Finally into the field

Things have been pretty busy and intense trying to launch The Health Network Programme in Tanzania.  There are only about 34,000 health workers for the 44 million people currently living in Tanzania.  Our programme will hopefully connect 9,000 doctors, specialist, clinical officers and assistance, as well as dental officers.  It is one thing to sit in an office, and think these numbers are quite alarming, but it is another thing to go out into the field and see how many people wait all day to see the 3 health workers at the local dispensary or health centre.

The hierarchy of medical facilities in Tanzania (from lowest to highest) are as followings:  Village centers, dispensaries (which cater to 6,000 to 10,000 people), health centers (which cater to 50,000 people), district hospitals, regional hospitals and referral hospital (only 4 in the entire country).

One of our field visits was to the Kisarawe District, located in the Pwani Region, which is the region southwest of Dar es Salaam.  The purpose of our field visits was to test our technology for registration.  The health workers use their mobile phones to register for the programme using a USSD registration menu.

We visited three facilities that day - Kisarawe District Hospital, Sungwi Dispensary, and the Masaki Health Centre.  The dispensarywas located 20  kilometers (roughly 12 miles) from the hospital, and the health centre was another 5 kilometers.

The road from the hospital to the dispensary was dusty, rocky and hilly.  We past several locals on their bicycles climbing the hills with heavy loads tied to their bikes.  It made me wonder how people get from the dispensary or health centre to the hospital where the licensed doctors are.  The nurse traveling with us explained that each facilities had an ambulance, and if the ambulance was unavailable, the patient would generally hire a vodavoda (motorcycle) to drive them.  I couldn't imagine how difficult it must be to travel down that dirt, bumpy, hilly road strapped to the bed attached to a motorcycle.

Ambulance at the health centre, located 25 kilometers from the District Hospital

It was wonderful to finally get to see at least 3 types of medical facilities in Tanzania, but it was also very humbling to see these health workers with very limited supplies and personnel treating a large population of patients.  One health workers told us that he lived close to his dispensary and that everyone is the area had his mobile number if case of emergencies.  He also treated an average of 25 patients per day.  Although I never asked about pay, I am certain they are not paid nearly enough for the amount of work that is required to assist these patients.

And just to give you a sense of our surroundings during our field visit, here are two photos of the type of buildings in the rural areas of Kisarawe.

Kipepeo, Tanzania - Finally!

After two hard weeks working with local partners as well as the team in San Francisco, Seattle and South Africa, we finally had a day off.  This past week was especially difficult as we quickly realized that things definitely get lost in translation, and that others (locals) often have unrealistic demands and expectations.  Enough about work though - let's talk about Kipepeo Village!

During my last visit to Tanzania, I use to spend my Sundays at Kipepeo beach.  Zanzibar is beautiful, but I would say that the beach at Kipepeo and probably many of the beaches in South Beach are just as beautiful.  The sand is white, the coastline is gorgeous, and you get to interact and see more locals than you ever do at the private beaches that foreigners often visit in Zanzibar.  It is also a cheap alternative to Zanzibar.

For the past 2 years, I have often thought about this beach and how beautiful and relaxing it was.  It did not disappoint!

From City Centre, you catch a local ferry across to Kigambomi.  The cost of the fare is 200TZS (.20 cents).  Quite a deal!  From the other side, we took a bajaj (a three wheel auto taxi) to our final destination - Kipepeo.




At the showers at Kipepeo Village, here is a sign to discourage urinating in the showers.  If you look closely at the photo,  you will see that a devilish creature is rising from the shower floor.

Ali and I sitting under our cabana enjoying the view and some beers.

We made a new friend, Essau Pwelle, a Tanzanian who has lived in the U.S. for nearly a decade.  He is an African Banjoist, from the Wandali tribe in the Mbeya Region, near the border of Tanzania and Zambia.  I just recently learned that the American banjo was derived from the African banjo.  There were some differences, such as the number of strings.  The American banjo has five strings, whereas the African banjo has 4 strings.  Most banjo playing in America is picking, but in Africa, they strum the banjo.  Essau told us that the only place in America where musicians strum their banjos was New Orleans.

Essau is trying to bring awareness to local Tanzanians of their history with the African banjo.  He said that he walks all around Dar es Salaam and no one seems to recognize the instruments.  He is part of a campaign by the National government to archive their musical history, as well as its influence to instruments around the world.

The African banjo in Essau's hand was wholly constructed in Tanzania.  The strings were taken from brake wires of a bajaja.  The gourd he picked up at a local market and had a local artist carve the outside for decoration.  The tuners are made from local rosewood.  This banjo will eventually be archived along with the name of every local Tanzanian involved in its construction.  Our bajaj driver did not recognize the instrument, but was very excited when he saw it, and basically grabbed it out of Essau's hand.

Essau invited Ali and I to a cultural performance next Saturday, where members of his band will play. There will be other performances as well.  It is nice to have something to look forward to - especially with tough work weeks.

We spent the afternoon listening to Essau and company sing traditional Tanzanian songs.  Not a bad way to spend the afternoon!

Me and a little girl, Essau was friends with the mother.  She was very cute, and very very sassy :)

Some locals decided to bury this Spanish guy, Essau's friend and guitar player in his band, with sand.  The woman next to the little girl is a Tanzanian woman who currently lives in Tanzania.  She is married to one of the sons from the Swedish pop group, Abba. 

I love this picture.  The Spanish guy is breaking free, and a local Tanzanian guy who helped bury him. The local guy saw the hand and jumped back laughing - I only wish I had a video of it :)

Mambo from Dar es Salaam

Hello everyone!

I am back in Dar es Salaam, Tanzania for 5 weeks to help launch a program through Switchboard - www.switchboard.org.  Switchboard is creating the largest network of health care workers in the developing world in partnership with the Ministry of Health and Vodacom.  The plan is to connect 9,000 health workers across the country - allowing them to make free calls and texts to other participating health workers.

I have been here for 5 days but it feels more like 2 weeks, as a colleague and I have been busy meeting with officials from the Ministry and Vodacom.  When we are not in meetings, we are working with out of country programmers to ensure that the technology is up and running in time for our tentative launch during the 1st full week of February.  It is pretty amazing that a simple cell phone will allow health workers to connect and collaborate to improve patient care in Tanzania!

I don't have a lot of stories as our days of work have been long, and usually end when we head to bed.  We have ventured out of the hotel a few times for meals, and have had some funny encounters with locals.  My colleague Ali has been mistaken for Julia Roberts a few times.  She does bare a slight resemblance to the actress.  My first night here, we went to a local place to get some barbecue chicken.  While waiting for our food, some local Tanzanian men came over and asked to take a photo with her.  It was pretty amusing.  People have also had trouble saying my name, and I mistakenly told a local that my name was Michelle, like Michelle Obama.  He told me "It is nice to meet you Michelle Obama."  I tried to explain, but he kept calling me Michelle Obama, so I just let him :)

Many things are as I remember them.  There is a bakery (The Corner Bakery) where I would always buy fresh bread after my bus rides home from work.  I went my 2nd day here and bought a loaf -- it was as good as I remember.

However, my experience this time is quite different.  Now I travel mostly by cab, whereas I previously relied heavily on local buses (dala dalas).  This time I am staying at a hotel instead of an apartment, but it is close to my old place.  I hope to make it down to my old place to see if my friend Ali (not to be mistaken with my female colleague Ali) still runs his barbecue stand at the end of street.

I hope to have some interesting stories to post soon.

Here is a photo of me in Giza, Egypt.

I had a 11 hour layover and decided to do a quick tourist tour to check out the pyramids.  It was interesting that most of the other passengers who also had long layovers were afraid to leave the airport or hotel that Egypt Air provided.  I can't say I have an opinion of Egypt as I spent most of my time getting in and out of the mini-van to see various tourists attractions.  I hope to return someday and spend more time there.

Hope everyone is well!

Coming to an end... Costa Rica

We are spending our final night in Bahia Ballena. Tomorrow we are squeezing in one last surf - well attempt at surfing at our spot in Bahia Ballena.

It has been a great vacation. Since my last post, we did some ATVing where I thought that I would drive myself off of the mountain! I had never been on an ATV, and honestly the instruction could have been a little better. Our guides were great though. Initially, we got to do a little test run, where drove around this little dirt road to get a feel for it. For whatever reason, I panicked and drove myself into a ditch. It was pretty funny, but it wasn't so funny when I almost drove off the road again when we were drive through the mountains. I guess I just had a hard time avoiding all of the rocks and stuff, but then I guess you are suppose to drive over them. I rode most of the way in a jeep while one of the guides drove my ATV because I wanted to stay alive for the rest of my trip. I definitely want to do it again, but probably not up and down steep mountain roads!




If you need to make a call when you are in the middle of the mountains, there are telephone booths!



We also did some ziplining in the Osa Mountain Village. I had done this before, but the few first runs totally freaked me out. I quickly got over it and happily zipped through the next 9 lines.




At the end of the zipline, they have a a rope they call the "Tarzan rope." They clip you onto the rope and shove you off the platform. I was a little afraid at first, but then I saw a 5 year old girl do it. If she could do it and survive --I certainly can! It was pretty cool, you are swinging up pretty high, and you just hope the rope doesn't break. Luckily, it didn't and I am still alive...


That's me swinging around!






Today, we went to Dominical,which is approximately 19 kilometers from our house. It is a little surf town, where people who can actually surf go. Nate from our group could actually surf, so he wanted to check it out. Four of us made it down the mountain and 3 of us rented some fiberglass boards. Unfortunately, they did not have soft boards, and the board I ended up renting was too small and not stable for me because I am a beginner. The waves are much more powerful and well harder.

It reminded me something that Nate had told me the first day I took my surf class. He said that the waves are like life. You have to be patient and wait for the right wave. Sometimes you have to pass on a lot of waves until you find the right one. Sometimes you think you found the right one and then it ends up being wrong or just fizzling out right in the middle of it all. Sometimes the waves pound on you and offering little relief, but when you finally catch the right wave, the ride is incredible.

Today the waves of Dominical really just pounded on me and offer very little relief. Let's hope tomorrow the surf at Bahia Ballena National Park with its gentler and longer waves will provide me with some great rides :)

Bahia Ballena, Costa Rica

I am sitting on the porch of the house we rented and listening to the sounds of the jungle. The group is out kayaking and snorkeling, but I stayed behind to do a little work and to recover from my 2 days of surfing lessons.

If you get a chance, I highly suggest heading out to Bahia Ballena. It is super relaxing and beautiful. I am one of 8 people on this trip. It has worked out pretty well except that 3 people missed connecting flights and arrived a day later, but they made it.

I arrived the night of the 28th and met up with Kerry, the sister of a childhood friend, in San Jose. We stayed a pretty swanky hotel the first night and then set out the next morning for Bahia Ballena. Along the way we stopped off to see the location crocodile attraction - actually it is just a bunch of crocodiles hanging out by a river. It was pretty cool though. If you look closely, you can see a pair of shoes next to the crocodile -
I hope it was just coincidental :)



Most of the group arrived a few hours before the new years. Since no one brought speakers for our ipods, we had to improvise. We put my laptop in a bowl and others put their ipods in cups and it really works :)



The last few days, I did a surf clinic through Bodhi Surf - in Bahia Ballena National Park. It was pretty cool. I loved my instructors, Gibran and Adriana. I managed to ride the white water several times my first two days and even rode a small green wave at the end of my instruction yesterday. After the first day, I was sunburned and extremely sore. I thought there was no way I was going to make it through another class. I was wrong - once I got into the water, I couldn't help but attempt surfing again. My body is still sore, my face is a bit sunburned as well as my arms, and my knees are a little scraped up. But in two days, I am going to do it again :) I only wish the waters of San Francisco were as warm and gentle as the waves in Bahia Ballena.

My knees:


It is a bite strange to just be hanging out after living and working in Africa last year. I haven't had much contact with the local people except at the grocery store. I definitely miss that part of traveling, but I can't complain. I am fortunate enough to be able to come to beautiful place like Bahia Ballena, surf and just chill out. Anyways - I hope everyone is doing well and that they had a great New Year. Obviously - mine has been fantastic in Costa Rica.

Take care and if anything else exciting happens or I finally get around to taking some photos - I will update you all.

Hasta luego amigos,

Michelle

---

Busua, Ghana

I am sadly and excitedly counting my final days on the African continent. For the past two days, I have planted myself in a chair at my hotel next to the beach - reading and watching the local kids run around the ocean. I can't seem to motivate myself to do anything else, and it is actually the best way to wrap up my time here.

It has been over 5 months since I said goodbye to family and friends and boarded a plane for Ghana. Shortly before my arrival in Ghana, I recently learned that it was located in West Africa and little else. It seems fitting that my last days in Africa should end where it began - Ghana. Since I haven't been very good about blogging, I will try give a quick little run down of where and what I have been up to.

For the first two months in Ghana, I lived and worked in Kumasi, Ghana, which is located approximately 250 kilometers north of the capital city Accra. Kumasi wasn't an easy town for me as I had a terrible time with the local food and left Ghana ten pounds lighter than when I first arrived. Kumasi was also a bit lonely and boring, but it also gave me a wonderful opportunity to interact with my neighbors and other locals. I also had a chance to travel around to rural areas surrounding Kumasi, which was fantastic. You can't really say you have been to Africa until you head out to the rural areas where you see people living very modestly, but still very cheerful.

After my most unfortunate problems with the Ghanaian immigration officials (still don't know why they are so difficult!), I headed to Nairobi for a little rest and relaxation before my next placement in Dar es salaam, Tanzania. Although I did not do extensive traveling in Tanzania, I did head out to Zanzibar on two separate trips, which was nice. After hanging out and working in Dar es salaam for 2 months at two different partner microfinance institutions, I crossed over to Kigali, Rwanda. My previous blog was about my time in Kigali, so I won't repeat it.

From Kigali, Rwanda, I traveled by bus to Bujumbura, Burundi, where I spent a few days. I went to Lake Tanganyika and just sort of saw the countryside from the bus.

After a few more days in Kigali, Rwanda, I headed to Nairobi, Kenya to collect Rob. While in Kenya, Rob and I traveled to Masai Mara for a safari. Masai Mara is probably the most beautiful place I have ever seen in my life. A huge Savannah where lions, zebras, warthogs, impalas, giraffes, etc. hang out naturally and wildly about. From Masai Mara, we headed to Lake Naivasha and biked through the national park, Hell's Gate, where we met our new friends John (a local Kenyan) and Marin (a Dutch traveler). After Lake Naivasha we headed back to Nairobi and to a town called Murang'a where we met with a local microfinance institution who specialized in giving out loans to borrowers to buy dairy cows. We even met with a few borrowers, which was my favorite part of my fellowship.

From Nairobi, we next headed to the coast and the island of Lamu, which is a predominately Muslim area located in northern Kenya. Lamu is beautiful and historic. We spent a few days in Lamu town and a few days on Shella which is the neighboring village. In Lamu, we took two dhow rides (dhow is a traditional sail boat), and I even road a donkey. After Lamu, we headed by bus to Mombasa, which is another coastal town, but located in the southern part of Kenya. Mombasa wasn't quite as charming as Lamu, but I did get to ride a camel there. Therefore, Rob caught a flight back to the States and I continued my journey back to Ghana.

Since I have been in Ghana, I have spent most of my time in coastal towns - Accra, Cape Coast, Takoradi and now Busua. In Cape Coast, I went to the Kakum National Park which boasts the highest canopy bridge in the world. Also, I went to the famous Cape Coast Castle which housed several hundred African slaves prior to the departure to the Americas. It was a very surreal and sad visit, but also important for people to remember this history, so that it never happens again.

From Cape Coast, I traveled by tro-tro (a small mini-van) to Takoradi, where I had the most deliciously pain au chocolat at Bocadillos, which is run by a French/Nigerian couple. Realizing that I wanted to be right on the beach in a sleepier town, I decided to head to Busua.

I hitched a ride with two Ghanaians, who were friends of the receptionist at my hotel in Takoradi), who drove me the 45 minutes to Busua and dropped me off in front of my new residence for the next few days - Busua Inn. The Busua Inn is this little place located right on the beach owned by a French couple who have been living out here for the past 5 years.

And here I plan to be until at least Saturday before I head my way back to Accra, see my friend Richelle and collect my bag for my Monday morning flight back to the States. It has been an amazing year, and although I am not exactly sure what I will do when I get back, I am excited for what awaits me. I remember very early in my time here a manI met told me that people come to Africa to learn about themselves or escape themselves. I would like to think that I learned a lot about myself and what I am capable of. This will likely be my last post from Africa unless something really exciting happens. However, since I am sloth-like in Busua, I doubt much will happen. I will miss all of the wonderful people that I have come across during my life and travels in Africa, but I am excited to see my family and friends - especially my two sweet little nieces!

See you soon America!

Kigali, Rwanda

I started this blog about one month ago, but I have just been too busy to complete it and post it, so here i go. Kigali, Rwanda was my first stop on my African vacation. Kigali is a beautiful hilly town which is by far cleaner than most cities in America. Here is the view of the city from the house where I crashed one night. The city sort of reminds me of San Francisco.

My first night I had a homemade pasta meal from Iyanna (a Kiva fellow from my class) and went to the Goete Institute where I saw traditional Rwandan dancing and saw Nasar Abadey & Supernova, a US based jazz band -- thanks to the United States Embassy.

The next day, President Paul Kagame was inaugurated for his 2nd term in Kigali. We (Sara, Jonas, Iyanna and I) woke up at 6:00 a.m. and took motos to the stadium. We hoped we would be able get an actual seat in the stadium, but we were too late. We had to sit on the lawn outside the stadium with the other locals and wait for the President. Although there were plenty of mzungus (whites) inside the stadium, we were the only mzungus in the area outside of the stadium. We made a lot of friends and got a lot of assistance from the Rwandan National Police. I chatted one up, well I attempted to communicate with him but he did not speak English. However, the policeman later pulled us out of a crowded area and let us sit in the front row of our section. It was interesting because Iyanna is African American and she stated that she never really gets to experience "white privilege," especially in Africa where they assume she is a local. I never really thought about it before, but I definitely noticed that we were getting special attention and consideration from the National Police. Below is a photo of Kagama during his inaugural address and a photo of two young boys who sort of hung around us. The little one with the camera was especially sweet offering me a drink of his water, which I couldn't drink because it came from their local tap.

Kigali, Rwanda is an interesting place. Another fellow and I went to the Genocide Museum where we learned about the events leading up to the genocide and the genocide itself. It was weird to walk around Kigali afterward knowing that such atrocities occurred probably right where we were walking. Rwandans are also pretty reserved but friendly, and it seem unreal that such an event could have taken place 16 years ago.

Kigali is also a very orderly place in an almost unnatural way. The local population definitely respect the police. Street hawking and begging have been outlawed. A few times I was sitting at a cafe and watched people running down the street with a police officer walking calmly behind them.

Another interesting thing about Rwanda - being identified as Hutu or Tutsi has been outlawed as well. Kagame is trying to create a society where people do not identify by their "tribes", but identify through a national identity of Rwandan. I am interested to see how it works out for them. In Tanzania, the first President Julius Nyere (I believe that is his name), has been credited for helping Tanzanians identified with a national identity and not a tribal identity.

Finally, there has been recent accusations of a double genocide where Tutsis have entered the DRC (Democratic Republic of Congo) and killed off Hutus. Kagame addressed it briefly in his inaugural speech and obviously very critical of such allegations from the UN.

I also crossed the border into Burundi, which is the total opposite of Rwanda. In Rwanda, you feel relatively safe, and in Burundi you have to look over your shoulder to make sure someone isn't going to follow and mug you. However, I also found some fantastic people in Burundi, especially a fellow named Cedric.

I went with another fellow to Burundi and silly us did not change money at the border. We were armed with a Lonely Planet map of the capital city, but soon discovered that it was totally incorrect. Using my horrible French skills from high school, I approached Cedric for directions to change money. Cedric kindly offered to pay for our bus ride to the money exchange location and he never even asked from payment in return. We obviously paid him for our bus fare and a little extra because he really did not have to help us.

That's the thing about being here in sub-sahara Africa. You can have several really horrible experiences with some people, but there are also so many kind people who help you along the way. I always wonder if I was in America and I was stranded somewhere without any money - would someone stop to help me. Especially someone who doesn't have much?