Updates from the field: Caroline West, Tanzania

7/09/2014

Jambo everyone!

Greetings from Tanzania! I arrived in Dar es Salaam at 8 o'clock on Monday evening without any travel issues. The visa process was a bit startling, but was handled quickly and was able to meet my boyfriend, David, and my driver outside of the airport. The first night we stayed at the Slipway Hotel—very comfortable—and enjoyed a meal seaside while watching the Germany-Algeria game. We met with Ginny Tuesday morning, and she brought us to Kalenga house where we have been staying since the first night. It feels very safe, and we met someone who is moving to Athens, GA in a month (small world, that's where David lives). Ginny took us to Muhimbili.

I'm still processing my overall first impressions, but I've never seen anything quite like it. There are people waiting outside the grounds, some of whom I assume are family members of patients. There are people gathered outside the methadone clinic, interesting anatomical/pharmaceutical themed pictures painted on the wall. There are baby cries wafting to the street from the labor/delivery ward. There is bougainvillea draped over big stone walls that surround the place. Dr.Mwambo was not there on Monday, so we decided to wander over to the diabetes clinic to see if Zacharias was there, someone who Ginny had met previously who works for Tanzania Diabetes Association (TDA). He wasn't, but a woman named Beatrice was.

Beatrice is a fount of information. She filled in so many gaps in information about how diabetes is screened, diagnosed, and treated throughout Tanzania. They are allied with the International Diabetes Foundation, and use "conversation maps" specific to Africa for community education. They have a questionnaire for everyone they screen, it's more extensive than ours but does not use a point system. They test for blood glucose using glucometers and strips, specifically Accucheck with are typically donated to them. Patients keep a portion of the form with their readings for referral, if need be. I will be writing up more about the discussion we had with her, but overall it was a very productive and we were lucky to meet her.

We have her contact information, and I am going to try to swing by her office after our visit to Kisarawe! Ginny, David, and I enjoyed a breezy lunch: vegetables, rice, beans. David got the banana/beef stew, which I tried and really liked. David and I then went exploring to Kariakoo market. We actually ran into two people on the street who were in the TDA office, and we recognized them and walked with them to the market.

The girl, Sophie, worked for TDA and was from the Congo, but had been living in Denmark. The boy, Chris, was a volunteer from the UK with Type I diabetes. The market was visual feast. I was too intimidated to buy anything, but very much enjoyed the obstacle of walking four or five blocks through endless humanity and the stuff humanity buys and sells. There was a man sitting on a counter, with a wall of bananas hanging in front of him; it looked like two legs sticking out of a yellow fruity sea.

There were dress shops with so many incredible patterns and colors of cloth. The smells! There were three guys who immediately picked up cabbages and started shaving them as soon as we walked by them. I asked David why anyone would buy a half-shredded head of cabbage, and he said they were selling the shredder (of course!).We bought a go-phone and had a Kilamanjaro beer in "social hall" where men were playing pool and women were eating lunch ("if you can't climb it, drink it"). We walked back to the Kalenga house, rested a bit, and went out to watch the USA soccer game at a bar full of ex-pats.

This morning I will be working on the SOP and we are meeting with a woman who does gender based violence counseling. Ginny is a fantastic host, and I am very glad she is here to host me, very very glad. Looking forward to Dr. Ploth's arrival! More soon! Having a great time and trying to soak everything in. This morning, David and I stopped at a small cafe on the way to the grocery store in an attempt to find some coffee. David came back to the table and told me, well I hope you're hungry because I somehow ordered half a chicken. I took the opportunity to observe what people were eating for breakfast. Casava (a very starchy soup) and broth (salty, flavorful), chicken with all the parts (minimilistic style of butchering). The chicken came with a pile of salt and some jalapeños, and was very cooked.

Thanks again for this incredible opportunity. All five-senses are active!

Caroline