Visit to Ocean Road Cancer Center, Dar es Salaam, Tanzania

The group consisted of Randy Hurley, Kitsada, Tara, Emily and me. Randy is a hematologist-oncologist with Health Partners; Kitsada is a resident in Internal Medicine at the U of M who will be starting a fellowship at the University of Iowa in a few months in Oncology; Tara is a labor and delivery room nurse at St. John’s NE in Maplewood and Emily is an OR nurse at the VA Medical Center.

Randy had previously made an appointment for our visit with the cancer center’s director. The director was not in, so the assistant director gave us a tour. He showed us the nuclear medicine department where they are able to do bone scans. From there he took us to the radiology department which is equipped to do simple x-rays, but ct scans must be done across town at a larger medical center. He then took us to the radiation therapy department where they have two cobalt machines and another unit which is very old. The physician in the radiation therapy department told us that sixty percent of their patients are cervical cancer patients and estimated that they treat about 1500 cervical patients a year. This number does not account for the women who are diagnosed in outlying hospitals who live in remote villages and never make it into town to receive treatment.

We were then shown the outpatient chemotherapy clinic. The clinic was equipped with hoods for mixing and nurses were dressed in gowns, masks and gloves to mix and administer the chemotherapy. Three physicians were seated behind a table writing orders. Patients were not taken to an exam area to undergo a physical exam, the physicians simply wrote, “Patient seen,“ in the chart and orders were written.

Next we saw the inpatient wards which included a very crowded pediatric ward. I believe that they had over 20 beds, many of which had two patients in each bed! A pediatric oncologist, from Ireland, Trish Scanlan, answered our questions. She has been at the cancer center for about 2 ½ years. They see a lot of Burkett’s lymphoma, some neuroblastoma, Wilm’s tumors and a small number of leukemics. Dr. Scanlan was very enthused about the chemotherapy nurse whom they have on staff. She rechecks doses, mixes and administers all of the chemo and serves as a great role model for the other nurses on the pediatric unit. Trish told us that the whole country has a total of 8-10 pathologists and that it can take up to 2 months to get a confirmation back on a tissue sample. We then visited the men’s ward and women’s ward. I believe that the most common diagnoses on the men’s ward are Karposi’s and lymphoma. The ward was filled with very emaciated men, obviously suffering from HIV.

The women’s ward had curtains up for privacy. A list of the 10 most common diagnoses seen in women with cancer was posted:

1. Cervical cancer
2. Breast cancer
3. Karposi’s sarcoma (seen exclusively in patients with HIV)
4. Esophageal
5. Endometrial
6. Ovarian
7. Leukemia
8. Squamous cell carcinoma of the tongue
9. Choriocarcinoma
10. Anorectal cancer

Another list was posted with the major nursing duties. I wish I had taken a picture of this. They were listed in order of priority and cleaning was listed above assessing the patient! From there we divided up in groups. Tara, Emily and I went to the cervical screening clinic and Randy and Kitsada went to the chemotherapy clinic. The screening clinic consisted of three nurses one of whom had to abruptly leave for her niece’s funeral. Visual inspections ONLY were done. The one nurse, Beatrice, did the exams and another nurse did the intake. Beatrice has a four year degree from the Aga Khan Nursing School in Dar and an additional 2 year degree/certificate in public health nursing. Beatrice would have the patient step up onto the exam table after she had wiped it off with alcohol and proceed to dip the speculum in a tiny cup of water (for lubrication) and shove the speculum into the patient’s vagina. Each of the women was in a significant amount of discomfort during the exam. She rarely said anything to the woman during the exam regarding what she observed. We were allowed to observe the exam including looking at the tissue through the colposcope. First she would coat the cervix with .3% acetic acid, wait a few minutes, visualize the cervix, then coat it with Lugol’s solution, then revisualize the cervix. Neither pap smears nor biopsies were ever done, no matter if there were aceto-white changes present or not. (I guess the rationale is why do them if you only have 8-10 pathologists in the country. Nobody ever mentioned whether or not they have cytotechnologists.) The women were then instructed to wait for instructions from the intake nurse – for follow-up instructions or prescriptions in the event of signs of bacterial or yeast infections. At one point during the exams, the intake nurse came back to where we were standing, took a close look at the earrings I was wearing and said to me, “I have holes in my ears also. You give your earrings to me!” Later she did the same to Emily. Then the two women proceeded to grill us on our personal lives – whether we were married, if we had children, asking Tara and Emily why they weren’t married yet or have children. I told her that I was not leaving Tanzania that evening as the other two were set to; that I plan to stay a total of six months. She responded, “You come to Tanzania for 6 months, with no plan what to do!?” I responded that I was there to volunteer, that I am there to work without pay. Did she have something she would like me to assist with? She misunderstood me and responded, “Oh you want job; you want to make money.” When I corrected her, her response was, “Oh you must be married to a very wealthy man!” Soon she said that she was done seeing patients.

The three of us then went outside to get a bottle of cold soda. While we stood there, a woman approached Tara with what appeared to be a script/receipt for chemotherapy. She was speaking another language (Swahili?) the receipt stated Adriamycin---83,000 Tanzanian schillings (TSH) (about $78.00 and another drug, the dose being 8mg, iv stat for 300 TSH (less than $3). (Dr. Hurley later told us that the second drug was zofran. She obviously wanted us to give her the money for her medications. My initial thought was, “okay, so we give her the money; what is there to stop a mass stampede on us to pay for everybody’s meds.” My next thought was, “so I give her the money, what happens when she needs the next course of chemo?” Later, Dr Hurley told us that they presently have a shortage of Adriamycin and the staff was sending patients out to purchase their own chemotherapy and bring it back to them for administration. I now wish that I had given her what limited amount of schillings I had, because hopefully by the time her next course was due, the clinic would provide what she needed.

Dr. Hurley and Kit met up with us about 45 minutes later and shared what they had observed.
Among others, they had seen a patient with ovarian cancer who was receiving Cisplatin and Taxol and another with cervical cancer who was receiving cisplatin in addition to radiation therapy, (not too unlike what our patients would receive in the states.) They do not have some of the newer drugs and if they do, the government requires that patients pay for the newer meds because they are so much more expensive.

Trip to Dar

We spent the last few days back in Dar so Sue could visit the cancer center and I realized it has been a week since I updated the blog. After our time with the Vinton's we relaxed over the weekend and attended a village near the main road to Ilula for church services with our friend, Israel Kaponda, translating for Lamont, who is a visiting pastor teaching at Tumaini. Israel Kaponda, or babu (grandfather) as we call him, is a retired pastor who is a lot of fun and who was our translator on our first trip to Tanzania and again last June. His son also came with us and Imanuel is studying biology at Ruaha College in Iringa and hopes to continue to become a doctor. Babu is not much over 5 feet tall and is full of witty sayings. He grew up when Tanzania was a British colony and is well educated. Whenever he gets the chance to talk to students he grills them about working hard and says "No Pain, No Gain. No Sweat, no Sweet. No Money, No Honey". He also cracked us up in june when he slept in a little bit and came out saying "I was practicing my death". He is deligtful and has lots of stories about earlier times in Tanzania.

I had some meetings last week with Reuben, who works with the well program, and Itiweni, who works with microfinance. This week I will be working with both to start visiting some of the villages with microfinance programs and do an inventory of well drilling supplies with Reuben. It is hard to get reports from the microfinance groups, or SACCO's Savings and Credit Cooperative Organizations which are government regulated. They are supposed to file monthly reports with a government officer but have not been so we are going to have to visit each and check their accounting and learn how things are going. These are rural village SACCOS so the loans are three month (beans) or six month (maize) for seed and fertilizer. There is concern because some of these villages are in drought affected areas and crop failures have probably created problems with repayment. Bega Kwa Bega is working with the diocese to bring maize to these villages to help them last until the next harvest comes in May or June.

The bad thing about a trip to Dar is the 8 hour bus ride each way. The good thing is part of that ride goes through Mikumi national park where we saw lots of elephants, giraffes, impala, zebra, cape buffalo, and water buck. We also stopped in Morogorro for lunch and saw one of the few golf courses in Tanzania. It was open, flat, and featureless, just the way I like them. The greens were black sand and the course had a beautiful mountain behind it for a backdrop. We went to Dar with a medical group and while they were visiting the cancer center (see Sue's blog) I and a couple others went to the National Museum which is small but interesting. I had been there before but they are expanding the Tanzania history section in a new building and I enjoyed it. I also learned why there is a WWII memorial plaque in the park in Iringa for the 40 or so Iringa people who lost their lives in the war. Tanzanian troops were brought all over the war fronts by the British. Tanzania was German East Africa until the end of WWI when it was given to the British to administer and called Tanganika. It was a British colony until independence in 1964 when it was combined with Zanzibar to form Tanzania. Tanzania started as a socialist government and its economy was slow to develop compared to neighboring Kenya. However, Julius Nyere, the first leader, did a good job of unifying the different tribes into a national identity which has made it a relatively peaceful place in Africa. They have a democratic constitution now and the current president, Kikwete, is considered one of the best leaders in Africa.

We took Scandinavia bus back to Iringa and I was sitting in the same seat that I was in when I was in a bus crash in Feb 2008 which made me think of that. We had to wait more than 2 hours at the bus station and did not leave Dar until 12:30 which means we would be arriving in Iringa well after dark. The driver was careful about passing which was reassuring but was on the cell phone half the time and would use the hand on the wheel to shift instead of the hand on the phone. These big busses apparently do not need a lot of steering. The ride was uneventful but we had to climb the escarpment in the dark and passed a truck and a bus that were on their side, apparently losing brakes coming down and driving into the hill side to turn over and stop. The highway between Dar and Iringa is narrow two lane and we were lucky neither accident blocked the road or we would not have gotten back to Iringa that night. Because of road construction, we didn't get to Iringa until 9:30 but it felt good to be back. We did the traditional end of trip things with the medical group and when we dropped them off at the airport I was glad we were not going with them. We have been here three weeks now and I like it. I am looking forward to working with students when the term starts but have quite a bit to do in the mean time.

Vintons at Madisi

We stayed with Steve and Susan at their home in Madisi with their two sons. Village Schools Tanzania is run by a Tanzanian and Godfrey and Steve travel all over southwest Tanznania visiting schools, meeting with government officials, and recruiting teachers much of the time. The school at Madisi is one of their first and is where the Vinton’s and Sarah Bickel live. Sarah coordinates all the volunteers that come to the schools to help teach English and other subjects and trains them for going to their villages. The school buildings and teacher homes are all made by the people in the village and are now all wired for lights from a generator. Students come to school at night to study because it gets dark about 6:30 here near the equator and most would not have good lighting options at home.
Susan teaches English at Madisi and they stress learning English well early because it is the language of instruction in secondary school. The VST schools all ranked very well in recent national exams for Form II (second year) students, clustered in the top 100 schools out of 570 in the Southern Highlands zone. This is remarkable for a school that accepts all students in a small village that competes against top schools that select top students from all over Tanzania. It is an example of the students in the villages working harder because they appreciate the opportunity to go to school so much more. The results were posted on a class room door and we would see students coming up at night to check the results. They are very proud of their school and accomplishments.

Posted school exam rankings (note highlighted VST schools at top) and reminder to speak English that is on every class room door.


The students at VST schools work as well as study.


Susan Vinton, Sue, and Sarah Bickel with Natural Forest behind them. The school is on the other side of the forest at the top of a hill. This was one of the better stretches of road in Madisi.


Sue helped organize the medications that Susan keeps to help the village.


The Vintons live as Tanzanians which means cooking mostly over charcoal, pasteurizing your own milk, home made yougart, roasting your own coffee beans, and using your village resources efficiently. Some villagers whould help out at the home during the day when Susan was teaching.


This fellow slept under my pillow every day and was there three nights in a row when I lifted my pillow to go to bed.


Me with Hobbs getting a cat fix.

Madisi Home Visits

As Dan informed you, we arrived in Madisi about 3 in the afternoon on Wednesday. We were in time to briefly meet Dr. Leena Pasanen. She is from Finland and has served Ilembula Lutheran Hospital in Ilembula for many years. It has a nursing program attached to it, so I hope to visit the site in the future. Dr. Leena left her adopted son in our care because she wants him to realize how good he has it in life. He was an orphan in Tanzania and I am not certain how he ended up as an orphan. Susan (Steve Vinton’s wife) took us to see her “friends” shortly after we arrived so she could make food, clothing, and blanket deliveries. Her “friends” are people who are HIV positive and have recently started ARVs and are not yet strong enough to have resumed farming again or have so recently, but do not have anything to harvest. At the first home was a woman who is blind, whose husband had died. She lives alone in a brick structure that has many gaps for the wind to go through and her foot had an ulcer on it with three of her smaller toes involved. We left her a blanket and some used clothing items with a promise to revisit her the following day to more thoroughly evaluate her foot.
The next family consisted of a woman with HIV who lives with her mother and her daughter. Her toddler daughter also has HIV and Susan left nutritional supplementation for her. She also left blankets and used clothing with them. Her mother would not let us leave until we each had had at least one banana. At the next house, an elderly man was taking care of his 5 grandchildren at least one of whom was positive for HIV. The children’s parents were already deceased and the man’s wife was also deceased. Susan left formula and blankets and this man gave her a chicken as we left. (The chicken was not happy in the car and she would squawk every time we rode over a bump – which was often.) These people have nothing and they are so giving!
The following day after tea and breakfast (homemade yogurt with granola) Susan, Dr. Leena, two of Susan’s students and I went on home visits. We visited Mr. FP who is married and has tested negative at least a couple of times and he has had a chronic leg ulcer for at least 3 years. One of the students put on gloves and we cleaned the wound with hydrogen peroxide then dressed it with a mixture of honey and sugar. We needed to return the following day to recheck it, cleanse it and this time applied papaya to it to enzymatically debride it of necrotic tissue. Then we applied a new dressing. He spoke Hehe and in a very frustrated tone told us that he had been a successful farmer and now because he cannot work, he is very poor. He lives on the hillside in a house made branches and one of his grandchildren is HIV positive and had previously been very malnourished. He was so grateful for our care and has a very positive outlook that his wound will heal and he will be able to return to farming. Dr. Leena put him on a couple of broad spectrum antibiotics. The second day we closed our visit with him with a prayer.
The next woman (“B”) we visited is HIV positive. She is a widow and in her 30s. She had started school and was doing very well in her studies. She had been selected to attend secondary school because of her academic success. Unfortunately she could not complete her dream of completing secondary school because she broke her leg. She kept spontaneously breaking bones and has osteogenesis imperfecta. She has two young children and lives with her mother. Her skull has begun to bulge unusually b/c of this disease and consequently she has an unusual appearance and is tiny in stature. The past season one of the students at the Vintons’ school noticed that her field had not been planted. The students organized a group to go over and hoe and plant her fields. Understandably, Susan was so proud of her students. Now they are going to fix her roof. “B” is such a sweet positive lady and is a victim of such horrible circumstances. She had developed shingles and was quite uncomfortable from this.
J, 19 year old girl, was the saddest case of all. She is HIV with metastatic Karposi’s sarcoma. She lives with her mother who cares for her. She acquired this “wonderful” disease when she was raped at age 13. We cleansed and wrapped her foot wound. She is clearly in a significant amount of pain. Susan left peanuts, sugar and another food item as well as a pretty soft quilt. We closed this visit with a prayer also. At one point in the visit I literally had to pray for the Lord to give me the strength to get an emotional grip on myself. I simply felt like sobbing!

That evening Susan showed us a fresh water pond that forms a reservoir. A ram pump collects water which hydrolically pumps water up to the house complex and the school. After she showed us this we went to visit Godrey’s wife, Grace and daughter (Godfrey is one of Steve’s assistant.) Susan explained what my role is in the states. Some time ago Grace had seen a screening clinic ad on TV and went in to Iringa to get a pap smear. There is a team based out of the Cancer Hospital in Dar which travels around Tanzania and does pap smears screening for cervical cancer and dysplasia. Grace is well educated and when Susan explained that I am very interested in this topic and how it relates to Tanzania, she said, “It is a good thing for the women of Tanzania”

Steve got home that night after nine o’clock with his two assistants. He had been visiting schools. Steve and Susan have very long days and continue to work with the students and HIV patients in the Madisi community. In one area, Susan said that she estimates that 80% of the households have at least one person with HIV. They live on a shoestring budget with each of them “earning” 150 thousand shillings a month. This is the same amount he pays each of his assistants. If you are interested in their work, check out their website: www.villageschools.org and if you want a good cause with almost no administrative overhead, this is it! They are incredibly giving, loving and dedicated people.

Bus to Madisi

Our trip to Madisi started in a 25 passenger coaster with 32 passengers and a chicken. Fortunately, I am quite a bit bigger than most Tanzanians and there was plenty of room. This bus took us to a smaller town called Mafinga where we went to a small restaurant for lunch and waited for our next bus to leave in the afternoon. Sue and I together had 4 meat samosas, 2 roasted bananas, 2 mondazi (deep fried Tanzanian doughnut), coke and water for 2900 Tsh which amounts to a little more than $2. I tried to leave a 500 tsh tip and the manager gave it back to me. Tipping is not common here and he couldn’t figure out why I was overpaying.
The next bus was a public bus called Likikima and someone at the bus station was looking out for us (knew we would be coming through) and got us situated in the front of the bus next to the driver. We waited on the bus watching the shirts in the crowd. One said “I haven’t lost my mind, I sold it on Ebay”. Many of those shirts we discard end up in Africa and are worn by someone who doesn’t have a clue what they mean. We once saw two girls holding hands with one wearing a shirt that said “I like girls who like girls” and in the villages they would only understand a simple, innocent meaning for this because they have no concept of anything else. (If they did they would never wear the shirt) The first stop for the Likikima as the conductor was collecting fares was the diesel pump. Cash flow in Africa is often tenuous and we were paying for the gas directly from our fares. The bus ride was a 3 hour trek on pretty bad roads (read slow) until we saw another bus and a man came to our window and asked us to change to that bus.
It was the huruma bus from VST that then took us through these beautiful tea plantations on the hillsides. Tea is a thick low bush with bright green leaves that grow so close together that the slope looks like a carpet. Pickers with large baskets strapped to their backs were in the fields picking leaves from the plants. We arrived in Madisi around 6 PM just in time to visit some friends of Susan Vinton’s who are getting back on their feet from AIDS with the help of ARV treatments. Ordinarily, AIDS might not be too severe in a remote area like Madisi but because of migrant workers and trucks that come for the tea, this area is not socially isolated. ARV drugs have been made available in Africa if people suffering from AIDS can get to a clinic for them. This is the purpose of the Huruma bus and Susan knows the people in the village and helps them while they get healthy enough to take care of themselves. Sue spent a couple days visiting patients with Susan and a Finnish doctor and I’ll let her tell about her experiences.

Off to the Vinton's

Sue and I are heading on a bus to Mafinga today where we will meet a bus that Village Schools runs to transport AIDs patients to clinics for treatment. It runs every day and will take us to Madisi where the Vinton's live and built the first school. Sue will be spending time there with a Finnish doctor who has worked in Tz for 29 years and make rounds of AIDs patients. I will follow up on the science project we did last June with their son Joshua and some teachers from Madisi. We will return Saturday and hope to go to Kising'a on Sunday for the first time. We had planned to take a beach vacation the following week but have decided to stay here so I can focus on the microfinance program and Water program. Here are some photos from around town and the bus terminal where we will leave from today.

Just received a text from Steve, their bus to Madisi is not running today. Trying to come up with Plan B. Par for the course here.
UPDATE: Have a plan B, will take a different public bus the two and a half hours to Madisi and get there before dark. Should be interesting.

Streets of Iringa with beans drying:


Wingreds, the largest grocery in town. They have a freezer with good meats and cheese, yougart, and milk in the refrigerator in back. The packaged items are typically more expensive than US so this market is not used by most Tanzanians.


Local daladala bus terminal:


Main Bus terminal, large buses go to Morrogorro, Dar, and Mbeya. Smaller coasters go to nearby towns like Mafinga an hour away:

Two days at the Ilula Hospital

I just got back from two days in Ilula with the Medical team. Spent one long morning in the Maternal Child Health clinic. It was a well baby clinic during which the baby/toddler is weighed and updated on his/her immunizations. Three women were HIV + and were counseled about “safe sex” and feeding the baby only breast milk for the first 6 months so mom’s antiviral meds are passed to the baby at the full extent. Then we had a woman who needed a tetanus shot b/c at that time I understood that she had been bitten by her spouse. Two women were from Isele and I tried to identify our church’s partnership with Isele and Kisinga, but I don’t think that they understood. I was impressed with the fact that they had come such a distance to the Ilula hospital for their care. The babies did not like having a Mzungu (white person) involved in checking their weights so many times they would cry when they would see me helping their mothers with this task. One woman came in the tiniest triplets!
The Vice President was supposed to come to Ilula for a dedication of the medical center as a district hospital so his secret service was occupying the onsite rooming house so the medical team was staying with Dr. Saga. His home was full to the brim, so I stayed with the nurses in their compound. They have very simple living quarters and I was made to feel like royalty. The nursing director, Grace, made sure I had a warm bucket of water with a smaller plastic pail for my bath/shower in the morning – no running water in the shower. All of her belongings are in her one room and each day she gave me a cup of hot cocoa to drink in her room. I have not used a cell phone to its full capacity ever in my life and tend to be quite technologically challenged as my husband and coworkers back home know. I kept hearing this beep that kept moving around in my room and then in her room. I asked Grace, “What is that noise?” She said, “ It is your cell; it means your battery is low.”
I went on Medical Rounds with Randy Hurley, and Kitsada (a U of M medical student who is from Thailand and is so very gentle with the patients) as well as the Tanzanian doctor, the nursing students, and Dede, an infection nurse from Regions Hospital in St. Paul. Dede is trying to make some suggestions, some of which are listened to and one of which got shot down yesterday. Lots of patients admitted with malaria, TB and HIV. The health care providers are in a position of high authority and they do show authority when necessary. One very emaciated man refused to be tested for HIV and the following day the doctor told him that if he did not agree to be tested, they could not deliver proper care to him and, if so, he may as well be on his way. Cancer is simply considered a disease of death. Saw a woman who had advanced cancer of the cervix and she had been diagnosed two years before. She could not afford to travel to Dar for treatment so never received the radiation therapy that had been recommended. I had asked a few doctor earlier how they screen. They simply don’t. So I would like to check into this further, see whether it is done elsewhere and what kind of interest there is in making any changes. A child had been admitted for what appeared to be either HIV or late stages of malaria. She was very listless and Randy guessed that she would not last long.

Tumaini Photos

Large classroom building in center of campus.


Science Building where Math and IT courses are taught.

AIDS awareness is pretty high and you see things like this commonly. (This region has the highest incidence of HIV in Tanzania, reportedly around 14%)

Will add more photos to this later of students who study outside on campus.

Soko (Market)

Sue and I are still staying in the bega kwa bega apartment waiting for more permanent accommodations. I went to the market today to buy some produce so we can do more cooking at home. The market is about 10 min walk from where we are staying and is like a very large permanent farmer’s market. The fruit and vegetables are good quality and there are many vendors selling similar produce so they are happy to see customers. I bought 2 kilo tomatoes (1500 tsh), 1 kg potatoes (1000 tsh), 3 dozen eggs ( 6000 tsh), 3 green pepper (1500 tsh), 2 large avocados (600 tsh), 3 dozen small red onions (1000 tsh), 19 bananas (1900 tsh), and 1 kg raw peanuts (1500 tsh) which we will roast. We are getting 1330 Tanzanian shillings per dollar from our ATM card so most of these things are quite a bit cheaper than home. Many of the prices are listed and I seem to be given accurate prices. I don’t try to bargain when I feel I am already getting good value. There are so many vendors that they do not try to charge too much anyway because of the competition. You can smell some of the manure fertilizer they use in the market and we wash things like tomatoes and potatoes with dilute bleach before we use them. There are other farms in the area that cater to expats with delivery of boxes of a wider variety of vegetables.

Front of the Market. There are many small shops surrounding the large roofed area.



Lots of tomatoes and red onions which are grown in this area.


Plantains are the green ones and the bananas are tree ripened.


Public service sign on the market encouraging people to pick up litter in a pretty graphic way.

First Class

I went to Tumaini on Thursday to sit in on a Java Object Oriented Programming class. The instructor is a visiting professor from Finland who has been teaching several courses the first semester. There are three class years in the IT program with 28 – 30 students in each year so class size is less than 30. They use a projector from a laptop projecting on a wall in the computer room for this class and also have a pad of paper, like the post it board paper but without adhesive. It looks like other classrooms use a blackboard. The students were very attentive, although Tomi said that the programming courses have been hard for the students because they are typically coming into the program with little computer experience and no programming experience. In class they were going over a programming assignment that the students had done in groups. Tomi said that the groups really work well together with students helping teach each other. He grades on individual exams however. This appears to be part of the social culture in Africa. People help each other a lot, perhaps because conditions have been historically difficult and that is a way for people to survive. One example of this social cooperation is on the highways. When you approach a slower moving vehicle they will turn on their right turn signal if it is not safe to pass (driving on the left so a right turn signal is towards oncoming traffic) and their left turn signal when it is safe. Another example on the highway is when oncoming cars signal you that there is a police checkpoint ahead by waving their arms for you to slow down. They don’t know you and they don’t have to do that but they do. Tomorrow I will finally get some pictures uploaded. Here is one of the apartment building we are staying in, it is as nice as it looks. They are still working on our longer term location.

Daladala

The holiday is over and after making appointments for meeting with the microfiance and wells coordinators on Friday, I headed to the University to meet with the Finnish IT professor here and have our work permits added to our passports. Tumaini is a few miles away and I took the local Daladala public transport. Daladalas are well packed mini buses with a the side door open and a conductor hanging out collecting fares. It costs 250 shillings or about 20 cents per ride. I wasn’t sure which bus to take but knew all along this road would be going somewhere close to Tumaini so I got in. The daladala crews do not speak English but the gentleman sitting next to me assured me that we were heading to Tumaini. He turned out to live near Tumaini and we got off together where he showed me a foot path shortcut through homes. It started to rain heavily and we were stuck and ducked into someone’s home after saying hodi hodi to announce our presence but we did not see anyone at home. He was about my age and we talked for 15 minutes or so waiting for the rain to stop and he turned out to be a physics teacher at Pomerini Secondary School, which is a diocese school about 70 km from Iringa. This is the school that teams from Global Volunteers have been helping. He told me that many students at his school are not very interested in science and, surprisingly, he thought that was because they did not see a very good future in science. Few of these students would go to University and the job prospects would probably be limited to being a teacher (many teachers are Form VI graduates who have never attended university because of the shortage of advance degree teachers). A teacher here has an income of about $200/ month, I believe. I think the lack of science resources must also contribute to its low popularity. After the rain stopped, he escorted me past his house to the gate of the campus. He had a cow grazing in the front yard, a tv dish on the roof, and his house looked much nicer than the one we ducked into. I took care of business on campus and had a lunch of a big plate of rice with a tomato vegetable broth, some tough pieces of meat, and some green vegetable with the Finnish professor in the school cafeteria for about $1. I enjoyed meeting him and we had a good discussion of his experiences with the first term. Sounds like I may only need to teach two courses and they may be different from what was proposed on Monday but that is typical of the dynamic planning that happens here. Apparently, the university thinks that the daladala is not suitable transport because they gave me the keys to a Toyota Land Cruiser to use while we are here. I agree with them.

First Day

Sue got you caught up on how we got to Iringa. I had a very good first day and was able to meet with Reuben, who is the office manager for the well drilling project, with Itiweni, who is the accountant that works with the microfinance program here, and with several officers at Tumaini. They have three programming courses planned for me for second term (Introduction to OO programming in Java, Java programming III, and procedural programming C++) . Denise had suggested that I teach a course on Bug Generation but they do not offer that here (actually most schools do not, my training was self study).
I have been having a hard time finding a 3G modem in Iringa, they are out of stock, so do not have easy internet access yet. They are working on our housing and have a car available for us to use. The heavy rains yesterday afternoon suggested it might be nice to have a car instead of waiting outside for a dala dala bus ride. It will also be nice for visiting some villages and a couple national parks. Will have to get used to driving on the left hand side of the road and do some defensive driving, :-).
Today is a National Holiday for Zanzibar Independence Day which is ironic since Zanzibar would like to be independent of Tanzania and even requires you to clear customs with your passport when you enter from the mainland. We will do some shopping and get caught up on email at an internet café.

On to Iringa

We arrived in Dar on the 9th around 4 pm and were greeted by one of our students, Juwata Mponzi . We had viewed the two U tube tapes of Susan and Steven Vinton while waiting in the NYC airport and after dinner at the FPCT center (where we always stay in Dar), Dan thought a woman we passed in the walk way looked like Susan. It was Susan and the whole family was there. We spent almost two hours talking to Susan and Steve – very helpful and educational. She told Dan that the students will expect him to be in a shirt and tie –that he o/w will have problems gaining their respect. (LOL!) Dan stated, ”I don’t have a tie with me! I never wear them at home!” She conceded with, “Well, with your age and size, you should not have a problem gaining their respect.” My guess is that he will be the Rodney Dangerfield of the computer science department.
Susan teaches students in their village as well as working with patients with aids. She has learned a great deal about health care from a Finnish physician who comes to their area (Mafinga) quite regularly. The Vintons have invited Dan and me to come to their village – for me to spend time with the Finnish doctor and Dan to spend time at the schools. It turns out that Mr. Mpenda Kazi (who was the biology teacher from the Madesi school) who participated in the “science fair” with our group last summer in Kising’a) is now enrolled in Nursing School in Morogoro. (Mpenda Kazi literally means “loves to work” in Swahili – go figure! It’s a good thing he loves to work if he plans to be a nurse in Africa. Tanzania makes the nursing shortage in the US look like a walk in the park). I am very eager to spend time with this physician- learned a great deal of low cost techniques of dealing with wounds and intestinal diarrhea prevention in that short period of time. They even knew of a physician who comes through Iringa every couple of months for the purpose of cervical screening.
Don Fulz and Gary Langness got in later that night and the four of us traveled with Dennis Ngede to Iringa the following day. Our housing arrangements are not yet completely set up so we are staying in one of the spare bedrooms in the BegaKwaBega Office.
Dan and I went over to Tumaini University this afternoon. We met with the woman who set up our work Visas and also the dean of the science department and the head of the IT department. Hopefully, in the next couple of days, we will get our living arrangements established and thereafter more reliable internet connections. The people at the University were able to give Dan some indications of what he may be teaching and presented some possibilities to me as well. Although that idea the Karen Mielke has of staying home and taking care of my husband does have merit. Cooking will be more work here than at home and this morning I had to show him where he had put his toothbrush. They are providing us with a vehicle, so that will definitely make life simpler. Tomorrow is a national holiday so we probably will not find out anything about housing until Wednesday. Friday, the medical group arrives, so I will probably be spending the week with them out at Ilula.
Dan ran into Blastus, Godfrey and Bariki this morning walking through town. Godfrey had been teaching and now is enrolled in business school in Iringa with plans to still go to college in linguistics. Anna is evidently graduating from form 6 in the next few weeks. I am eager to find out about her future plans/dreams. We had a nice dinner with Bariki at Lulu’s.

Dubai Layover

Sue and I had a restful night at the Arabian Courtyard hotel in Dubai. We were upgraded and this hotel is right across the street from the Dubai Museum for those that were here with us in June. In June it was 100 F at night when we landed, last night it was 72 F, this is the time of year to come to Dubai! Emirates provides the hotel and even a complimentary breakfast buffet for travelers with long layovers. We could see the Burj Dubai from our room which is the tallest building in the world, is a half mile high, and opened this month. It must be three times as tall as any other building in Dubai and looks unreal.

We leave in an hour for Dar and hope that we see our 5 bags have made it. Overnight at a church compound where we will meet two retired pastors coming in for 3 months that will give us a ride to Iringa on Sunday. This will be the end of easy and free internet access. Now I have to sort out our 3G network options in Tanzania.

still up in the air

From: dan mcintyre
Subject: still up in the air

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10 hours in has us over iraq after watching the hurt locker. not much point to this blog but you can send 160 char emails for 1 usd sowhynot

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Up In the Air

we are just wakng up on Emirates EK202 and are justcoming over Norway. We still have 6 hours and 5500 km to go to Dubai. crowded but slept well.

On the Way

Sue and I are lounging in the Oasis lounge at JFK complements of Mitch who gave us some day passes. We had a short night as always happens and got our packing down to 5 bags. Packing for these trips feels like a wrestler trying to make weight. We got a break when Delta only charged us for the extra bag and not the 4 allowed bags because it is an international trip. The flights are on different tickets so they did not have to do that for us. We took off on the runway along the famous first hole at the Fort. It is nice symmetry for my last view of the Twin Cities for 6 months to be the Fort Snelling Golf course where I am scheduled to play an hour after arrival on July 8th. Must be a good omen. We hang out here til our flight to Dubai leaves at 11 pm. They have great food in this lounge and us fixed income types have to look for a deal whereever we can find it. Thanks Mitch!

Packing and Goodbyes

We had a nice send of yesterday with a retirement party at 3M. Surprized that so many people wanted to celebrate our leaving but I can understand. It was fun to see many people I have worked with over the years but not seen in a long time. Hopefully the rest of the Kayak team can pick up the slack on bug creation to keep Denise happy. Today we are packing fevorishly. We are allowed to check in 200 lbs in 4 bags and have about 100 lbs of medical and computer books. Really we do not need more personal stuff for 6 months than we would for 2 weeks with the exception of some kitchen items that might be hard to get the same there. We can relax and think about what this all means when we get on the plane at 7 AM tomorrow.

A New Year

This is a new year in more ways than most. Sue and I left our jobs last week and are busy preparing for our trip. At least for now it seems more like changing jobs than retirement. I will actually have three jobs because in addition to teaching in the IT department at Tumaini University I will be working with a water well drilling group St Paul Partners where I am now on the board and with a Microfinance program for villages around Iringa. We will also make some connections with Steve and Susan Vinton who live and work in SW Tanzania building schools and supporting HIV patients. Their website is Village Schools and Steve posts a lot of interesting emails about their work. We will have good internet access in Iringa and plan to update this blog regularly. There should be a lot of interesting things to share.