Wednesday, July 8, 2009

Open, Semsem

Getting close now:

One last half day out in Kongwa region. I've been very happy during the past two days in Kongwa, both in terms of the work we were doing and the people we were able to interact with. Today only drove that home a little more - I'm a little bummed to be back in Dodoma after what feels like a very short visit.

Armed with a sturdy vehicle packed to the brim with boxes of medical supplies, we headed out with Mama Elizabeth on a distribution run, trying to beef up the resources of some of the local sites. First, however, we made a special stop that I hadn't anticipated. Directing the driver to a roadside stand out on the edge of town, Mama Elizabeth had a quick chat with the stand's owner and then accepted a heavy plastic bag from him. As we drove off, she turned and plopped it into my lap. "Semsem! For your vegetables," she announced.

This was quite a surprise. The evening before, it had come up that I was allergic to both peanuts and cashews, both of which are used for cooking oils here. Both Victor and Mama Elizabeth had agreed that semsem oil, made of crushed sesame-like seeds, would be a good solution for me. But I'd completely forgotten about that covnversation until now, as I examined the 10-lb bag of seeds on my lap. "Asante sana!" I returned ("Thanks so much!"), not exactly sure where I'd be able to use this stash but touched that she'd worked out this delivery for me. It's a pretty great first Tanzanian gift, I think. Even if I'm not sure how I'm going to get it back to Dar.

Semsem safely stored, we stopped by two dispensaries to drop off drugs and supplies, sort of like Santa Claus if he operated out of a Toyota pickup truck. The second dispensary happened to be in the middle of a newborn weighing event, with many mothers and infants queueing around a scale dangling from a nearby tree branch. Babies were hoisted one by one into the sling to spin around sloooooowly, trying to figure out what was happening, before being recorded and reclaimed. Probably the cutest picture I've ever taken.

We moved on to one final health clinic, which was notable for the clinical officer's suggestion that her staff needed training to help treat complications of abortion. Abortion is mostly illegal in Tanzania, which of course means not that it doesn't happen but that we have very bad data on how often it happens. There is a girls' school near this particular clinic, so they are faced with the consequences of botched abortions perhaps more often than other clinics we'd seen. Victor noted this down, though it's unclear what WD can do on this front - hard to run a training session for something that isn't supposed to be happening.

Our last stop was a private health facility, of all things: the Catholic-run Center for Disabled Children, high atop a local mountain road. After all the public facilities we've seen, this one looked simply spectacular. They had plenty of staff. They had physical therapists. They had wheelchairs for all the kids. They had a beautiful, spotless operating theater. They had a wheelchair-accessible pool, for Pete's sake. (Not that it actually had water during the dry season, but still.) Music was playing, walls were painted cheerful colors....I think I'd gotten so used to certain facility standards during this trip that I was sort of shocked by what a clinic could be here, given sufficient money. There is wealth here, just not so much with the Ministry of Health (or at least, not doled out by the Ministry of Health.)

Our passage back to Dodoma involved with leaping aboard one of the coach buses that zoom through Kibaigwa. Most buses slow down for approximately 30 seconds, just enough time for passengers to buy water or cashews or giant bags of potatoes from their windows, then careen off down the road. On our third try, Victor and I managed to stop a bus long enough to stuff our bags underneath and leap aboard, just as it pulled away from the curb. Fun adrenaline rush.

I took Victor out for dinner for my last night as his tagalong research assistant; we feasted on ugali, vegetables, beans, rice, and Safari beer. (I tip my hat to Tanzanian food for being emminently edible. This sounds like a backhanded compliment, but is actually very reassuring in a country where you never known what the next restroom will bring.) It's been good tagging along with him and I'll look forward to seeing him again in Dar. Sort of sad - who will give me little lists of Swahili words to learn now?

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