Thursday, March 1, 2018

Feb 12 – Feb 19 The Challenges of Inadequate Health Care - The Needless Suffering

Monday, February 12
I started to tackle the mounds of mostly-boxed flash cards. As much as I like to organize, this is not something I could do every day. Fortunately, I am not at a loss for things to do. The Micro Loan workshop is Wednesday, so I spent the afternoon walking in Moshi and getting supplies.
It is such a treat for me to visit and reconnect with people I have not seen for 2 years. Chui Traders is one of my favorite stores/curio shop. The owner founded a workshop for those who are physically handicapped where they are employed and trained in arts and crafts. The store sells many of their items. I was so glad that he remembered me. BLOG
I stopped at the bank for funds for the Micro Loans and my rent. Seriously!! my card was blocked again! I knew my credit union would not open for another 30 minutes so I went to the stationary store.
I have been buying supplies from Jambo Stationary since 2012. Alice is the owner and is always in the most pleasant mood.  I walked in and surprised her. We exchanged lots of hugs and kisses. She shared that Stella, who has worked there for years had a baby girl yesterday!
At 8:20am (Ohio time) I emailed my credit union and got a message back before they opened at 8:30. Apparently, the credit card company only allows withdrawals for one week at a time due to the fact that so much theft occurs on debit cards in this area of the world. The card was activated and I withdrew funds. My choice in the future is to contact the credit union each week or use Western Union. Western Union is the clear, easy winner. However, I want to be clear that I love my credit union and their service has been superlative.

Tuesday, February 13
More fun with flash cards today. I actually finished cataloging and rearranging them. Nie shared that Neema, the mother-in-law that Rehema is caring for, had to go to the hospital. (We visited there last week.)
Also, Elly has some personal issues she needs to deal with and is no longer able to work with us. Asha, who helps with Nie and Jonas will take Elly’s place. It was agreed that Asha and I would work together on some of the responsibilities and I will eat whatever the family is having (minus the meat). I feel better about this arrangement because it is more comfortable for me.

Wednesday, February 14
Nie shared that Asha’s older sister has a disabled child whose condition is not improving. Nie invited Ruika and her daughter, Safina to TAFCOM today. Safina (8 in June) was diagnosed with Spina Bifida and underwent spinal surgery in Arusha in 2015. (A doctor from KCMC donated all the funds for surgery.) Following a 6-month recovery period, the surgery had not solved the problem. Safina is unable to use her legs. One side of her body and the leg on that side are also twisted inward.
According to doctors at KCMC, there is another issue farther up the spine. After a series of tests this month, it was determined that Safina also has Spinal Tuberculosis. She was prescribed 3 medications which will cost $145 per month. She is to have monthly visits at the clinic and be re-evaluated at the end of 6 months. In the meantime, Safina is to go for physical therapy every week. Safina had been attending Physical Therapy when her mother could afford it. Rukia would also love for Safina to attend school.
I am glad I was sitting down for this story. I really don’t like this theme of tragedies that continues to visit us.
The afternoon was certainly more hopeful as we were able to give out 10 Micro Loans. The recipients attended a training in business management and each was provided a small notebook to track income and expenses. This is one of my favorite programs and the repayment rate is always impressive. Nie and I will talk more about ensuring that this can be a revolving program.

Friday, February 16
I did not go to Minnesota Academy today. There is a teacher staff meeting tomorrow and I will be sharing my observations and recommendations. Nie and I had been discussing Chausiku’s situation (the 71-year-old raising her granddaughter). Before becoming ill, Chausiku had a food business. As she is starting to feel better she wants to start her business again as there is currently no source of income.
We decided because of her age and health, a grant would make the most sense at this time.
We stopped at Chausiku’s home. She was moved by the gesture of generosity and you could feel the energy of her gratitude when she received the funds.
Our intention was to visit Rehema and Neema at the local Pasua hospital. We were advised Neema had moved to St. Joseph’s, a private Catholic hospital. I have been there a number of times over the years and although the care is better than the public hospitals, it is still a difficult place to visit.  The room had at least 6 beds on each side only covered with sheets. It was a crowded room with people sitting on the beds of their family member. Visiting hours are scheduled around meal times because the hospital does not provide food. Rehema was also spending the night and sleeping on the same bed.
During our visit, a friend of Nie and Jonas’ walked by. His sister, Regina was also in the hospital. Regina had been the first tailoring teacher at TAFCOM. Nie knew Regina had health issues but was not aware of her hospitalization. We walked past the rows of beds and on the other side of a curtain were 2 beds. This was their ICU. Regina had been in the hospital for 5 months and was in a coma. Her eyes were open. It was a haunting look that showed no sign of life. She died 2 days later.

Saturday, February 17
Today was a teacher staff meeting. I had prepared a multi-page report of my observations at the pre-school and Minnesota Academy. Jonas asked me to share it along with recommendations. There will always be areas of improvement which we did talk about at length. The biggest issue is the lack of textbooks for each child. Because of the number of non-paying students, families cannot afford textbooks. Those with textbooks share with others.
I want to focus on the positive. I was most impressed with the ways teachers encouraged the students and the mutual respect between teachers and students. It was not uncommon for a student to correct a teacher if they misspelled a word or copied something incorrectly on the board. It was always done respectfully, with the teacher expressing their thanks.
What I realized from my observations is how challenging it must be for both teachers and students in an English-speaking school. The teachers are teaching in a second language to young people who must also comprehend and speak in a second language. One of several differences between the public and private schools is the fact that the private schools teach all their classes in English, where the public schools use Kiswahili and have English classes. When the students move to Secondary school, all classes, public or private, are taught in English. This gives the private school students a definite advantage.
I feel that the mutual respect grows from this shared experience of communicating in a 2nd language. The teachers know and appreciate that the student understands a concept or spelling of a word when a correction is brought to the teacher’s attention. During one class, the teacher remarked to his class, “I like students who advise their teacher. It shows you are confident.”

Sunday, February 18
The family had been planning a trip to Kili Home WEBSITE for today. Joan and Happy were super excited. It has a large play area with rides and a blow up jumping center. I had invited Amina  and we wanted to make sure she knew when to come to the house. A message was left with her older brother. As I left for my run at 7:15 this morning, Amina arrived. What kid gets up at that hour on a weekend morning? I am guessing she was pretty excited too.
It is so refreshing to see children playing, laughing and thoroughly enjoying themselves. I think it is something we take for granted. For me, it is these moments when I know that the poverty and hardships of their lives are left behind, even if for a short time.

Monday, February 19
Lots to discuss with Nie and Jonas this morning.
There are at least an additional 10 clients who need a Micro Loan. It is not an easy task deciding who to give the funds to because the list of potential recipients is always growing. Pasua is the 2nd poorest ward in Moshi. To make this a revolving program, TAFCOM will accumulate repayments and at regular intervals provide loans to 2 new people.
Chausiku and Rafina are priorities at the moment. Chausiku’s meds run out tomorrow. Nie has a meeting and will drop off the funds for a month’s worth and also check on her new business. Funds will also be given to pay a portion of the school lunch fee for Hadija.
Rukia approached 5 schools to enroll Safina. Because of her physical limitations she was rejected by all. She is almost 8 and has never attended school. We decided to have Rukia come to the office Wednesday morning to discuss Safina’s needs and the logistics of having her attend school here. Jonas said to build a ramp would be the easy part.

I researched Spinal Tb and was overwhelmed by what I learned. Here is a short excerpt from an NIH site. "The spinal column is involved in less than 1% of all cases of tuberculosis (TB). Spinal TB is a very dangerous type of skeletal TB as it can be associated with neurologic deficit due to compression of adjacent neural structures and significant spinal deformity.
Using multidrug therapy, the recurrence rate for skeletal TB is approximately 2%, although the relapse rate was much higher when a single drug regimen was prescribed. Long-term multidrug antituberculosis regimens will likely reduce the relapse rate. Spinal TB is the one of the most common causes for a kyphotic deformity in patients from many parts of the world, and particularly in developing countries."

I am going to take a wild guess that this reference to "developing countries" is directly correlated to poverty and their antiquated health care systems. Rukia’s mother expressed concern that Safina’s condition had worsened because she was unable to afford medication and physical therapy. It is impossible not to be angry about this. So many medical issues and even deaths could be avoided if there was access to quality health care like we are so fortunate to have.

No comments:

Post a Comment