UACC, Arusha

It's only the end of day two here in Tanzania and I feel as though I've been here forever. Today was an incredible day. We started at the Ngurdoto Dispensary and Clinic. It's in a rural area outside Arusha and they do HIV testing there and also maternal health and delivery. We moved on to another rural clinic after that - the Usa River Clinic. We were given a tour by the physician there and even got to sit in on a consultation with a two-year old who was crying because she had a fever. I was struck by the lack of resources in the laboratories at the clinics we have visited. Even at the nice private hospitals, they are lucky to have the basics - a machine for CBCs, a machine for chemistry, a centrifuge, and a microscope. There is a great need for capacity-building in regards to laboratory technology.

We then went to the Angaza HIV Testing Clinic. It's run by the Lutheran Church. Judith, one of the counselors, gave us a great overview of their procedures. As I asked her questions, I realized that their program is almost exactly like testing here in LA County. They focus on building rapport, respecting confidentiality, being client-centered in their counseling, and using a referral network for HIV+ results. They seem to have many of the same challenges as well - stigma, low status of women, poverty, etc. Although it is reported that cases are generally transmitted through heterosexual sex, I wonder if homosexuality is not common, or if it is just not acceptable to discuss. There also seems to be a low incidence of injection drug use (although marijuana and alcohol abuse are common). In Tanzania they have a universal testing procedure using rapid tests. Although they do store them in a refrigerator, there doesn't seem to be any quality control procedures.

We met a group of young Australians who had set up a program in Ghana where women with HIV made bags that were sold at the Australian university. They are now starting up an identical program in Tanzania (today was day one for them). I got contact info from them, in hopes that we can collaborate to distribute them in the States as well. I am so impressed with the work that they are doing.

We also got to see a man in Arusha that was an herbalist. He makes herbal medicines to treat all sorts of diseases. His specialty is a treatment for dental problems. It was an interesting experience - a run-down building with dark, dirty hallways, smelling of excrement. The doctor seemed more like a salesman, according to some people in our group. He did make a point that I agree with - that more research needs to be done to evaluate the efficacy of herbal treatments. He talked a lot about treatment for "male weakness" (ED).

The evening back at the UAACC was even more remarkable. We shopped for goods made by the students here and I spent some time with a young man named Kami. He is a musician and producer that Mama C has taken under her wing. He's had a tough life. He was born in Kenya, never knowing his father. His mother moved him and his younger sister to Germany with a step-father that he did not get along with. When his mother died, he had to leave his sister with the step-father (who she got along with well) and moved to Tanzania. He does not even know where his sister is anymore. He took a group of us to show off the small recording studio where he and Mama record their collaborations. He does the beats and she sings poetry. Mama is using her CD sales to help him raise money to come to the U.S. to study music production and he is also going to work on his own album. He then led a discussion with us and some African students here on topics like global warming, education, and HIV/AIDS. Kami is an incredible young man with big talent and big dreams. I hope to be able to help him with his goal of coming to America. Listening to Mama's music feels like being wrapped up in a hug.

SOME OBSERVATIONS:
- Don't stand outside money exchanges or large, fancy hotels. You will be harassed by people selling things.

- Tanzanians love their cell phones. There are ads everywhere. As Sheila pointed out, "Even though they may not have running water, EVERYONE here has a cell phone."

- There are bars and petrol stations everywhere. People really seem to like their beer and gasoline.