I started the week with one of my most favorite activities here, attending the children’s mass. The church is packed children, many quite young. They are for the most part very well behaved. If someone does get out line or tarry before entering a pew, a designated usher, known by the striped oblong of fabric draped diagonally across his chest, is there to toss the laggard into his seat or reprimand aberrant behavior. Size and culture make this a rather mild action, but it is enough to cause an impartial observer to chuckle.
The choir is a sight to behold and a wonderful earful to hear. It seems as talented, if less practiced, as the adult choir which performs at other services. Their joy, enthusiasm and ability to engage all the children in the church is an inspiration and an emotional enticement to feel that all work being done in TZ is worthwhile. The gusto of the group, led by a director who in height barely clears the altar rail, and their rhythmic swaying and swinging, as they render hymns to convey spirituality combined with harmony would energize the most lethargic of church attendees. I wish the camera could do a better job catching the charisma of these halleluiah song birds, and I am committed to videoing them before my return, but til then I hope this picture gives the viewer a sense of what I speak.
The upward swing on which this experience usually leaves me, reversed when I met with Dr Corrado on Monday for his English language lesson, and he shared with me recent happenings at the hospital. A few days prior, a woman and her three children were admitted with headache, vomiting and in general debilitated state of listlessness. She reported that they had picked and eaten mushrooms immediately before becoming ill. The three boys were put in Dr. C’s ward; the mother was taken to adult wing to be cared for by the Tanzanian staff. After initial evaluation, Dr C started to question the mushroom ingestion connection. He decided to treat for malaria, and the boys responded positively. When he went to the mother’s ward to report the finding, the staff informed him that she had died. The most remarkable aspect of the announcement, he observed, was the lack of emotion with which they made the report. He had expected, if not sorrow for the death itself, at least some angst over the fatal misdiagnosis.
As we puzzled over the lack of reaction, a scenario came to mind from the 1990’s in the US. My daughter, volunteering in the Hugh O’Brien Leadership program, was guiding a group of inner city high school students, selected for demonstrated leadership traits, to a hotel on the south side of DC for a weekend of seminars and development exercises. While they were gathered in the hotel foyer, a man was shot on the street directly in their line of vision. My daughter was sickened and appalled, but the students showed little change of affect. It occurred to her that though this was her first time seeing someone mowed down, it was not theirs and that their past experiences were inuring them to reacting to the incident with horror. Dr C and I, and others I have spoken to, conclude that we are witnessing the same principle at work here in Tanzania. Death and disease are so frequent that, as one friend put it, that they tend to be expected and accepted with little emotional upset conveying a sort of a business as usual mentality.
Dr. C recounted three others of this week’s cases, with less than fatal outcomes but still heart rendering. One was of a boy who came in with a fractured limb and a resulting open wound. His family had treated the wound with traditional method of placing a piece of raw meat on it. The wound became infected resulting in a need to amputate. I have a picture of the infected hand which is too gruesome to share so instead I will show you one of the child smiling with his new stump. Dr C is looking for a prosthetic for him.(In the other picture, Dr C and staff help a young patient adjust to the hospital environment.)
Another laid in the description of a child with a fractured leg surrounded by a very large liquid filled blister. Querying the parents as to the origin of the blister, he discovered they had poured boiling water on the limb as an attempted cure.
The third, captured in a picture, is of a child with two broken legs:
Fractures are treated with traction, in this case for three months, because plaster casts are calculated as too expensive. The price the child pays a significant price for lack of mobility.
Combined with the high incidence of severe, often deadly, malnutrition of the under five age group and of HIV in both the adult and infant population, which I described in the Nuances of Tanzania post, these instances paint a depressing, heart wrenching picture.
The Inertia and passive acceptance with which it is met by those affected is a posture which we suspect arises from a poverty of material means, a poverty of a vision, and a wealth of experience of witnessing suffering and death.
The bleakness of this picture might seem without remedy but for several realizations.
Education can address most of these issues and this country, unlike so many others, does not have the internal strife or civil war to impede its delivery.
The Children hurt by their family attempt at home remedy are victims of ignorance not malice or abuse.
Those suffering from malnutrition are living in fertile land where there are options to a better diet at arm’s length if those options are identified and utilized.
HIV is a preventable and containable if people are more aware of its causes and treatments.
Other diseases, like malaria, which has a high rate of fatality here, can be caught and easily cured in early stages if sufferers know what symptoms to suspect.
There are a numerous organizations and individuals who have come to try to make a difference.
Global Outreach is doing its part in training students, the hope of the future, to use the internet and providing access to it. This week, I witnessed young people surfing such issues as standard treatment for concussion, symptoms of malaria, suggestions for evaluating early childhood development stages and scholarship opportunity in the field of Public Health. In a location where regular medical care is hours away by bus, being able to attain basic information is crucial. The woman with the concussion , for instance, learned from NIH website that rest is the recommendation for recovery for less than severe concussions. Based on that, she did not take the 9 hr trip to Dar, closest point for professional assessment, risking a significant setback, to garner the same information. She is now recovered.
Below; Head of School at St Joseph’s , a secondary school recently brought on board and computerized by GO. Pictured is Head of school, Stan and Grayson, who is teaching Microsoft Office to the teachers who are seated.
Bega Kwa Bega,(shoulder to shoulder) is a Lutheran organization which has paired sixty -six parishes in the Twin Cities of St Paul and Minneapolis, Minnesota with as many sister parishes here. Groups of their parishioners, often accompanied by their pastor come to visit on a continual basis. They go to villages bringing special skills and knowledge. They mingle with the local people exchanging wisdoms. Leaders tell us that there are more MN parishes which are in the process of hooking up.
BKB has established a university, and supports five secondary schools and a hospital in the Iringa Region. They offer many substantial scholarships for aspiring students.
They are providing considerable education both formally and informally.
UNICEF and countless NGOs are here as well as the individuals whom I describe in the Interesting People I Have Met and Leading Tanzanians posts are here trying help with education. Unicef has estimated that there are 35,000 children with severe malnutrion in the Iringa area and have initiated a program to identify them.
In an effort to add to these efforts, Dr. Corrado and I have decided to collaborate on a nutrition awareness prevention project. Knowing the extraordinary size of attendance at church services throughout the Iringa Region, we plan to ask pastors of all denominations to use the pulpit to do a piece on properly feeding children, as they finish breast feeding, with fruits, vegetables, and when available eggs, milk and chicken , replacing the easily consumed , empty ugali (flour and water mixture) which now often compromises the totality of toddler diet. We will ask them to stress the moral component emphasizing that feeding children is as important as feeding male adults.
These purveyors have an added advantage of knowing what is available in their villages; therefore, they can tailor recommendations to available produce.
We will do the same with the schools and prepare instructions for the hospitals to give to mothers leaving pediatrics and maternity wards.
Indicative of infrastructure issues in Africa, our largest challenge will be printing instructions for handing out. Paper and copy machines are in such short supply here that costs dictate a need to produce the leaflets in the States. We then must find people who are coming willing to carry packets because postage for mailing of such weighty items is prohibitive. These obstacles, inconceivable in the Western World, are typical of the mundane considerations that are part of daily life here. Until we are able to overcome them, we will provide pastors, hospital and school administrators, and other appropriate staff with World Nutrition Guide Standards to modify specifically to produce in their areas and verbally advise family members, which in of itself , we believe, will constitute a meaningful step forward. While we appreciate protein deficiency will persist in many cases, the lack of needed vitamins will become less of a detriment.
We will do the same with the schools and prepare similar instructions for the hospitals to give to mothers leaving pediatrics and maternity wards.
These thoughts and actions, while we regard the first picture in this post , the ones below, and the dozens of children wherever we venture, make us take heart and start once again on an upward swing.