Script and Service: Field notes from a travelling pharmacist on global aid, work, and adventures

Every day I learn something about the way culture, superstition, religion or tradition affect the care that patients expect and receive in hospital. For example with pregnancy. In Tanzanian culture pregnancy is hidden because being pregnant increases the mother's vulnerability to social or physical harm. If she miscarries or has a premature baby it might be thought she had attempted an abortion. Medical notes never state a woman is pregnant. Instead they will say she has not had a period for say, 9 months. There is no noise from the delivery ward where women give birth alone, without a sound or pain relief. When a baby dies during delivery mothers are not meant to cry or hold the child and often they do not get a funeral. Instead the mother has to bury them outside the village. It is very hard to work to improve the care that babies and children receive in a culture where newborns do not get a name for the first month of life because they are not yet a person . A...

This is my new name, here in Tanzania. Claire was proving too difficult to pronounce so we have settled on a more exotic adaptation. I enjoy it when someone exasperates "Oh, Claaaara!" after I've said something inappropriate, yet again. My integration into village life is moving along. We had chapattis home-delivered in the mornings which was lovely. Then the price of a chapatti rose 50% allegedly due to an increase in the cost of flour. After researching that no other chapatti vendors had raised their prices we decided to make a stand against wazungu rates and put an end to our regular delivery, a shame for all. But on the upside I am now getting maziwa freshi (fresh milk). Half the village was on the look-out for a cow for me. The first few leads I had came to a dead end when the cows' milk supply dried up. Then someone knew someone who knew a man who knew a cow in the next village. Three days a week a boy arrives at 6.30am in tatty clothes, home-made rubber ...

*No money and a little bit of danger My first hint of danger - I made the mistake of leaving the town of Masasi too late, on a dala dala so wrecked you could see tarmac through the chassis. After 90mins the driver decided he wasn't going any further. It was dark, I didn't know where we were, and bus stops here are yet to install the digital next bus is due in XX minutes announcers.  After waiting at what may have passed for a place where buses could be hailed, the village got wind of a mazungu in their midst and before long 30+ men and children were enjoying the Saturday night spectacle that a stranded mazungu provides. Piki-piki drivers offered me rides back to Nyangao but I didn't fancy getting on the back of a cheap Chinese motorbike after dark, with a potentially drunk driver, on roads where you could disappear up to your neck in a pothole. People were trying to tell me there were no more dala dalas but I suddenly suspected everyone of trying to trick me and rob...

Some Tanzanian miles have been covered in the last month. Back from 2 weeks in the big smoke, Dar Es Salaam, for VSO training and language lessons. I'm now equipped with what to say if the police ask for a bribe; I know it is rude to smell food before you eat it; inappropriate to hang your underwear in public view; bad manners to blow your nose or pass wind in company; culturally insensitive not to greet people and ask after their home, family, children, work, chickens, farm so on and so on. I also have a better idea of what I am here to help do. Incidentally, this is to ensure one million women and children have better access to health services and that mother and child mortality is reduced by 50%, by the end of 2015. It so happens that I am only here until the end of 2014, which kind of relieves the pressure on me somewhat. It was much fun meeting the other new volunteers.  Eating out, shopping, getting on buses with 30 pale-skinned, wide-eyed new arrivals; nothin...