Week 11 - Priorities Plus a Grand Finale Weekend for Amanda

April 30 - May 6

Nie and I continued this week working on the profiles of the families that receive assistance and support through the Home-Based Care program. Of the 24 families we have profiled so far, 18 are single mother households; 4 have husbands in the home. There is one husband who works out of town, and there is one single parent father. As Nie relates their stories to me I can’t help but feel incredibly overwhelmed. These feelings stem not only from the magnitude of the poverty and basic needs of each family but also from a consuming desire to do whatever it takes to lift these people out of poverty. I find it so difficult to prioritize and establish boundaries.

Unfortunately the cycle of poverty here is not just familial; it is systemic. The educational and health care systems, in particular, exacerbate and contribute to the destitution of these people.

Primary education is supposed to be free but each school also assesses a fee to help defray their costs; food is not provided; and a uniform must be worn by all students. After primary school, the students must then pass a national test to continue on to Secondary school. Therefore, if the student fails they have just hit a dead end in terms of ever gaining the skills needed to earn a living wage.  A report published in 2009 indicated that only 49% passed the national test for Secondary school and of those who passed 90% were selected to attend because there is not enough room to accommodate the students.

As I had mentioned in a previous blog, if fees are not paid a school can send the child home which could easily result in a lack of motivation and desire to attend.  A significant number of children do not move past primary school because of lack of income to cover the expenses. According to a UN report in 2011, only 36% of students transition from primary to secondary school. The biggest obstacles students must overcome include a lack of a proper study environment at home; an inability to master the English language; poor nutrition/health; and other economic related issues.

While discussing the families I asked Nie if when we visit these families she will inquire about whether school fees are current for their children.

Nie explained that she cannot ask a family about school fees because the family will expect TAFCOM to pay for them. The cultural rationale/thinking is, “Why are you asking if you cannot do anything about it or are not going to help?” This is so difficult because I would imagine that the majority, if not all, of the Home-Based families are behind in their school fees. This creates another complication when a volunteer decides to sponsor a child’s education and then does not follow through. This becomes a burden for TAFCOM because a commitment has been made. I am doing my best to help in ways that can have an impact but without a long-term commitment. This adds to my overwhelmed state of mind. Education is so important to me but here eating and health must come first.

The health care system is like nothing I have ever experienced. Deborah still can’t hear out of one ear, has been to numerous doctors, and been given new meds each time. This seems to be fairly routine when one is ill and causes me to question the competency of the health care providers. In addition to the financial burden of medical charges, repeated trips to health clinics are costly in terms of transportation and time away from generating income.

I recently met a doctor at the gym. He interned in the US at both a large and small hospital. He said even the small hospital was better than the best in Tanzania. For him the most glaring differences between the US and Tanzania health care systems were in terms of the technology and quantity of medical equipment, and the doctor:patient ratio. In the US, there is 1 doctor for every 300 people. In Tanzania there is 1 doctor for every 30,000 people.

Worst of all is the problem of AIDS. Embarrassingly, my education is lacking when it comes to HIV/AIDS so I have been researching online and asking questions of Nie. The first home visit I made when visiting Tanzania in 2009 was to the home of a couple where the man was dying of AIDS. It is a scene that will be etched in my memory forever. He was lying in his bed, looking very emaciated, with his wife sitting nearby. He died later that year.

When a person tests positive for HIV they are also given a blood test to determine their CD4 count (also referred to as T-cells). If the CD4 level is above a certain amount they are to be retested every 6 months. ARV drugs (Antiretroviral: http://en.wikipedia.org/wiki/Antiretroviral_drug) are given when the CD4 count goes below a certain level. These are immune boosting drugs which are taken daily for the rest of the person’s life. They must be taken with food or can cause stomach upset.  Sadly there are too many who do not have enough money for food and rather than suffer the stomach problems will not take the drugs. In addition, there are multiple side effects, especially when the disease is advanced. Nie explained that the side effects are so bad that some do not take the ARV drugs. Another deterrent to even taking the first step of being tested is the stigma that is attached to having AIDS.

Martha, one of the women Nie works with, discovered she was HIV+ when she was giving birth to her second child.  The baby died during the birth. Her husband believed that the reason the child died was because his wife was HIV+. He refused to get tested for HIV and became abusive towards his wife.  When Martha’s mother learned about how she was being treated she raised the money to move her daughter to Pasua and live with her and other family members.  Martha was forced to leave her first born (5 years old) with her husband. Due to the stigma surrounding HIV/AIDS Martha is even ostracized by some of the extended family she is living with. 

ARV drugs are provided free by the government. However, medications for opportunistic infections are not. An opportunistic infection is defined as any illness related to a lack of immunities. Usually the symptoms and illness are worse for the HIV+ person. Examples include: malaria, shingles, TB, pneumonia. So we have people who don’t take their drugs because of lack of food and serious side effects which makes them far more susceptible to other illnesses which they cannot afford to treat. Plus not taking the ARV’s regularly can lead to drug resistance. This is an inevitable death sentence. How will we ever impact the spread of and deaths from this disease when there are so many obstacles to overcome?

The most innocent victims of this disease are the children. AIDS can be transmitted to a child during pregnancy, childbirth or through breastfeeding. Also, the disease progresses more rapidly in children than adults.

I shared some of my feelings with Nie. Fortunately, I gain a lot of strength from her. She agreed that we needed to set some priorities as she too feels we have been very busy with a variety of tasks. So this week was one of planning.

The Home-Based profiles are as complete as they can be until we make home visits and update our information. We will set aside one day each week for this beginning next week. We both agree that Micro-Loans and Family Planning should be our major areas of focus. We went thru the profiles and identified 8 women who would be good candidates for a Micro-Loan. We put a budget together and Nie will contact the women. A Business Management Workshop will be held on May 19^th. In 2010, TAFCOM initiated this program and sponsored a 5 day workshop. Our budget is very tight and we do not have the funds for 5 days so in meeting with our facilitator he agreed to condense the curriculum to one day. I also felt badly because his fee was more than we could afford and I had to work out a lower fee.

We chose to offer the Micro-Loan workshop this month so that I will have the opportunity to track the progress of the women over the next 3 months. This program has been so successful in the past and although the businesses the women choose will not necessarily move them out of poverty; it will provide them with the means to meet their basic needs and, hopefully, educate their children and be prepared for any emergencies.

Our other focus area is Family Planning which, again, is not even a consideration for a family who doesn’t have enough food to put on the table. (So to speak, few if any of the homes I visited had tables.)

We identified those families with child-bearing age women and will organize a Family Planning workshop for June. TAFCOM has held this type workshop in the past so it should be relatively easy to duplicate. Also, we had some volunteers visit TAFCOM recently and one of them gave us almost 300 condoms. We should have no problem distributing them. After all I am learning about AIDS and how horrific a disease it is, this workshop will be a great educational opportunity.

Our other priority is planning an event for the group coming from the US for the Malaria Project on June 3rd. There will be 16 people and we will take them to Pasua to see the Center and learn about TAFCOM’s programs. The children will perform; the Tailoring women will have items to sell and we will provide some traditional food. I really enjoy event planning like this so am feeling very much at home with this project. I will spend part of this weekend putting together an agenda, children’s songs and greetings, price list and sponsorship info.

  

When we visit the Center I am spending time with the kids but also with the tailoring women. They are learning to crochet and we are talking about expanding the items they make. A previous volunteer taught them to make yoga bags and she is now selling their products on line (www.maishadesigns.com). I have been talking to them about a basic quilting for placemats or blankets and making napkins and table runners. They already make purses, headbands and aprons. I am most likely going to mail a box of items home to sell. Any requests let me know.

Deborah, Amanda, Me, Jacqueline

Raheem with Cake Spoon

Friday – this is Amanda’s last weekend as she leaves for Canada on Monday evening. It was the most fun-filled weekend yet. We decided it was time to bake another cake. Amanda and I went into town for the ingredients. Deborah wanted a vanilla cake so we bought flavoring and decided on chocolate icing. I am not sure if I mentioned before that the oven here is very small and only has one temperature (which is unknown). There is no cake pan so we just use a large metal pot. The cake took over an hour and a half to bake. We had trouble getting it out of the pan and took turns banging the bottom with a wooden spoon. I swear it weighed 5 pounds. I don’t understand how we did it but it tasted great and was very moist. The whole thing was eaten within 24 hours. We had some for breakfast and it was great with tea.

Saturday – Magembe and Dennis were playing in a basketball tournament so I went to watch. Amanda was a on a day trip and met me there. On my walk to the courts I noticed a young man peeing into a bush along the path. I walked in the road but it just so happened that by the time I was near him he had finished, greeted me in Swahili and joined me walking down the road. It is not that uncommon for a man to relieve himself on the side of the road. I also saw this on several occasions when I ran at the field near the market. The men at the market always used the same bush!

Magembe 

The basketball courts are on the same road I take to TAFCOM. Most days I pass this particular house where there are 3-4 kids playing outside. We always exchange greetings. I passed them again today and they seemed so excited to recognize me on a non-work day. The kids here so easily capture my heart with their contagious smiles.

I could hear music blaring before I could even see the basketball courts. Amanda arrived shortly after I did and there were 3 other muzungu. They turned out to be some of the Peace Corps volunteers we met when we were with Andrew! The games were 3-on-3. Unfortunately, neither Magembe nor Dennis’ teams won but everyone seemed to be lighthearted and cheerful.

Konyagi (similar to Gin)

Amanda had wanted to try Konyagi, a local “spirit”. So after dinner we took Magembe and Dennis to Pamela Bar and I succumbed to peer pressure from the younger generation.  Amanda and I ordered what we thought was a shot of Konyagi with tonic water. Our server brought us each a bottle of tonic and a 200ml bottle of Konyagi. (Amanda did the math before drinking and figured it was the equivalent of at least 6 shots per bottle.) Fortunately the bottles of Konyagi were unopened so we sent one back. Our server then proceeded to pour half the bottle in each of our glasses and topped it with the tonic water. OMG it was way too strong. We kept adding tonic after each sip and finally asked for a second glass so we could divide it again. We both slept very well that night.

Sunday – What an amazing day! Ibrah drove the family and Amanda and me to the Chemka Hot Springs. I have no idea how he found it, the roads felt like an amusement ride as we were jostled and tossed all over the jeep going over bumps and potholes, through water and on roads that were deserted and in the middle of nowhere. When we arrived I could not believe the beauty of this place; gorgeous trees with monkeys swinging through the branches over our heads; springs as clear as any water I have ever seen. It was impossible to capture the essence of this natural beauty on film.  There was a swing to propel you over and into the water or you could jump or dive off the many tree roots that jutted out over the edge of the water. I chose the swing, twice. It was great fun, however on my 2^nd attempt my hands slipped and I belly flopped into the water which caused great amusement for the family and locals. The local kids were climbing the branches, jumping off edges and performing acrobatic diving from the ropes. They were totally fearless.

Chemka Hot Springs

Notice the tree roots

Me Letting Go

2 local boys together on the rope

An Example of the Roads we drove on

Another Road

Squatty Potty - Notice the foot  imprints

I returned home refreshed and renewed. Amanda and I went out for her last ear of roasted corn and as always it was delicious. I can’t imagine it is good for you since it is typically cooked out of the husk, right on the grate, over charcoal. We have decided that it is most delicious with lime juice rubbed all over it. (You can try this at home!)

Roasted Corn with Lime