Day 12: Sekou Toure Hospital.

Mwanza, Tanzania - Visiting the Sekou Toure regional hospital in Mwanza this morning, we were reminded of how lucky we are to have the health care service we do in Canada. While the hospital was better equipped than the one we visited in Kenya earlier in the trip, its inadequacies were punctuated by its complete lack of electricity and water since last night. They have no back-up generators.

A large number of the hospital’s patient base of 4-5,000 lines the hallways on long benches, or sits on the lawn. One woman brought with her a basket of live chickens as geckos scurried along the floor. Each of the “In case of emergency, break glass” cases was cracked.

Each day, the hospital helps bring 40 babies into the world and cares for 80 HIV/AIDS patients. One advantage of its being a government-run hospital is that patients only need to pay 5,000 TSH (approximately $4.75) for a registration card that will cover all of their examinations, necessary diagnostics like ultrasounds or x-rays, and any medications. Wait times are only two hours.

HIV/AIDS patients undergo mandatory counselling sessions before they are able to see a doctor, and the room where one such session was being conducted was full of women and young children. And the surgeries scheduled for today? They will have to be postponed until such time as electrical power returns. Such is life in Africa.

This afternoon, we went back to the kitchen so that Meaghan and Alison could deliver follow-up exams related to the mamas’ English lesson earlier in the week. The mamas were busy cooking lunch for one of the local schools, for whom they prepare breakfast and lunch as a side business. We also returned to the Forever Angels orphanage for a couple of hours and it was nice to see I was remembered from last week.

Glasses: Half-Full.

Mwanza, Tanzania - All within five minutes today, we witnessed a large contrast of activities within the community where the interns’ apartment is located. Returning from the market, we saw a crowd forming as people hurried from all corners to see what the commotion was about. People were smiling, laughing and pointing toward a large throng of people amassed in front of a couple of stores, and someone else was lying on the ground. Suddenly, two police officers appeared from the centre of the mass, one firing shots into the sky, as they whisked an uncooperative suspect away. Yet five minutes later, when we came back outside, a crowd had formed for a different reason: some of the performers we had seen in the HIV/AIDS morality plays last week were doing an African dance, backed by musical instruments reminiscent of a southern jug band. Quite the activity – and a little surreal.

The heat hung heavily and we really felt its effects as we walked throughout the city, and over to the community kitchen, where Meaghan and Alison also teach the ‘yogurt mamas’ English three times a week. Today’s lesson was about the possessive forms of subjects and the interns worked with the mamas in both Swahili and English to help them understand proper sentence structure. The mamas were also really excited to receive reading glasses, which Meaghan’s mother had sent to the community. It was cute to see them trying on different frame styles, but the glasses should really benefit the mamas in their studies and day-to-day work.

All the while, a number of the community’s younger children began appearing on the kitchen’s steps and looked in at us with curiosity. Playing peek-a-boo and making some funny faces sent them into peels of laughter and led to their pretending to hide on the steps or to their scurrying away, only to return all over again.

Mabatini.

Mwanza, Tanzania - "Hapana, Asante"
(“No, thank you”) I said to the ‘yogurt mamas’ this morning after they expressed many thanks for our visit and for our support. “We teach you about probiotic yogurt, you teach us about life,” Gregor added. With the experiences we have had over the past week, such a statement resonated with a tremendous amount of poignancy. The energy the ‘yogurt mamas’ bring to the Western Heads East initiative and to their community is tremendous. I am privileged to have had the opportunity to witness this first-hand. We were meeting with the mamas for the last time as a full complement of team members on this trip; Gregor, Jennifer and Maryanne have just left for the airport. I, however, look forward to working with them again over the coming weeks before I, too, return home to Canada.

From a personal standpoint, I have been amazed to see the sheer number of children running about and looking shyly, excitedly or sometimes with trepidation, at these “muzungus” coming into their community in a Range Rover. The Mabatini village is not exactly a tourist destination. They are quick with smiles when you engage them, and are fascinated by seeing pictures of themselves on the back of a digital camera. Today, I nearly incited a mini riot of children who rapidly surrounded me after I took a photo of one of the boys and showed it to him. Soon, children – seemingly extricating themselves from crevices in the walls – clamoured around for their opportunity to be photographed and to be around the visitors. It was as though it took one to break the ice, to show we were friendly. The excitement is infectious. Of course, my handing out superballs to a few of the children only whipped the crowd into more of a frenzy, but you can’t possibly begin to bring enough for everyone. Children are, literally, everywhere.

This, of course, is one of the big reasons this project is so important. While I can presume it’s the same throughout the majority of Africa, I have seen first-hand, and know to be true, that malnutrition, disease and lack of access to potable water are ravaging populations in Kenya and Tanzania. It has been astounding to see so few senior citizens throughout our travels. I get a sinking feeling in my stomach when I realize just why that is: the average life expectancy is just 45. It’s universal whether you’re in Canada, the United States, Kenya or Tanzania: the children are the future. With this in common, we could certainly learn from each other to help create a better future around the globe. Despite their hardship, and often limited opportunity, the children here are, for the most part, extraordinarily happy. Many are sick, but they do not look defeated. Nearly all their clothes are in tatters, but “sawa” (“it’s alright”); it’s hot here.

It’s something I would suggest we think about a little more often as we stress about deadlines, bills and what shade of taupe to paint our walls. We certainly have poverty, disease and a different kind of malnutrition in North America, but here, it seeps into everything the dust can reach. Which is to say, everywhere.

Day Four: Mwanza.

Mwanza, Tanzania - Without question, the days painted with the experience of visiting various towns and commun- ities have thus far proved to be the most rewarding – both personally and professionally. Being among the people has provided unparalleled opportunities for seeing how other people live, and also for how much we have to be thankful. The sights. The smells. The sounds. The feelings. Our senses are alive and being pulled in so many directions.

Today, we visited the birthplace of the Western Heads East project in Africa – the Mabatini community kitchen. Before we had the chance to do so, however, we had a successful meeting with Regional Administrative Secretary Alhaji Yhya Mbila, who cleared space in his morning schedule to meet with us at the prompting of Amran Batenga, Chairman of the regional Chamber of Commerce, with whom we met last night.

Our objective during the meeting was to increase awareness of, and generate increased support from government for, the Western Heads East project. “We all out support it; we’re talking about AIDS, which is a big threat,” Mbila said. “Mwanza is the hub,” he began, telling us that the lake region is home to 30 per cent of the country’s population. “Historically, we have competition economically with Kenya and Uganda, but invariably, we are the best.” While he previously had little knowledge of the project, he was sufficiently impressed that he promised to visit the community kitchen over the next month to experience it first hand.

Which is what we did next. Greeted by the mamas, who were all wearing green Western Heads East T-shirts (which read, on the back, “How can a cow fight HIV? Western Heads East”) along with their traditional kitenge, we were given portions of the probiotic yogurt that has helped them build their reputation in the community. Though we eventually added a little bit of sugar, it tasted quite good.

The mamas’ kitchen is a small room with turquoise walls and a mural depicting the community engaged in the yogurt making process on one wall. Awash with green plastic containers, a small floortop stove, a refrigerator, other tools and a table for distribution, the kitchen will need to be expanded to increase opportunities for sustainability. The village of Mabatini is dry and set into the hills with dirt roads and people everywhere. Most of the buildings are stone and the wind whips down the laneways, carrying with it dust and the excited trills of children. I look forward to revisiting the community over the next week or so and seeing more of it. It was an amazing experience.

Following our time in the kitchen, we are treated to a cultural experience as the local Tunda Sana theatre troupe ushered us in as honoured guests to watch a series of performances aimed at teaching people about HIV/AIDS through drama. While I likened it in my head to opera – which you don’t necessarily need to understand the lyrics to enjoy – we had an interpreter and were truly blown away by the performance, and the experience. Following the main morality plays, the audience was engaged to ask questions of the actors, who remained in character while providing their responses. It struck me how this encouraged important discussion among the group, and was impressed by the actors’ ability to reply in metaphor. On one such occasion, for example, an actor portraying a philandering girlfriend was asked, “Why have more than one boyfriend,” to which she replied, “You can’t live on the same diet of rice.” This also happened to be the one time an actor had no answer to the follow-up question: “If you need change in your diet, why not women?” I also thought that was a pretty enlightened question for this area. The session wrapped up with a traditional African dance, which was also a tremendous, unexpected experience.

Looking out at a rainbow arcing over Lake Victoria, I feel almost like I have found the pot of gold of experience; this has also been another amazing day.

Day Two: Oyugis/Kasipul/Kabondo.

Advance caveat: I'm aware this is far too long a post for a blog, but it was such an important day, I feel I had little choice. Given the inconsistency of Internet service here, it also comes relatively unedited.

Kisumu, Kenya - Put simply, this was one of the most incredible days of my life. While there is so much to say, I still feel trepidation in my fingers because words – especially in the written form – seem unable to do justice to all we did and experienced in such a short time. Without first-hand knowledge, much of rural Africa is, unfortunately, beyond the context of understanding for many North Americans.

Complaints about traffic and poor road conditions rank somewhere between hobby and sport in Canada, yet, I have never endured a ride bumpier than today’s trip past various villages into Oyugis, Kasipul, Kabondo and points between. The roads – where formal ones exist – are in serious states of disrepair, while others have been carved from the earth and wend their way awkwardly up hills and over jagged rocks. But it’s not that we could complain about traffic. The roads were nearly devoid of cars, though a few buses spewing black exhaust made things interesting on the narrow strips of pavement.

No, instead, the roads were lined with people walking or cycling, carrying with them their wares, belongings or other people – one bicycle transported five people. Along the way, children waved, smiled and ran alongside the truck; others led their goats and cows along the ditch. As we climbed into higher elevations, the relatively arid terrain gave way to lusher, tropical trees and plants, including coffee, pineapple and banana. Consistent throughout, though, was the poverty. The landscape was dotted by small villages of mud huts or tin-roofed shacks in varying states of disrepair, and by town markets teeming with activity and people hawking their wares.

Following a two-hour drive, our day began at the Rackuonyo District Hospital, where we met with the superintendent, the district AIDS/STI coordinator and representatives from KEMRI and the ministry of public health. The project’s researchers sought permission to include some of the hospital’s 5,000 HIV/AIDS patients in the probiotic yogurt project, a proposal agreeable to the superintendent, so long as privacy standards are maintained. Visiting the hospital was interesting in its own right as it was equipped with very few facilities – mostly an outcropping of small buildings the size of an average North American kitchen. Additionally, when we walked in, a technician was drawing blood from a long line of patients – without wearing gloves. This was mind boggling, particularly given the high-risk nature of the task.

We were then welcomed in the Kokal village by the Oranda Women’s Group, who will likely follow in the footsteps of the ‘yogurt mamas’ in Mwanza, Tanzania, and begin preparing probiotic yogurt for their community. “We are very happy for your visit,” the group’s chairperson stated as we were ushered to seats of honour in their compound as cows grazed and small children sucking on sugarcane peered with curiosity at their visitors. “This is the only project like this in all of Kenya, so you are leading the way for the country,” said Canadian scientist Gregor Reid.

We then made our way through villages to meet with the Nyanam Women’s Group, who showed great promise as advocates for the project and demonstrated particular strengths in communications, marketing and sales. “My argument has always been, who brings food, brings life,” added Isaac Luginaah, the project’s principal investigator. There could be real value in leveraging their aptitudes to help spread the word of benefits from probiotics and to potentially involve them with the sales aspect, rather than yogurt production itself.

For lunch, we stopped at a roadside restaurant and I enjoyed some local fare: fried chicken and a slab of ugali. While I came to Africa armed with 50-60 Swahili words, I have limited my use to fairly basic sayings, particularly “habari”, “nzuri” and “asante” (hello, I’m fine and thank you, respectively), but at lunch I used my first full sentence: “Samahani – naomba una chupa ye maji baridi; asante sana” (“Excuse me, I would like a cold bottle of water; thank you”).

In the afternoon, we met with two more groups of mamas to examine other viable options for community kitchens and were asked some important questions, including one about whether traditional, local sour milk products provide the same benefits as probiotic yogurt. Differences between controlled and uncontrolled fermentation are important to distinguish. According to Professor Reid, while the sour milk may provide certain benefits, bacteria in it dies in the gut and, thus, does not provide the same beneficial qualities as probiotics.

I am amazed by how ubiquitous Coca Cola is here. The company’s logo was permanently overlayed in the corner of a television program featuring music videos. Shiny red, well-painted bus shelters bear the Coke logo (and were unquestionably financed by them). In many villages, bright red Coke stands rise up between dilapidated shacks housing other businesses. And, in nearly all cases, the Coke buildings were the nicest ones in the village. Even more shockingly – and perhaps the irony of ironies – one of the hospital buildings was sponsored by the beverage maker (and bore a large mural to that effect). In a community with a 17 per cent HIV/AIDS infection rate, however, I suppose the hospital’s need for funding surpasses concern for diabetes, gum disease and other drawbacks of soda consumption.

For someone as interested as I am in the world and in how people live, today was an incredible opportunity to experience a different people, a different culture and a different way of life. It was amazing. Children would invariably bound along, waving and giggling or retreat shyly. Many would then soften with wide eyes and take off with peels of laughter with their friends. Replying “nzuri” to their timid hellos left them tickled pink. In matching school uniforms, they’d cut down the laneways and peer into the buildings we were in, often unsure until we waved or said hello. Then came the widest smiles. Driving through the countryside and villages, and meeting the mamas in the various communities was rewarding on so many levels.

This was a day to remember.