reunion

Habari from Zanzibar!

After a somewhat bumpy ferry ride on which they played Home Alone on the televisions, we made it here. This beautiful island is where I am for the next (and final) three days of my trip in Africa. They successfully eradicated malaria here on Zanzibar a few years ago, and we are learning about how that happened. This place is about 98% Muslim, so it is cool walking the streets during Ramadan. A lot of restaurants say "No service during Ramadan" or "only open after sunset." It is cool to be participating with this island in their holy month, and to not have to smell the awesome seafood cooking in the restaurants until after sunset when I am allowed to eat it too!

Yesterday was one of my favorite days of the trip. I got to take my whole team back to the place I lived when I was here in 2007. This meant an incredible reunion for me with several of my friends i have been keeping in touch with the past two years. One girl in particular saw me, and started running to give me a hug. She has had a baby girl since I was here who I also got to meet. I had no idea anyone else would even remember me, but some stuff I drew (maps of the US etc) was hanging in the office, and they showed me pictures of me in a slideshow. It was so wonderful to see everything again. And I surprised my host mother by quickly stopping by her house. She dropped everything she was holding and said "Amy?!" It was awesome. They also had just hired a slave girl when i was there before and she was terrified of me and spoke no english. She is now a beautiful 18 year old who greeted me in english! We also visited a local dispensary and my good friend Don told me he has had malaria 7 times. In the last year. I told him next time I come back and ask him how many times he has been sick, I want his answer to be zero. He laughed and said he wished that could be true. It was a wonderful day overall.

We also recently visited the town of Bagamoyo, where an innovative malaria vaccine trial program is underway. What struck me the most was the people who are in charge of the program. Most were female muslim scientists. I loved that. And really respected that that was happening.

I have learned a lot here in my time in africa about malaria and its drastic affects on communities, and I am excited to take that info back with me to the States. Next post will be from Chicago!

diarrhea

We went to a rural dispensary yesterday. The line outside the door was huge for basic services and medications, but Charles, the only staff member there, stopped serving the people (much to my guilt) to give us a quick tour and answer our questions. He had on the wall in his office lists for the last three years of the top ten most common sicknesses people visiting the dispensary are suffering from. Regardless of age or gender, the number one illness on every list was malaria. So frustrating. These people will be so much more free once it is gone. I asked Charles if they had any health education classes and he ushered us to the backdoor where there were about 35 mothers crowded around with their children listening to a woman holding a small baby boy named Moses who had diarrhea. The session was about the basics of diarrhea and what you do to help your children when they get it. It was fantastic to see so many people there. And they were thrilled beyond words to greet us and hear Tim, the member of our team who is best at swahili make some small talk with them. As we were leaving I saw a little boy in a Superman shirt running around with his dad waiting their turn for service. He was so cute, and the image seemed to transcend being in Africa and made me think of any little kid with his dad anywhere in the world hanging out.

We got to attend TTCIH (Tanzania Training Center for International Health--the place we are staying) graduation. It was about four hours long and completely in swahili, but it was a cool moment to witness all these eager young health care workers excited to go out all over Tanzania and do good work helping people. This place is the cream of the crop as far as teaching goes, and I am excited for what those graduates will do for their country. One of them who is going into obstetrics told me his favorite thing about being a doctor is having a woman come in to the hospital as one person and go out as two. I thought that was awesome.

We gave small presentations today to some of the main doctors that have helped us with training the last two weeks. As we stood up there in partners and shared, the lead doctor expressed how powerful it is that we are Muslims and Christians and other religions doing this together. I feel like since being here I have already forgotten how unusual this group is. They are all my friends now and of course we dont see eye to eye on theology and God, but it absolutely has not stopped us from being friends and wanting to tackle poverty and malaria together. A good reminder that this job is so important, and our working together is not the norm.

Yet.

Nazareth

We visited a leprosarium on Saturday. It was called Nazareth. Leprosy still exists in the world, but thankfully the cases are decreasing every year. I was prepared to feel very overwhelmed, but it seemed to be a place filled with hope. We were greeted upon entering by a very friendly man with no toes or fingers who showed us a new contraption that has just been invented that helps him to eat on his own. basically it is a velcro strap that ties around what is left of his hand, and then things like a toothbrush or comb or spoon can be attached to it. So cool. He modeled brushing his teeth for us very proudly. The rather abrasive and intense man who ran the leprosarium, Enoch, showed us all around and I met a bunch of people. What struck me the most was how welcoming the residents were to us. Many are staying there for the rest of their lives, and they happily showed us their beds and few possessions. I was also very impacted by the people who were working there. many had leprosy themselves (like the cook) but were serving the others and cleaning wounds. What a fantastic example of dignity. Just because someone is deemed "unfit" or "unusable" by society does not mean they cannot serve others. I saw that in action at Nazareth. And I think that plays out in lots of different situations of prejudice or misunderstanding, not just leprosy. It was a Catholic place, and I felt overall that they really caught the vision of being the hands and feet of Jesus on earth. The people who live there are people. Not hideous or forgotten creatures unworthy of anything. They had a garden overflowing with veggies, and a caring staff. Everything obviously wasnt perfect, and they are very poor, but it was a really cool place nontheless.

We went on a long hike today in the Udzungwa Mountains. We went to the top of a waterfall and looked out over sugarcane plantations and small villages. My partner and I talked to our guide a bit about malaria, and he thought that if you just drink enough water once you are sick, it will go away. I told him if he sees his friends doing this, he should tell them to go the hospital. A lot of people around here simply don't know that. Education is such a key part of ending deaths from malaria. And we had a session on anemia in class on Friday. Turns out getting rid of malaria will also cause a sharp decrease in anemia patients in the hospitals, freeing the doctors to admit more sick people.

I love being here again. I feel like I am kind of holding my breath and I am not really aware of it, and when I get to Tanzania suddenly there is this large exhale. It is really wonderful.

Time for bed. 4 am Ramadan breakfasts come early.

entomology

We learned all about the entomological side of things this week. That means we looked at a whole bunch of dead and living mosquitoes and learned all about what this facility is doing in research. It was so bazaar. I would walk up to a cage of mosquitoes, breathe, and they would all flock to the side of the cage closest to the heat from my breath. Gross. And weird that something so small can cause so much pain and death for so many. But Tanzania just received over 100 million US dollars from WHO to help get bed nets to everyone, so that is awesome news. One of WHO's directors visited this research facility run by the same people at a different location a few weeks ago and was very impressed. She says she looks forward to coming back in 2015 and celebrating the end of malaria deaths in Tanzania. Me too!

We went on rounds (kind of) with medical students on Wednesday in the hospital. I spoke with a lot of different people with all sorts of different ailments from burns to malaria to fractures. All ages. There was a painting on the wall of starving children with big red X's through them, followed by a picture of a smiling fat baby and instructions on how to get food for your kids. Probably not something I would see in the US! It is culturally normal for people to just hold hands here, but it was still kind of odd for me to be walking around this busy hospital with my male med student translator holding my hand. A typical day here is usually classes taught by the hospital doctors and researchers, and visiting the hospital wards or going and talking to kids at a nearby school.

Yesterday we went to the local mosque and spoke with the Imam and some of his assistants. They were very kind to us. He told us how he knew the mosque would be happy to help with health care needs for the community, like distributing bed nets, and they would be willing to work with the local catholic church, but they had never been asked by anyone to do so. There is so much potential there for effective change and inter-religious collaboration. It is exciting. And we took a super awesome/incredibly akward group picture afterwards that included the men and women separated by a huge amount of space and the assistant Imam staring straight at the ground. You will have to see it at some point. It kind of makes you uncomfortable just looking at it. We laughed for a long time.

Godlisten

We visited the maternal health/baby area of the hospital this morning. We walked in and there were probably 50-75 mothers with their children waiting in line for services such as immunizations and check ups. The babies were so beautiful. I talked to a woman and her ten month old son named Godlisten. I asked her a lot of questions through the translating doctor about malaria and the affect it had on her family. She said this was the third time she has been to the hospital with Godlisten having malaria. Her other child has had it six times. They have a bed net, but the kids still get malaria. She said the prospect of having to not worry about malaria would make her feel better. She has no husband. The most intense part of the interview was when I asked her what she finds joy in. She said nothing. She said her life is difficult and there is no joy. I looked at the beautiful baby boy in her arms, and doubted her words. And I thought about the fact that his name was Godlisten. Did she know what the name meant? Was it a cry to God, begging him to listen to her in her pain, or could it have been a reminder that God does listen and hear her? Does He? She probably doesnt think so. It was very sad. We filmed the interview so I now forever have her answer as a reminder for why I am trying so hard to do what I do. And why I will never give up and throw in the towel. People need to find hope.

After talking to this woman, we spoke with an older lady who was a nurse working with pregnant women in the ward. She loved talking about her work, and has been at this place for 18 years. She happily told us about how she got sick and was treated so well by nurses years ago, she knew that she wanted to provide those same services to others. She loves what she does and says she is most happy when she helps women to have healthy babies.

Two women from the same community, but very different stories and attitudes.

This is a place of contrasts.

cry

I made a baby cry yesterday. We were walking through the village of Ifakara and I was greeting people and talking as much as I could in swahili. I must have gotten over confident because I went up to a woman with a beautiful baby girl and greeted the mom then bent down and said hello to the girl. She took one look at me and started screaming in what I am assuming was terror. Poor thing. White skin would be a lot to handle for the first time, and even worse when the white skin is mlefu (tall). I laughed and apologized to the mother who was also laughing.

We went on a canoeing trip yesterday on the Kilombero river. I was hoping to see a hippo, but apparently they didnt feel like finding us. I was ready to offer one of my toes to them as a sacrifice, I guess they are actually really mean and eat people. I thought the lost toe would be a compelling story later on. I feel like I am kind of experiencing African tourism for the first time, even though I have been here before. I dont quite know how to handle it. It is just so far removed from the reality of an average Tanzanian's daily life and I find that hard to reconcile. And being with a large group of westerners is also very difficult.

We went to the local catholic church today. There were a lot of people there and the music was awesome. I wish I understood swahili so I could follow along. We were seated on the stage for the entire service. This has happened to me before and I know they do it to honor us as guests, but I also think it makes it easier for everyone to look at us. It would be much more rude if they had to crane their necks backward to stare at us sitting behind them dont you think? I think it is funny. We met with a lot of the teenagers after the service and they asked us some questions. One of the guys asked what we were going to do as foreigners to help them with AIDS. How do you even begin to answer a question like that? Especially when you have been in the community for four days? We are going back on Thursday and I hope to talk to him one on one. We are trying to emphasize that we are here to learn from them and see what they are already doing so we can come alongside as much as possible. This is so opposite to traditional norms of western aid, and I think it will take a lot of foreigners coming in with the same idea before people here really believe it. For so long we as westerners have said that we were listening to them, when in reality we just came in and did what we wanted without actually consulting any of the local people. I had a great discussion today with some of the other fellows about the ethical constraints of international aid. Fascinating stuff. And really frustrating. I am trying my best to simply listen to the locals, because we want to work through an asset based approach in an area that has traditional been viewed in a deficit based way. It takes a total shift in thinking.

In other news, I am leading a Christian reflection time tomorrow for all the fellows. I think I am going to talk about Joshua and the verses about being courageous. I think courage in our work is something we all need and it can transcend religious differences.

Also apparently a bunch of chickens are being killed on Tuesday and I have invited myself to the festivities. I think I will have some good video footage afterwards, in spite of potentially never wanting to eat chicken again.

And I have decided to practice ramadan. It is something I have been thinking/praying about for months and the two muslim fellows here support me participating with them. So starting August 20, I will not be eating or drinking from sunrise to sunset. I am excited for what I will learn through the experience.

Ifakara

We made it!
After a rather harrowing and bumpy ten hour drive from Dar es Salaam in a four wheeler yesterday, my rear end has officially recovered and I am currently lounging under a mosquito net in my room while the sun sets. Not bad at all. We are in Ifakara at the ttcih (tanzania training center for international health). It is really impressive. They want to be respected internationally, so they have wireless internet and awesome classrooms and buildings. Definitely like nothing I have seen in Africa before. This place doubles as a malaria research facility and they are doing very innovative cutting edge research on eradication. We heard from the director today and the stuff they are working on is fascinating. They are running trials right now on some sort of fungus that mosquitoes are attracted to. The mosquitoes (or Umbu in Swahili) touch it and die within 48 hours or something. Basically a green version of DDT.

Learned a lot today about primary health care and what that looks like in reality on the ground in a rural community. We had lectures from several of the doctors and researchers on site. I am convinced more then ever (well, actually I was pretty convinced before) of the necessity of community health workers. Especially because hospitals simply arent around in as many areas as people need them. We took a long walk through the hospital today and hung out in the women's malaria ward for a while. I attempted to remember my swahili from last time, and basically failed. Made a friend with a masai baby named Paul who looked malnourished and had malaria. His mom was there too and could not have been a day over 17. It was so difficult because there are ten of us westerners, and I hate being labeled as the token rich foreigners who walk into a ward to basically look at the sick people. We were all hired for this job for our creativity, brains, and entrepreneurial skills and we all hated the implications that we were treating the Tanzanians as projects. So we are developing a system which we are going to pitch to some of the leaders tomorrow in which we can potentially break into three smaller groups and take a translator with us to visit the different wards on different days. Much less overwhelming for the sick, and much more humanizing. And it will be much easier to talk to people. They have a large HIV/AIDS ward and I am praying that I can just stay there all day one day. Or at least a few hours. Most of you probably know HIV/AIDS is a huge passion of mine, and that was my sole purpose in coming to Tanzania the first time. I basically just want to spend as much time in the hospital with the sick as possible.

In many ways we are creating this program as we go, and need to ensure the learning we need to have to be effective when we go back to our home countries happens while here. This is hard because I really want to learn about everything the doctors tell us, but I also have to be simultaneously formulating questions about hands on programs with malaria, and how faith communities are involved/could potentially be more involved. I am foreseeing this to often include steering the discussion away from things I find incredibly interesting into slightly murkier waters where the questions dont really have answers.

What an exciting time to be involved in this fight! The questions dont have answers because the answers dont fully exist. Yet. That is why we are here. To help figure out the answers to questions about why people continue to die from malaria. And then change it. It costs 100 shillings (about 8 cents) for the anti-malaria drugs, and $2 for a bed net. Faith communities are perfectly positioned to help.

Our work is so important. Lives are on the line. If that is not incentive for me to throw my whole brain into this, I dont know what is.

moving

I leave for TZ at 3 am tomorrow. Couldnt be happier about it. Our time there looks like it is going to be unreal. A lot of it will be spent learning from African health experts about different endemic diseases, then visiting clinics and hospitals where the actual work is being done. On my previous trips to Africa, I have mainly spent my time trying to fit in and experiencing life exactly as the locals do. I think this trip will be different because it is solely focused on our learning about disease and malaria so we can partner with african communities in the long term to create sustainable change. As I think about the difference that will mean for me in experiencing Tanzania, I think the best I can do to give the people dignity is to bring my best mind and talent to focus on what I will learn, and swallow the fact I will not be experiencing life the way tanzanians for the most part do. Since I cant have the close live-with experience I had before, I am planning on throwing myself totally into what the doctors and experts teach me and grappling to retain as much as possible. To be as effective as possible to make as much change and save as many lives in the long term as possible. I think that is my best bet to deal with being driven around in an air conditioned van.

London has been absolutely fantastic. I have learned so many new things, and had a lot of fun in the meantime. Today during a media training session we were broken up into groups and we all had to create our own movies. I am very proud of my group's, it was called "The Chase" and involved a harrowing scene on the tube where we got yelled at by a security guard. The other fellows are brilliant and incredible leaders from their perspective communities, but they are also a lot of fun and it is nice to have time to be silly in between the very important work of inter-religious dialogue and learning about malaria.

One of the leaders said a very interesting thing the other day; "Sub-Saharan Africa is currently enslaved to endemic disease. So working to fix the broken healthcare systems and get people proper treatment is a modern day form of fighting slavery. I LOVED that.

More to come from the gloryland. aka Tanzania.

Amy

video worth watching

All the fellows recently watched this together when the Muslim fellows did their presentation on Islam. The song is by a Muslim American country singer. Definitely worth four minutes of your time.

http://www.youtube.com/watch?v=sbcmPe0z3Sc

overwhelmed

Overwhelmed. That is how I felt yesterday at the hindu temple. It was like nothing I have ever experienced, and I didnt feel like I had any idea what was going on. I was trying to understand, but it was very foreign. It made me realize how the language I use to describe my own faith is probably very confusing to people who did not grow up in the same tradition. This has not been a problem when I have surrounded myself by others similar to me, but that is absolutely not the case now or for the next year. I need to work on that because I did not really like that feeling yesterday.

Today was fantastic. I just got back from seeing Romeo and Juliet at the globe theater. Loved it, but I was still mourning Juliet's death when they got got up and burst into song for the finale dance. it was strange to see her dancing around after she had just killed herself. And my butt fell asleep after about two minutes on those benches. A fun experience to say the least.

Also today we had presentations from the buddhist, sikh, unitarian and muslim Fellows. It was a very rich time for me to try and cram all this information I have always wanted to know about those religions into my brain. I really think this training is priceless just for the relationships I am forming with this diverse group of people and the way they are expanding my worldview. I love it.

bye malaria

The training continues and just keeps getting better. Today was the completion of an intensive two day leadership training course which involved a prisoners dilemma activity we were filmed participating in. We got to watch the tape today and see ourselves and discuss different aspects of communication and leadership. Really enlightening. The rest of the day was spent on training in working with media and developing e-campaigns, as well as presentations from me and my fellow Christians on the basics of our religion, followed by a great presentation by the Jewish fellows about Judaism.

Last night we had a grand time at a reception at the Tony Blair Faith Foundation HQ. Did you know the building it is in was the original American embassy and John Adams lived there? The political scientist in me thought that was very cool. They have given us flipcams with which to film videos. I have been doing this and would post them here, but I have not filmed anything I think you all would find particularly interesting. But stay tuned. Tomorrow we are visiting a hindu temple and I am thrilled to learn about hinduism because I know very little at the moment.

I feel like I have my feet planted a bit more the last 24 hours. I am getting into the swing of things, and have some of the basics down. Everyone is really so fantastic and interesting and brilliant. I have trouble deciding who to talk to during breaks because I want to speak with everyone. And it is such an honor to be considered one of them. All these incredible people are pouring a lot of their time, talents, and energy into making us really fantastic, and I am really starting to believe we will make a lot of positive impact in our respective communities. Poor malaria. I dont think it will be around much longer. And it will not be missed.

And I got a Mcdonalds Mcflurry tonight. Tasted very different from the American version, but Subway here smells the same. I think that is weird.

lemon juicer

I feel like my brain is a lemon in a lemon juicer right now. Seriously, so much has been crammed into the last three days I kind of feel nothing because there was so much.

And pretty much most of it is new. I have experience with the more action side of this (Millenium Devleopment goals, malaria, social justice, etc). But the multifaith dialogue I am stunningly ignorant. We have now been to a mosque for juma prayer, an orthodox jewish synagogue for shabbat, and a roman catholic parrish for sunday morning services. And we spoke with the leaders of each of those places after, asking lots of questions.

So much to learn.

It is humbling to think I thought I knew more then I did. I pretty much feel like I am starting from zero on a lot of the basics of these other faiths, as well as how to actively try and engage with these different groups to think about working together on malaria eradication. Our goal is to try and strengthen these people to become better and stronger in the religion they are already a part of, while working together with other faiths on pressing international issues since service is something high on the priority list for all different religions.

If that was not articulate that is because this is only day 3. Cut me some slack. This program is incredible and I am so thrilled to be able to learn all of this. And I know a lot of people dont believe the stuff I saw today can actually exist. A room full of 30 young people, aged 20-25 from hindu, sikh, muslim, buddhist, unitarian, catholic, christian and jewish backgrounds dialoguing about how we can all work together to change the world. And we all get along. And we genuinely like each other.

Now that is a future I am excited to be a part of.

More to come, but I need to let my brain rest a bit.