God bless suspension systems

Another marathon day here on the Health Sector Development Study front. We laugh at weekends here. Ha ha, we say.

Victor, Halimu (the Chamwino region's Reproductive and Child Heath director), and I launched out for the mountainous region of Chamwino today. About 15 minutes into the drive, we careened off the single paved road that connects Dodoma to Dar and spent the next 45 minutes navigating completely unpaved dirt/sand/dust paths. This is what SUVs were actually made for, kids. Huge, knock-the-wind-out-of-you potholes the whole time, taken at approximately 50 mph. It was like riding one of those rickety wooden rollercoasters they have in the "Wid West" section at amusement parks, except more painful. Kind of hoping I'll bruise along the seatbelt line and thus prove to you, Gentle Reader, what a crazy ride it was.

The view bouncing by the windows was great, though. Big craggy mountains in the background (Victor suggested they looked like Arizona, but as neither of us has been there, we couldn't say for sure) above wide, rocky plain. And the baobab trees! I love them! They look like the tree where the evil sludge lived in "Ferngully", if any of you remember that. Enormous trunks, wide as redwoods, that immediately erupt into scraggly little branches only 40 feet up or so. Great body type.

Arriving in the village of Mkang'wa (I can't really hear the apostrophe, but I saw it written so I know it's there), we were greeted by bright sun, sandy soil, and a constant moderate wind bringing the scent of woodfire. It actually tricked my brain for a minute into thinking we were near the ocean; the dryness gave it away. The local dispensary's Chief Medical Officer, clad like most men here in a loud shirt, trousers, and plastic flip flops, proudly gave us a tour of his buildings. It's actually a pretty smooth operation he's got there, taking full advantage of the local climate: the clinic gets electrical power from solar panels on its roof and collects rainwater off the same roof to fill a huge collecting tank. Very clever and effective. Near the tank, I spied a row of malaria bloodtest microscope slides along a wooden bench, drying in the sun. Whatever works, I say.

The clinic seems to be working well with limited resources; it has a solid record of no maternal deaths for the past four years, but has trouble keeping drugs in stock thanks to the bureaucratic machinations at the Ministry of Health. Not having their own ambulance, they borrow one from a local Anglican mission. Again, clever.

After interviewing the dispensary workers and a group of locals, we dropped by the nearby Mvumi Hospital, which has a Maternity Waiting Home. I've been curious about these Homes ever since hearing about them in the office in Dar; they're set up so that women in rural areas can show up a few weeks BEFORE they go into labor, hanging out near the hospital, gestating along, before safely delivering their babies and heading home. The Home at Mvumi is off to the side of the main hospital campus. Upon first sight, it appears just like the typical main square of any small Tanzanian village, just if everyone in that village were 7-9 months pregnant. People are cooking over small wood stoves, others are selling fruits and vegetables, chickens are wandering about, and the women often bring a family member or two along as well, so it's a good scene. The ward with beds was a little windowless for my tastes - but since there are only 18 beds and definitely at least 30 pregnant women milling about, most of them aren't affected by the official sleeping arrangements anyway.

Victor seemed very nervous to be surrounded by all these oddly shaped women. Halimu and I were amused.

On to Handali, where we went through two more interviews...probably overdid it. By the last interview, Halimu was yawning, I was tired, and Victor's questions seemed a little rushed. (He was even taking notes in Swahili - a true sign of exhaustion from a man who (rightly) takes pride in his simultaneous Engish-Swahili translation abilities.)

No journeys tomorrow, on the official Day of Rest. I'm not sure what I'll do, exactly, and am considering dropping in at the Anglican Church next door, simply in search of company and music. (I can hear their childrens' choir practicing through my windows and they are fabulous.)