Everyday stories about life in Tanzania, written October 9, 2017 by Debi

Wow!  I just realized we leave Tanzania three months from today on January 9.. Don has got our trip home all booked. This time we will travel EAST and it will take six weeks before we are back in Walla Walla!  We used a travel agent to help with flights because it is a rather complicated trip. We will stay approximately a week in Phuket, Bangkok, two places in the Fiji Islands and Cabo San Lucas where we will be joined by all three sons. 

We wanted to be in Tanzania through the holidays at least once and we picked a doozy of year because Seth (Erik's son) and family will be here for Christmas. More on those plans another time. 

Attached are some pictures of typical places to buy produce. Even nice stores sell the produce outside in little shacks. The last picture is outside a particularly upscale store. I only took pictures without people in them because it is considered rude to take pictures without people's consent. 

I try to walk every day. I have chosen a route that winds up the mountain and has a soccer field on top. This route is not heavily traveled by vehicles so there is less dust. On clear days there is the most glorious view of Mt Meru. I encounter people along the road and I will share some of these interactions and observations. 

Tanzanians tend to be very soft spoken and rather shy. When meeting someone going the opposite way, they don't look at you (well I stare at the ground too because the path is so rough) and they tend to wait until they are next to you or even past before uttering a greeting. Invariably, if you pause to visit a minute, they will ask, "Where are you going?"  Don says this happens when he is bike riding too. It must seem strange to them that we have no destination in mind. 

I asked a man with a stop watch, who was timing what looked like world class runners going FAST around the soccer field, if he knew the distance of one lap. He said 550  meters. So three laps is one mile. Orjantan heard Don telling me how far he rides his bike to work and I told him about the length of my walks. Orjantan said he found this discussion hilarious. He said no Tanzania wonders about such things. You just walk where you need to go and never think about how far it is. In fact, if you ask a Tanzania how far some place is, the pat answer is, "Not far."  

I pass several school yards on my way. Little girls, especially, seem to find me fascinating. They drop what they are doing and run full speed to greet me. It is hard to tell how old they are because they are so small. So many are "stunted" from malnutrition. They love to touch me and grab my hand. Sometimes I have three girls holding each hand. That tends to slow me up!  One little girl looked at me so adoringly and said, "You are so beautiful (I am in my oversized t-shirt and stretchy pants wearing a sweat band). I especially love your hat!"  I definitely feel like a novelty. The boys play a different game. They take turns as if on a relay running up and touching me and then running away. Or they hold out their hand and say, "Money?"  I have started answering by saying, "Money? You want to give me money?" They laugh and run away. 

One day I passed a school and there was a group of men talking. One looked like a professor wearing a suit coat, trousers and dress shoes. Another had on a jean jacket and a jaunty sporty hat. Next was a traditionally dressed Maasai with red robes, tire sandals and a long walking stick. The last two were wearing PINK puffy ski jackets. You see everything!

I must mention the smell. In addition to dust, there is the stench of burning garbage. If too many households burn at the same time, it makes my eyes water. Unfortunately they burn plastic along with leaves and other garbage. 

One day I could hear chopping which is not unusual because people are always gathering and chopping wood for cooking over outdoor fires. Suddenly, I heard a cracking sound which I recognized from my wood gathering days with my father. It sounded like a tree coming DOWN!  I looked up in time to see a huge branch coming down on top of me!  I RAN to the other side of the road. Thankfully, a motorcycle did not collide with me while I was in flight mode!  I only had a few small branches fall on my head and shoulders. The bulk of the branch was caught by a hedge which was leveled. There was a man way up in the tree holding a machete. I hollered , "WHAT?!  WATCH OUT!!!"  He answered back meekly, "Sorry." I see that leveled hedge everyday along with the broken off branch and I am thankful to be alive and writing about it. I have never had that happen at home!

Wema's family feels pretty at home at our house. One thing they love are my ice cubes.  One day Orjantan said, "Debi, there is something I do not understand. How do you get your ice in such perfect little squares?"  

It took me a second to wrap my head around the question. Can you imagine not knowing about ice cube trays?  I think it illustrates well the gulf between industrialized nations and the developing world. I can't help wonder what the world would be like if more people could experience what life is like for 80% of the world's population. I know it has opened my eyes....and my heart.. 

❤️Debi

Our anniversary trip

For our 39th anniversary, we visited the historical town/port of Bagamoyo. It is an old port dating back to the 13th century (Arabs and Indians) and later became a major port and the German capitol of German East Africa.  It was a terminus for caravans from the interior - ivory and slaves. The local museum has a lot of information about the slave trade, but the major mainland port may have been farther south.  Slaves went from the coast to the island of Zanzibar where there was a large slave market.  I will send you photos from there is a couple of weeks.

A neck shackle  was one type of slave restraint.  The other was attaching one slave to another by tying the necks of the slaves to the fork of a branch as seen in the drawing.

This chain was used to attach to the neck shackle.

The last known survivor of slavery in TZ. Died in 1974! The slave trade was finally outlawed by the British, but existed as an underground human trafficking trade for another couple of decades.  They finally caught the last of the slave traders in the sea cave where they plied their trade.  I told you it was underground.

Sewa Haji was an Indian businessman/philanthropist who built/donated multiple community buildings including a hospital that later moved south to Dar es Salaam and is now the big national hospital, Muhimbili Hospital.

19th century German government buildings still exist.

Slave "quarters" at the toll house.

Cannon from the Portuguese era 16th to 18th centuries that were still used by the Germans as late as 1905.

This tower is all that remains of the first German Lutheran church in Bagamoyo.  Dr David Livingstone, medical missionary, explorer, slavery abolitionist and of "Dr Livingstone, I presume." fame died in present day Zambia from malaria and dysentery.  His heart was buried under a tree where he died and the rest of him was embalmed and carried by porters 1000 miles back to Bagamoyo where he laid in state in this tower then made his last expedition to Westminster Abbey where he currently resides.

19th century water purification system.  Water is placed in the stone basin, percolates through the porous stone and drips into a bucket underneath.  I use this same technology in my house in Arusha today.  The materials are newer.  Stainless steel didn't exist then.  The basic technology is the same.

There is a bustling, aromatic fish market on the beach.  Fish is sold fresh or cooked.  Here are these little fishies being deep fried.  The crunchy final product is eaten whole.  Heads, fins, bones - the whole thing. Place your orders now and I can bring some back for you.

Don

Debi's blog entry about our halfway mark and Maasai friends.

It is hard to believe we have been here three and a half months!  Honestly, I think you are expecting me to say that time has just flown by, but actually, I feel like we have been here a year already!  Everyday life is HARD. And being a "people person" like me, makes transitions lonely for me. I stay "busy", but I miss my friends and family. Each time we have moved, I have been surprised at how long it takes me to feel at home. You just cannot create a mountain of friends instantly....and especially not in such a foreign place!  However, I am happy to report we are WELL and Don's hearing is back to baseline. I struggle with the dust and that continues to cause coughing and sneezing and blowing, but that is due to allergies and not illness. 

Don feels useful at work. His stories about the patients he sees and their diseases fascinate and sadden me. I will let him write about that. My role tends to be "hospitality coordinator" for all the visiting nurses, medical students, residents, biomedical technicians, etc. Most people come for  1-2 months, but some stay for six months. Saki, a University of Minnesota pediatric resident from JAPAN, is here now. She is the ONLY visitor right now so she needs company as much as I do. We have gotten together often for dinner and shopping and games and movies, etc. I will be sorry to see her leave September 22. Fortunately, that is the day Wema comes home from school for a break. 

Speaking of Wema (the 14 year old Maasai neighbor who rescued me from bad dogs a year ago), the connection with her family continues to unfold. She is attending a boarding school in a neighboring town, but we see her older brothers, Orjantan and Ombeni, and her younger brother, Herison, often. They bring their laptops and various devices to our house to use our wifi. We also play games and they get to experience all kinds of new food....like broccoli!  Anyway,  those computers have been life changing for them!  It has truly opened the world to them!  Yes, they download movies and play games, but they also download tutorials on how to prepare for SAT exams! They are SO bright and self disciplined!  The older brothers have big dreams of going away to college and they are pursuing scholarships and wish for sponsorship. Sponsorship is HUGE here. It seems like every Tanzanian success story has a sponsor behind it....Someone willing to invest in that person's education. 

Ok, here comes a long story about Wema's family.  If you continue reading, I promise a surprise ending!  We recently met Wema's cousin, Allan Kilevo, who lives in the US (Virginia) and was here for a wedding. Orjantan brought him to our house for a quick visit on his way to the airport. We encountered a very bright man in his 40's? who speaks flawless English. He married a Caucasian and has two children. We were delighted to meet him and hear the story about how he ended up in the US. 

Turns out, he was working as a waiter at Tarangire, a safari lodge about three hours from here, when he struck up a conversation/friendship with visiting tourists. These tourists were friends of the owners of the safari lodge, the SIMONSONS, long time missionaries here. The Simonson's and Rowbergs have had deep connections for decades! Long story, but these tourists were so taken with Allan that they eventually provided his plane ticket to the US and helped him attend a community college. He excelled and wanted to continue studying business at a university.  Simonson's used their influence to get him an international scholarship at Concordia College in Moorhead Minnesota!

Well, this was all just mind boggling to us to learn that Wema's cousin was connected to the Simonsons!  Dave and Eunie Simonson started the Maasai Girl's School where Wema now attends!  That made us curious about Wema's family tree. We heard she comes from a rather influential family, but we did not know how everyone was related. Orjantan talked with his mom and provided us with a family tree which is complicated. The family is large and people here take their father's first name as their last name. 

The tree starts with Wema's grandfather named Kilevo who had a first wife and after she died, a second wife. (Many Maasai have more than one wife at the same time). Kilevo had five children, including a son, Mesiaki who is an influential person around here, with the first wife. Then Kilevo had 11 more children with his second wife. Victor (Wema's father) was number 9 from that mother. Incidentally, this wife (Wema's grandmother) died last summer when we were here and she is buried on their property. I remember when she died and am sorry we did not get an opportunity to meet her. 

Apparently, Kilevo was fairly well off, at least in terms of land. The large family has now divided up this land, but most of them still have generous parcels next to each other and within walking distance of our house. 

Ok....so back to Allan and our remarkable visit. We learned that Allan's father was Mesiaki. That is a well known name here but we did not understand his connection to Wema until we studied the family tree. Mesiaki is Wema's uncle. We were curious to meet him, especially after meeting Allan. Both Linda and Erik had told us about Mesiaki but no one knew the exact connection to Wema. 

So, last week Orjantan brought Mesiaki to our house!  (Saki was here too and finds the connection to Tanzanians through us fascinating.) In walks this handsome, stately gentleman using a cane. We were so happy to meet the patriarch of the family!  His story is every bit as remarkable as Allan's, who is his 6th child out of 8. We learned that he is 84 years old and living nearby with his wife. He is a retired Lutheran pastor! He also received sponsorship in the 1960's and even attended Luther Seminary in St Paul Minnesota!  He used his newly acquired smart phone (just amazing that he is so capable!) to show us family photos. So we had a glorious evening getting to know this remarkable man. He has written a book....a memoir, but it is in Swahili. 

Anyway, here is the the punch line:  Mesiaki finally figured out who we are because he has met met Erik....and we discovered that he also had known Ray, Don's father!  Now this just seems hard to fathom that Wema's family has had connections with our family from long ago...and we are just now figuring it out!

Tonight we are invited to Wema's house (Saki too) for a dinner of bananas and beans cooked in coconut milk. They asked me to bring a plate of fresh veggies and dip. Eating cold food is new to them but they tried it at our house and enjoyed tasting hummus and curry dip. They love experiencing new things!  So our relationship with this family continues to be one of the highlights of living here!

I wanted to end with this story. As I mentioned, my main function is to provide various types of gatherings for various people several times a week. Preparing all that food requires a lot of effort because the shopping is so difficult and involves so many stops in the midst of traffic that is nerve wracking. Each time I do this I am aware of how difficult everything is here!  Everything is so much harder and more time consuming than at home. 

I decided to throw a "going away party" for Wendy, a visiting medical student from New Zealand. I invited Jacobsons and another American couple our age who were leaving the next day as well. I told Wendy I could handle up to 14 people so she could invite 8 more including herself. Included on her invitation list was a Japanese woman she met on Safari, her safari driver and a performer she met at a nearby safari lodge!  With such a wild assortment of guests, I knew it would be an interesting evening. 

I knocked myself out and fixed a vegetarian meal since Wendy and a another visiting resident are vegetarians.  We enjoyed carrot curry soup, mediterranean rice salad, Thai peanut salad, chutney, fruit salad and an amaretto/almond/ lemon bundt cake for dessert. Wendy is Chinese and she brought dumplings made from scratch!  Linda contributed a green salad. The evening was such a fun global experience!  That is probably my favorite thing about being here....all the global connections. 

So the "old folks", like us, left first. The last to leave were the Tanzanian young men: the safari driver and the back flipping, fire tossing performer. They thanked me over and over for including them and for all the good food. As they left, they said my name should be changed to MOTHER AFRICA!  This would not be so funny if they said this to Linda....she actually deserves that name!  But for me, with all my difficulties adjusting and all my grumbling about the inefficiencies in this strange place, the irony of being referred to as "Mother Africa" has kept me laughing! And laughing is indeed the BEST medicine!

❤️Debi

Sunset in Tanzania

More hospital cases from Don

What do you do when somebody doesn't have a measurable blood pressure? That's kind of a problem. A 26 year old woman came into the hospital in the midst of having a miscarriage. That's the first problem. She does have a heart beat, but the blood pressure is so low that it can't be measured. This is considered to be a bad situation. She also had excess fluid in her body, heart failure. Her heart was huge on chest X-ray. The platelet count was low so we initially were concerned that she had HELLP syndrome.  Yes, that is really the name of that syndrome. The platelet count came up quickly so either it reversed quickly or it was a lab error. We don't have any of the intensive monitoring equipment to duplicate monitoring that happens in the US.  We also don't have blood pressure or heart contraction stimulating kinds of medications. We used very small doses of a diuretic to increase urine production.  We can't help the blood pressure, but can carefully reduce the excess water situation. By the next day she is feeling somewhat better and I am barely able to find a blood pressure..  Her echocardiogram showed massive chamber enlargement and mitral valve stenosis and regurgitation; the valve is too tight and leaking at the same time most likely due to rheumatic heart disease which has become fairly rare in the industrialized world, but is still common in the developing world. She survived and we are following her as an outpatient to continue to get the rest of the fluid off and adjust her heart failure medications plus she will see the gynecologist to manage contraception.  She will not likely survive another pregnancy. It pays to be young if you get sick.

Two weeks earlier, another no blood pressure and in heart failure ICU patient came in and we also couldn't hear bowel sounds. You hear your stomach growl every once in a while.  Your doctor can hear bowel sounds ALL the time. Normal hemoglobin is higher than 12 and we think about transfusion at 7.  Hers was 2.8 probably from a bowel perforation and internal bleeding.  We gave her a transfusion which can help the anemia and blood pressure, but contributes more to her heart failure so we also gave her the diuretic.  The next day we also found pneumonia. She won't survive anesthesia or surgery so we treated her multiple problems medically and she did seem to perk up then suddenly died two days later. I don't think she could have survived in a US ICU either.  When you get so many strikes against you, additional organ systems start to fail and survival becomes impossible. Failure is more likely when practicing medicine in a "resource poor" setting. My digital medical textbook recognizes that 80% of the world's population live in resource poor countries and gives different treatment recommendations for resource poor settings.

We do get some straight forward and almost always successfully treated kinds of problems.  High blood pressure because of stopping the pills, new diagnosis of diabetes, malaria. Globally, malaria is the #2 cause of human death behind humans killing other humans. I have not had a patient die from malaria while I have been out here. It is particularly deadly for children and pregnant women so the OB and pediatrics wards have the high risk patients.

We just sent home a patient with a disease I have never seen before.  After seeing my photos, you will be more experienced than 99.99% of doctors in the US. A Maasai women came to the hospital with the right side of her face extremely swollen.  I had to pry her eyelids apart to get a peek at that eye. She also had two funny looking skin ulcers on the back of her neck.  I didn't have a clue as to what those things were.  The intern in casualty (urgent care) suggested a diagnosis. I looked it up in my digital medical text downloaded in my smart phone.   Sure enough.  That is what the patient had.

Raised, swollen edge and black eschar (like a scab) in the center.  Anthrax. There was that anthrax bioterrorism in Congress in 2001 with a bunch of anthrax cases.  However, in the 2 decades prior to that, there had been only 7 known cases.  It is not common among the cattle-herding Maasai, but it isn't rare either since most human infections come from infected animals.  

The humorous puzzle was the intern's history that the patient got the infection from eating a "caccus." I wondered if the intern was misspelling "cactus." When I asked about that, the verbal report was that she had eaten a "cawcus" (my phonetic spelling). That was when I recognized the Tanzanian soft R sound in that word.  She had eaten a dead sheep, a carcass. The intern had written a phonetic spelling of how he pronounced carcass. The Maasai think cooking meat well cures all ills which is partly true, but in the processing of the "caccus," you get exposed to the bacteria and the bacterial spores. Infection follows.

She was a particularly delightful Bibi ("Grandmother" in Swahili which is  a respectful title), waving to us with both hands when we saw her on ward rounds (2 weeks of IV antibiotics). She only spoke Maa, the Maasai language, so I had to talk to her through a series of 2 translators (Maa to Swahili, then Swahili to English). She consented to posing for a photo with me which I appreciated since Maasai are reluctant to be photographed unless you pay them a modeling fee.

Then she decided to be funny and rub my head. She needs 2 months of anti-anthrax pills to protect against repeat infection if the spores start to activate and grow. After 2 weeks of IV therapy, my risk of getting anthrax from her was slight, but that was more exposure than what I was planning on. At least I will recognize it if I get anthrax skin lesions.

Don

Hospital cases

Working at Selian Lutheran Hospital is an amazing experience. Some days, I would replace the word "amazing" with "overwhelming." I have enormous respect for the medical staff I work with here. They work in a very limited resource condition without getting discouraged.  I have been impressed with the quality education they get in their training in Tanzania.  I work mainly with doctors-in-training, but also have interaction with the other staff physicians.  They have a sound understanding of the science underlying the practice of medicine. In addition to knowing how to use their local tests and treatments, they also know about tests and treatments that are not available here and sometimes anywhere in the country.

I see monthly statistics only for the limited time I am here.  The death rate is down 30% this year on the adult medical wards compared to last year. I can't say what is causing the difference.  I don't take credit since I was not here for most of the first 6 months. We still see bewildering problems.

I recall a dramatic case last year of a patient feeling sick and consulting the local herbalist, a common practice. He took whatever the herbalist prescribed and becoming comatose in 1/2 hour.  He was then brought to our hospital.  Since we didn't know what was in the herbs and have no toxicology testing available, our only treatment is supportive care and waiting for the liver to detoxify the body. That patient never woke up and ended up dying. We recently had a nearly identical situation occur.  This time, however, the patient woke up three days later with all vital organs intact and ultimately walked out of the hospital. Herbalists, by the way, are not witch doctors (who do exist in the Maasai villages, but are a different type of practitioner). Herbalists have learned from their elders how to use local plants so it is knowledge that is passed down through the generations. We only see their treatment failures and they don't publish placebo controlled, double-blinded clinical trials of their products in the New England Journal of Medicine, but they must have some successes or they would not have any customers. There are researchers, medical anthropologists, who study the herbs used by traditional herbalists to look for therapeutic pearls there that can be incorporated into western style medicine.

Speaking of traditional health practitioners, there are also traditional birth attendants who attend most of the deliveries out in the bush country. They have learned their art from older birth attendants. There are not nearly enough obstetricians and western medicine trained midwives in the country so the traditional birth attendants provide a valuable service. I recall visiting a Maasai village, by coincidence, where a baby had been delivered the night before. The traditional birth attendant didn't live in that village, but was fortuitously visiting her relatives.  The labor was not progressing so cow's cream was given to the mom to try to stimulate labor. When that didn't work, the attendant decided that the problem was a transverse lie; the baby was sideways.  She performed an abdominal massage to rotate the baby head down and the baby was born without further difficulty.  Without that intervention, both mother and baby would probably have died.

We recently saw a woman at Selian that had strange symptoms.  She complained of numbness and weakness in her arm and leg on the right, but didn't really have  demonstrable abnormalities on exam.  Things were not right, but it wasn't clear what was going on. She also had a strange thing about her scalp.  It was spongy like fluid under the scalp. We asked to have a CT scan of the head done which is a big deal since it is very expensive for pastoralist Maasai and involves transporting the patient to another hospital where they have a CT scanner. That revealed a 9 centimeter in diameter meningioma, a tumor of the membrane wrapping around the brain.  It had eroded through the skull so there was leakage of cerebrospinal fluid underneath the scalp.  Never seen that before. She was referred on to the neurosurgeons who are unfortunately far, far away in Dar es Salaam.

Adult medicine in the right side of the building and pediatrics on the left.
The ground has a purplish cast to it due to the fallen petals from the large jacaranda trees in the courtyard.

Medical lecture in the cafeteria.

Arti, the woman in blue, is from the University of Minnesota which sends out Chief Medical Residents from their Global Health Department. They come out to be teachers and also to get more personal experience in tropical medicine.

Don

Debi's entry. Cyclists, money & food and other anecdotes.

Last week Erik and Bernice were both gone all week on business. We wanted to have Nashesha over when we got her all to ourselves. She has such a busy social schedule that we finally got her on Thursday, but she said she had cyclists and wasn't sure we wanted to invite them too. We said SURE!  We love meeting her friends!  I told her I was making a big pot of spaghetti sauce and there would be plenty. (More ripe tomatoes to deal with!)

Turns out, these were not "friends" exactly. They are members of an international biking club and when near another member, they make contact and get a bed and a meal or two before resuming their trek. Don picked them all up st Nashesha's house and I was surprised to see 40 year old adults come through our door!  I was even more surprised to learn they are from ITALY....and I was serving them spaghetti! We offered them wine and beer and cheese and crackers before dinner. They acted like they were in the lap of luxury eating at the Ritz! 

They took out a laminated map of the globe with their route outlined with a magic marker.  We were astonished to see that they have bicycled from Alaska to the tip of South America, and all over East Asia and Australia and are now making their way across Africa!  They carry their tent and supplies with them and when going through a desert, 20 liters of water each!  I felt like we were accidentally in the company of world class explorers!  What an enchanting, memorable evening we had!  And there is nothing like feeding campers for getting compliments on your cooking!  

A word about money here. One US dollar equals 2230 shillings. The numbers are so big when buying things that an easy estimate is to drop the "thousand" and divide it in half. So 10,000 shillings is approximately $5.00. Wages are very low (we pay Mebo 10,000 sh/day and she is happy to have the work since so many are unemployed) and prices tend to be low too. I can buy 26 long stemmed roses for 5000 sh. They don't last as long as in the US...a week at most, but they are 10 cents apiece!

It is easy to take on the norms around you. So many people watch their pennies and do without anything other than the necessities. It is also easy to start thinking of 5000 shillings as $5.00 (instead of $2.50) since in the US the price would be easily be that much. I found myself wanting to buy a wider roll of aluminum foil since I would struggle to wrap a loaf if bread or cover a cake with the foil that came with our rental house. The wider roll was 6000 shillings and I thought that was a LOT so I did not buy it. Next time I struggled with my foil, I realized I was agonizing over a $3.00 purchase!  

Food costs are just amazing. Everyday vegetables (tomatoes, onions, carrots, cucumbers, green peppers, potatoes, green cabbage, eggplant) are very cheap.  I just bought a kilo of tomatoes for 2000 sh which is like 25 cents/pound. I bought this at a vegetable stand and I bet Wema's mother could have done better. A huge pineapple (and better tasting than anywhere) is 3000 sh. ($1.50) Also, we have a garden so I can pick lettuce, spinach, Chinese cabbage, all kinds of herbs in addition to free avocados from our trees. We have three different kinds. Incidentally, the avocados are the size of 4 at home and one is 500-1000 (25-50 cents!) if you buy it. I make guacamole regularly and it costs very little. The chips to eat it with seem expensive ...7000 sh, but I have to remind myself, that is not $7.00, but just over $3.00!

Meat (I use the term broadly to include fish and poultry too) is another interesting thing. Now that I know where to go, I can find beautiful meat. The cows here are skinny by US standards and the beef tends to be very lean and tough. Linda warned me about this and said the hamburger is actually very tasty and more tender.  The mince (hamburger) is so lean that I add a little oil when browning it!  There is almost no fat!  The color is pure red. When I make a meat dish, I buy two kilos of round steak which is cut in cubes.  Again....pure red....no marbling. I put it in the crockpot for 24 hours!  It has wonderful flavor and it just falls apart. Linda does hers in the pressure cooker but I am afraid of using that. The cost seems very high....most people eat meat twice a week because of the expense. I assumed it was terribly expensive because it is priced at shillings/kilo, but I just realized it is $3-4/pound!  When we serve chicken or beef it is usually in a sauce mixed with vegetables over rice pasta or potatoes. The Tanzanians, especially the Maasai, just love beef. 

When we eat at a restaurant, the food is really GOOD!  They use spices so well. I would say the food tends to be spicer than in the US overall. There is a huge Indian influence. The bill is almost never over 15000 sh apiece....$7.00. Tipping is not expected. At really fancy tourist place like the upscale restaurant where we ate last night was 130,000 which included wine, appetizers, two dinners and two deserts!  ($58.00) That was a splurge!

So, it is not expensive to entertain at home  or socialize in restaurants here. That is a huge plus. Wine and beer are also interesting. The beer is really good. We don't drink beer anywhere other than here. It comes in 500 cc bottles for 2000-2500sh. ($1.00). Wine comes from abroad, mostly South Africa, but also Australia, Chile and New Zealand. It is not of Walla Walla quality, but some is not bad! I pay 13000-20000/ bottle (I just did the math...$6-9!  Jeepers!  That is less than I thought!).  See what I mean about thinking of sh as dollars?  Soft drinks in a reusable glass bottle are 400sh (18 cents!) and a 500cc plastic bottle is 1000sh, but then I have to recycle. 

Ok, on to other stories. There are so many!  What to choose?  I will start with this one:  we recently got a fancy invitation to an event at Selian Hospital where Don works. Our invitation came hand written to Dr Rowberg and wife on the envelope. This was billed as a "Celebration". The Bishop of the Tanzanian Lutheran Church would be present to celebrate the transition from government involvement to independent control. Truly, I am not sure if that was the purpose or just that they needed money and planned a big celebration to raise money. There is so much I do not understand!

So, we skipped church and raced to arrive for the 10:00 beginning. We parked the car, raced to the courtyard where tents and chairs were set up only to find NOT ONE PERSON in the chairs!  Once again, you just have to laugh!  We were on Wazungu (white people) time. 

Debi (in the shadows on the right) and one other person seated at the 10AM start time.

We had also been informed ahead of time that the medical staff was expected to contribute money to the effort. It was made known that the head Tanzanian doctor was going to give 300,000. The expectation was communicated clearly that everyone should follow suit. Can you imagine???  People in the US would revolt!  Not here!  A doctor who could not attend gave us money to contribute to give on her behalf. She warned us that we would be expected to say over a microphone how much we were giving!

On the way there Don said he would like it if he contributed 300,000 and I contributed 300,000. ( We feel so rich and humbled by the generosity of Tanzanians...300,000 is HUGE on their salary). I thought about it and told him I was thinking of following him to the microphone and announcing that I would give 400,000!  Don jerked his head toward me and said, "WHAT"?  I said, "Never mind!  I got the reaction I was hoping for!"  😄😄 

That day we witnessed Tanzanians contributing 5000 and 10000 sh notes along with money for auction items like a live goat on a leash. Altogether $62,000 was raised!  It seemed like the miracle of the loaves and fishes! (Don's editorial note: There is one difference with our experience and the biblical story.  Our group all got up and danced in the aisles in celebration.)

Anyway, while sitting in those chairs waiting for the celebration to start, I looked down at my legs. I was wearing a dress and my bare legs were exposed. My skin looked so WHITE!  I looked at my legs thinking, who do those belong to?  Who is the person wearing white stockings!???

It reminds me of another funny story...when the boys were all at home and growing like weeds. They all wore size 13 tennis shoes. I was used to dealing with left over belongings cuz we had a pool and the kids were always leaving towels and other things behind. One day I looked at all the shoes in the laundry room and saw these small tennis shoes. I wondered what child left them. Then I realized they were MINE!

That is exactly how my white legs looked to me that day!  I don't know how to better tell the story of culture shock....whether we are raising teenagers or going to the third world!

More stories will come!  I can't  do more at this time!  As I write, the Rowberg family campout is starting. I hate to miss it!

❤️Debi

Debi entry. visiting Wema

We have crossed the two month dateline. I am happy to report we are both doing better in every way. 

Don's hearing MUCH improved, but is not yet back to baseline; he will see the ENT specialist again on August 26. I think I am over my original respiratory trouble and I had ONE day if being Kleenex free before coming down with something new!  I don't know if this is a dust allergy or a new virus!  I am coughing up new stuff and it cost me a night of fun last Friday, but I am better....and I am sick of being sick...if not sick, not well either!

As far as adjusting to the culture shock, I think it is amazing that in such a short time one can adjust to so many things that are unlike home. Now it is the dry season and our windows are always open. Each day my IPad is not just covered with dust....it is dust mixed with sand. Funny how that begins to seem normal. You get used to litter...terrible, disgraceful litter. I understand the new TZ  president wants to combat this and declare every last Friday "clean up day".  A great start...Trouble is, where will it all go without a collection system?  Traffic remains a daily challenge, but even that starts to seem more normal.  I love being the driver for new visitors to TZ. They gasp and cry out helpful suggestions which makes me feel accomplished and confident in comparison. 

Last night was an exception. We had a near miss. Drivers are CRAZY here!  On a curvy road we met head on with a car in our lane passing several cars on blind corners. When I saw his headlights coming at me, I veered left, but there was also a bicyclist to avoid. How I missed both of them as he squeezed in front of me to his lane, I will never know!  All three of us in the car needed some recovery time. I am glad once again to be alive!  

The BEST experience for our little group of visiting medical people was to visit Plaster House. Somehow we never got there last time but are so happy we got to visit this time. For more information on this inspirational place see their website:  www.theplasterhouse.org. 

Again, the visionary, Mark Jacobson, realized that the healthcare system was missing some of the most vulnerable and needy among the regional population. Somehow it seems only logical to me that if you are able to provide care and treatment to society's most deserving, they will come!  Not so!  There is too much fear of a healthcare system and all the unknowns and expense involved. It is incredible to me that the way the staff finally got referrals was to go to schools and talk to school kids about the miraculous treatments available. They would show pictures of kids with club feet, cleft palates, severe bow legged ness from fluorosis and severe burns and ask, "Do you know of anyone who suffers from any of these conditions?"  Kids would recognize these afflictions amoung their siblings at home!

Nine years later, plaster house is the most amazing facility able to treat some of the most severely disabled children!  Just a simple cast is a challenge to care for in a cow dung hut which is home to the Maasai!  It did not take long for professionals to realize a residential treatment center would be necessary to treat the toughest cases.  Many children come in so malnourished (with hemoglobins of 3-5 when normal is higher than 12!) and with such complex medical needs that they require therapy and food prior to corrective surgery. 

We saw a clean, rather modern, peaceful, attractive facility where everyone helps everyone else and a place where the most disabled are not alone. We witnessed an impromptu soccer game where kids, using various assistive devices, were amazingly adept at moving the ball around!  One boy's foot was so severely deformed that he was running on top of his foot!  He was obviously getting pre-therapy and surgery was in his future. 

The burn cases were the hardest to see. We have seen these cases before, but I don't think we have ever seen so many in one place. Two people were so scarred that their faces were hard to describe. They looked like what Halloween masks try to portray!  My stomach did flip flops and I cannot think about them without a visceral reaction. Imagine trying to live your life with that kind of deformity!  

Plastic surgeons come from the US twice a year and do amazing reconstruction on these victims. Orthopedic cases and other reconstructions can be done by the general surgeons (who have extra training) at the hospital system where Don works. Mental health is pretty nonexistent in TZ, but the work done at this place is nothing short of life changing and transformative. The coordinator realizes that kids come in SO damaged by their disability that part of the care is to rehabilitate their inner being. Sometimes this takes years.  

I am SO grateful to the US and Canadian doctors who work here full time and for the visiting US plastic surgeons who do miraculous work on their "vacation"....many were Mark Jacobson's classmates!  Also, I am grateful to the mostly US sponsors of these children who contribute money each month to sponsor one child. They treated 700 kids last year!  Just astounding!

Back to other news...our daily routine is that Don gets up and goes to work and I stay home and do whatever.  I do not yet have a niche other than hospitality. I brought all kinds of improvement resources out with me, but so far no one has asked for my help. I am still overwhelmed by all the cultural differences that I would not know where to start!  Maybe by putting tape on the floor so people would know to line up?  😄 Of course it would take a Tanzanian leader to think this is a good idea, etc. I am hoping Tanzanians will be interested in this kind of work and I could be a resource for them. 

In the meantime, I have "get togethers" of various kinds with various people.  Sometimes it is snacks on the patio, sometimes dinners and sometimes picnics. I can find the most amazing food now that I know where to go, like frozen raspberries and Pacific Northwest salmon!  I am trying all kinds of spice blends. One if my favorites is a called  chicken masala. I plan to bring back a container of Chicken Masala when we return.  it makes a yummy chicken dish to eat over rice...really easy and really good!   

Last Saturday we ( Don, mama, Orjantan, Herison and I) went to visit Wema. Turns out, we were breaking all kinds of rules and norms for a student in boarding school!  Who knew??? At first they said we could stay 10 minutes, but later relaxed the rules after we spoke with head master.  We stayed three hours and had so much fun playing cribbage...and UNO!  I brought two UNO decks because I thought it would be easy for Wema's family to catch on. We had a hilarious moment when Herison played a wild card and got to choose the new color. He chose PINK!  They are not used to playing cards so they make many mistakes. They deal the wrong way and even hold their cards backwards so we can see what is in their hand. Fortunately they find their mistakes to be very funny!

Wema is doing extremely well in school. We met a teacher who is sure she will be in the top 5 of her class...if not #1!  And the teacher said Wema is a leader among students and works to spread encouragement and kindness. I am so grateful we are able to support such a deserving young woman!

Don came home from the hospital recently and said, "Well, today I think I was worth what they are paying me."  ($0.00). He has become familiar with the common diseases and the treatments available so he does not hit the books immediately upon coming home. We are also making an effort to get to know the Tanzanian staff which is a delight to me. I don't like feeling like such an outsider. 

Linda and Mark will be back in two weeks which will be really nice!  Ann Rowberg, who is newly retired, will spend most of November with us. We will celebrate her 70th birthday and Thanksgiving while she is here!  So, things are looking up!

Thanks for your interest and your prayers!

❤️Debi