January 2007 Medical Mission Trip

Ten people representing several congregations of the Saint Paul Area Synod are traveling to the Iringa Diocese this December and January to continue work under the direction of the Ilula Health Center Task Force. The group includes Dr Gary Moody, Sue Everhart, Nicole Orloff, Jenny Mickelson, Heidi Moll, Kathy Lewis, Kari Hurley, Evan Hurley, Angela Hurley and Dr Randy Hurley. Seven of the 10 group members are returning travelers.

The goal of the trip is to continue to facilitate support for Lutheran sponsored health care in the Iringa Diocese in Tanzania. This model of mission medical work is somewhat unique in that it emphasizes primarily supporting the work of the Tanzanian health professionals who work at Ilula. The group plans to see patients, participate in surgeries, perform ultrasounds and work in the HIV clinic.

The most important goal, however, is to continue to foster the relationship between the Ilula Health Center and the Minnesota based Ilula Health Center Task Force. A stronger relationship allows for better communication and prioritization of needs at the Health Center—a necessity for achieving a sustainable upgrade at the facility.

The travelers will send reports on their activities via email, so check back here frequently throughout the month to read of their experiences.

12/28/06 Update from Amsterdam

Greetings All:

Just wanted to send a quick note and let you know we are on our way. You can imagine the Hurley household was quite chaotic these last several days--with the holidays and an appropriate level of procrastination before getting ready to leave. We had a tremendous number of people call, and stop by in the last several days wishing us well with prayers, thoughts, and gifts/donated medical supplies to bring to our Tanzanian friends.

In addition to the 4 Hurleys, Kathy Lewis is traveling with us: a family friend, college freshman and member of Easter Lutheran Church in Eagan. Sharon Moody, a member of Our Saviour's in Hastings is also on the flight--she is leading 3 others from Trinity Lutheran in North Branch. After their trip concludes, Sharon will join us. Her husband, Dr Gary Moody, departs January 2nd with the rest of our crew: Sue Everhart (ultrasound), Nicole Orloff (dental), and nurses Heidi Moll and Jenny Mikkelson. I'm looking forward to seeing the progress at Ilula and seeing our friends from Tungamalenga.

We've just spent 8 hours on a plane and have another 10 to go--2 full work days worth of down time--sleeping/eating/reading. I'm reading A Central Liberal Truth by Lawrence Harrison--a nice complement to other books by economist Jeff Sachs and ecologist Jared Diamond regarding why some societies develop faster than others. Harrison's thesis is that culture plays a large role. In chapter 2 he describes how northern European societies such as Norway, Denmark, Sweden, etc have both a high standard of living and get good marks from Transparency International regarding government--he actually ascribes this in large part to their Protestant (Lutheran) religion--not just
work ethic but sense of "who's your neighbor" social identity/values, etc. Coming from Minnesota, it is a nice thought since we live in a state that consistently ranks high in education, health care, etc--perhaps all of those Lutherans and social values--and perhaps it bodes well for a developing nation like Tanzania which has a rapidly rising Lutheran population.

In closing, Evan gave me a travel journal for Christmas since he knows I like to journal on these trips--it has several inspirational quotes--the very first seems appropriate: "It's where you go and what you do when you get there that tells us who you are."

We'll keep you posted, thanks for the prayers.

The Hurley's and Kathy Lewis

1/2/2007 Hospice Care in Tungamalenga

We just had a wonderful visit with our friends in Tanzania. It was wonderful to see familiar faces, and of course they have warm greetings for all the SOTV congregation. There were many questions about friends in the states, and I have a huge bag of letters for people at home! We did have the opportunity to visit with Barnabas [Kahwege, clinical officer at the Tungamalenga Dispensary] as he was home from medical school, which was wonderful. He will be heading back to Tonga at the end of this week. On this visit I was able to sit back a little and notice things I hadn't noticed before. One thing that is very evident is how highly regarded Barnabas is. At every preaching point on our way out of the church I would notice people line up behind Barnabas and touch his elbow to consult about a sore knee, chest pain, eye pain, stomach problems. He took time to listen to each one, and ask questions. He was able to provide a course of action for each person. What a wonderful asset he will be to the community here when he returns from school as an assistant medical officer, having completed the equivalent of two years of medical school.

Barnabas was kind enough to take us on four home visits. We brought hospice kits to each patient and Barnabas was very good about going through what was in the kits and instructing patients about how to take the Ibuprofen and the multivitamins. At the first home we met three sisters who live together. The oldest sister was taking care of her two younger sisters, Candida and Gabriella. Both of them had been abandoned by their husbands when they were found to have HIV. Candida was quite ill, and not very mobile, Gabriella was somewhat better, however it was obvious that she was ill too. Both of them had received the free government testing at the Idodi health center. When they tested positive they were told to go to the Iringa hospital to get CD4 testing. This is the test that determines if a patient is immunocompromised enough to receive free antiretroviral treatment. The problem is that they can't afford the bus ride, the CD4
testing and two nights stay for the three of them, (the older sister would have to accompany them to take care of them). As a result they continue to deteriorate. We were unable to leave that situation alone, and fortunately we were able to raise enough money to allow them to go to Iringa and get the antiretrovirals that they need.

The next visit was to a house of another HIV patient. This patient was doing very well and able to function without problem. She described herself as being well. The difference here is that she has been receiving antiretrovirals for the past year-- a great testament to what a difference they can make.

The final house we went to was a very sad case that unfortunately we could do nothing to help. A mother had a five month old who had a severe case of hydrocephalus. (This is where the cerebral spinal fluid accumulates around the brain. The head becomes very enlarged and this will eventually result in death.) It is always so hard to feel that you can do nothing to help a situation.

This has been a wonderful visit, our Tanzanian friends warmly greet everyone at SOTV and ask that we continue to pray for them, as they will for us every Thursday!

Kari Hurley


January 3, 2007 The Rains and Malaria Came Early This Year

Kamwene All: For all those that have been here and been greeted in the multiple preaching points around Tungamalenga, you know what I mean when I say the Holy Spirit is alive and well here! We have enthusiastically been greeted by all of our friends: all are happy and healthy.

Typically the rainy season starts in January and lasts until May. For the past several years the rains have come late (end of February) and have been insufficient. This has led to crop failure the past several years, but also, the water reservoirs ran low, leading to loss of hydroelectric power. The people have prayed hard for rain. Actually, this year, the rains started at the end of November. The people thank God for this. It has been raining nearly everyday since, and in fact, they have more rain than they need (there is flooding in many areas--the road out to Tungamalenga was amazingly difficult with washouts). They thank God none the less.

Unfortunately, with the rain comes the mosquitoes, and with mosquitoes comes malaria--their peak malaria season is typically March but already they have had many cases at the Tungamalenga dispensary. They are running out of drugs such as quinine and
routine antibiotics.

We visited Makifu preaching point in a slight drizzle. The sanctuary does not yet have a roof (SOTV has gifted them money for this but it takes time to get the iron sheeting delivered from the larger towns and now the roads are not so good). We attend a brief service--as visitors, we are allowed to sit under a plastic tarp to stay dry. The congregants are not so lucky: they are huddled together under 2 tin sheets that have been propped up with branches to form a shelter. They, of course, don't seem to mind--they sing incredibly joyously. All the while, I am thinking, now, would I also walk a mile or two barefoot down muddy paths to go to church on Sunday only to stand in the rain during the worship service? Just as those here thank God for rain, so too should we be thankful for what we have.

We visited the Massai preaching point, Kibaoni. Just as last year, they are curious about how Pastor Deb's ankle is--I assure them she is much better--she no longer requires her Massai walking stick to get around--I explain that she now sometimes uses it as a method for exclamation when she preaches!

Last year we treated some of the Massai men that had several medical conditions (mostly skin infections/cellulitis). Two of them come up to me to show me how well they have healed up. They bring their relatives up to us to see if we can figure out what is wrong with them. While munching (gnawing?) on sheep meat and swigging Cokes, I examine a young boy with an enlarged spleen--most likely due to malaria. Another has a tropical ulcer on the leg that I am afraid has been present for years--if left untreated these chronically draining ulcers can lead to squamous cell cancer of the skin. I am afraid it may have gone on too long.

Everywhere, we accept the gratitude from those here for all of the support from SOTV; SOTV's presence is everywhere--from building the church to sponsoring students to the many people running around with SOTV T-shirts on. We stopped at the Idodi Government Health Center about 30 minutes from Tungamalenga. We went to see a patient in their T.B. ward--he was an elderly Massai man, and he was wearing a purple SOTV HYPE T-shirt (purple is the traditional color of Massai men).

One of the most humbling things to do--something I wish every member of SOTV has the opportunity for, is to be here to accept thanks. It is something that is necessary, to allow those to provide their thanks. But really, the thanks belongs to those back at home: the vision of our social concerns committee, the encouragement of our pastors, but more importantly, the generosity of donors from SOTV.

Thank you all,

Randy

January 6, 2007 The Medical Team Arrives at Ilula

Jambo from Ilula!

We are all doing well. Today we spent some time in the laboratory learning about lab tests and looking at slides. The lab technicians explained the staining methods for malaria blood smears and TB smears. We then were able to look at the slides with a microscope. It was very interesting to see malaria and TB cells. The lab technicians were very helpful and informative. Everyone at the Ilula health center has been wonderful and we are being treated very well. We can't wait to share our many wonderful pictures and stories. God bless you all.

Heidi Moll, RN


We are at Ilula now and the rest of our group has arrived (10 in all). There is all kinds of activity going on--building of housing for staff/short term medical personnel, and the Clinton Foundation is building a separate building to move the HIV clinic into (it currently is being run out of the main clinic and they are running out of space). Painting the outside of the buildings (with money from the local government). Evan and Kathy Lewis (studying landscape architecture) have been helping the grounds keepers get the place looking sharp--there is a government inspection planned for January 11th to determine if Ilula Lutheran Health Center will be upgraded to hospital status--this is a very important designation since the facility would then get more money from the government for staff/drugs, etc.

I often think life here is a roller coaster ride of hope and despair.

There was a bus accident yesterday: several were killed and about a half-dozen patients were brought to Ilula. The most serious was a 35 year old woman with multiple facial lacerations; she lost 4 front teeth (I had to pull the remaining chips out). Her son was not injured but he was covered in blood from holding onto his mother. While Kari was helping me clean the wounds, Angela took the son out, gave him a piece of candy and a new shirt to wear (from the stock she had collected to give to the orphanage).

Then there is hope: we've seen multiple lives transformed here from the gift of education that SOTV provides. Grey Saga now has a masters in nutrition and is running the nutrition program for the International Rescue Committee in 5 large Rwandan refugee camps (22,000 people each) in northern Tanzania. Robert Mwasika is teaching at a Hotel Management College in Arusha after himself obtaining a degree from support from SOTV members. Barnabas Khawage is getting clinical officer training and will be back to serve at the dispensary in Tungamalenga.

Two twin infants were brought in: the 13 month old children of a mother with advanced HIV who was too sick to breast feed. These were the first true cases of severe protein/calorie malnutrition I have seen (marasmus). One kid weighed 6.6 pounds, the other 9 pounds (at over 1 year old!).

Then there is hope again: a 19 yr old was brought 70 km by 2 nuns from a Catholic dispensary to the Ilula Health Center because she needed a C section due to obstructed labor. We took her to the operating room--when the baby was delivered, she was not breathing but we successfully resuscitated her!

Then some despair: a 26 yr old was abandoned by her husband after giving birth. No one to pay the meager maternity fees or take care of her. It is interesting how this is dealt with here: the hospital administrator sent a letter to the village elders who make the community put pressure on the husband to come and accept his responsibility.

Then hope: a very sick 16 yr old boy (he looks about 12) came in with fever and seizures--quite obtunded (delirious). The main differential is cerebral malaria vs meningitis: we can not do spinal taps here, so we treat him for both--quinine for the malaria, chloramphenical ( cheap but very effective antibiotic banned in the US years ago because of certain rare side effects--and resultant law suits) and penicillin for the meningitis. He made a miraculous recovery--I have a picture of him smiling that we will get on the web site.

We will worship at the Ilula hospital tomorrow. I ran into the pastor in town and he welcomed us. He said, "You will preach."....I said, um..., no. He said, "You will sing then."

Perhaps a fitting quote from the travel journal Evan gave me: "To be tested is good. The challenged life may be the best therapist." I'll let you know.

Randy


January 8, 2007 Food and Fun, Bega Kwa Bega

The fun thing today was that we announced we are throwing an all staff party this Friday night. Everyone is invited--food, coke, fanta, singing, and of course, there will be dancing! We announced it after morning devotions today and the whole place is excited! We got the idea after watching our group cooking with others here: all of the fun and excitement they were having--bega kwa bega.

Randy

Jambo rafikis,

Sue Everhart here; I am an ultrasound tech from Regions Hospital and a part of the Shoulder to Shoulder group that is here in Tanzania. I am writing from Ilula Health Care Center to share some of the great happenings here.

Yesterday was a great day in many ways. One of the wonderful events of the day was that the new ultrasound machine was installed properly and we are now able to use it. We have scanned a few patients so far, and I anticipate a lot of learning and scanning in the next week. This is such a valuable tool for Dr. Saga. The old machine has been broken for quite awhile now. With the inspection for hospital status possibly this Thursday, and it being required to obtain this status, we are blessed to have it up and running now.

Another amazing aspect of yesterday was the compilation of events that led up to Dr. Mwakalebela and his wife joining us for dinner. We offered to help the cooks, Eva and Flora, with dinner, to ease the work load for them. They graciously accepted our help (really an attempt to allow us to participate, but they did most of the work). As it turned out, this became a perfect example of bega kwa bega (shoulder to shoulder) in action. We cooked, we talked, we laughed and giggled like school kids, trying to understand and learn each other's language, cooking methods and culture. It was a real heartfelt connection between us that has moved us from acquaintances to friends. Randy and Gary even joined in by entertaining with brief singing and dancing, Tanzania style.

Back to work, talk to you soon. Blessings,

Sue


January 11, 2007 On the Road to Idete

The rains have stopped for the last 2 days—the prediction is that the roads will be dry, and thus, passable. Today’s quote in the travel journal Evan gave me is a Buddhist proverb: “If you are facing the right direction, all you have to do is keep walking.” Looks like it is a good day to go to Idete.

Idete is a village 75 km from Ilula that is partnered Bega Kwa Bega with Farmington Lutheran; it is located southeast of Iringa in the highlands/mountains around 8000 to 9000 ft in elevation; it has a dispensary there and Sara Otterness, a member of Farmington, gave me $200 to buy drugs for the dispensary. We’ve kicked in another $100 (total $300) and bought much needed supplies: anti-malarials, antibiotics, lasix, etc. Two large boxes full—enough to last several months. We add to this the remainder of our supplies that we brought over: syringes, gauze, gloves, lidocaine ampules and the remaining Hospice Kits that Kari’s nursing group put together. We find their total drug supply consists of about a dozen containers of drugs, most nearly empty.

At 5:30 a.m. every morning, someone in the Health Center Compound rings a bell—he rings it again at 5:45 and then again at 6 a.m.—perhaps a Tanzanian version of a snooze alarm. We are on the road by 7:30 a.m.: 5 of us plus our driver: Evan, Jenny, Heidi, Dr Saga and me. Kathy Lewis has a brief bout with gastroenteritis. Because we have heard the roads are not good Kathy has elected to stay behind—impeccable judgment. We are told that if it rains, we may not be able to get back. We fill the land rover with 70 liters of gas (cost about $1/liter).

As we get into the highlands, we enter a pine forest reminiscent of home—this area is known for its lumber—I’d love to meet a Tanzanian lumberjack. Someone starts singing the Monty Python song “I’m a lumberjack and I’m ok…”. We get the giggles. There are several hairpin turns but also some wonderful vistas. Where water runs off the mountain it floods the dirt road into mud—driving thru this reminds me of driving thru slippery deep snow. People are walking along the side of this difficult road with bags of stuff on their heads—we are miles from any sort of building or structure—you wonder where did they come from and where are they going?
 

We get to Idete after 3 hours. It is on a flattened area after traversing a ridge top. It has not rained yet but there are clouds that look threatening. We are greeted by Job, the assistant clinical officer (2 years training post high school) and Miriam, the nurse assistant (1 year training post high school). They attend to the medical needs of people coming from 10-20 Km away and from even farther up in the mountains: delivering babies, immunizing the people, treating malaria and pneumonia. Behind the dispensary is the inpatient ward: 5 or 6 mud, stick, and grass huts, that people stay in. We enter one. It reminds me of what Native Americans must have lived in in the early
1800s. The ceiling is low—I can’t stand up straight (remind me to ask Pastor Paul Harrington how many times he bumped his head when he was in Tanzania last July). Lying on a reed mat on the dirt floor next to a small fire is an elderly man who probably has congestive heart failure. Other huts house other patients: one with advanced HIV, another with pneumonia—at least they have private rooms!

The people here are excited to see a doctor (ie, me)—I feel highly inadequate given the paucity of knowledge of tropical medicine and my own training that has relied so heavily on diagnostic tests. Interestingly, I see 4 or 5 elderly patients—in their 70s and 80s (known one really knows the exact age; they explain “this one is more than seventy,” “this one is more than 80…”)—a geriatric clinic in a country where the average life expectancy is only 42 due to HIV. Mostly they have arthritic-type complaints—perhaps from decades of working bent over in the fields or in the homes. You do not have to be a physician to know that life seems kind of hard here: you can tell by looking in their eyes, feeling their hands, and looking at their bare feet—over the past 7 or 8 decades have they ever worn shoes?

We are invited to a local restaurant for lunch: Devota, a woman who looks to be in her mid 20s and colorfully dressed, runs a small canteen a little ways away from the dispensary. You enter a shack about 5 feet by 10 feet in dimension again with a low ceiling (again, remind me to speak to Pastor Paul). I can’t stand up straight—there is only room for 1 table with benches on each side—all 6 of us squeeze in and sit down—thankfully we are the only ones there—no waiting. We dine on ugali, beans, chicken (it amazes me the number of chickens that must be slaughtered when wazungus come to town—by now I bet the chickens know to run for cover when a white person shows up), and the largest bananas I have ever seen—they are the size of large Idaho potatoes! All washed down with the traditional beverage: warm coke.

We head back to the clinic to see the remaining patients—a cloud bank moves in – it is like we are standing on a mountain side in a dense fog. It begins to drizzle and I get nervous. We elect to hop back into the land rover and make our descent knowing that if it rains too hard, we may never leave Idete until the end of the rainy season in May. We all hold on tight as the driver goes surfing down the road thru washouts. Evan starts singing “bumping up and down in our white land rover…” to the tune of bumping up and down in my little red wagon. Once again we get the giggles. Along the way, we pick up 4 other Tanzanians (Pastors and people Dr Saga knows). They are sitting in the back and talking, laughing, and carrying on in Swahili—apparently oblivious to what we wazungus think could be impending peril. But by grace, we get down off the mountain and it quits raining. We actually get stuck in a traffic jam where a large truck carrying
timber has broken down in the middle of the road. There are 3 vehicles on each side unable to pass. There are perhaps 30 Tanzanians standing outside—2 with shovels trying to level out a path around the stalled truck. Evan and I take our turns shoveling dirt and gravel until at last, we can get the vehicles by. A fortuitous stop—we meet the local mayor of the Kilolo district and ask her to please help convince the government to register Ilula as a hospital. She gives us a sincere reply that she will do her best. We make it back to Iringa and find the rest of our group—Kathy has recovered and had gone with the rest of the group to the Image secondary school. She promises to relate her story as well.

Our time in Tanzania is becoming short—6 more days, and we start to feel some urgency to complete all of our goals: meeting with the Clinton Foundation tomorrow, another Ilula Staff meeting, collecting data regarding the HIV clinic for a possible combined Minnesota-Ilula publication, meeting with the Wildlife Conservation Society, and getting final plans from our friends in Tungamalenga for a planned upgrade of the dispensary. A lot more to do, and a lot more to come.

Randy


January 12, 2007

For those who don't know me, my name is Jenny Mikkelson and I'm a nurse.This is my third trip to Tanzania, and I always enjoy the experience. Ialways learn something new, and it's great to connect with fellow brothersand sisters in Christ.

One of the new experiences for me this year was the CTC. CTC stands for Care and Treatment Clinic. It is a program dedicated to the care and treatment of HIV/AIDS. This the main project of the Clinton Foundation. I was able to follow the doctors and nurses in the clinic as they met with patients. It's was interesting and at times sad as we followed patients through the clinic process. First, pretest counseling, and then, taking blood for the test, and finally the discussing and counseling about the results of the test. There were many positive HIV results, but Dr. Saga explained that a lot of people don't come in for testing until they "know" something is wrong. The great thing about this program is that once testing positive, the patients are started on medication, so as to reduce transmission and stay healthy longer.

There are many new things happening at Ilula and it is all exciting.  Hospital status hopefully coming soon, the building of the Medical Education Center, even all the new buildings that are going up....it's an exciting time to be here.

Asante Sana for your continued prayers and support.
Kwaheri,
Jenny Mikkelson


January 15, 2007 Dental Hygiene at the Primary School

What an amazing and amazingly different world! As a dental assistant, during this trip I was fortunate to spend some of my time at the local primary school, going into the classrooms to help teach proper oral hygiene to approximately 600 of the 1200 children. For me this was a very exciting and neat experience. Although there were some slight communication barriers, I feel we did a great job...... using hand motions and face expressions! Hopefully this will be a continued gift we can continue doing in the future.

Nicole Orloff

Guilty Pleasures at Ruaha National Park

We had a very productive day Friday, 1/12/07, the day prior to leaving for Ruaha National Park. We purchased $1500 worth of drugs for the Tungamalenga dispensary with money wired over from SOTV. We met with the Wildlife Conservation Society (WCS). They have an interesting project in Ruaha that has importance for the villages just outside the park such as Tungamalenga and several of its preaching points such as Makifu, Mahuninga, Makambalala, Idodi, Mapogoro, and Kibaoni. The WCS is interested in the interface between the health of wild animals, their interaction with cattle and livestock and how that affects the health of Pastoralists such as the Masaai
that live in the area. Several diseases such as bovine tuberculosis and brucellosis can be transmitted between wild animals and livestock and can affect people that live closely with their livestock. The WCS primarily have backgrounds in animal health and epidemiology but need help with the human health component. We, of course, have close connections with the medical infrastructure in the area since we support the Lutheran Dispensary in Tungamalenga.

We also met with Clinton Foundation representatives on 1/12/07. Ilula was the pilot project for developing a rural AIDS initiative in Tanzania. It was good to finally meet them: the ways we each support Ilula are quite complementary without much overlap—kind of like pieces of a jig-saw puzzle.

On Saturday, we set off for Ruaha National Park. It was raining but the skies eventually cleared. For those who have been to Mwagusi Safari Camp at Ruaha, they know what a special place it is. After two weeks of living at the hospital, the warm showers and cold drinks were wonderful.

Due to the rains, everything is very green and lush here—food is plentiful for the animals and they seem happy. Giant snails with shells 5 inches long appear on the walking paths every morning to greet us. The multitude of insects seem glad we are here—some want to get too intimate with us—crawling up pant legs, etc—and require reprimand. There is no better display of the diversity of God’s creation then the insect world here at Ruaha. Most all of the large animals have their babies in the early rainy season so food will be plentiful—so we see baby giraffes, hippos, zebras, baby baboons and impala.

I’ve been here several times before and have developed a habit of not going on a game drive on the second afternoon—I prefer to hang out in camp and in our bandas reading, relaxing, writing, reflecting (quote from the travel journal Evan gave me: “the greatest journey is the one inward”) and just watching nature.

One of the safari vehicles in our party got stuck in mud about 20 feet from 3 lions as they tried to get just a bit closer for that perfect picture. They had to sit there for over 30minutes waiting for the other vehicle to come, scare away the lions and winch them out.

The rain here has drastically changed the park. There is water everywhere. The Sand River at Mwagusi, normally dry, is a raging torrent 30-50 yards wide. To get into camp you cross the river on a zip line. If it was not for the crocodiles and hippos (they are known to have a contrary personality), they could offer exhilarating river raft trips.

During a dry spell on Sunday, we moved our bus back up to the main gate—fortuitous thinking since it rained so hard that night that the bus would never have made it out crossing the many small streams that were now way overflowing. We cross waist deep water in safari jeeps—water enters the back bed of the jeeps. The jeeps can’t get across one river. Fortunately, they have constructed a footbridge across the river—we go single file across this rickety bridge suspended by cables above the river—it reminds you of a scene from Raiders of the Lost Ark.

It is troubling to get back to the poverty stricken villages after 2 nights of luxury at the safari camp. These past 2 days were part of a life most Tanzanians will never know. When we visited the government primary school in Ilula, the teachers asked us if we could help buy desks for the students. We feel guilty that the expense we paid for a weekend for 11 of us would probably have paid for 150 desks at the school. Definitely unsettling. We are all tired and begin our journey back to Dar Es Salaam tomorrow, then the long flight home. Can’t wait to see you all.

Randy


January 17, 2007 Homeward Bound

We left Ilula early Tuesday morning for the 8 hour bus ride back to Dar. Before we left we met two German electricians, Henry Sommerfeld and Michael Wenchol. They are working on a Power Protection Project (PPP) at the 12 Lutheran hospitals in Tanzania.
Although Ilula is not technically a hospital yet, the Evangelical Lutheran Church has included it in the project. This project is designed to install surge protection equipment to prevent damaging surges in voltage from the often-times unreliable electrical grid.

The project is funded by Global Health Ministries (www.ghm.org). GHM is a Minneapolis-based non-profit organization. It is the largest supporter of overseas Lutheran medical mission work in the USA. It specializes in collecting, refurbishing and shipping medical
equipment, funding health care projects around the world, and offering technical advice. GHM’s footprints are all over Ilula. From the computers in the main office, the equipment in the operating room, to the ultrasound machine. GHM has been working with the Minnesota Ilula Health Center Task Force since its beginning nearly 5 years ago. It has several Ilula projects including funding for shipping containers of medical equipment, and funding the training of Yunfa Sovelo, a medical officer, and Frank Sanga, a pharmacy assistant.

The bus ride to Dar is long and hot. We descend from the rather cool highlands of Iringa/Ilula down to the more tropical climate at sea level. The air conditioner on the bus can’t quite keep 9 wazungus comfortable but the four Tanzanians with us don’t seem to mind. Some are sleeping, some are listening to their I Pods, Kathy Lewis is writing in her journal, and Evan is doing calculus problems (just for fun).

There comes a time in every trip where the longing for home and loved ones exceeds the daily excitement of traveling in a foreign country. I’ve reached that point. We can’t wait to see Kari and Angela and give them a hug. We depart at midnight tonight for the 24 hours of travel back to Minnesota. I hear you have some snow for us. See you soon,

Randy


Neema Craft Shop: A Workplace for Tanzanians with Disabilities

Who would have thought that a first year college student could find their niche south of the equator in a third world country? I have been heavily involved in volunteering with people with disabilities since I was in middle school. Upon coming to Tanzania, I truly didn't expect to be able to see such aid for the most unfortunate population of an already unfortunate country. On our trip to Iringa, I was told about this craft shop that I should check out and was very enthusiastic to do so! First stop: Neema Crafts Workshop!

The first thing I noticed walking into the café was a man outside of the shop. The man was sitting in a hand-powered wheelchair. I approached him to talk to him. I must say Tanzanians in general are incredibly friendly people, but there was something about
the way this man's face lit up that was far beyond any other smile I have received. His face said everything, but I also received many warm greetings and an enthusiastic handshake!

Inside the shop it was very comforting. There were beaded bracelets, necklaces and earrings strung across the wall. There were photo albums and picture frames, beaded sandals and handmade cards on the shelves. There were rugs, quilts and scarves on display. The items were just beautiful! The café also sold homemade bakery items and had a lounge on the floor above! I made quite a few purchases feeling content, but not truly satisfied. I had noticed the workers through the window as I was looking at the items on display. I noticed a sign that said offered tours of the workshop and felt a real desire to go back and talk to the creators of what I had just bought.

Within a few days, I found my way back to Neema Crafts Workshop and asked for a tour. With a smile on his face and excitement in his walk, the cashier of the shop immediately led me into the work area! The feeling upon walking into that work area is indescribable. I could sense the pride in the workers to be a part of this shop; I could see the hope and promise that was brought to each person in the room. The tour first led us back into the paper-making room. Bright colors of paper were in the process of being pressed, freshly made from elephant dung! Next was the area where yarn was being dyed for what would later become rugs. In the following section, half of the
employees were busy with their projects. One table of employees were making bracelets, while another was putting together photo albums. I talked to a few of the workers who taught me some basic sign language. The last area was where individuals were weaving rugs and scarves. My friend Abraham was very proud to show me his masterpiece that he was working on as well as the one that was on display in the main shop--a beautiful purple rug!

Each individual is such a talented, wonderful artist. It goes to prove that despite a disability, every individual has strengths in their abilities and can be a productive attribute to society. Neema Crafts Workshop employs nearly seventy individuals who are either deaf, blind or physically disabled. Many of those who are physically disabled had been inflicted with polio. Even as few as ten years ago, an individual with polio would have been seen dragging themselves on a box or else on the ground. Thanks to Mrs. Susie Hart who helped establish Neema Crafts Workshops, they are now using hand-powered wheelchairs!

After the tour, I could not help but make more purchases in the shop, particularly pieces that were made by my new friends! When I finally left the shop, there was that man in the wheelchair again. His eyes lit up once more as he eyed my purchases. He knew as
well as I did that the purchases I had just made were going directly to his fellow employees! I received that heart warming smile and an enthusiastic handshake once more.

The shop is actually looking to expand their facility. Many of the workers must work at home because the center is not spacious enough to hold all of the employees. The new building would provide additional space for work and training, increase the range of crafts being made, and add a Physiotherapy Department and Audiology Unit to provide needed services for the disabled trainees and workers. In addition, there would be ADA accessible bathrooms which don't exist at the current shop. Neema Craft Shop still needs to earn half of the proceeds to pay for the new site and building. If you care to donate, help fundraise or know of donors, you may contact Susie Hart by e-mail at neemacrafts@hotmail.com!

I continued to return to this shop many more times during my visit to Tanzania. This shop and the story behind how it was founded is an inspiration. This shop is my heart's desire, only real. It is truly something special to see an outreach to all individuals of the community, especially the most unfortunate. For many people who come to Tanzania, there is that special moment or place that captures the heart; it is that place that keeps a person coming back for more. Neema Crafts Workshop is that special place in Tanzania for me. The flight back home never truly means good-bye but rather a farewell until next time. Perhaps one day my calling, like so many others, will lead me back to Neema Crafts Workshop!

Kathy Lewis


January 19, 2007 Epilogue

We returned home yesterday, departing near midnight from Dar Es Salaam—the temperature in the un-air conditioned airport was in the high 80s with perhaps nearly 100% humidity. We arrived home in Minnesota to several inches of snow on the ground and early morning temperatures in the single digits.

I spent several hours at Ocean Road Cancer Institute in Dar Es Salaam on our last day. This, as the name implies, is right along the Indian Ocean in an old hospital built by the Germans in the late 1800s. Robert Koch, a famous microbiologist (who identified the
etiologic agents of T.B and cholera) came here around 1900 to study malaria. I met with Dr Richard Lyimo, the Chief of Clinical Services. I presented him several oncology and hematology textbooks. These textbooks were gifts from two pharmaceutical company representatives: Jennifer Feinberg of Celgene, and Lee Richards from Lilly Pharmaceuticals. Each had also donated other items (Jennifer provided digital thermometers and antibacterial hand wash that we distributed to the dispensaries; Lee contributed toys that went to the Ilula Orphan Program).

I spent some time in the outpatient chemotherapy clinic reviewing patients: among these included a woman receiving cytoxan, adriamycin and 5FU as adjuvant therapy for breast cancer, a man receiving cisplatin as a radiosensitizer for esophageal cancer,
and 2 men receiving adriamycin, bleomycin, and vincrisitine for metastatic Kaposi’s sarcoma (an AIDS related cancer). I was impressed at how similar some of these treatments were compared to therapy we use in the United States. The outpatient clinic treats 30-50 patients per day; it is warm inside the cancer center, but a nice breeze is blowing through the window off the Indian Ocean—I can see the ocean from where I am sitting in the chemo clinic.

One of the interesting things about traveling is how people you have met weave in and out of your lives. We had met a couple in Tanzania 2 weeks ago, Simon and Marni, and actually had spent New Year’s Eve with them in Tungamalenga at the Hill Top Lodge learning some traditional HeHe dancing. They are from Toronto and were making their way across east Africa for a month long vacation. Marni is working on a doctorate in social anthropology—their goal was to visit a hospital in Zambia that Marni’s grandfather, a missionary physician, had helped build in the early 1900s. He had died of malaria and was buried in Zambia.

We ran into Simon and Marni in the Dar Es Salaam airport: they were taking a Swiss Air flight eventually back to Toronto as we were getting ready to come back to Minnesota. She related a wonderful story of how they made it to Zambia and found the hospital
(which was subsequently named after her grandfather) and his grave. They even met a 94 year old man who had worked with her grandfather. The people there had welcomed them saying they felt their prayers had been answered; they wondered why it
had took so long for some one else from the family to come and visit. They now have a project to work on in Zambia.

We also have a lot of work to do here: promoting the work in Tungamalenga and Ilula. I feel we accomplished a lot in the last 3 weeks and look forward to sharing our stories.

Randy
 

Medical staff at Ilula Health Center prepares to deliver a baby by c-section

in the surgical ward which was completed in July 2005.

Dental assistant Nicole Orloff demonstrates
oral hygiene at the Ilula primary school.