Maybe after another 5 weeks, I'll be able to extend the map to include the rest of the World.

There was a shock in the village recently, when the price of lunch jumped up 50% to 60p. A scandal worthy of the local press, should there be one. In retaliation, I have started going to the only other restaurant in town (read: wooden bench) for my daily culinary experience. Mama Pepe also charges 60p but she has a sunnier disposition, always gives us seconds, and has a varied lunch menu that extends beyond beans. On alternate days she cooks okra in a fishy sauce and if you're lucky you get a piece of potato. For two days this week though she wasn't able to cook at the restaurant due to other commitments. But she still made us lunch, which she delivered to the hospital in plastic tubs. The only downside with Mama Pepe's shack is the fact you have to pass the old restaurant to get there. This is done in a discreet, scurrying gait to avoid the disapproving stares from our former chef (as discreet as one can be, considering there are only 4 white people in the village).

The Old Trafford "pub" where many an evening is spent accruing  beer bottle tops

Mama Pepe is giving me cooking lessons this weekend. It could be interesting as she speaks not a single word of English. We made a plan (I think) to meet on Sunday at saa 5, time 5, or 5 o'clock (i.e.11am). Swahili time-keeping is 6 hours behind English. Six o'clock is twelve midday, so the sun comes up at twelve, goes down at twelve. But she phoned me unexpectedly this morning which is a huge problem when you don't have the benefit of sign language to communicate. I think she told me she was cooking fish today if I wanted to join her, but she could also have been warning me of an atomic bomb about to go off. I have absolutely no idea. Anyway, apparently she is coming to my house Sunday morning at which point she will "carry me" to her home, although I may have got this wrong too.

Sandra giving a lesson on Bundesliga

Last weekend, James and I went to Mtwara to greet Sandra who came back from her two week holiday in South Africa. She brought us many heavenly goods including Nutella, pancake mix, maple syrup, chocolate Weetabix and Haribo. All this made up for the fact there was a terrible thunderstorm which left the town flooded and us stranded at the beach-house, followed by some riots against British Gas which the police had to break-up with tear gas. It's like being back in Sutton on a Friday night. I also spent the equivalent of £12 on my first apple in months. The dala dala ride on the way back saw James sat on by increasingly larger and larger passengers. Throughout the journey, the small girl became a Big Mama who turned into a Big Papa, all perched on James' knee. Maybe we were on the dala dala named Unlucky Boy. But thank God it wasn't the one called Double Impact or Titanic.

Other highlights include an unexpected public holiday thanks to Maulid Day, the birthday of the prophet Muhammad. We are celebrating with a BBQ for which James is preparing home-made beef burgers (possibly Halal) and freshly baked bread rolls. I'm thinking of turning it into a real party and taking along my game of Yahtzee. The burgers had better be good because James is in my bad books after teaching me to say "I would like some shoes" rather than "I would like some onions" when I went to the vegetable stall.

Sister Columba was shockingly honest with me this week by saying my photo on the Nyangao Hospital website "is not good, really not good". This must have been true given that nuns are known to lie under no circumstances (I'm never trusting my mum again when she says I look fine). Thankfully, Dr Janki (Head Surgeon and website designer) agreed it was not a good look and has now changed it to a photo where I look slightly less shell-shocked and anaemic.

Only one more week in Nyangao before I head back to Dar Es Salaam and then to the town of Morogoro in the mountains, for language school and in-country training. The other new VSO volunteers all arrive from the UK in a week's time so we will have 2 weeks of getting to know each other and Tanzania before we all go to our placements around the country. I arrived out of cycle hence have had a 6 week head start on the others which isn't necessarily a bad thing in terms of getting to grips with the culture and language. I am making a bee-line for any volunteers based on the island of Zanzibar so that I will have a sofa to sleep on whenever I visit this supposedly heavenly isle.

But I'd like to end by dedicating this blog entry it to my good friend Rahul who has recently had laser eye surgery. Let this be a message to all young boys - if you don't pay attention to your mommy when she tells you to stop playing with your thing, you will indeed go blind.

Not quite like Grey's Anatomy

The muzungus were invited to a big hospital meeting this week although we had no idea what it was going to be about. In the meeting room everyone seemed very solemn except for the woman asleep on a desk in the corner. It was held in Swahili so I am still none the wiser. I understood every 20th word, "....because.........but.........then........extra duty (that one was in English).....holiday......problem". It may have been something to do with the hospital having no money which seems to be a recurrent predicament wherever I work. I spent the time people watching. I still don't know many names but the man was there who looks like a human Hush Puppy and so was the guy who is always chewing a toothpick. Someone else fell asleep and I stared at Hush Puppy man. Then it was over.

The only difference? There's a mirror in the VIP cubicle

Today's Swahili lesson day was called At the hospital. I now know how to say My private parts are aching (Ninamaumivu sehemu za siri) and The tests show that you have gonorrhoea (Vipimo vya maabara vinaonyesha unaumwa kisonono). I am also good with Swahili anatomy. E.g. breast = titi. More than one breast = matiti. The list of vocabulary that I had to learn included test(s) which I initially thought said testes in which case I was going to tell the teacher to forget any further classes. There's no doubt people passing the room wondered why I was repeating breast, breasts, private parts, itch, diarrhoea, gonorrhoea, I have diarrhoea, you have gonorrhoea, nurse please come and take him to the laboratory - after that we will know what he is suffering from, breasts, itch, privates....Next lesson is going to be a big anti-climax.

Just some of the mangoes that hit my roof each night

I also went for my first run today. Waited until 6pm so it was less hot (30 degrees). Everyone was very smiley as I dragged myself onward, soaked and wheezing. They waved and shouted "Hongera!" (congratulations), but they probably thought, crazy muzungu. Four young girls ran alongside me in school uniform - they stopped when I stopped, ran when I ran, (cried when I cried). It was really cool. But they didn't break a sweat and were chatting and probably doing their homework all the while. Saw some beautiful countryside which is so green at this time of year. Sadly, my IPOD got stuck on Africa theme so Circle of Life and Hakuna Matata were playing on loop...I refer here to an earlier post that explained my playlist was selected by someone else...

At work (for it is not all play, I promise) I went on the surgical ward round with the doctors. My only saving grace was the fact I'd had a light breakfast. It's hard to describe what you see on the wards. Patient after patient with open fractures after falling from a mango tree, a coconut tree, or after being in a piki-piki (motorcycle) accident. Wounds exposed to the air - bone, muscle, flesh - with the traction weights consisting of plastic bottles filled with sand. The man with an incision from sternum to pubic bone, fastened together with huge, crude, metal staples. The man whose face had been half eaten by a hyena. He has no eye or nose, cheek or lips. The woman who has spinal injuries and can't walk, but because there is no such thing as rehab here, gets sent home. There's only one wheelchair in the hospital, the physiotherapist told me. The man with a colostomy bag made out of an empty cashew nut packet, stuck to his skin with glue. The children with amputated limbs courtesy of gangrene. I could go on. The saddest thing of all is that no-one ever cries not even the children, but you can see from their faces they are in agony. As we left the ward, a woman was wheeled past us on her way to the ICU. I remember her face clearly; her eyes wide with fear. She was staring, unblinking, grasping the hand of a woman walking with the trolley (Nurse? Relative? Did she even know?). In the medical meeting the next morning I heard she'd died of an asthma attack. 

It is a good thing I go on these rounds. Both from a clinical pharmacy point of view and the simple fact it's a stark reminder of the lack of quality healthcare the average Tanzanian has and Nyangao is the best hospital in the region for surgery. People travel from as far away as Mozambique to be treated by Dr Janki, the renowned Nyangao surgeon. My memories of it are dirty bed sheets, human bone, flies that won't fly away, and the smell of rotting flesh.

On a happier note,  I now have mushrooms growing down the walls in the bathroom so there is a lot more variety to be had at meal times.

Nuns wear Nike too

One month in and it feels like I have been here so much longer. Running around the Princess Royal Hospital (wearing inappropriately high heels and short dresses), dancing on boats in the middle of Winter, walking the streets of London collecting sights, making cupcakes with the girls (and boy) - all distant memories. But I miss you all muchly and think of you every day.

It was my first full 5 day week on placement. Spent a morning in the CTC clinic (Care and Treatment Centre) dishing out medication to adults with HIV/AIDS. Children and pregnant women come another day. So many patients. Started to learn the ropes in the pharmacy and make plans for the new Outpatient Department Pharmacy that is opening in the next couple of months and will be my project. They are still building it, so I'll wait and see when it is ready for business...we're working on African time. We placed the monthly order for drugs and laboratory/theatre/x-ray supplies - what we need came to 29 million shillings but we only have 10 million. So we'll get less than half of what we need for the next month. Anyway, MSD (Medical Stores Department) never has everything you order, which is strange as they are the government organisation that we must use as first line distributer. As pharmacy is responsible for ordering the entire hospitals supplies, I'm thinking of reducing the stuff the laboratory needs so we can get more drugs instead (only joking James)...

Breakfast - mandazi (sour doughnuts), mangoes and quality (?) Africafe

We took Sister Columba for lunch to the restaurant the other day but she got into trouble later from Big Boss Sister - apparently nuns shouldn't eat in public with lay folk. But it meant I got jam sandwiches the next day for morning tea, so that worked out well.

Sister C and me. My Korean is worse than my Swahili.

Speaking of nuns, this weekend there was a pilgrimage to the memorial for Sister Walburga, a German missionary nun who was killed in Nyangao in 1905. 14 nuns visiting from Kenya, Namibia, Uganda and India were visiting the region as part of their training to become fully fledged nuns in a few months time. We walked a couple of miles out of the village into the surrounding countryside. Past mud houses, farming families, small maize fields and rice paddies, with children laughing and hiding from the peculiar procession walking by. 

It was fantastic to see a new side of Nyangao and the great views over the surrounding plateau. James and I got told off for talking when the group should have been focused on singing and prayer. But our Swahili hymns are not up to scratch and I only know one prayer. 

We were invited to lunch when we got back to the convent. There was CHICKEN! Followed by an awkward conversation where Sister Regina asked what denomination I was.  Caught unawares and panicked, I started off by saying "Well......I'm not Catholic (please don't take away my chicken)", then waffled on incoherently until she dozed off or thought I was a lost cause.  Couldn't admit I was there for the experience and the sodas. And my knees wouldn't cope with Catholicism. The prie-dieu is really hard.

RIP Sister Walburga

Nun fun

It is officially the short wet season now which means most days there are heavy showers in the afternoon. They don't last long though and the temperature cools down afterwards, which is always welcome. The weather report recently said it would be 35oC, but it will feel like 48oC. I'd rather they weren't so honest.

Dr Jankiewicz and his wife, Mama Penda, invited us on a trip to Ndanda today. The home of Ndanda Spring Water (Slogan: An excellent product that money can buy) we filled up our empty bottles before going for a swim in a very refreshing lake. I was assured there was no risk of schistosomiasis but Dr Janki waited until the actual second I had got in to tell me, "people sometimes see animals in the lake". WHAT SORT OF ANIMALS?! "Big lizards," he said, "but no-one has seen a crocodile yet". Thank God for that. Nevertheless, I didn't stop looking underneath me and was replaying episodes of Crocodile Hunter in my head the whole time.

As I settle in to life in Nyangao, I look for at least one happy thing every day. Whether it's the thought of an ice cold, expired Sippy Cola when I get home (yes, I know how to party), a meal other than rice, an evening where you don't spend 30 minutes on the run from a half spider/half scorpion-type creature, or hearing from a friend, it all helps. Today's happy thing: writing about the nuns pilgrimage just as "I love Rock and Roll" by Britney Spears played on the IPOD Shuffle. FYI the playlist was selected by my best friend...I love you dearly, but some of your music choices are suspect!

Language blunder of the week: Asking someone if they had been watching my friend, instead of asking if they had seen my friend. Ergo implying they were a pervert...smooth. 

Not the only muzungu* in the village

It's time I showed you what you are missing and gave you a tour of the village. It won't take long believe me, although Nyangao is larger than I imagined because it needs to provide for the hospital staff and the many patients and their relatives who pass through. St Walburg's hospital has a very good reputation for surgery and has one of the only functioning x-ray machines in the region. Patients come from as far away as Dar Es Salaam and Mozambique to have surgery here.

The High Street (Top Shop is opening its flagship store next month)

The church

The school

The hospital has 220 beds and 220 staff. At any one time most of them are chilling somewhere - sat on a bench catching the breeze, taking a nap on an empty bed, or having a wander around the hospital and chatting with colleagues. St Walburg's also has the only ICU in Southern Tanzania - what gives it the "intensive care" status though is the availability of a sats monitor and the ability to provide oxygen at a higher flow rate than the other wards. I hope I never need it...

"AIDS is dangerous, no cure or prevention, watch you do not get it, avoid fornication"

"AIDS is dangerous, no cure or prevention, watch you do not get it, avoid fornication"

Where the patients are lined up awaiting theatre

Where the patients are lined up awaiting theatre

The pharmacy stocks medication in line with the World Health Organisation's Emergency Medication List for Developing Countries, so there's not much choice when it comes to drug treatment. We don't ask about patient allergies, stage of pregnancy, whether a woman is breast-feeding, or about drug interactions....in fact, we don't worry too much about what is prescribed. If the prescription can't be deciphered (the doctors writing here is even worse than the UK - imagine!), we make a guess at what it says or what we think it should say. I am fairly sure I gave someone Betadine wash instead of co-trimoxazole tablets the other day. My bad.

The pharmacy

The pharmacy

The view from the dispensary

The view from the dispensary

The VSO volunteers go for lunch every day at the small restaurant outside the hospital gate. It's speciality (indeed its only dish) is wali, maharagwe and mbogo; that's rice, beans and  spinach if you've let your Swahili slip. Sandra's unending positivity shone through when she remarked, "mmm, this is really tasty", while I was thinking it tastes the same as yesterday, and the day before, and the day before that. But actually it's true - it really is tasty food and for 40p you can't knock it.

The restaurant

On New Year's Eve there was a special service in the hospital chapel, followed by an all-singing, all-drumming staff parade through the wards to bring good luck; the patients were sprayed with Holy water and they were all given a bar of soap for washing clothes. Then we got to finish work early and watch a gangster-style rapper from the village entertain the staff. A typical post-work activity for me, then.

I thought he was wearing a Calvin Klein shirt but it turned out to be the lesser known brand Kalvin Klient

I thought he was wearing a Calvin Klein shirt but it turned out to be the lesser known brand Kalvin Klient 

At last, I have started having Swahili lessons three times a week though I'm not sure if I'll get on with the teacher. He has an annoying propensity to answer the questions he asks me before I get the chance to answer them myself. At one point he exclaimed, "you know nothing..." to which I rather angrily replied, "that's why I need a teacher!". In his defence, he was probably frustrated by my poor use of the future tense of the verb to have.  Apparently if I say, I will be a dog, it's not quite the same as saying I will have a dog. However, any lessons are better than none. Until now I have been relying on a phone app that teaches Swahili to the Armed Forces. Lay down your weapons and are there armed men near here?, have a rather limited use in Nyangao.

Language blunder of the day: Asking a man who was clearly unemployed and had a mental disability, "How is your work going?"

On a positive note, Mission Convent has gone incredibly well this week. Sandra and I invited Sister Columba to our house for chai which went down well. She brought us many mangoes, Korean trinkets and a statue of the baby Jesus which I tried to stand on a ledge in the lounge as a gesture of appreciation, but embarrassingly he kept falling off. Turns out the baby Jesus prefers to lie flat on his back. 

Then, I spent 3 hours on the weekend, helping Big Boss Sister fill out an application for a course in Germany. It took a painfully long time and I ended up writing it myself but I was rewarded with bread and jam, mangoes, fruit juice and some rice with beans and sandy spinach for lunch. Today, I said I would help her set up an email account. She thought divine intervention had stopped her setting one up over a year ago, but really it's just poor Vodacom signal at the Convent. I wonder whether BigBossSister@gmail is already taken?

Finally, sour dough bread straight from the Convent - it made a nice bruschetta

Finally, sour dough bread straight from the Convent - it made a nice bruschetta

Question of the day: Why are there millions of insect wings outside the back door every morning? Where are the insects they belonged to and why are they leaving their wings here?

Clearly, I've been on my own too long....

*Muzungu - white person