Thursday, January 8, 2009

UAACC, Arusha

Sites visited: AICC (private hospital)
Old Arusha Clinic (private hospital)
Mt. Meru Hospital (public hospital): Mental Health Clinic

What a day! We’re back at the Community Center surrounded by children. Blues Clues is on TV, kids are drawing and playing with balls (as we inflate them), and next to me a young girl is singing and learning to play guitar. There is so much joy and peace in this place. Driving through the colorfully painted gate feels like entering a sanctuary. It feels a little like summer camp here. Eight of us are in a room of bunk beds (the other eight in another, identical room). Dr. Piane (sleeping next door) commented on our chattiness as we were getting ready for bed last night. Even though we’ve only just met, our group had bonded closely. A few of us picked up a game of HORSE on the basketball court (I don’t think I made a single basket!).

The day started with a light, but delicious breakfast at the UAACC and then it was off for a day with our drivers. Nothing really seemed to go as planned, but it was amazing anyway. We started out at an originally unplanned stop – the AICC. This was a private hospital. It was great to talk to the physicians and nurses about common ailments that they threat, but we left with the suspicion that this hospital did not give us a clear picture of the reality of the healthcare system here. There were almost no patients, but we were told that Saturdays are busy because a lot of specialists are at the hospital on that day. Most patients stay in two-bed rooms and the facilities were clean and pretty well-stocked. They even had private VIP rooms. They had a fairly advanced x-ray machine purchased from the U.S. a year ago and a small laboratory. They are even able to send out specimens for HIV PCR testing if necessary (but I got the sense that this was a very rare occurrence). In Tanzania, the procedure for HIV testing is an algorithm using up to three different rapid tests to confirm a positive result. They also check CD4 counts and their priority is getting patients started on ART (much like in the U.S.). One difference that I noticed is the types of opportunistic infections that are common. Of course PCP and cryptococcal meningitis were mentioned, and TB was high on the list (I think it’s less common in the U.S.). I thought it was strange that KS wasn’t mentioned. I’m not sure if this was just overlooked, or if it is more common in the U.S.

The Old Arusha Clinic was more of the same (also a private hospital), so we were interested in seeing the Mt. Meru Hospital (a public hospital) to compare. We weren’t allowed to visit the actual hospital, but we visited the Mental Health Clinic there (an NGO, funded by donations, so the hospital has less oversight). Sheila, the Irishwoman that runs the clinic (also a psychotherapist) explained some of this secrecy to us. She was actually very helpful in explaining a lot about the people in Tanzania, the healthcare system, government, and the patients they see. Of course there are cultural differences, but for the most part, people are people no matter what country they’re in. Tanzanians suffer from the same problems we experience in the U.S.: domestic and sexual abuse resulting in PTSD, addiction, depression, struggles with power, struggles to save face and protect reputations, and various stigma to be fought. She was really a wonderfully genuine woman with a lot of insight and a kind heart.

It’s a little difficult in the city to fight off people peddling goods and difficult to adjust to thinking in shillings and exchange of currency, but it’s helpful to have our drivers to guide us around. I’m also struggling to learn a few Swahili words and phrases. I’ll list a few I’ve learned:

Asante sana
– thank you very much
Habari – something like “how are you?”, but literally closer to “what’s the news?”
Response: nzuri – good
Habari za asubuhi – good morning (literally “what’s the news of this morning?”)
Response: nzuri sana – very good
Jambo – general greeting to foreigners
Hujambo – How are you? (literally: “nothing wrong with you, I hope?”
Response: Sijambo – I am well (literally: “there is nothing wrong with me”)
Mambo – slang greeting like “whaz up?’
Response: Poa – cool
Karibu – Welcome (to invite people in) or you’re welcome (in response to asante)
Karibu/asante tena – you’re welcome/thank you again
Hapana – no
Ndiyo – yes
Rafiki – friend
Duma – cheetah
Simba – lion
Kiboko – hippo
Pole – I’m sorry
Pole pole – slow/careful
Tafadali – please
Ubarikiwe – bless you (after someone sneezes)
Twende – go
Simama – stop
Sasa – now
Marisha marefu – cheers! (literally: long life)
Maji – water
Kidogo – little
Kidogo kidogo – a little bit
Kwa heri – goodbye
Jina lako nani – what’s your name?
Response: Jina langu…- my name is…
Mungu – God
Mzungu – white person/European
Safari njema – good journey/bon voyage!
Lala salama! - goodnight! (literally: sleep in peace)
Hakuna matata - no worries (yes, they actually say this here... I didn't just get it from The Lion King)

1 comment:

  1. Kim!! I read all of your posts and your trip sounds like it was absolutely incredible... makes me want to someday realize my dream of doing travel nursing in Africa! I guess we'll see where life takes me... I'm so happy that you had such an amazing opportunity to go over there! We need to get together after I take my state boards in Feb so we can chat :D I miss you!!!!