January 2008 Medical Mission

Several groups of Minnesotans are traveling to the Iringa Diocese this winter to continue the work of the Ilula Health Task Force.

Paula Swiggum and Diana Neal led a group of eighteen nursing students from Gustavus Adolphus College and St. Olaf College. They will spend a week observing and working at the rural dispensary in Tungamalenga before a brief visit to the Ilula Hospital.

Dr. Gary Moody leads a group of sixteen who will be based at Ilula Hospital during Janaury. Dr. Randy Hurley will follow in February. The goal of our travel is to continue to facilitate support for Lutheran sponsored health care in the Iringa Diocese in Tanzania. This model of mission medical work emphasizes 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.

Global Health Administration Partners Sends First Assessment Team

Global Health Administration Partners (GHAP) will launch its pilot phase February 3-11, sending an Assessment Team to Ilula Lutheran Hospital.  GHAP is a new program from Global Health Ministries for partnering with oversees mission health administrators to enhance their practices in health care management.

While visiting GHM’s offices in August, the Iringa Diocese General Secretary, Nayman Chavalla, expressed his desire to participate in the pilot phase of GHAP’s development. The Assessment Team of Magdeline Aagard, Bill Essendelft and Cindy Wilke will review and provide feedback on Ilula’s organizational structure. For more information about this exciting addition to the GHM ministry, contact Cindy at cindy_wilke@ghm.org.

January 22, 2008 Discovering Our Purpose at Ilula Hospital

Habari za mchana from the Ilula travelers. Samahani for not sending a report earlier, but the internet has been neither readily accessible nor reliable up to now. First, let me send along our thanks to all who have been praying for us as we travel. We are all well and doing fine.

We arrived at Ilula Hospital around 6 pm on Friday, 18 January, and were warmly welcomed by Dr. Saga, Faith, and the new Doctor in Charge, Dr.Boniface. Early the next morning the entire group joined Dr. Saga for rounds. In the course of the morning we saw more than 40 patients and within the first hour of work, while rounding through the maternity ward, we discovered one of the purposes God had in mind for our visit this year.

A young woman who had been sitting on a low cement wall just outside the maternity ward as the rounds began made her way inside when she saw Dr. Saga through the window. She slowly made her way through the group to greet Dr. Saga. He, of course, returned her greeting and, continuing to hold her hand gently in his, he explained to the group who this woman was.

She had first been admitted to Ilula on December 6. She had been pregnant and went to one of the dispensaries near her home to give birth. The labor proved long and difficult so the medical officer there attempted to pull the child out. When the efforts failed he sent her by truck to Ilula, some distance away.

By the time she arrived at Ilula, she presented with an arm prolapsed, that is, the arm of the baby was protruding from the mother's body. Dr. Saga performed a C-Section for her to deliver the child but, unfortunately, the child was already dead.

While this was a devastating loss, it is not the end of her ordeal. Subsequent to her delivery and as a consequence of the difficult birth, the woman developed a severe infection and required treatment with very expensive antibiotics.

The treatments were successful and the woman was fully recovered, physically. However, the high cost of her delivery and treatment left her with a total bill of 148,000 TSH—an astronomical cost for a poor village resident. Somehow, she and her husband were able to collect 65,000TSH to pay on the bill but were not able to come up with the rest.

The woman's husband left to try to raise more funds. Meanwhile she was stuck at the hospital, unable to leave until the remainder of her bill was paid - this is the standard practice in Tanzanian hospitals. She had been there since December 6 and it was now January 19. When we heard her story, Dr. Moody spoke up immediately saying that a person who traveled with us previously, Tracie, had written him a check just before he left and instructed him to use $100 of it to help those patients who could not pay their bills.

Dr. Saga translated the news for the woman and told her to get her things together because she could go home that morning. Others in the group contributed the money to cover the cost for her and her mother to take the bus back to their home.

As we were finishing rounds, nearly 3 hours later, this woman and her mother came to us with tears in their eyes, thanking each one of us and praising God.  It was a powerfully emotional and humbling moment.

Later that day, over lunch, Dr. Saga told us what the woman said to him as he gave her the money for the bus and a receipt for her fully paid bill. She told him, “I did not know what to do. Sometimes I was so ashamed I did not want even to look in your face or to have anyone see me still here in the hospital. I do not have words to say what I feel for strangers who do not even know who I am to help me in this way so I can go home to my family.”

Our whole group is deeply grateful for Tracie's generosity. Because of her kindness, a sad and suffering woman was released from a part of her pain and sent home where her to continue her healing. Tracie allowed us to be the instruments God used to touch this woman with the deep love God has for her and for each of God's children.

This is an incredibly powerful reminder of the need for us to continue to raise support for the indigent patient funds at Ilula. These patients do everything they can to pay what they are able but often come up short. Meanwhile the hospital tries to be both compassionate and wise in the use of its resources.  Yet they still need another partner, other companions, to stand shoulder to shoulder with them to help bring healing and life to those who need it most.

We give thanks to God for all who so faithfully support the work of the doctors, nurses, and staff of Ilula Hospital. There are many more stories and I will do my best to send more along soon. Until then, remain blessed and know we are thinking of you all.

Grace and Peace,

Lamont Koerner, on behalf of the 2008 Ilula travelers


25 January, 2008 A Typical Day

According to the itinerary attached to our devotion booklet, Saturday, 19 January, was to be an "orientation to Ilula" day. We had no idea how right that would turn out to be.

Our day began with rounds in the ward Saturday morning and several important encounters, as I have already reported. However, that was only a glimpse of what lay ahead. We were planning to head to Iringa right after lunch. But at 1:30 pm Dr. Saga came to the guest house where we were eating and informed us that they were prepping a woman for an emergency C-Section and invited our medical personnel to scrub in.

Needless to say, Dr. Moody, Dr. Koerner, and several of the nurses, Tara & Chloe, were in the O.R. within minutes. Several hours later they returned to the guest house to announce the successful delivery of a healthy baby girl named Lydia.

As soon as the docs and nurses changed clothes, we headed to Iringa for a brief orientation to the town, some quick shopping, a failed attempt to access e-mail, and dinner at the new Lutheran Center - a great addition to places to stay in Iringa and the food was FABULOUS.

At the Lutheran Center we connected with two other Minnesota groups - there were more than 50 companion synod travelers on the plane with us on the way to Tanzania!

Earlier in the day Kim Schrader, a social worker traveling with us, accepted an invitation to travel with a team of nurses to participate in a mobile HIV/AIDS Clinic they were to conduct in Image. Kim had never been to Tanzania before, knew no Swahili, and was the only one of our group traveling with the team. Yet she eagerly accepted their invitation and worked alongside them throughout the day. Their team finished seeing more than 100 people just before 6:00pm.

As the mobile clinic team was headed back to Ilula they came upon a woman in labor and having great difficulty. The woman was trying to get to Ilula. So, of course, they got her into the vehicle and returned to Ilula as quickly as they could.

Meanwhile, in Iringa, Dr. Saga's phone rang at about 8:20 pm and he told us that there was another emergency back at Ilula Hospital. So we quickly gathered up our group and got the doctors back to Ilula. By 9:40 pm they were back in surgery. Shortly before 11:00 our docs and nurses returned to tell us the C-Section went well and another healthy baby had been delivered and another mom saved. It was in fact the woman Kim and the mobile clinic team brought back to the hospital with them. Talk about shoulder to shoulder team work!

When the surgical team came back to the guest house we all decided to have our first devotional and check-in time together. As the stories and observations of the day were being shared with a combination of great excitement and some exhaustion, someone wryly observed that according to our itinerary, "medical work" didn't even start until the next day!

The next day was Sunday and the main event was the worship experience at Ilula parish where we were warmly welcomed. Dr. Moody greeted the congregation in KiHeHe, one of the local tribal languages, during the service and the congregation was thrilled to receive his greetings in their own language.

On Monday the Ilula Task Force here in Tanzania met for several hours in the afternoon to discuss the state of the hospital as well as their vision and priorities for the future. It was a productive meeting and an important opportunity to meet with the new Doctor in Charge, Dr. Boniface, and the new task force chair, Pastor Chavalla.

We discussed the building activity currently underway (X-Ray Casualty Building and the first of the education center buildings), staffing issues, and the hoped for future designation of Ilula as the District Designated Hospital. We learned that Ilula's registration as a hospital has not yet resulted in an infusion of government funds. That will not take place until the District Designated status is achieved.

On Tuesday, 22 January, Dr. Moody and Lamont Koerner met with the builder who is responsible for the construction on the Ilula campus. Mr. Mwachanga and his son Joel took us on a tour of the construction sites and updated us on the progress. Mwachanga estimated that the X-Ray Casualty building could be finished in 5-6 months and the education center building within 10-12 months.

Bill VanEssendelft, a recently retired University of Minnesota administrator, has had several meetings with the new interim administrator at Ilula, Adrian Lyapembile. Bill will be remaining at Ilula for two months to work with and mentor Adrian in his new position. Bill and Adrian were also in attendance at the annual hospital board meeting held on Thursday, 24 January.

Thursday was another big day for our group. Will & Jan Carlson, Becky Carlson, Becky Koerner, Pastor Chavalla from the church head office, Dr. Saga, and several others traveled to 5 dispensaries in one day.

They visited Ipalamwa, Idete, Ihimbo, Pommern, and Image. The fact that Ipalamwa and Idete are very remote mountain villages makes the feat of seeing all of these dispensaries in one day amazing. The fact that the day they were traveling was a rain soaked day which turned the roads to slippery muddy conditions makes their successful journey nothing less than a miracle. As Dr. Koerner said when they returned to Ilula, "With God and a good driver, anything is possible."

The objective of the trip was to access the current conditions at the dispensaries, hear about the needs and priorities, and then bring that
information back to the task force and churches in Minnesota.

Meanwhile also on Thursday, four others of our group - Chloe, Melissa, Kim, and Tara traveled with a team of nurses to do a vaccination outreach clinic in the village of Ibumbo, about an hour north of Ilua.

Several more members of our group traveled to Ilambilole to visit their partner parish on Thursday. The evening check-in and devotion was a rich tapestry of experience, observation, joy woven together through many individual experiences in various places accross the Iringa Diocese.

For ALL of these experiences and the MANY more not mentioned here, we heartily say, Bwana Asifiwe!

Blessings to all of our friends and family back home. We look forward to seeing you all soon.

Grace & Peace,

Lamont Koerner


Nursing Students Spend J-Term at Tungamalenga Dispensary

For a January term course, nursing students from Gustavus Adolphus and St Olaf Colleges visited Tanzania and had many memorable experiences that have had a profound impact on how they see the world and the way that they see caring is manifested in a culture very different from our own.

We spent five days in Tungamalenga immersed in the community, attending church, visiting homes, meeting with guardians of village orphans, playing with the children, sharing meals in the church social hall, and most importantly working alongside Clinical Officer Barnabas Kahwege in the Tungamalenga Lutheran Dispensary. When Pastor Bonnie Wilcox told Paula a few years ago that taking nursing students to Tanzania "would be an answer to prayer," little did we know how literally that would come true.

A young mother came into the clinic appearing to be near full term in her pregnancy and walking slowly as if she were in the early stages of labor. We soon learned that her bulging abdomen was filled with fluid (ascites) from liver failure, rather than a baby. Her husband had died of HIV/AIDS two years before leaving her widowed with three children and her widowed mother to care for. Now, for the second time, she was in need of paracentesis to drain the fluid from her abdomen which could only happen at the Iringa Regional Hospital, three hours away on a very bumpy road. Relatives were trying to come up with the money to take her, but the amount needed to transport her, her children and her mother to care for her while there was not affordable.

On rounds the next morning, Barnabas told the students that the best they could do was supportive/palliative care as her condition was most likely caused by her own case of AIDS. Those in the room decided that we could help and money was collected. The next morning, Barnabas handed her an envelope with enough money to transport her by ambulance to Iringa, for her children and her mother's transport and enough left over to purchase food that they would need to prepare for her while she was hospitalized in Iringa. As we gathered by her bed and he explained to her what was in the envelope, her hands came together in prayer and she raised her eyes to heaven before
saying, "asante sana" (thank you very much) many times over. We were humbled and overcome with emotion that a gift that was so small in our relative wealth could do so much for this beautiful young mother who was so ill through no fault of her own. Pastor Bonnie's words came back to me immediately. If for no other reason (and there were many), this was one that made the trip worthwhile.

Through their journals and group discussions, the students shared a profound sense of gratitude for the privilege of meeting our friends in
Tanzania. They would describe them as warm, hospitable, happy, joyful, generous and spirit- filled. The importance of possessions just doesn't exist there. As one said, "there are no qualifications to being worthwhile here."

We sang Jesus Loves Me together with the children at the orphanage, we prayed the Lord's Prayer with the Maasai in English and Swahili together under an acacia tree in their boma and shared much laughter and love in the bush of Tanzania. These future nurses were forever changed and I can't help but think of the many lives they will touch in a different way because of this experience with our brothers and sisters in Tanzania. Asante Sana, Jesu.

Paula Swiggum, professor of nursing


February 7 GHM Administrative Team Arrives at Ilula

Habari. What fun we're having. We drove from Dar to Ilula on Tuesday, arriving at Ilula in time for dinner. On the way, we drove through a game park and saw giraffe, elephants, impala, as we whizzed by. We didn't stop to take photos. We did stop at a restaurant for lunch and we all had various curries - yummmm.

There are 4 other Americans at the hospital staying in the guest houses too—one from Colorado College, the other 3 from Minnesota. They are very generous about sharing their food and stories. Two are helping me on the administration project we came for (Bill and Christine). The one from Colorado College (Megan) is teaching some HIV/AIDS education classes and the other woman (Tara) is a nurse, helping with clinics.

Wednesday we had a tour of the hospital, asking many questions to understand the lay out and how they work. The administrator who has only worked there for three months took us on the tour. We went into the OR and morgue and also attended the "morning meeting." After lunch we met with the General Secretary of the Iringa Diocese. We met with him for two hours and learned many things. It was a very good meeting and included the doctor in charge. It helped to clarify many things for us and he was very open to answering our questions, to help us understand the situation here.

Today we were up early to drive to Iringa to meet with Bega Kwa Bega. The weather is mild (hot in Dar by the coast). It rained hard Tuesday. We collect rain water at the guest house to use for drinking water (boiled of course) and bathing. They have a submersion heater to heat the water quickly. We ran out of rain water for that purpose today so I used the submersion heater in tap water. Unfortunately the water is so hard, that I was shocked every time I put my hand in to mix the water so that it heated evenly! But it's worth it to have warm water to pour on myself versus the cold shower approach. There are definitely mosquitos. We have mosquito nets on our bed and screens on the windows (but not doors). Around evening, we shut the doors and stay inside, slapping mosquitos. They are much smaller than the ones in Minnesota.

I'm also collecting stories from the travelers who are here. The hospital conducts mobile clinics in the surrounding villages. The work involves doing immunizations, evaluations of babies, and family planning. The women have a choice of type of birth control they want to use. Tara assisted in inserting Norplant (an intradermal insertion) for one woman - using only the light available from a cell phone! She's going to give me a photo of the room - no electricity, small window and it was raining so little light was coming in.

Kwaherini (goodbye) for now.

Cindy Wilke



February 10  Greetings from Randy in Amsterdam

I begin this journey, as I have in the past with a brief (or not so) statement of plans and purpose and what is on my mind on this, my sixth trip to Tanzania.  Due to work obligations, I was not able to travel with our medical group last month but Gary Moody briefed Kari and I over breakfast on Saturday regarding their trip and work yet to be done.  I plan to travel to Ilula and Tungamalenga to connect with the people there and assess the progress of our projects in both these areas.  
 

I am spending the first day in Dar--to visit Ocean Road Cancer Center and also to hopefully meet the US Ambassador to Tanzania, Mark Green, and fill him in on the good things people of St Paul are doing in the Iringa area.  Mark Green is a Wisconsin native and Badger alumni who obtained his law degree the same year I graduated from medical school from the University of Wisconsin in Madison.  I have been in e-mail contact with him this past week and hope to meet him.

On the flight, I have been reading the book "The Language of God" by Francis Collins--he is a geneticist and physician who was in charge of the human genome project and speaks of the harmony of science and faith.  In the next to last chapter, he describes an event in his life that perhaps I could have written:  in 1989, he and his daughter traveled to Africa to do some medical work, and it was there in a small village, while delivering medical care to people he had never met, that he began to understand the nature of God and love and purpose and the power in simple acts of kindness from one person to another.  I too had a similar experience in 2002--and am now back for my
sixth time.  Perhaps as many of us from St Paul who travel again and again to Tanzania, I benefit from this trip more than the people in Tanzania benefit from my presence there.

I've brought a couple other things to read: Crossways stuff, parasitology and medical entomology stuff, and a first draft of a book that a patient of mine is writing--a patient who I treated for squamous cell cancer four years ago, whose husband was a patient of mine several months thereafter and died of small cell lung cancer:  she is writing from the perspective of cancer survivor and cancer widow.

I am traveling light on this trip: just 1 gym bag of stuff--half of which are things people have given me to bring over:  gifts for the nurses from Kari, computer stuff from Evan, drug money and midwife kits for Idete (from Sara Otterness) and drugs and assorted stuff for Ilula from Dr David Klevan.  Those of you who have traveled with me will remember a patient of mine, LS, who use to cross-stitch little crosses and animal ornaments for me to take and give to people in TZ.  She died just after Christmas--but knew I was going to TZ this year--before she died she brought me a shoebox full of hand made little rocking horses and cowboys to fit on top to hand out to the kids at the hospital.

I leave behind a whole bunch of patients that I am worried about.  I have a number of young people (20-50 year olds) in my practice right now all dying of assorted cancers and a bunch more whose outcomes are uncertain.  These people are usually always on my mind when I am at home--but lest I not forget them, I traditionally write their names in the opening pages of my travel journal.  The other day I was reading through past travel journals to get contact info for people at the hospitals, etc--it was humbling to read back through all of the names of patients in my books.  There are those that need your prayers for peace and comfort.

As for me, I am on a little bit of an adventure:  I'll keep you posted.

Randy Hurley


February 12, 2008   A Day in Dar and Meeting the US Ambassador

Greetings all: I spent my first full day in Tanzania in Dar.  It is hot and steamy here--a bit of a contrast to the ten-below temps I left.  

I spent the morning at Ocean Road Cancer Institute. It is the only cancer center in Tanzania and is run by the government in a facility built in the late 1800s by the Germans.  The famous microbiologist, Robert Koch, studied malaria, T.B. and trypanosomiasis here 100 years ago.  I saw about 15 patients with Dr Joel Manyahi in the outpatient chemotherapy infusion center.  They treat many of their cancer patients just as we might back in Minnesota but don't have access to really high-tech stuff. They are primarily limited by diagnostic capabilities, access to certain very expensive drugs and pathology services.  

The difficult thing is that several of the patients here have what would be considered in Minnesota highly treatable diseases.  A young man with testicular cancer (think Lance Armstrong!), a 27 year old woman with acute leukemia, and a 39 year old nun with chronic

myelogenous leukemia (CML).  The patient with CML is especially troublesome because one of the "homeruns" in oncology over the past several years is the development of a drug called imatinib which specifically and effectively targets the underlying problem in CML and leads to very high remission rates--unfortunately it costs $20,000/year for this oral pill that is relatively free of side effects.

I went to the US Embassy and met Ambassador Mark Green--a Wisconsin native and UW- Madison alumni-- and was able to discuss with him the Bega Kwa Bega partnership and all of its aspects including healthcare, education, well drilling, micro-finance, etc.  I
appreciated Mr Green's time since he is busy getting ready for President Bush's visit here next week. Maybe he will pass along info about SPAS's faith-based initiative to the president.

The political story here in Tanzania is that President Kikwete just replaced 1/2 of his cabinet and down-sized his cabinet; The prime minister resigned and a new one was appointed--all over a corruption scandal. Apparently the power company here, Tenesco, was forced to make payments to a fictitious company called the Richmond Company--and this contract was awarded by the former prime minister and cabinet members. It is reassuring to read the papers here--a free press is vital to this democracy--as they are critical to the scandal.

I head for Ilula/Iringa today and to Tungamalenga this weekend.

Randy

February 15  Dar to Ilula

So, do you ever have one of those nights when you are so excited about the next day that you wake up several hours after you go to bed and lie awake in bed because you just can't wait until first light to arrive and don't want to oversleep?  Not even Crossways of Safari Lager could put me back to sleep.   Reminds me of when I was a kid and my dad would plan a fishing trip early in the morning.

I arrived at Ilula in the evening 2/13/08 and was met by Bill Vanessendelft and Dr Saga. After our meal I went to bed but after initially falling asleep, woke up early.  I was able to walk around the grounds of Ilula in the early morning--a lot of new construction going on.  They have a new Dr in-charge, Dr Boniface and another medical officer, Dr Catherine--both very capable and competent people.

I took the Scandinavian bus from Dar to Ilula on Tuesday 2/13: a 6-7 hour trip in "semi luxury" class.  Met two people of interest on the bus;  one was Emmanuel, a well dressed Tanzanian of perhaps late 20s who had gone to Dar to pick up his wife, sister and mother in law as well as his 2 year old son Peter and bring them back to Iringa where he works for the Tanzanian cigarette company.  His little Peter was dressed in a little 3-piece pin striped suit complete with little vest.  He obviously loved his dad since he sat on his dad's lap the whole way (he had a lot to choose from: mother, aunt, grandma!).  This, of course, put him right next to me--I think I kind of fascinated him--probably never saw a bespectacled hairy white guy before.

The other person I met was Jan Carmichael: a retired paralegal from Orange County California who decided to join the Peace Corps after she retired.  She is alone living in a village 30 miles from Njombe doing community development--no running water/electricity and signed up for a 2 year commitment.  Asked why she left sunny California for the middle of Tanzania:  "Someone needs to help these people, it might as well be me."

Lots of impressive people all over this planet.

More later,
Randy


February 19    A Visit to Tungamalenga Dispensary

Pole sana: I apologize for no emails since last week but the internet is down at Ilula.  On Friday 2/15 Bill Vanessendelft and I took a Land Rover from Iringa to Tungamalenga. Our driver, Esau, formerly worked at Ruaha so it was like having a safari guide on our trip.

We pulled into Tungamalenga and visited the new ward at the dispensary.  Shepherd of the Valley should be proud: a new 20 bed ward complete with solar power, beds, tables and appropriate equipment.  The project came in $1300 under the $60,000 budget despite several additions including a covered walkway to connect to the outpatient area and a water holding tank that provides running water to the facility.

The only problem is that Barnabas Kahwage, the clinical officer, is still away at training (sponsored by SOTV) until June.  They do have a lab assistant, Geoffrey, who is trying his best to assume the role of daktari, and the government provides clinical protocols for delivering health care where there is no doctor.

Then I rolled into town and the word got out that there was a doctor from Minnesota at the clinic.  I worked all day Saturday and part of the day Sunday seeing 71 patients.

Some of the clinic visits were kind of flattering:  an elderly man with a 20 year diagnosis of back pain comes to see me because he thinks I may be able to sort him out;  the nurse from a  government dispensary from a village 15km away came for a second opinion on a skin rash (psoriasis? fungal? pellagra?).

Some of the clinic visits were kind of humorous:  a middle aged man says he is "passing worms in his stool: you know, the little ones with black heads" (hmm...o.k.).  Another woman states she had: "stool like goat" (I do not know the differential diagnosis or treatment for that one).

Some were tragic:  a middle aged woman with blindness in one eye from shingles involving the face/eye several years ago; could I help her? (No.)  A two year old whose mother was afraid he was deaf: he did not seem to hear and was not verbal--perhaps from meningitis at a young age? Could I help him? (No.)  A three year old girl with anal atresia (malformation of the anal canal) and a middle aged woman with what I thought was advanced nasopharyngeal carcinoma. Any help here? (No.)

And at least one visit was inspirational:  last year Kari and I did a home visit on two sisters with advanced HIV who were essentially in hospice care because they did not have the money to get to Iringa to get anti-retroviral drugs.  Kari and I had provided about $120 to cover their travel expenses.  One of the women, Candida, survived, is on anti-retroviral drugs, is now healthy and came by to see me and thank me.

I was late for church at Mapogoro preaching point Sunday morning as I was seeing patients. We pulled up and made our way to the front to sit just as Pastor Alfred was baptizing perhaps ten kids and babies.  We then had communion in this small village--something I have only done once before in Tanzania--they even had communion wafers. Reminds me how the church here in Tungamalenga really is the
bread of life: providing community, education, health care, hope and comfort.  Afterwards the Mapogoro evangelist invited us all into his home for some chicken. Sitting there, I could see sunlight shining through the roof (ie, there were holes in the roof).  He asked me to take 35 baskets back to Minnesota and sell them so he can get money to buy iron sheets for a new roof.  

Anyone need any baskets?

Randy


February 20  Development at Ilula:  Umoja Nguvu

I left Ilula this morning and rode with the St Paul Lutheran group to Dar Es Salaam.  I am hanging out at the airport waiting for the long journey home.

I spent the past week (minus the weekend at Tungamalenga) at Ilula, doing morning rounds with the doctor in charge, Dr Boniface, and with Dr Catherine (assigned to Ilula from the Clinton Foundation HIV program) and Dr Saga.  We would see clinic patients in the late morning and often do any surgeries in the afternoon.  Monday Feb. 18th we were all up late: an evening c-section for a woman with obstructed labor, then, a woman came in with vaginal bleeding (a miscarriage) and had bled down to a hemoglobin of 1.8 (normally 11-15 grams--I did not know it was possible to survive with a hemoglobin that low). We did a D and C and were busy getting hospital personnel to donate blood.

I left Ilula around 9 am today.  After morning devotions and morning report I was asked to speak a word of goodbye to the 40 or so staff members that gather for these morning prayers and case discussions.  My message (interpreted by Dr Saga) was one of thanks and an expression of how much pride I have in their work.  I indicated to the new staff there that those that have been there a long time (some nearly 40 years) have seen a wonderful transformation at Ilula.  Not just new wards, operating room equipment, but also a transformation in the staff and people of Ilula. I indicated that Dr Gary Moody, myself, my family and others keep coming back to Ilula year after year
because we feel they are our brothers and sisters: when we come together as one body, there is so much we can accomplish.

Umoja, Umoja Nguvu. Unity...unity is the power.

We all stood in a circle with joined hands and Dr Saga led us in a call-and-response verse of this song--a fitting way to end my stay.  I have always liked that song, ever since I first heard it with the 2002 SOTV group, sung by perhaps 100 students while standing on the steps of Pommern Secondary school in the highlands of Tanzania.  I don't know what it is about certain music that can bring a bit of emotion to you.  For some it is "Silent Night," for others maybe the "Star Spangled Banner" or a piece from Bach--but for me, it is Umoja Nguvu.  I suppose if I were a neuroscientist and could figure out the receptors in the brain where music, love and faith converge, perhaps we could identify the soul.

By the way...it is incredibly hot and muggy here in Dar--what's the weather like in Minnesota?  Guess I'll find out tomorrow.

Randy