Hospital Visit

It goes without saying that if you spend 6 months in Africa after having gone 20 years without spending more than a couple of weeks outside of the same small town, you will probably get sick. In all honesty I’ve been lucky- I made it through a full month without getting anything worse than a nosebleed.

I hadn’t been feeling so hot this past weekend. Well, that may be a poor choice of words- I hadn’t been feeling so great this past weekend. It started on Thursday afternoon, just the normal sick feeling- headache, congestion, stomachache, sore tonsils, and that horrible achy feeling that makes your skin crawl when you move or touch things, including the bed, the covers, and air. However, the normal sick feeling doesn’t feel so normal when I can hear the voice in my head taunting, “Malaria! Ebola! Sleeping Sickness! Zombie Virus!”

By Friday morning, I legitimately felt like I was dying. So when I finally succumbed to Mama Kawishe’s most guilt-producing looks of sympathy and agreed to go to the hospital, I had to brace myself just a little bit. She was comparing my symptoms with those of malaria, and was convinced that I had contracted the disease. I was too, a little- it is a practice in futility to try and avoid all the mosquitoes, because they’re everywhere, and if my memory serves, the malaria medicine isn’t a 100% prevention guarantee.

My first thought was that since malaria is a blood disease, the test to determine malarial infection would be a blood test. Despite my dad’s and Papaw’s most furtive attempts to turn me from needle-fearer into future-surgeon, I still cringe at the sight of a needle. And if they just hurt medium-amounts in America, surely in Africa they’re the size of bamboo shoots?

Upon arriving at the hospital (TMJ, a privately-owned place in Kawe), we parked the car and walked into the outpatient waiting room, which is also the inpatient waiting room and also the emergency room.

Literally the very first thing I saw upon walking up the ramp into the building was a gurney being pushed out to a large van by two nurses. A white sheet covered the body on the stretcher almost completely, although a pale, sallow white arm was exposed. Aside from seeing an open casket once, this was the first time I’d ever seen a dead body in real life, and as I was already nervous this didn’t help at all.

We entered the waiting room, which was hot and humid even with the open doors and presence of several oscillating fans. We were instructed to wait in a long line to present name and insurance information and be given further instructions, and Mama Kawishe, being the gracious and kind host mother she is, told me to sit (read: collapse) on one of the chairs in the waiting area while she waited in the line for me.

The room smelled like dust and tension. It had the same décor of the Titanic- marble floors, eloquently designed ceiling tiles- but it was obviously old, outdated and in need of maintenance. The whole place had a tinge of yellow to it, as though smokers lived there. There were a lot of people waiting, crowded onto the red plastic chairs, and in the middle of the waiting area there was a bored and irritable-looking nurse sitting with a stethoscope and pressure cuff, her feet propped up on the scale in front of her.

She was painting her nails a poisonous green color and watching the overhead TV, which was repeating movie trailers for “Unstoppable”, “Stone” and “Due Date”, all movies I am now interested in seeing (or perhaps it was just the effect of seeing such a plethora of mzungus on the screen). Every once in awhile a prevention ad for malaria and tobacco use would pop up, or else an ad for a nearby boutique.

By the time I was adequately sure I knew the film progression by heart, Mama Kawishe was at the front of the line and we were soon directed into a small room just off the waiting area.

A young Arab woman sat at the desk in the room, and to my relief she spoke English with a fine American accent. In most situations I wouldn’t care about the language or accent with which someone spoke, but when I’m asking about needles and sterilization I want to be perfectly sure that I am heard correctly.

She asked about my symptoms, medical history, prescripton drugs, and other routine subjects, and then she examined my mouth and ears.

“It’s probably not malaria,” she said, setting down her shiny-ear-looking-thingy and pulling some prescription papers out of a box on her desk, “but I want you to get a blood test to be sure-“

I whimpered a little.

“-and I’ll order a blood pressure test-“

I thought of the irritable-looking nurse outside.

“-and then you just bring the results right back to me and we’ll see what’s wrong.” She handed me two prescriptions, one that just said “BS” and one that just said “BP”, and a little purple object a little larger than a pen cap. Upon further examination I realized it was the needle with which I was going to be stabbed momentarily, encased in protective plastic.

I went and sat tentatively on the edge of the chair next to the irritable-looking nurse, who waited a full fifteen seconds after I sat down to draw her eyes from the TV screen and acknowledge that I was there and in need of her stethoscope-wielding services. She (grudgingly, I thought) strapped the cuff on and, after inflating the thing to painful capacity, took her time in getting the stethoscope to my arm and releasing the air in the cuff. I could see the veins on the back of my hand starting to pop up, which almost never happens, because I think my veins like to stay hidden where needles can’t find them.

After the nurse scribbled a large fraction onto the note that said “BP”, and looked at the other one and pointed me down a long corridor, where a faded yellow sign hung from the ceiling and said “LAB”.

At the door to the lab, I waited until I saw someone that looked professional enough to give my “BS” paper to. A young man in jeans and a button up T-shirt took it and steered me into the lab room, plopping me down into a chair and taking from me the purple needle-holder.

A large man appeared at the door, leaning against the door frame and blocking the exit.

The men inside the lab room bustled around, looking into microscopes and arranging tubes with yellow or dark red contents inside them. The lab was a sunny room, although it had the same old and yellowing feel that the waiting room had to it. Had you removed all the people, it could be the sort of place people use in horror movies about abandoned hospitals (the movie Session 9 comes to mind, if anyone is interested in that sort of thing).

No sooner had I sat down than the man grabbed my hand and started attacking my finger with the cotton swab. I remembered the size of the needle I’d handed him and my exact thoughts were, “NO WAY IS THIS GUY GOING TO STICK THAT NEEDLE UP MY FINGER. I’d rather have malaria, thanks.” (To be fair, these were the thoughts I had about polio, yellow fever, typhoid, tetanus, and influenza when I had to get those shots from the health department before my trip).

He put the needle in a sinister-looking blue thing that at the time looked like it should be used to tranquilize bears at a zoo. My faint request that he put on some plastic gloves went unheard, though when I looked around the room I couldn’t even see a box of them.

He brought the death-needle closer to my hand and I literally pulled my hand back and looked him dead in the face.

“What is going to happen here?! What are you going to do?!”

He just grabbed my hand back, and said “No pain! No pain!” very fast, and jabbed my finger with the blue thing.

I’ll be honest, it didn’t hurt a bit, it was just one of those spring-loaded needles they use to type your blood at a donation site, but I had braced myself for pain akin to having my finger removed with pliers. In my defense, I think it was really unnecessary for them to hand me a two-inch-long needle when all they needed was the 1/8^th of an inch at the end, and then let me sit there and fret about it for ten minutes.

The man wiped my blood on a little clear plastic plate and gave me a cotton ball to stick on the end of my finger. I sat outside the lab room on a red plastic chair next to a set of very young twin girls (both holding cotton balls to their fingers) and their rather large mother. I grinned at the twin next to me.

“My finger has a heartbeat,” I said to her, smiling, knowing fully well that she couldn’t understand me. She looked at me a little funny and mumbled “Sijambo” and turned back to her mother. If my mom had been there, I know she would have probably snorted and laughed, because Elf is one of her favorite movies. I didn’t eat the cotton ball, though.

It took about twenty minutes to get my lab results back (doodles, I thought, because I couldn’t read the writing; way to perpetuate a stereotype, doc) and then I was back in the Arab doctor’s office.

“Your blood test came back negative for malaria, although you did have a high nerophlosmopippydoopedoodah count-“ (whatever that is) “-which does indicate an infection, so I’m going to prescribe you some antibiotics, and some anti-histamines for your congestion, and some painkillers…-.”

She handed me a sheet with the prescriptions on it, we thanked her, and we left. The pharmacy is conveniently located in the waiting room, which I think is another thing America needs to seriously pick up on.

The entire visit cost me about $18 (25,000 TSH), and that’s without medical insurance- mine isn’t accepted in Tanzania except for emergency visits. To put this in perspective, though, $25 is a good half of what most people get paid in a week in Dar Es Salaam. Additionally, this particular hospital is privately owned and operated, and is in quite better shape than a government-run hospital, which would be cheaper but also less safe and less efficient.

The Arab doctor explained to me that while the building doesn’t look very nice, they do their absolute best to make sure that their treatments and equipment are completely sterile, and they don’t re-use needles. She told me that that much can’t be said for all of the hospitals in Dar, though, and some of the more rural hospitals will lie if you ask whether their equipment is sterile.

All in all, though, I had expected a lot worse. It was an overall positive experience and I will be using TMJ as my regular hospital in Dar, when I inevitably get sick again or get mauled by a hippo.

Next time: Discussing a topic of your choice! I’ve had a few suggestions already, but feel free to comment and suggest more.

Oh, and I'm fine now, by the way. :)

Love you Mom and Dad J Eli, excellent job on your Silver Key in the art show- I’m so proud, I hope you never give up the artwork! Miss you tons Nana and Papaw, I love you so much!

Kwa Heri,

Emily

Bombs in Dar

If you watch the world news closely, you may have seen that there were some bomb explosions in Tanzania.

http://www.cnn.com/2011/WORLD/africa/02/17/tanzania.bombings/index.html?hpt=Sbin

I plan on writing more to put in the blog tonight but I’d like to address this first so that I don’t lose any details as time goes on.

Around 9:30 last night, I was sitting in the dining room with Mama Kawishe helping her with her English class homework. I was just about to point out how prepositions are used when we both heard and felt a large BOOM, coming from what felt like right outside the house. The curtains blew inside the house as though someone had directed a giant fan at them, and we could feel the explosion reverberate in our chests, not unlike the feeling one gets when standing too close to a subwoofer. The windows that were shut rattled and the floor shook beneath our feet. It sounded as though someone had dropped a mattress flat on the porch right outside; it sounded very close, or else very loud.

We were running on generator power at the time, and my first thought was that the generator had exploded. Seconds after we felt the first blast, though, there was a second, and Dada came running into the room, looking petrified and speaking very rapidly in Swahili, pointing outside. Mama Kawishe and I both jumped up and hurried outside, where everything looked normal. We stood for a few moments trying to figure out what was happening, when there was another blast and I, standing in the open-air outside kitchen, felt it much more vividly and went back inside.

Jackson was just sitting at the big dining table inside, and didn’t seem to think anything bad was happening. I asked him if he knew what was going on, and he just said simply, “Bombs.”

To a small town girl in Africa for the first time, this is about as reassuring a statement as “Glenn Beck just got named supreme dictator of the world!”

After a few minutes of me shooting him dirty looks and hissing “This isn’t funny! What’s going on?”, Jackson told me that it was probably a bari, or military bomb storage warehouse, that had blown up, which happens when bombs are too old and not disposed of properly. He said it had happened once before, a couple of years before, and that several people died and it destroyed several homes.

The blasts went on like this for several hours, and stopped around midnight. When I boarded the school bus this morning, Mr. Mchombe (the teacher who sits on my left while the bus driver sits on my right) told me that there were 10 reported deaths, and over a hundred injuries from the blasts from the night before. I was a little taken aback by this news, and he went on to explain that the government will probably not give decent compensation to those affected, or provide enough money to replace whatever homes may have been destroyed.

At the school, all the teachers were talking about the blasts. Around 9am, we could hear more booms in the distance; whether this was more rogue bombs or a controlled detonation of the remaining weapons, I don’t know. I wasn’t fond of the situation at all, and chose to put in my headphones and let the score to Inception be my soundtrack for grading papers. I was jerked to attention around 11am by another teacher, who told me that the radio had just informed everyone that three of the largest bombs were about to be detonated. The other teachers were crowded around the windows to watch, but soon after, the radio announced that there would be no new detonations.

The official report so far is that 20 people have been killed and somewhere around 125 injured, a dozen of those in serious condition. One of the other teachers at the school, Mr. Moses, has a close relative in the hospital from the blasts. The airport was shut down, and several cellular service providers sent text messages out to their clients in Swahili, giving information about unclaimed children at police stations and advising everyone to be calm.

For the sake of my grandparents and other concerned relatives- I am fine. The blasts happened 6 miles south of me, much closer to the airport. As I am typing this, the military is investigating the situation and inspecting other bari to be sure that this incident isn’t repeated. If anyone now feels deterred from visiting the country, let me assure you that this is an isolated incident and that Tanzania remains one of the most peaceful and stable countries in Africa.

Will post again very soon with more news about the rainy season!

Love you Nana and Papaw, Miss you so much!
Mom, Dad, and Eli- I love you and miss you very much. Hope to talk to you all again soon!

Still Worth It.

- Gutting wild animals with the large knife after hunting them down with the corkscrew attachment: NO

- Opening bottles of wine in my forest tent deep in the Congo: NO

- Tweezing out splinters of wood from injuries sustained when rope bridge collapsed during my narrow escape from the spear-wielding natives: NO

- Cutting strips of cloth to use as a tourniquet on saber-toothed lion wounds: NO

- Using the toothpick to clean my teeth after cooking and eating crocodile meat using the large and small knife attachments, the corkscrew, and bottle opener: NO

-Manicure set: YES

Nasema Kiswahili kidogo!

I apologize that it's been so long since my last post; things have been very busy here. I get up at 5am every morning and don't get back home from the school until 6pm, and I have to be back in bed by 9 or 10pm or I'm a zombie the next day. It's difficult getting used to the schedule because I have never been good at going to bed early (my parents are probably nodding vigorously right now).

Because I've settled into a routine here, though, it means that I have fewer big stories to tell, but more to say about daily life. I learn a little more every day, and fall more in love with the country and the people with the more time that goes by. I won't lie, last week was very difficult as far as adjusting goes. I found myself often thinking that 6 months was going to be a very long time.

But it is getting better daily- I know when I leave here in July it will be a difficult goodbye. I am becoming close to the other teachers at the school (in particular Joyce, Dorcas, and the athletics teacher whose name is too complicated to remember yet) and Mr. and Mrs. Kawishe (who have done wonderfully in making me feel welcome and at home) and Jackson (it's a little like living with Eli again) and Dada (she is remarkably quick at picking up English- when I came here she didn't speak a word at all, but now she is forming small sentences!).

Jacqueline came home this weekend and she and I and Jackson went to the Mlimani City Mall to get groceries. It was a bit like grocery shopping at Big Lots or Roses, but that was welcome in comparison to having to fight with the salesperson for everything. I even found a box of Oreos! It wasn't hard, I just had to follow the choir of angels and gold light shooting out of the "biscuits" section.

We went to a bookstore in the mall as well. The selection of leisure reads (in English, anyways) was very limited, but I bought a colossal English/Swahili dictionary, "The Green Hills of Africa" by Ernest Hemingway, and a book by Nora Roberts called "The Reef" that looked promising but turned out to be a disappointingly soppy romance novel. The shopping experience took me home for a little while, and I really enjoyed feeling like I was back in a first world country again, until the power went out and we had to hastily finish our shopping in the dark. Jackie told me that it is very dangerous to shop when the power goes out, because the security cameras aren't functioning and anyone can steal anything from anyone.

It rained for about five minutes today, bringing the cumulative rainfall time to about thirty minutes since I've been here. Today was different though somehow; the rainy season is only a few weeks away, and it shows in the clouds. I had been out on the fields at school after classes ended, where the athletics teacher and a group of students were teaching me how to play Netball (like basketball combined with ultimate frisbee). We looked up and there were dark, angry clouds forming just to the east, right over the ocean. The wind was starting to blow a little cooler, and in all honesty the effect was quite pleasant, with softer light and a nice breeze. However, when we boarded the buses a little while later, it was plain that these clouds meant business.

All along the route home, the clouds followed the main city street, Bagamoyo Road. Dar Es Salaam was gripped with a sort of daring haste; the same feeling I imagine one would get on a courageous battlefield when the bigger, badder enemy was on its way. People were hurrying to get their work done, walking quickly along the sides of the road. The Maasai shepherds had their flocks in full retreat, pushing their goats (Mbuzi) and cows (Ng'ombe) along at a good trot towards the groves of trees in the outskirts of the city. It had started a good steady shower by the time I was let out at my stop, but by the time I got back to the Kawishes, less than a quarter-mile away, it had slowed to little more than a drizzle. I hear that when the rains start coming regularly in a few weeks, some of the roads to the school will get too bad to drive on, in which case we will have 'Flood Days'. Takes me back to my sophomore year in high school, when Asheville was under 5 feet of water and I had to postpone getting my braces off for two disgustingly long weeks.

Everything else is going; it is hard to say everything is going well because I really do feel like I live here now, and as with anywhere, there are positives and negatives to living in a specific place for any length of time. I am thoroughly enjoying teaching- I can communicate with the kids so much better than I can communicate with adults, for some reason. Perhaps it's my considerably terrible sense of humor, or maybe I just relate to the kids better because I am also antsy and get bored easily.

Additionally, I love being able to put things into good metaphors for the kids. Today one of the teachers sprung a class on me, asking if I could fill in for him as a "guest speaker". As it turned out, the subject was HIV/AIDS, something I know next to nothing about (they don't teach much about it in American schools, because it isn't as much of a problem there as it is here) and I had a sneaking suspicion that he simply felt too awkward having to explain about safe sex to a bunch of fourth graders, and that I was a delightfully eager new teacher who would be happy to fill in on a class. He gave me the science book, which did have everything I needed to know to teach the subject, and when I asked when the class started, he looked at his watch and said "I think about five minutes from now," and walked away.

So there I was, half an hour later, comparing the immune system to a human's personal little military. I described a virus as an invading army, and related antibodies and the immune system, saying that if a virus is using a new weapon, like a gun, then the body might sustain a few losses before it realizes that it can protect itself against the new virus, using something like a bulletproof vest. I was pretty impressed with myself until I realized that they were fourth graders and couldn't understand a word that was coming out of my mouth, and I resorted to writing definitions on the board and asking them questions to make sure they understood what I was teaching them. They seemed to have picked up on it rather well, although I thought my clever metaphor might have been better received in an older class.

I have been learning Swahili quite quickly, though, to the delight of everyone here. The hardest part is remembering words and names, because they all sound so similar. It's a bit like going to a party and having to remember the names of everyone there all at once, but all the names are fourteen syllables long and start with K.

Fun tidbits of information:

- I saw a snake charmer on the street the other day. I was delighted to know that snake charmers are real and not something Disney created to make Aladdin more exciting.

- I heard a song on the radio today in Hadza language, the infamous 'click' language. I almost wanted to laugh because it sounded so bizarre, and I could see the looks on some of my friends faces if I started singing lyrics in Hadza.

- The Kawishes got a dog today, to use for security purposes. She is a 3-month-old German Shepherd/Rottweiler mix and is very cute and sweet. Mama Kawishe wants me to name her- I like the name Kenna but I think maybe a good generic American name would break the pattern around here nicely.

- I know I'm not supposed to have favorites as a teacher, but since he's really part of the nursery program and not one of my students, I think this doesn't really count. A little boy named Elias has become my absolute favorite child here; he's only about 4 years old, but he is the cutest little kid ever. He has this great big smile and the only word he'll ever speak to me is "Yes", no matter what I ask him. He copies everything I do, and we have funny face contests on the ride home. I'll see if I can't post pictures of him soon.

- One of the teachers asked about chicken pox, and I told her how some American parents have chicken pox parties for their kids. It may be a few more weeks before they stop making fun of us white folks for doing that. (Joyce imagined a mother riding around with a loudspeaker yelling "Come one, come all!" and inviting everyone to her house to get infected).

Anyway- from here on out, I want to know what you want to know about. There are so many little differences between life here and life at home, and it would be impossible to try and address them all at once. I've enabled comments on this for people who aren't members of Blogger, so everyone will be able to leave a comment and say what you would like to hear about. I'll still leave posts about whatever I feel compelled to write, but with a daily routine newly in place you might find yourself being bored with reading about how sentence structure is taught or how my feet swell up when I wear heels for too long.

Also- here is my address. I know it is expensive to mail things all the way to Tanzania, but letters are better than gold to me, and a few photos wouldn't go amiss either- something for me to post on the wall next to my bed. :)

Emily Clevenger
P.O. Box 40829
Dar Es Salaam, Tanzania

Love you Mom and Dad and Eli!! Miss yall so much. Nana and Papaw, I love you and hope to hear from you soon!

Kwa heri na usiku mwema,

Emily