TIA Moments

“This is Africa” or TIA moments are a daily occurrence here. The power goes out in the middle of cooking, a plumbing disaster turns your bedroom hallway into a lake, and getting an office key takes three trips to town and over a week because the key fundi’s are not exactly precise. Sometimes TIA moments border on the absurd, such as the day I went out for a run and was nearly run over by two cows being chased by the tails by a man in a pink ski cap. Sprinting cows aside, its about 80 degrees here on a cool day!

We had such a classic TIA moment on our first trip to Arusha that I was nearly laughing out loud. Shortly after we arrived, our taxi driver decided to take us to a place he described as a Masai free trade center. We thought it sounded interesting, but after battling traffic for nearly an hour to get there, Cultural Heritage didn’t exactly live up to his description. With giant plastic tusks marking the entrance and a 4 story tall Masai shield leaning against the building, it looked more like Disney meets Africa than anything else. To make matters worse, it was completely deserted. Our driver turned the car off and quickly jumped out to ask if they were open. When he returned, we discovered not only that they were closed but that we might in fact be staying for a while. The car had died, and getting it going again wasn’t looking promising. What I learned over the resulting few hours is that there is a miracle cure for all car problems in Africa…. water! After dismantling the passenger seat to get a closer look, our driver decided that the battery was the source of problem. We found a car fundi to help us – the African version of a mechanic – and he had just the ticket… pouring a liter of water onto the battery. It may sound shocking, but it worked like a charm! Before we knew it the car was up and going again, and we were on our way for an afternoon of exploring the city.

Searching for the problem...

Success! Brandi and Sarah celebrate the water miracle cure.

A Long Walk

Does Uru mnambe sound remote? I discovered on Saturday that it definitely is! Grant, a recent Duke grad who is spending a year in Moshi before medical school, invited us to join him and his friends on a hike to see waterfalls. Our destination, Uru mnambe, was absolutely breathtaking – a 120 meter tall waterfall high in the mountains, fed by Kilimanjaro. Getting there though…. that was another story! We had no idea the hike we were in for when we set off on Saturday morning. We started walking toward town, expecting to catch a dala dala on the way up the mountain. But much to our dismay, no dalas came! So we just kept walking… and walking… and walking up a mountain road for hours.

We passed countless rural villages on our uphill trek. The vegetation became more tropical as we gained altitude, until there were banana trees everywhere. Women passed us with bananas and vegetables on their heads, walking to market in Moshi to sell their goods. One woman actually had a chair on her head, which seemed completely bizarre until we later discovered that the town of Uru specializes in making furniture. Children ran out to the road to greet us, and despite quite a bit of staring everyone we passed was very friendly.

The last hour of our five-hour uphill climb was on a narrow dirt path, winding along a stream surrounded by hundreds of coffee plants. The view was spectacular, but with an impressive drop-off on the other side of the path we made sure to enjoy the scenery mainly during breaks!

Over twenty kilometers and an additional few thousand feet of elevation later, we finally reached our destination. We shared a lunch of peanut butter and honey sandwiches beneath a banana-thatched roof hut overlooking the waterfall, enjoying the view and appreciating the chance to rest. After our long trek, peanut butter and honey has never tasted so good.

We hiked fast on the way back to Uru, our tired legs more than enough motivation to catch the last dala down the mountain. This time luck was on our side, and we made the bus! Walking merely one way gave me an immense appreciation for the distance the women in these villages travel to go to market everyday. I cannot imagine doing that walk both morning and night, much less with a heavy load. Needless to say our Uru mnambe excursion was much more than a relaxed visit to a waterfall. It was quite an experience!

Hour 4, and we're still walking...

Getting closer... ever closer

Happy smiles after lunch!

Kilimanjaro Dirt Road Hash

Sunday was a first for me – I went on my first hash! Some of you - particularly my college roommate Laura - are hashing veterans, but this was the first time I’d actually experienced it for myself. A hash is kind of like a group run, but no one knows the trail beforehand. The group follows patches of flour set out on the ground the day before, and periodically there’s an X made out of flour indicating that the trail could be anywhere… so everyone fans out and searches until the lucky individual finds more flour and yells On on! Everyone then falls in line and the hash continues.

Hashes are known for being particularly adventurous, and this one did not disappoint. We ran through cornfields, crossed streams, and traversed many a dirt road. It was a great way to catch a glimpse of rural life in Moshi, and the scenery was beautiful, complete with blue sky and a spectacular view of Kili. I’m sure that the Tanzanians we passed along the way thought we were crazy, but they greeted us anyway and often pointed out the way. Barring a few areas where we are fairly certain chickens ate the flour, we managed to make it through the entire course and back to the host’s house for a giant feast of local fare. It was a great way to spend a Sunday afternoon!

Work, Home, and Play - Pictures from Moshi

With finding food still a daily challenge, over the weekend Sarah and I decided to treat ourselves to a night out. Logically, where else would we go in Northern Tanzania but the local Chinese restaurant? Yes, our first dinner out was at Panda Chinese, and it was delicious. We managed to find it on our own, which was quite a feat since there are no street signs here. It seemed abnormally quiet when we first arrived, but soon a giant green safari jeep pulled up and about 20 Japanese men rolled out. Needless to say the restaurant filled up pretty quickly.

Welcome to A5, our new home! We have the best house on the compound, but we may be a little biased. The garden in the back is fantastic. We can't eat the tomatoes fast enough, that's for sure.

Without internet at home or phones that call the US, we spend a lot of time reading in our living room in the evenings. The power goes out fairly often though, which makes for an interesting scramble to find flashlights and candles in the pitch black. Luckily there have been no major injuries from walking around in the dark!

I'm standing outside the front entrance of KCMC, the hospital where we work. Moshi has is very tropical - and its spring here - so flowers are everywhere.

This is the view from our office and also the area where ambulances deliver patients to Casuality (the Emergency Room). There are no sirens here, although they probably need them - the patients who come in by ambulance are very ill.

Week One - Getting Settled

I arrived in Moshi, Tanzania almost a week ago, and it has been a whirlwind of getting acclimated to a new culture and way of life since then. Tanzania is in East Africa, with the Indian Ocean to the east and Mount Kilimanjaro in the north. Moshi is the closest town to the mountain, but at this time of year Kili stays hidden by clouds nearly all day.

The plane ride from Amsterdam to Kilimanjaro was fascinating – we passed jagged coastline, the Sahara, and all kinds of rugged terrain during those 9 hours. As we neared the airport, and again on the drive home, I learned my first lesson about Africa. When its dark here, its really dark! The pitch black made the drive down dirt roads full of potholes quite an adventure.

Sarah arrived the day after me, and we have been learning to navigate this new place together. Even the most basic needs, such as finding food, are a real challenge right now! And the language barrier certainly doesn’t help – we know a little bit of Kiswahili, but not nearly enough to understand what’s going on around us. Most of our adventures thus far have involved going into town. Our first trip was quite an eye-opening experience. People, cars, bicycles, and animals were everywhere. It seemed like complete chaos, and even the cars were driving all over the place – it is apparently optional to stay on the correct side of the road! On that first trip we were with the infectious disease fellow, Elizabeth, who is fluent in Swahili. She only took us to two places – first the grocery store and then the market. The grocery store was hilarious – we walked in excited to finally purchase some food for home, but for the first few minutes we stood paralyzed in the middle of store, completely bewildered. All the cans were labeled in Arabic, so we had no idea what any of the food was, much less what to buy!

Our subsequent trips to town seemed a little less overwhelming, and we even took a dala-dala – Tanzania’s form of public transportation – on our last trip. The dala-dala’s are minibuses that are quite literally crammed with people. I counted 19 in ours and couldn’t even see everyone, and it is meant to seat about 8. It took us two tries to catch one before we were finally able to push our way on, and getting situated with our grocery bags and all those people around us was kind of interesting! Immediately after we got on and squeezed into the last available seats, two Masai stepped on after us, fully dressed in traditional garb. Even more surprising was when they began to speak to us in perfect English. It made for a fascinating ride home.

Sarah and I are living in the Doctor’s Compound, which is adjacent to the Kilmanjaro Christian Medical Center where we work. Our house is fantastic – it used to belong to one of the Duke attendings, but when he and his wife moved back to the States they decided to pass it on to us. We have 8 chickens in the backyard and a huge garden, complete with banana trees, tomatoes, avocados, and so much more! We even have a mango tree, which should be pretty exciting in a few months when mango season starts.

KCMC, the hospital where we are working, is where Duke has based their research in Tanzania for nearly 20 years. It is considered the best hospital in the region, and the campus is huge. It includes the hospital, medical school buildings, lots of dorms for all the students and residents, and separate areas for ophthalmology and dermatology - two of the strongest fields here. Despite its status, manpower and resources for patient care are shockingly scarce. They have a lot of trouble with “brain drain”, in which Tanzanian doctors go to train in the US or Britain and don’t return home, leaving the hospital short-staffed and the medical school without adequate professors. I am hoping to get involved in more clinical work once I become more proficient in Swahili, but for now, simply learning the ropes of clinical research and preparing to begin enrolling patients in the two studies I’m working on is more than enough to keep me busy!