Christmas Day in Bukoba

Valerie and Raheem hosted a splendid Christmas Day at their house for an assorted group of volunteers, four Canadians, Baraka, an adopted Tanzanian boy, a Phillipino and five Brits with some friends dropping in. It was just as well as it rained all morning and was clouded over, hot and humid all afternoon.

We had roast chicken, roast potatoes, roasted Meditteranean vegetables, two different stuffings and gravy. This was followed by an M and S Christmas pudding ( brought back by Chandrika), trifle and in recognition of where we are Tropical fruit salad.

Pressies under the Christmas tree was followed by Trivial Persuits.

Train journey from Dar to Mwanza

We chose to travel home by train across Tanzania, a 2 day journey, we were told.

We travelled 1st class as advised, which gave us a two bunk compartment and a sink in the corner. We arrived early at Dar station, which was heaving with humanity and all their bags heading for Christmas somewhere else. We finally set off late after much shunting at 7 pm.

The train was packed and we were pleased to have a space to ourselves. The guards and attendants were concerned for our safety (from theiving) and insisted we close our outside window at night for security as there were many stops at halts along the way. We were brought food to the cabin which consisted of chicken and rice/chips and spinach. This was the only thing on the menu for the whole trip apart from omlette and spiced tea for breakfast. The food was delicious and hot, if monotonous, and washed down by warm beer. A strip wash before bed was most welcome, best done in the dark so as not to terrify anyone outside.

Dawn brought us to a completely different landscape; dry, parched land, with many baobab trees standing sentinel and distant hills covered in scrub.

We arrived in Dodoma, the so called Capital at midday. Still very dry. Someone enterprising has planted olive trees which seemed curious but they looked healthy and were in fruit. All came clear when we saw a Lombardy style church with seperate campanile....the Italians were here!

Travelling by train was a wonderful way of witnessing rural life in Tanzania. The hardship was clearly visible; children in old ragged clothes, shoeless and thin.

Bicycles seemed the only common form of transport apart from train and feet. Even the cows were thin.

We arrived in Tabora, Annie's birthplace at 11 at night, so not much to see apart from another very busy station. Here the train split in two, 8 carriages being taken off to go to Kigoma. I (A) watched fascinated as a family of 12 including 5 kids squeezed themselves into an already full carriage, with all their bags, through the window amid much heated discussion....made First Great Western seem a doddle!

Coming further north and climbing all the time, it became cooler and the countryside greener. We passed small rice fields (Shinyanga is famous for it's rice) and generally people were more prosperous.

Coming into Mwanza we passed through a valley bordered by huge rock formations, remimdimg us of Dartmoor Tors. We eventually arrived in Mwanza at 3pm, 44hrs after setting off from the coast.

All along the way when stopping at halts and stations, there were people selling wares---anything from wooden spoons, woven mats, pottery stoves to rice and food. Our neighbour bought something every time for Christmas! We were also filmed by a Japanese film crew making a documentary on train journeys.....

We caught the (smart) night ferry from Mwanza, arriving at Kemondo Bay in the early hours and arrived home safely. It was good to sleep in a bed that night that was not moving!

Annual Volunteer Conference

Every year VSO brings in all 78 Volunteers for a conference. There is a lot of important discussion, updatimg, networking and sharing of ideas, problems and experiences. We were particularly pleased to meet other Health Workers who are in the field of HIV/AIDs. Francijn, a yound Dutch Dr working in the South has worked very hard in her placement and gave us a memory stick with more than 330 pieces of information about her project! Invaluable to us.

Volunteers gave presentatoins about their work and Rupert gave an excellent presentation (with powerpoint!) on "Sex and Development" which was well attended and very well received. Much to some peoples initial disappointment, it was more about the effects of rapid population growth and lack of adequate contraception on development than about sex per se. However he was asked by several people for a copy of the presentation, so we hope the message will spread....

There were other excellent presentations. We enjoyed one on water supply and sanitation and another from a friend in Dar in Media who is part of a national campaign to increase awareness of HIV to young people.

It was fun to meet up with our intake group again and to hear their stories. Such diverse experiences of work placements, housing, climate etc. We were kept working all day. Rupert and I had the surreal experience of going for our evening dip in the Ocean, accompanied by the sound of the bagpipes played on the beach by a Volunteer who happens to live in Saltash and plays for the Cornish Pipers at Tavistock Carnival!

Evening entertainment was predictably fun, including live music and Karioke. (Not on the same night!)

Mafia Island

Once a year VSO arrange a volunteers conference in Dar and so we took the opportunity to spend the preceding weekend on Mafia Island. It is about 30 minutes flight south of Dar and has a large National Marine Park.
The photos speak for themselves. It was lovely.

The Mafia Lodge had a superb open sitting and dining area with a field leading down to a lovely beach and a beach bar. We went snorkelling out on a reef twice and saw a truely amazing collection of coral and fish. It is difficult to describe the intensity but both time we returned overawed by the experience. It was one of the best sites we have been, the water was a little cloudy but we were so close to the coral and fish it did not matter.

We managed a sunset sail in a small dhow with just us, our host Ali and the skipper. Sparkling South African wine, the quiet rustling of the sea and an interesting chat with Ali about the seperation he feels having an Arab mother and how South Africa made him feel very uncomfortable with the racial tensions. The sunset as always was beautiful and the sail back in the gloaming just so perfect!

(Double click on the R picture and you may see a full moon rising between the palm trees)
It was all over too soon ( not helped by missing our flight the first day due to Precision Air changing their schedule at 24 hour notice).
This is Mafia Airport Fire Service, pressed into action (!) twice a day.
We did not see many Tanzanians (apart from the hotel staff) though one can take a ferry to the local village across the water and wander round the small island. certainly worth it for 3 or 4 days but not more if you are interested in what Tanzania has to offer.

Care and Treatment Centre (CTC)

Rupert works in the CTC looking after those people who are HIV positive. Kagera was the first place in Tanzania to recognise AIDS in 1982 but treatment with antiretrovirals has only been available since 2004. It has slowly been extended from Bukoba to outlying hospitals and Kagondo started in February this year.
We have an active counselling and testing centre mainly run by a superb nun Sister Renate. They have done about 2000 tests this year and the positive rate is about 12-15%. This is mainly among the worried or those with symptoms. The background rate is about 3% in antenatal mothers and posssibly 4 % in the adult population. It is higher in the towns and Bukoba runs at about 8%. What no one has adequately explained to me is why the prevalence rate has dropped from 15% in the 1990s. The rate in South Tanzania is rising from 7% to 14%.
The CTC has about 300 patients on their books with about half on antiretrovivals (ART). Adherence to drug taking is amazingly good and most people are very insistant on taking their tabs. The response is often dramatic, with appetite returning weight going up 6 or 7 kg in 3 months and going back to working in the garden. It is difficult to predict what the future will hold but if one views it like chemotherapy for cancer, it gives people a year or two or three or more to teach, be a mother, work in the garden or whatever.
Unfortunately many people are prsenting late and die within a few weeks of starting treatment. There is still stigma but the women are much better at coming, adhering to treatment and be willing to talk about things and show other people how life can continue on ART. Again it is similar to the attitude prevalent in the UK in the sixties about cancer before effective treatment became available when one just did not talk about cancer.
Rupert works with Sister Immaculata who is very determined and works without a break till all the patients are seen. Fortunately this is by 12 or 1 pm. Godi, our nurse works very hard and is good at councelling and encouraging the patients. After the clinic I wander round maternity and womans ward but that is not arduous with only 4 - 10 patients on womans ward. Later I am spending my time sorting out the registrer and planning where I can be most useful over the next 9 months.

Sunday walk to Bugasha

It was time to explore a bit so we set off to find the Lake. Heading due East we were greeted often and given much advice. The best one from a young teenager was 'there are many ways to the lake' and after a long pause 'but I think you should go......' and he drew a map in the earth with a stick.

We came over the escarpment and found it was the same village Annie had been to last month, Bugasha. A leisurely stroll down the path found us at the Lake shore, in all about 2 hours.

We had soda and sweet bananas and were surrounded by curious children. An interesting man with good english asked us about life in England and talked of life by the Lake. His brother turned up and he had extremely good knowledge, knowing about Papua New Guinea, New Caledonia and othe far flung places. It turned out he had trained as an aeronautic engineer in Moscow. He asked searching questions about why the economic situation in the world had taken a down turn and who was responsible. Not the easiest question to answer but after blaming the irresponsible gambling by bankers we ranged far and wide- China, interest rates, price of tilapia, supermarkets etc...

Life is not easy, fish are more scarce but there is always time for coffee (Kahawa) under the mango tree. We then strolled back under the hot sun. Next day most of the staff were amazed we had walked there. 'Why didn't you take transport?

Birthday Party

We went up to Ndolage Hospital to celebrate Rupert's birthday along with Teresita whose Birthday was three days before. She is a Philipina nurse tutor also with VSO. Ndolage is on an escarpment high above lake Victoria near Kamachumu, the original European settlement in Kagera. The Hospital is run by the Lutheran church and VSO have had a presence here for many years.

We took the opportunity to have a regional VSO volunteers conference so 5 Philipinos, one American and 5 British Volunteers assembled. We went off to have a look at the dramatic water fall and the lovely view over the countryside.

Later we joined together for the joint Birthday party and had a great feast organised by Teresita. There was more than enough to eat and three Birthday cakes. Afterwards Angelita, a retired family doctor and Tersita gave us a great demonstration of Philipine dancing

Outreach Baby Clinic Tanzanian style

Annie works in the Reproductive and Child Health clinic, which covers antenatal mums, babies and all outpatient HIV testing.
The Hospital has four outreach baby and postnatal clinics, each run monthly.
The first visit I went on was to a village by the Lake. Sounded lovely!
It was wet, grey and chilly when we set off. The good vehicle (and it’s driver) went off to the Bishops ordination crammed full of excited Nuns and other VIPs. We had the Toyota Land Cruiser pick-up, definitely past it’s first youth.
Turning off onto a minor dirt road spoiled by the rains, on past an army camp complete with guard and barrier (sapling on 2 forked sticks). We then stopped mid road and turned sharp R, into then out of the ditch, onto a footpath. Mmm.
Footpath got narrower and boggier, definitely bumpier. We turned a corner and there was the loveliest bay. A rocky escarpment backed it with the village nestling near the shore, fringed with trees and shambas. Smoke from cooking fires curling out of the thatched roofs, distant sounds of village life. We then came to the escarpment…still no road, footpath disappeared, only rocks that descended at an alarming angle downwards. We must be stopping here. Ah no.
Over the large rocks we went, lumpybumpy, sloping down at an alarming angle, huge rocks--4WD helped out there--then we bombed down the (relatively) smooth track to the Lakeshore, straight on, into the Lake! Sharp turn R, we drove along the lake shore, nearside wheels on wet sand, offside wheels in about 2’ of water, keep going, keep going! It was now that I realised our driver had never been here before, and was being directed by my colleague, elderly male nurse with whom I was crammed in the front seat. Driver distinctly nervous now, asking where to turn onto land again, and finally chose a less boggy area and we made it. Phew! The "clinic" is a community house, made of mud and wattle, hay on the floor, a small bench and table. There seemed to be about 2million Mums and babies, all squeezed in on to the floor, spilling outside, waiting patiently. We saw over 200 Mums and I vaccinated about 60 babies, in the semi dark, all in 3hrs… Then home time!
Setting off once more, this time with the tarp over the back to keep my 2 colleagues dry, back through the Lake like some latter day landing craft, and up onto the land, over the sandy path and ooops! Stuck in the mud. Driver did something with rocks and 4WD again, with revving and black smoke we were off. Power began to fail at the stony escarpment bit. Now I was worried about the engine. We made it over the stones but then stalled. Driver stressed, bonnet up, running between accelerator and engine. I offered to help (as I was the only other driver on board) by applying pressure to accelerator for him, which helped with the engine, but not his dignity. (I now have a reputation of being able to drive a Toyota Land Cruiser into the Lake!)
The following clinics were interesting, if not quite so exciting, but maybe more of that later…

Our Home

Our home is simple but we are busy making it comfortable. It is a semidetached with living room and 2 bedrooms, a walled enclosed courtyard and kitchen , shower and loo. The basin is in the courtyard so we brush our teeth gazing at the stars in the African sky and I shave with the cool light of the African dawn. Having a shower is challenging as it is cold only and the ambient temp is only about 18-20' C. The backyard is clean but the walls need a coat of paint. We have a few pots of fowers/mint/basil mostly provided by Valerie in various old margarine containers.

The countryside stretches behind and there are many birds including glossy starlings, assorted finches, hawks and what is that large grey parrot? Kids pass frequently morning and afternoon walking to and from school and looking/staring/giggling/running and saying "Good morning, Sir/Father/Doctor" whatever the time of day. We walk 5 minutes to the hospital though it can be a very wet 5 minutes.

This is the view from our porch.

We have been busy planting cuttings and plants that Valerie gave us and hope some take. We went out into the countryside to dig up some pretty flowering plants. One passing Tanzanian woman thought it was good that we had some plants for custom medicine for tummy ache and one of the nuns coming back from the garden thought it odd that we had dug up weeds to put in out garden. The teenage girls next door thought it was hilarious. I suppose somewhat similar to digging up some Queen Anne lace or dandelion to put in ones garden !
Sunset over the valley behind our house.

St Joseph's Hospital, Kagondo

At last we have arrived and been welcomed by the sisters and staff at Kagondo. The hospital is just off the main road down south from Bukoba. It was founded by the White Fathers in 1912 and has undergone renovation so it is bright and airy and very clean. It is staffed partly by nuns and partly by lay staff. It has the usual wards and though it can hold 150 patients, it is only half full. It has Xray, a simple laboratory, physiotherapy and last month connected to the internet through an excruciatingly slow line
Rupert has been set to work in their relatively new HIV/AIDS clinic and there is a surprisingly good attendance and adherence to clinic appointments and drug taking. Annie is working in the Maternal and Child Health clinic also with a brief to work with HIV positive mothers to try to reduce maternal to child transmission.
The Lake is about 4 miles away and we hope to walk down one weekend. It rains almost every day for 2-4 hours then clears in the afternoon. The nights are cool and in the evenings we reach for an extra T shirt or fleece to warm up. The view down the back road shows the blue roof of the hospital in the distance. Our house is in a cluster just to the right and the new secondary school is in front.