tag:blogger.com,1999:blog-28387536802314837982024-02-07T03:53:14.847-08:00Ilula-Friends-2013Kenhttp://www.blogger.com/profile/08062952252731045537noreply@blogger.comBlogger21125tag:blogger.com,1999:blog-2838753680231483798.post-28666951131450399262013-02-09T00:06:00.002-08:002013-02-09T00:06:44.304-08:00Dar es Salaam and Amsterdam
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<div class="MsoNormal">
The eight of us are now in the DAR airport, Julius Nyerere
International.<span style="mso-spacerun: yes;"> </span>It is nearly 10 PM and
boarding should start in about an hour for 11:59 PM departure.</div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
Yesterday was a productive day.<span style="mso-spacerun: yes;"> </span>The Pharms went to Muhimbili University’s
School of Pharmacy.<span style="mso-spacerun: yes;"> </span>They met with the
outgoing and incoming deans for a mutually beneficial meeting.<span style="mso-spacerun: yes;"> </span>I don’t know the language, but they did talk
about capsule manufacture and pill making.<span style="mso-spacerun: yes;">
</span>Or something.</div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
Now Tessa and I really had fun!<span style="mso-spacerun: yes;"> </span>We went to Power Foods where Plumpy’Nut is
manufactured.<span style="mso-spacerun: yes;"> </span>It is a small factory with
stainless steel machines in a couple rooms where we could peer in, but not
enter.<span style="mso-spacerun: yes;"> </span>The workers wear special clothes,
etc.<span style="mso-spacerun: yes;"> </span>Most of the space is actually
warehouse for the twenty tons of Plumpy’Nut they manufacture each week.<span style="mso-spacerun: yes;"> </span>Twenty tons!<span style="mso-spacerun: yes;">
</span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
They do make a couple other products, mostly special flours,
but the real deal is the Plumpy’Nut.</div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
Kulwa, our driver, patiently waited.<span style="mso-spacerun: yes;"> </span>After our exhilarating tour, we picked up the
rest of the group.<span style="mso-spacerun: yes;"> </span>We still had a couple
hours before dinner so we asked Kulwa to take us to the beach for a while.<span style="mso-spacerun: yes;"> </span>He took us to Coco Beach, well known as a
classy place.<span style="mso-spacerun: yes;"> </span>It was.<span style="mso-spacerun: yes;"> </span>We sat ocean-side and sipped a cool one.<span style="mso-spacerun: yes;"> </span>It’s only an expression.<span style="mso-spacerun: yes;"> </span>Kiswahili is “baridi.”<span style="mso-spacerun: yes;"> </span>They warmed up pretty quickly in the
heat.<span style="mso-spacerun: yes;"> </span>We still had a great time.<span style="mso-spacerun: yes;"> </span>Some walked the beach for a time then we sat
in the cool shade.</div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
Dinner was with Dr. Saga and his three sons, Grey, Fadhili
and Godfrey.<span style="mso-spacerun: yes;"> </span>Grey works for USAID, so we
had a great talk.</div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
This morning, we went to Slipway and caught the ferry to
Bongoyo Island.<span style="mso-spacerun: yes;"> </span>It has beautiful beaches
and some nice little bandas, loungers and chairs.<span style="mso-spacerun: yes;"> </span>We had lunch there too.<span style="mso-spacerun: yes;"> </span>It was tasty, but we did need to hurry to catch
our boat back to the mainland.<span style="mso-spacerun: yes;"> </span>A couple
of people who should know better got pretty burned today.<span style="mso-spacerun: yes;"> </span>Despite the fact they did use sunscreen, the
Tanzanian sun bested them.<span style="mso-spacerun: yes;"> </span>I cannot tell
you their names, but their initials are Ken and Laura.<span style="mso-spacerun: yes;"> </span>Amazingly, the others did fairly well.</div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
We went to Sea Cliff Hotel and ate at the restaurant
Karambezi Café.<span style="mso-spacerun: yes;"> </span>It has become more or
less a tradition to do that.<span style="mso-spacerun: yes;"> </span>It is so
nice to sit in the open and look out at the ocean.<span style="mso-spacerun: yes;"> </span>The food was good.<span style="mso-spacerun: yes;"> </span>Several desserts were had and enjoyed.</div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
And now we are waiting to board KLM flight 567.</div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
Amsterdam </div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
Arrived in Amsterdam and ready to board the flight home. Slept a little. Off to the gate. Don't want to miss this one!</div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<br /></div>
Kenhttp://www.blogger.com/profile/08062952252731045537noreply@blogger.com0tag:blogger.com,1999:blog-2838753680231483798.post-74619143662938004972013-02-06T07:48:00.003-08:002013-02-06T07:48:33.423-08:00Random thoughts as we prepare to depart
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<br />
<div class="MsoNormal">
</div>
<div class="MsoNormal">
First, there is so much left to say and I cannot cover it
all myself.<span style="mso-spacerun: yes;"> </span>I can only hope some of my
colleagues offer their voices.<span style="mso-spacerun: yes;"> </span>It would
be a much more beautiful harmony than this solitary voice.</div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
I was noticing things today.<span style="mso-spacerun: yes;">
</span>Ally was looking out across the beautiful savannah and enjoying the
spectacular view.<span style="mso-spacerun: yes;"> </span>It is among my top
favorite views in the world.<span style="mso-spacerun: yes;"> </span>OK, so
there are a few of them.<span style="mso-spacerun: yes;"> </span>Let’s not split
hairs.</div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
On the low end, I noticed that burning trash smells the same
as it does at home – unpleasant.<span style="mso-spacerun: yes;"> </span>But
also, the fragrance of freshly cut grass is the same sweet pleasure.<span style="mso-spacerun: yes;"> </span>The fresh smell of rain is also the same as
at home.<span style="mso-spacerun: yes;"> </span>I suppose you won’t be able to
remember that for a few months as you go outside and your nose burns from the
cold!<span style="mso-spacerun: yes;"> </span>But I give you my word, it smells
the same here in Africa as at home.</div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
The people are kind too.<span style="mso-spacerun: yes;">
</span>They are especially tolerant of wazungu attempts at their language.<span style="mso-spacerun: yes;"> </span>They seem surprised and pleased, even if they
often laugh too.<span style="mso-spacerun: yes;"> </span>I think I can speak for
all when I say we were gratified at the response to our education sessions on
Hypertension and Diabetes.<span style="mso-spacerun: yes;"> </span>The pharmacy
folks on drugs and more and Tessa on nutrition and more really shined!<span style="mso-spacerun: yes;"> </span>It would NOT have happened without them.<span style="mso-spacerun: yes;"> </span>Now Dr. Rite has in mind next year we should
cover neonatal care and resuscitation (Kelsey Watt, Pediatrician comes to mind,
and Jane from the Ob. side), fracture management (Jane, think that orthopedist
you know is available?) and benign prostatic hypertrophy and prostate cancer
(some primary care doc and an oncologist seem likely candidates, especially an
old PC specialist).</div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
At the moment, we are on the bus and just passed through
Kitonga Gorge.<span style="mso-spacerun: yes;"> </span>Only saw one apparent
head-on truck collision on the roadside.<span style="mso-spacerun: yes;">
</span>It is still a long way to Dar.</div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
We left Ilula at 9:10 AM.<span style="mso-spacerun: yes;">
</span>Gary returned the Lubawas’ car to Tumaini and got caught in rush hour
traffic.<span style="mso-spacerun: yes;"> </span>This was non-existent a few
years ago but is obvious now.<span style="mso-spacerun: yes;"> </span>I went to
take a few photos of the unfinished Nursing School Dorm and Multi-Purpose
building with Emmanuel, Ilula’s Lab Director.<span style="mso-spacerun: yes;">
</span>He decided we should take and alternate route back up the hill to the
Ilula campus.<span style="mso-spacerun: yes;"> </span>“Wet,” he said.<span style="mso-spacerun: yes;"> </span>As it happened this coincidentally provided
him an opportunity to go right past his house for an impromptu visit to meet
his wife and see the house he is renting.<span style="mso-spacerun: yes;">
</span>I was a little anxious that I would be holding up the group, but since
Gary had been nudged into operating on Africa time, no worries.<span style="mso-spacerun: yes;"> </span>Hakuna matata!</div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
We arrived in Dar about 6:15 our time, safe and sound.</div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
Time for dinner!</div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<br /></div>
Kenhttp://www.blogger.com/profile/08062952252731045537noreply@blogger.com0tag:blogger.com,1999:blog-2838753680231483798.post-65195053612365021332013-02-02T16:59:00.000-08:002013-02-02T16:59:21.943-08:00Mbigili Lutheran Church
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<br />
<div class="MsoNormal">
Ok, this one is a week late and you may have read the punch
line.<span style="mso-spacerun: yes;"> </span>Our friend Beate from Amani
Orphans Home Mbigili invited our group over to visit and play with the
kids.<span style="mso-spacerun: yes;"> </span>Jane Cassleton had brought a
Whiffle Ball and Bat, so despite the inclement weather, we did manage to get in
a few innings of baseball.<span style="mso-spacerun: yes;"> </span>We started by
showing them how to hit the ball.<span style="mso-spacerun: yes;">
</span>Duh.<span style="mso-spacerun: yes;"> </span>Like they needed
lessons.<span style="mso-spacerun: yes;"> </span>The part they didn’t get was
the base running.<span style="mso-spacerun: yes;"> </span>One would it the ball
and several would run to the tree, er, uh, base. Or another tree.<span style="mso-spacerun: yes;"> </span>Pretty soon all the kids were running the
bases and the wazungu were trying to hit them with the ball (whiffle ball,
remember?).<span style="mso-spacerun: yes;"> </span>Soon it started raining a
bit, so the game was over.<span style="mso-spacerun: yes;"> </span>I think we
declared everyone a winner.</div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
Sunday, I went to church at Mbigili Lutheran Church,
sponsored by Richfield Lutheran Church.<span style="mso-spacerun: yes;">
</span>Last year, when they wondered who this Olson was, they looked through
the Richfield Lutheran Church Directory to find me, but without any success.<span style="mso-spacerun: yes;"> </span>I think Pastor Rolf had been there just a
couple years ago.<span style="mso-spacerun: yes;"> </span>Nope.<span style="mso-spacerun: yes;"> </span>We do not have the good fortune to be
related.<span style="mso-spacerun: yes;"> </span>But it is probably true that we
all look alike to the Tanzanians!</div>
<div class="MsoNormal">
<br /></div>
<div class="separator" style="clear: both; text-align: center;">
<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEj7_ej3kGSGMI_zFIFockYnxKtMnvCncXrMR9rLrcQoy4ifLyjM14plRtQ9CHZDi2pvl10YoWfrnjS7vLV7RBtx6bDywzcBsmaUHzInEzv0_frXBgyyuAWEN-Km83yRjXidqY5I6RtHIBQ/s1600/M+Luth+Ch+2.jpg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" height="240" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEj7_ej3kGSGMI_zFIFockYnxKtMnvCncXrMR9rLrcQoy4ifLyjM14plRtQ9CHZDi2pvl10YoWfrnjS7vLV7RBtx6bDywzcBsmaUHzInEzv0_frXBgyyuAWEN-Km83yRjXidqY5I6RtHIBQ/s320/M+Luth+Ch+2.jpg" width="320" /></a></div>
<br />
<div class="separator" style="clear: both; text-align: center;">
<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhj8lDL81r_ZB7afD7Z3C5kKCkIS63brbKr-yPr5HeZWHuKQPpYth2dZbcsgJI2urH244zadRfDtmcPG8yZRen1URQb-WC7YUhx3SZiiju7g3GmYfDNAXPCSwcsdSfYVxOegvEYzlTy1Kc/s1600/M+Luth+Ch1.jpg" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" height="240" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhj8lDL81r_ZB7afD7Z3C5kKCkIS63brbKr-yPr5HeZWHuKQPpYth2dZbcsgJI2urH244zadRfDtmcPG8yZRen1URQb-WC7YUhx3SZiiju7g3GmYfDNAXPCSwcsdSfYVxOegvEYzlTy1Kc/s320/M+Luth+Ch1.jpg" width="320" /></a></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
We missed the pastor.<span style="mso-spacerun: yes;">
</span>He was at Image (e-mah’-gee, not im’-ij) for a multiple ordination.<span style="mso-spacerun: yes;"> </span>Five hours, not including 2 hours travel time
each way.<span style="mso-spacerun: yes;"> </span>The evangelist did a fine
job.<span style="mso-spacerun: yes;"> </span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
Outside the church, I noticed a little girl, six or seven, I
suppose.<span style="mso-spacerun: yes;"> </span>She had ratty hair with crusts
on her scalp.<span style="mso-spacerun: yes;"> </span>You may have read this
earlier.<span style="mso-spacerun: yes;"> </span>It is called Tinea capitis, a
fungal infection of the scalp. It occurs in the US, but it is a result of
poverty and dirt.</div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
Please read this from The Lancet: <a href="http://www.thelancet.com/journals/lancet/article/PIIS0140-6736%2813%2960150-6/fulltext?elsca1=ETOC-LANCET&elsca2=email&elsca3=E24A35F">http://www.thelancet.com/journals/lancet/article/PIIS0140-6736%2813%2960150-6/fulltext?elsca1=ETOC-LANCET&elsca2=email&elsca3=E24A35F</a>
</div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
Enough is enough.</div>
Kenhttp://www.blogger.com/profile/08062952252731045537noreply@blogger.com0tag:blogger.com,1999:blog-2838753680231483798.post-53972204628438421262013-02-02T05:11:00.002-08:002013-02-02T05:11:59.783-08:00A Day at Ilula
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Thursday, January 31, 2013</div>
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It was an interesting day.<span style="mso-spacerun: yes;">
</span>We started the day by saying goodbye to Dr. Jane, Dede<span style="mso-spacerun: yes;"> </span>Ouren and Mary Thompson.<span style="mso-spacerun: yes;"> </span>It was great to have them all.<span style="mso-spacerun: yes;"> </span>We had the privilege of keeping Mary and Dede
an extra week due to some scheduling difficulties that worked to our
advantage.<span style="mso-spacerun: yes;"> </span>They had a great time and
again it was to our advantage.<span style="mso-spacerun: yes;"> </span>This was
a synergism for us with Jane Casselton too.<span style="mso-spacerun: yes;">
</span>She is originally form N. St. Paul, now a 4<sup>th</sup> year medical
student at Tulane, planning on obstetrics and gynecology.<span style="mso-spacerun: yes;"> </span>She worked hard, did well and was an integral
part of the team.<span style="mso-spacerun: yes;"> </span>She got lots of C-section
and delivery experience, we got a great resource.</div>
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<br /></div>
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We went on rounds after morning report.<span style="mso-spacerun: yes;"> </span>We saw two septic neonates, one three days,
the other two weeks old.<span style="mso-spacerun: yes;"> </span>We pondered the
proper treatments.<span style="mso-spacerun: yes;"> </span>One needed an IV that
was difficult.<span style="mso-spacerun: yes;"> </span>She needed to be off
oxygen for an hour.<span style="mso-spacerun: yes;"> </span>I hope she is
improved by morning.<span style="mso-spacerun: yes;"> </span>The other was doing
a little better.<span style="mso-spacerun: yes;"> </span></div>
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<br /></div>
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Next, we saw a young man injured playing “football”
yesterday evening.<span style="mso-spacerun: yes;"> </span>He was having
increasing belly pain and looked awful.<span style="mso-spacerun: yes;">
</span>He had an acute abdomen.<span style="mso-spacerun: yes;"> </span>Among
several possibilities would be a ruptured spleen.<span style="mso-spacerun: yes;"> </span>He was transferred to Iringa.<span style="mso-spacerun: yes;"> </span>Likely he got an exploratory surgery in lieu
of the CT scan he would get in the US.</div>
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<br /></div>
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We also saw a kid who looked quite scared.<span style="mso-spacerun: yes;"> </span>He had a swollen foot, but Dr. Saga said he
was out of the woods by about 4 hours after his snakebite and this was the next
morning.<span style="mso-spacerun: yes;"> </span>I would still look scared, I am
sure!<span style="mso-spacerun: yes;"> </span>He was discharged.<span style="mso-spacerun: yes;"> </span>It wasn’t a black mamba.<span style="mso-spacerun: yes;"> </span>Or a spitting cobra.</div>
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<br /></div>
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This afternoon, we put on a three-hour conference on
hypertension.<span style="mso-spacerun: yes;"> </span>Tomorrow it is
diabetes.<span style="mso-spacerun: yes;"> </span>It went well today.<span style="mso-spacerun: yes;"> </span>The Doctor-in-Charge said it was well
received by the attendees.<span style="mso-spacerun: yes;"> </span>Actually, he
said they thought it was “Great!”<span style="mso-spacerun: yes;"> </span>We
were pleased.<span style="mso-spacerun: yes;"> </span>Of course Dr. Rite said he
thinks we should do some conference for them every year!</div>
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<br /></div>
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At this moment some of the women are locked out of their
residence.<span style="mso-spacerun: yes;"> </span>Somehow the old-style key
broke off in the lock.<span style="mso-spacerun: yes;"> </span>Ah!<span style="mso-spacerun: yes;"> </span>Success!<span style="mso-spacerun: yes;">
</span>Dr. Moody and my Leatherman got the door open.<span style="mso-spacerun: yes;"> </span>Whew!</div>
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<br /></div>
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Sadly, we learned that the boy we sent to Iringa died in
surgery.<span style="mso-spacerun: yes;"> So did one of the babies. </span>Sometimes we are helpless even
when we know what to do.</div>
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<br /></div>
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Just a normal day at Ilula Lutheran District Hospital.<span style="mso-spacerun: yes;"> </span>Then there is tomorrow.</div>
Kenhttp://www.blogger.com/profile/08062952252731045537noreply@blogger.com0tag:blogger.com,1999:blog-2838753680231483798.post-29295143024670231162013-02-02T05:02:00.000-08:002013-02-02T05:12:56.320-08:00Irindi<style>
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Tuesday, January 29, 2013 </div>
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<br /></div>
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The Institute of Agriculture vehicle and Roger Blomquist
picked up Tessa and me at 9:15 AM.<span style="mso-spacerun: yes;"> </span>We
walked to meet them, since the main road in Iringa is torn up to put in a storm
sewer.<span style="mso-spacerun: yes;"> </span>There is a big trench, scheduled
to be back-filled by tomorrow.<span style="mso-spacerun: yes;"> </span>Didn’t go
to see if it had been done. (It wasn't until Saturday.</div>
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<br /></div>
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We drove to Irindi.<span style="mso-spacerun: yes;">
</span>It is this side of Ruaha Mbyuni.<span style="mso-spacerun: yes;">
</span>(Say “Ruaha Mbyuni” three times if you can.)<span style="mso-spacerun: yes;"> </span>Irindi itself is a way off the asphalt.<span style="mso-spacerun: yes;"> </span>Pastor Felix met us.<span style="mso-spacerun: yes;"> </span>We drove another 6 km to the demonstration
plot.<span style="mso-spacerun: yes;"> </span>They are growing rice, not corn,
since their plot is quite wet.<span style="mso-spacerun: yes;"> </span>It has
been a little dry until now, so the planting is about two weeks late.<span style="mso-spacerun: yes;"> </span>With some rain the crop can catch up.</div>
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<br /></div>
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We had the opportunity to ask some nutrition questions after
Venance gave his instruction about the rice crop management.<span style="mso-spacerun: yes;"> </span>We learned a great deal.<span style="mso-spacerun: yes;"> </span>One important item is that they would like
nutrition information.</div>
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<br /></div>
<div class="separator" style="clear: both; text-align: center;">
<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjB3-adyba5VsuBywGQmqghVO-RLkfw-P8Zha5W7q5tBBObJn0jeDuBP8yolYM6XdJgDezgyDPzdPYeqFTWYG8juCxI5QrXUCpif6otJtuEKkx6q4QpWSbRrdlgKtfz4ZqYHbNXP2n1BIM/s1600/Irindi+Rice+Field.jpg" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" height="240" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjB3-adyba5VsuBywGQmqghVO-RLkfw-P8Zha5W7q5tBBObJn0jeDuBP8yolYM6XdJgDezgyDPzdPYeqFTWYG8juCxI5QrXUCpif6otJtuEKkx6q4QpWSbRrdlgKtfz4ZqYHbNXP2n1BIM/s320/Irindi+Rice+Field.jpg" width="320" /></a></div>
The photo below is a field of tightly packed rice seedlings. To the right is a field of newly planted seedlings in rows. It is the first time the Institute of Agriculture has done a demonstration with rice. About one third of the plant should be under water and the plot is about two weeks behind. This was Thursday and it has rained the last three nights, so tthey should be fine now. We hope.<br />
<div class="separator" style="clear: both; text-align: center;">
<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjvzTiP2i1oFm8g973F19UdkVgMJUPgOPtb7HZWo4YJWYwEl5ZcIe-fV40t313-1zMy8RgzYw5brbcek-kkb17nFalAUSwpcT_rkbEDhLUvDUcDekWJhikZ54OvdeommUBdgtTL52OHZ_I/s1600/Irindi+seedlings.jpg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" height="240" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjvzTiP2i1oFm8g973F19UdkVgMJUPgOPtb7HZWo4YJWYwEl5ZcIe-fV40t313-1zMy8RgzYw5brbcek-kkb17nFalAUSwpcT_rkbEDhLUvDUcDekWJhikZ54OvdeommUBdgtTL52OHZ_I/s320/Irindi+seedlings.jpg" width="320" /></a></div>
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<br /></div>
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<br /></div>
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On the way back to Ilula, my friend Beate from Amani
orphanage asked if I could look at a couple kids.<span style="mso-spacerun: yes;"> </span>On Sunday we saw a little girl with a fungus
infection of the scalp that is generally the product of poverty and dirty
living conditions.<span style="mso-spacerun: yes;"> </span>Now apparently a boy
at school had been identified with a rash on the scalp too.<span style="mso-spacerun: yes;"> </span>I went to see him.<span style="mso-spacerun: yes;"> </span>I think it is just impetigo, but we will know
in a few days if it doesn’t quickly respond.<span style="mso-spacerun: yes;">
</span>They have a couple other kids at Amani with impetigo too.<span style="mso-spacerun: yes;"> </span>I don’t think it is an epidemic, but a couple
kids are pretty uncomfortable.<span style="mso-spacerun: yes;"> </span>Also,
since there are a number of kids with HIV, fungal infections are quite common.</div>
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<br /></div>
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Luisa, Beate, myself and one of the Amani staff as
translator went to deliver the antifungal to the little girl from church.<span style="mso-spacerun: yes;"> </span>Her mama was holding a newborn and I
recognized the woman from the hospital last week.<span style="mso-spacerun: yes;"> </span>Of course, the little girl from church was not the only child with
Tinea capitis.<span style="mso-spacerun: yes;"> </span>We gave another girl the
remaining pills we had.<span style="mso-spacerun: yes;"> </span>At least they
know what is needed and how to use them after we leave next week.</div>
Kenhttp://www.blogger.com/profile/08062952252731045537noreply@blogger.com0tag:blogger.com,1999:blog-2838753680231483798.post-40165439702032076322013-02-01T21:51:00.000-08:002013-02-02T04:40:56.618-08:00Happy Birthday, Ken!<table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto; text-align: center;"><tbody>
<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEic2bnspNicI3rqUruOK-0Ze50tUV5mqMYHAtWQsJO0DV-QJbmHzlP7f_8P_8YPzpGZdRttzujWFeDCpUH8xCqF0IU_2MwAwguM7tNrJi-oisE0jOY1lYCG-Nw8Iq_bo9CWrUjPtKdAupM/s1600/IMG_1801.JPG" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" height="298" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEic2bnspNicI3rqUruOK-0Ze50tUV5mqMYHAtWQsJO0DV-QJbmHzlP7f_8P_8YPzpGZdRttzujWFeDCpUH8xCqF0IU_2MwAwguM7tNrJi-oisE0jOY1lYCG-Nw8Iq_bo9CWrUjPtKdAupM/s400/IMG_1801.JPG" width="400" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">Ken na Rafiki</td></tr>
</tbody></table>
Today we celebrate Ken's birthday, who has been an amazing mentor, resource, and friend this trip. Thank you, Ken, for your dedication to this hospital, these people, and to the incredible learning experience for all students here.Anonymoushttp://www.blogger.com/profile/04799493982350374480noreply@blogger.com2tag:blogger.com,1999:blog-2838753680231483798.post-12266634993169755102013-01-30T04:48:00.000-08:002013-01-30T04:48:02.979-08:00PIzza WednesdayIt's finally Pizza Wednesday! We have been planning this evening for many days, giddy in anticipation for the gooey goodness of greasy comfort food. However, it marks a bittersweet night: the night before our beloved daktari Jane and Nurse DeDe and Mary will be leaving. This mini party will be a small going away party for these wonderful people. Jane and I had a fun rain run this afternoon, since last night's downpour encouraged a lazy morning this morning. We returned to a wonderful post-run feast of rice and peas, cabbage, pineapple, mango, and of course, Jane's Tony Chach seasoning.<br />
We have spent most of our day preparing for our training sessions about Diabetes and Hypertension that we will present to the medical staff here at Ilula tomorrow and Friday. Yesterday was another incredibly stimulating and exciting day. Ken and I headed to a small village with the director of the Institute of Agriculture at Tumaini University, who sponsors the COmpanion Village Project, aimed at increasing the crop yield of villages through collaboration with the village pastor. We were able to fit in a small nutrition lesson, as well as a water purifying technique using the heat and UV rays from the sun. The villagers were very responsive and it was a very rewarding experience.<br />
We distributed more Plumpy'nut today to malnourished children, whose parents were very appreciative. It is always a wonderful feeling to pass out this nutritional supplement, but you always wish you could do more for the family.<br />
The Minneapolis weather is not at all inviting. How I wish I could stay in this sunny 85 degree weather forever. We only have one week left here in Ilula before 2 days in Dar, where we will fly out of. I am already dreading the transition back to reality, where chickens do not run wild and clothes are not hung to dry in the sun. The good news is, I have a feeling this is not my last time here.Anonymoushttp://www.blogger.com/profile/04799493982350374480noreply@blogger.com0tag:blogger.com,1999:blog-2838753680231483798.post-60454332119985760322013-01-29T06:05:00.001-08:002013-01-29T06:05:16.485-08:00Monday Good news- Bad news<span style="-webkit-composition-fill-color: rgba(130, 98, 83, 0.0976563); -webkit-composition-frame-color: rgba(191, 107, 82, 0.496094); -webkit-tap-highlight-color: rgba(26, 26, 26, 0.296875); font-family: Noteworthy; font-size: 20px; font-weight: bold; line-height: 26px;">Monday, 28/01/2013</span><br />
<div style="-webkit-composition-fill-color: rgba(130, 98, 83, 0.0976563); -webkit-composition-frame-color: rgba(191, 107, 82, 0.496094); -webkit-tap-highlight-color: rgba(26, 26, 26, 0.296875); font-family: Noteworthy; font-size: 20px; font-weight: bold; line-height: 26px;">
Since Friday was a national holiday (Mohammed's birthday) and Sat & Sun the OPD clinics were closed Monday brought out the crowds. There was standing room only in the OPD hallway and long lines at registration, the lab, and the Pharmacy. </div>
<div style="-webkit-composition-fill-color: rgba(130, 98, 83, 0.0976563); -webkit-composition-frame-color: rgba(191, 107, 82, 0.496094); -webkit-tap-highlight-color: rgba(26, 26, 26, 0.296875); font-family: Noteworthy; font-size: 20px; font-weight: bold; line-height: 26px;">
The 3 Dunguya friends referred by the Palliative care team on Thursday arrived via motorcycle in spite of the muddy road conditions. Sunday brought a torrential downpour to the area. And today we had more rain later in the afternoon. Electrical power was intermittent for two days following.</div>
<div style="-webkit-composition-fill-color: rgba(130, 98, 83, 0.0976563); -webkit-composition-frame-color: rgba(191, 107, 82, 0.496094); -webkit-tap-highlight-color: rgba(26, 26, 26, 0.296875); font-family: Noteworthy; font-size: 20px; font-weight: bold; line-height: 26px;">
Good news - bad news! The first patient had a negative cervical cancer smear but the 2nd patient was HIV positive on re-testing. </div>
<div style="-webkit-composition-fill-color: rgba(130, 98, 83, 0.0976563); -webkit-composition-frame-color: rgba(191, 107, 82, 0.496094); -webkit-tap-highlight-color: rgba(26, 26, 26, 0.296875); font-family: Noteworthy; font-size: 20px; font-weight: bold; line-height: 26px;">
The first patient received antibiotics at no cost for a vaginal infection ( paid for partially by the hospital "poor patient fund", CTC, and another donation by a MN visiting nurse ;). Although the antibiotics were covered it took two trips to the community pharmacy to locate and purchase the correct amount as the hospital pharmacy was out of stock. Although the order clearly stated 2 gm every day for 5 days, the clerk would only sell me 5 Gm the first trip. So I walked back to the hospital pharmacy to re-confirm the dosage and learn a few more Kiswahili words to make my case that I needed 5 more vials. Hurrah! I was successful on my 2nd trip. The general ward nurse inserted an IV catheter with an insertion port and gave the first dose. Now let's pray the patient will return the next four days to complete the course. She has no family in Ilula so will have to make the trip back and forth every day to that remote village by foot. It will take her 2-3 hours each way. </div>
<div style="-webkit-composition-fill-color: rgba(130, 98, 83, 0.0976563); -webkit-composition-frame-color: rgba(191, 107, 82, 0.496094); -webkit-tap-highlight-color: rgba(26, 26, 26, 0.296875); font-family: Noteworthy; font-size: 20px; font-weight: bold; line-height: 26px;">
<br /></div>
<div style="-webkit-composition-fill-color: rgba(130, 98, 83, 0.0976563); -webkit-composition-frame-color: rgba(191, 107, 82, 0.496094); -webkit-tap-highlight-color: rgba(26, 26, 26, 0.296875); font-family: Noteworthy; font-size: 20px; font-weight: bold; line-height: 26px;">
The other two patients were counseled and treated in CTC. Healthcare in Ilula. </div>
<div style="-webkit-composition-fill-color: rgba(130, 98, 83, 0.0976563); -webkit-composition-frame-color: rgba(191, 107, 82, 0.496094); -webkit-tap-highlight-color: rgba(26, 26, 26, 0.296875); font-family: Noteworthy; font-size: 20px; font-weight: bold; line-height: 26px;">
All's well that ends well but in Tanzania the heart wrenching stories never end. </div>
Anonymoushttp://www.blogger.com/profile/13376374214286652783noreply@blogger.com0tag:blogger.com,1999:blog-2838753680231483798.post-90741494713118948202013-01-29T05:57:00.000-08:002013-01-29T05:57:22.630-08:00Palliative rounds at Ilula<span style="-webkit-composition-fill-color: rgba(130, 98, 83, 0.0976563); -webkit-composition-frame-color: rgba(191, 107, 82, 0.496094); -webkit-tap-highlight-color: rgba(26, 26, 26, 0.296875); -webkit-text-size-adjust: auto; font-family: Noteworthy; font-size: 20px; font-weight: bold; line-height: 26px;">Ilula hospital palliative care rounds leave one astounded at the caring and commitment of the team. Two nurses, a clinical officer (comparable to a physician's assistant in USA), and a chaplain travel to surrounding villages to visit patient's with terminal or chronic diseases. They assess current and ongoing medical, psychological, social, and daily living needs. These patients are cared for by family members- grandparents, grandchildren, children, spouses, siblings, cousins, etc. Many times the patient is the sole care provider for other family members. One I vividly remember was a grandmother with cervical cancer caring for her three orphaned grandchildren. Another was an elderly woman with no means of support caring for her husband who was bedridden due to a serious hip injury 5 years ago. Their eldest son had died of malaria when he was in college. The younger two sons were unemployed and reportedly no help to the parents due to excess drinking. There was no food in the home when we visited. We left our donuts and energy bars brought along for lunch. </span><br />
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Another 35 yr old woman living with HIV was experiencing a two day illness with fever, headache, neck pain, coughing, and general malaise. It was recommended that she go to the out patient clinic at the hospital to be tested for malaria but had no money for the registration fee of 2000 Tsh equal to $1.25 USD. The chaplain gave her the money. </div>
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<br /></div>
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On another day at a remote village one of the women living with HIV was experiencing some clinical signs and symptoms of an infection and was advised to be checked at the CTC (Clinton Foundation Counseling and Treatment Center for AIDS and HIV) on the Ilula Hospital campus. Her only means of transportation were walking (3 hours one way), riding a bicycle (she does not know how to ride a bike), hitch hiking (unreliable as cars rarely make it to this village due to washed out roads, or hiring a motorcycle which would cost 10,000 Tsh ($6.25). That was a no brainer! I could easily donate $6.25 for a motorcycle ride for this community volunteer who was recruiting villagers to be tested for HIV. In the afternoon this admirable team split up so half could continue visiting patients in homes and the others set up a mobile HIV testing clinic. 20 patients ages 8-70 (12 F; 8 M) were counseled and tested for HIV. One was indeterminate; one was reactive. Both were referred to CTC; one for re-testing and the other for ARV treatment. </div>
<div style="-webkit-composition-fill-color: rgba(130, 98, 83, 0.0976563); -webkit-composition-frame-color: rgba(191, 107, 82, 0.496094); -webkit-tap-highlight-color: rgba(26, 26, 26, 0.296875); -webkit-text-size-adjust: auto; font-family: Noteworthy; font-size: 20px; font-weight: bold; line-height: 26px;">
Back in the hospital van we prayed the driver would be able to keep the vehicle upright as we curved around potholes, boulders, up and down into washed out sections , and over rutted trails. Luckily there were only six of us in the back so we could have two buns each on the benches for balance. On the way up to Dunguya we gave 7 young schoolchildren a ride home for lunch and on the way back we gave a woman a ride to a neighboring village. They think nothing of squeezing 10-12 in the back and 3 in the front on these outreach trips.</div>
<div style="-webkit-composition-fill-color: rgba(130, 98, 83, 0.0976563); -webkit-composition-frame-color: rgba(191, 107, 82, 0.496094); -webkit-tap-highlight-color: rgba(26, 26, 26, 0.296875); -webkit-text-size-adjust: auto; font-family: Noteworthy; font-size: 20px; font-weight: bold; line-height: 26px;">
Warm greetings from Tanzania. Dede</div>
Anonymoushttp://www.blogger.com/profile/13376374214286652783noreply@blogger.com0tag:blogger.com,1999:blog-2838753680231483798.post-83350186193577278992013-01-25T23:54:00.000-08:002013-01-25T23:54:22.821-08:00Plumpy’Nut
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A Pastor friend, Bonnie Wilcox, a veteran of Tanzania trips,
asked how Plumpy’Nut came to be at Ilula Hospital.<span style="mso-spacerun: yes;"> </span>This is a story that bears endless repetition
(if you ask me!), so I am happy to oblige.<span style="mso-spacerun: yes;">
</span>She mentions an organization called Edesia that uses Plumpy’Nut around
the world.</div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
In 2011, one of our first med students, Kelsey Watt, MD, now
a Pediatric Resident in Colorado, and I were the last to go home from
Ilula.<span style="mso-spacerun: yes;"> </span>While we were here, we were stuck
by several very ill children.<span style="mso-spacerun: yes;"> </span>I have
photos of two of them, but truly, they are gruesome and for the eyes of medical
personnel only.<span style="mso-spacerun: yes;"> </span>You will need to use
your own imagination, but I think you can hardly overdo it.<span style="mso-spacerun: yes;"> </span>One of the children died 2 hours after
admission.<span style="mso-spacerun: yes;"> </span>She was two and looked like a
bag of bones.<span style="mso-spacerun: yes;"> </span>This is marasmus.<span style="mso-spacerun: yes;"> </span>The other, about 18 months, was swollen all
over, with puffy cheeks, puffy hands and feet and tremendously swollen
genitalia.<span style="mso-spacerun: yes;"> </span>This is kwashiorkor.<span style="mso-spacerun: yes;"> </span>This boy was here for our entire stay.<span style="mso-spacerun: yes;"> </span>I do not think we did anything for him that
helped.<span style="mso-spacerun: yes;"> </span>Both would have been fine with a
six-week course of Plumpy’Nut.</div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
Someone told us of this product.<span style="mso-spacerun: yes;"> </span>Kelsey and I looked into it.<span style="mso-spacerun: yes;"> </span>We even developed a talk centered around
malnutrition.<span style="mso-spacerun: yes;"> </span>Well, Kelsey did most of
the work, I edited it, but I get credit due to being the “professor.”<span style="mso-spacerun: yes;"> </span>Call or write me if you want to hear it!</div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
I brought the story home to my congregation at St. James,
who graciously had a special offering for us to share with our local food
shelf.<span style="mso-spacerun: yes;"> </span>In a conversation with my lovely
mom, I told her the Plumpy’Nut story.<span style="mso-spacerun: yes;">
</span>Her circle at Zion Lutheran in Anoka graciously made another
contribution.</div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
We were able to buy about ten cartons of Plumpy’Nut, 13.8
kg, each with about 150 sachets of the stuff.<span style="mso-spacerun: yes;">
</span>For children between 6 months and 3 years, our target population, 1-2
sachets (packets) per day is the dose.<span style="mso-spacerun: yes;">
</span>The full course is six weeks.<span style="mso-spacerun: yes;"> </span>But
only 2% of children die of malnutrition directly.<span style="mso-spacerun: yes;"> </span>But it figures prominently I 80% of deaths in
children under five.<span style="mso-spacerun: yes;"> </span>Malnutrition kills
by potentiating any other illness.</div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
Of course, there are varying degrees of under nutrition,
both acute and chronic.<span style="mso-spacerun: yes;"> </span>The average need
for Plumpy’Nut is about 2 weeks and one packet per day.</div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
For Tanzania, the national statistic is that 38% of children
under five are stunted (low height for age).<span style="mso-spacerun: yes;">
</span>This is a sign of chronic malnutrition.<span style="mso-spacerun: yes;">
</span>Thirty-eight percent!<span style="mso-spacerun: yes;"> </span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
All children admitted to the hospital are nutritionally
stressed.<span style="mso-spacerun: yes;"> </span>And furthermore, since the
families provide food for their loved ones who are patients, anyone
undernourished when they are admitted are likely to remain so.</div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
We developed a protocol for prescription of the Plump’Nut
and a concept paper for a program, too long to present here, but a description
of it might be good for another post.<span style="mso-spacerun: yes;">
</span>Many children relapse in 3 – 4 months.<span style="mso-spacerun: yes;">
</span>So treatment at the hospital is the easy part!</div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
My dear church and others have provided enough Plumpy’Nut
for about 1/3 of the need for the worst cases, but I would like to expand its
use if possible.<span style="mso-spacerun: yes;"> </span>For example, some of
you have met Amri Lubawa, a young lawyer who is paralyzed and with terrible
bedsores.<span style="mso-spacerun: yes;"> </span>We think he looks wasted
compared to last summer.<span style="mso-spacerun: yes;"> </span>I was hoping to
get a grant to supply it ongoing for Ilula Lutheran District Hospital, but so
far no luck.<span style="mso-spacerun: yes;"> </span>“I have not yet begun to
fight!” to quote John Paul Jones.<span style="mso-spacerun: yes;"> </span>(And I
would gladly accept help and advice.)<span style="mso-spacerun: yes;"> </span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
What the heck is this magical formulation anyway?<span style="mso-spacerun: yes;"> </span>It is (by weight) approximately one part peanut
butter, one part powdered milk, one part powdered sugar, one-half part oil,
like sunflower oil and necessary micronutrients (vitamins, etc.).<span style="mso-spacerun: yes;"> </span>Plumpy’Nut is a brand name.<span style="mso-spacerun: yes;"> </span>The WHO has a recipe and I would love to see
a version made here locally!</div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
Anyone want to help or donate or point me toward the
funding?</div>
Kenhttp://www.blogger.com/profile/08062952252731045537noreply@blogger.com0tag:blogger.com,1999:blog-2838753680231483798.post-46631630087340468942013-01-24T05:56:00.001-08:002013-01-25T09:41:36.684-08:00Human Interest Stories – an everyday occurrence at ILH<style>
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<div class="MsoNormal">
Laura Brown is one of our Pharmacy Residents.<span style="mso-spacerun: yes;"> </span>She was here last year as a student and came
back!<span style="mso-spacerun: yes;"> </span>Yesterday she became an “everyday
hero.”</div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
There was a 14 month-old child admitted with malaria and pretty
typical symptoms of fever, lethargy and anemia.<span style="mso-spacerun: yes;">
</span>The malaria can tear up the red blood cells.<span style="mso-spacerun: yes;"> </span>This infant’s hemoglobin was 2.8.<span style="mso-spacerun: yes;"> </span>Normal would be more like 15.8.<span style="mso-spacerun: yes;"> </span>There are people wandering around with
hemoglobin nearly this low.<span style="mso-spacerun: yes;"> </span>Mostly they
have pernicious anemia.<span style="mso-spacerun: yes;"> </span>But they got
there slowly.<span style="mso-spacerun: yes;"> </span>When hemoglobin drops to
this level quickly however, it is a disaster.<span style="mso-spacerun: yes;">
</span>The body cannot transport enough oxygen to feed the tissues, let alone
heal.<span style="mso-spacerun: yes;"> </span>This little tike needed a
transfusion.<br />
<table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto; text-align: center;"><tbody>
<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiE44uJePcY3jXogBnVlyoozHidFqItGq4iidYuxzxdwAWlos6wRBbdE4Kxut58AJinbnJM9ueOLR8AwOBRYml7iUPCPlSJzNwr-WabgneZknhNGIRMX9sqWoUDnridSeZciKM6NvHiByA/s1600/Laura+and+Transfusion+Girl.jpg" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" height="240" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiE44uJePcY3jXogBnVlyoozHidFqItGq4iidYuxzxdwAWlos6wRBbdE4Kxut58AJinbnJM9ueOLR8AwOBRYml7iUPCPlSJzNwr-WabgneZknhNGIRMX9sqWoUDnridSeZciKM6NvHiByA/s320/Laura+and+Transfusion+Girl.jpg" width="320" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">After transfusion!</td></tr>
</tbody></table>
</div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
As Laura modestly put it, “There were lots of us willing to
give a blood donation.<span style="mso-spacerun: yes;"> </span>But everyone else
had their immunizations before they came.<span style="mso-spacerun: yes;">
</span>Mine were up to date from a year ago.”<span style="mso-spacerun: yes;">
</span>So she donated a pint of blood.<span style="mso-spacerun: yes;">
</span>Our little friend made a miraculous recover and today was standing by
mama.<span style="mso-spacerun: yes;"> </span>She isn’t done with her treatment,
but she is recovering, thanks to Laura’s gift of life.<span style="mso-spacerun: yes;"> </span>These stories are not just about the wazungu.<span style="mso-spacerun: yes;"> </span>Many of the employees give blood when it is
needed.<span style="mso-spacerun: yes;"> </span>They are everyday heroes
too.<span style="mso-spacerun: yes;"> </span>It is a daily occurrence here.</div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
Today Augustana Lutheran Church visited Ilula Lutheran
Hospital, so I had the privilege of giving them the tour.<span style="mso-spacerun: yes;"> </span>Then they feasted with us at lunch on Anna’s
great cooking.<span style="mso-spacerun: yes;"> </span>We went by the Private
Ward, where Amri is.<span style="mso-spacerun: yes;"> </span>You may recall the
name if you read Iringa-Friends-2012.<span style="mso-spacerun: yes;"> </span>He
is still here and has been now for nearly a year.<span style="mso-spacerun: yes;"> </span>He is still dealing with pressure sores.<span style="mso-spacerun: yes;"> </span>The Augustana people were gracious and
generous to give money toward his care and to the Poor Patients’ Fund.</div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
They had a novel idea also: What would a donation of $10,
$20, $50 or more supply?</div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
I can put a face on some of that.<span style="mso-spacerun: yes;"> </span>A full course of Plumpy’Nut (RUTF, “ready to
use therapeutic food), a sachet (packet) per day for six weeks would be around
$16.<span style="mso-spacerun: yes;"> </span>(Not much, unless your entire
annual income is $360.)<span style="mso-spacerun: yes;"> </span>More typically,
we would use for a couple weeks, so $5.<span style="mso-spacerun: yes;">
</span>We will have about a thousand kids under five years of age admitted to
ILH.<span style="mso-spacerun: yes;"> </span>Of those, 38% are stunted, a sign
of long-term under nutrition.<span style="mso-spacerun: yes;"> </span>But ALL of
the children are under nutritional stress.<span style="mso-spacerun: yes;">
</span>Just counting the 380 kids who need RUTF for 10 days or so, now we have 3800
doses needed per year, just for the children overtly under nourished and not
including any of the children who need nutritional support during their illnesses.<span style="mso-spacerun: yes;"> </span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
I am proud and thankful to say that again tis year, St.
James came through with enough donations for fully 1/3 of what the hospital
needs.<span style="mso-spacerun: yes;"> </span>Way to go, St. James!</div>
<br />Kenhttp://www.blogger.com/profile/08062952252731045537noreply@blogger.com1tag:blogger.com,1999:blog-2838753680231483798.post-69223422632847182662013-01-23T06:20:00.002-08:002013-01-23T06:20:44.341-08:00Ruaha National Park<div class="separator" style="clear: both; text-align: center;">
Meet Taja. She was such a model for us and is just a glimpse of the amazing animals we saw on our Safari. I'm sure more pictures will follow, but I know some people back home would love a sneak preview. The weekend in Ruaha was outstanding and such a treat amidst a lot of hard work by the entire team here. It was such a great way to send off the crew that is now on their way to Dar to fly back to Minnesota and to welcome Vandi to the team.</div>
<div class="separator" style="clear: both; text-align: center;">
<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiMtdJCr4UZacEqyLTzQpFPrKGYUVaKsC1t82XlBZnwpsr5E56QANSF50EZ3lGdmHMf1NZjUmzgp2IwzqhuVs8ZtlyZZDw7Wyu-7MBoqG8BxXZjsWXlwz1fIO4Bx3fHbmp9I2FJvrqtnzk/s1600/CSC_0064.JPG" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="213" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiMtdJCr4UZacEqyLTzQpFPrKGYUVaKsC1t82XlBZnwpsr5E56QANSF50EZ3lGdmHMf1NZjUmzgp2IwzqhuVs8ZtlyZZDw7Wyu-7MBoqG8BxXZjsWXlwz1fIO4Bx3fHbmp9I2FJvrqtnzk/s320/CSC_0064.JPG" width="320" /></a></div>
<br />jesshttp://www.blogger.com/profile/03405738980185648477noreply@blogger.com1tag:blogger.com,1999:blog-2838753680231483798.post-44460863188714487062013-01-23T05:46:00.000-08:002013-01-23T05:46:28.794-08:00Huruma Centre, January 22, 2013
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<i><span style="font-family: Calibri; mso-bidi-font-family: Calibri;">Dear Friends,</span></i></div>
<div class="MsoNormal" style="margin-bottom: 13.0pt; mso-layout-grid-align: none; mso-pagination: none; text-autospace: none;">
<i><span style="font-family: Calibri; mso-bidi-font-family: Calibri;">Here is a non-medical miracle from our friend Gary Langness, one of
the influential in BKB.<span style="mso-spacerun: yes;"> </span>He wrote and
sent the following to his friends and family and he gave me permission to
reprint it here.<span style="mso-spacerun: yes;"> </span>The point of this isn’t
that I had the privilege to participate.<span style="mso-spacerun: yes;">
</span>It is that Mama Chilewa has put in yeoman’s effort for the many orphans
she has helped, with way too little help.<span style="mso-spacerun: yes;">
</span>Too few teachers that need to be paid, buildings unoccupied because it
takes increased overhead to use them.<span style="mso-spacerun: yes;"> </span>It
isn’t so hard to get money for a building (believe it or not), but it is
difficult to get funds for operations, especially since they need to be
ongoing, not a one time donation.</span></i></div>
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<i><span style="font-family: Calibri; mso-bidi-font-family: Calibri;">Here is the story from Gary:</span></i></div>
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<span style="font-family: Calibri; mso-bidi-font-family: Calibri;">We have heard that it is very cold in Minnesota so I thought I would
send you an email so you had something to do other than to wonder when it would
be warm again.</span><span style="font-family: Helvetica; mso-bidi-font-family: Helvetica;"></span></div>
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<span style="font-family: Calibri; mso-bidi-font-family: Calibri;">On Monday Carol and I went to the Huruma Centre, the orphanage where
Mama Chilewa is the director. Our purpose was to find out the cost of
providing new school uniforms, sweaters, and shoes for 36 primary school
children that live at the orphanage. Mama was also going to have a list
of the school fees for each child so we could secure the needed money from the
local bank and pay the fees. As we sat down in her office I noticed that
Amy, one of the care givers was hand writing a list and I wondered why it was
not being done on Mama’s computer. About that time Mama said very
quietly, “I am old and so is this computer.” She was trying to print out
the school fee sheet… it was not working… it would have to be done by hand.</span><span style="font-family: Helvetica; mso-bidi-font-family: Helvetica;"></span></div>
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<span style="font-family: Calibri; mso-bidi-font-family: Calibri;">As we were leaving Mama looked at Carol and said, “May I ask you
something?” Receiving an affirmative response from Carol she asked about
the possibility of securing a computer from the U.S. The problem with
purchasing a new computer in Tanzania is that you can never be sure that all
the parts are new and that it will work once you get it home. “How much
would it cost?” she asked. I looked at her and realized that everything
about life was hard for Mama. She was dejected and appeared to be tired
of always trying to do something positive for the children but never quite
having what she needed. I told her I did not know how much a computer
would cost but we would check into it. She thanked us and we headed home.</span><span style="font-family: Helvetica; mso-bidi-font-family: Helvetica;"></span></div>
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<span style="font-family: Calibri; mso-bidi-font-family: Calibri;">Back at our apartment sit two HP laptop computers. I have this
friend Tom who is the Director of Development at Luther Seminary. A few
years ago, Tom spent several weeks with us here in Iringa. He knows about
the people and the needs. The last two years Tom has purchased two
reconditioned laptops for us to bring over here and use where needed. I
offered to pay, but Tom just smiles and says, “I want to do this.” My
Scandinavian background has me silently protesting thinking I should say I
would be happy to pay for them… instead I say to myself, “Quiet... just accept
the gift… say thank you… let Tom know and experience the joy of giving. “ I
then called Dan McIntyre and asked him if he could equip the computers with
software… “Yes, I be happy to do that!”</span><span style="font-family: Helvetica; mso-bidi-font-family: Helvetica;"></span></div>
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<span style="font-family: Calibri; mso-bidi-font-family: Calibri;">On the way home from the Huruma Centre we stopped for lunch.
Once seated, I called Ken Olson, a family doctor from St. James Lutheran Church
in Bursnville. Not only does he know medicine he also knows computers… in
fact he builds them. I asked him if he might have time to go with us to
the Huruma Centre… back to see Mama Chilewa… bring her one of the laptops
sitting in our apartment and hook it all up. He did not say yes… he said,
“I’d love to!” I called Mama and asked if she was still in her office…
she was… I told her we would be there in 15 minutes. Ken, Carol, the laptop
and Gary headed for Huruma. As we walked into her office and she spotted
the laptop she began to smile. Ken sat down and did what computer geeks
do… hooked it all up to the printer… made it all work. Then he invited
Mama to sit next to him as he taught her how to use it… I noticed Ken would
just point to buttons she could push and Mama pushed them… the smile on her
face grew larger… tears welled up in her eyes and I thought there might be a
lump in her throat… and then she said, “This is a miracle.” Is it a miracle I
thought… well not the feeding of 5,000 with a few loaves and bread and two fish
kind of miracle… but to Mama it was a miracle and the smile on her face made me
a believer.</span><span style="font-family: Helvetica; mso-bidi-font-family: Helvetica;"></span></div>
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<span style="font-family: Calibri; mso-bidi-font-family: Calibri;">I saw the joy in the face and eyes of Ken and I wondered if it was a
miracle for him as well… well not the catching so many fish that the boat
nearly sank and having to call for help from fellow fishermen kind of a
miracle… but the miracle of joy in Ken’s heart as he just made life much easier
for Mama and the kids at Huruma.</span><span style="font-family: Helvetica; mso-bidi-font-family: Helvetica;"></span></div>
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<span style="font-family: Calibri; mso-bidi-font-family: Calibri;">Then Carol offered to spend time with Mama today, transferring
documents and getting the computer to do what Mama needed. These two
women, from different continents and backgrounds sat together and made good
progress… and they laughed and smiled and bonded even more deeply… and it
is a miracle… well not the changing water into wine kind of miracle but a
miracle of friendship and the joy that both of these women will share for the
rest of their lives.</span><span style="font-family: Helvetica; mso-bidi-font-family: Helvetica;"></span></div>
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<span style="font-family: Calibri; mso-bidi-font-family: Calibri;">As I watched this all play out I realized this is all that I ever
wanted as a parish pastor… to share the good news of Jesus and to help people
become generous so they might know the joy that comes from giving… so that the
lives of others might be better… and along the way to sense a joy they never
felt before that leaves them smiling on the inside and on the outside.</span><span style="font-family: Helvetica; mso-bidi-font-family: Helvetica;"></span></div>
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<span style="font-family: Calibri; mso-bidi-font-family: Calibri;">Mama smiles today… so does Dan… so does Tom… so does Ken… so does
Carol… and so do I because I had the opportunity to see the joy in all of them…
it is enough to make me want to dance… but that would not be a pretty sight, so
I will just smile…. that is what the miracle of generosity does to you.</span><span style="font-family: Helvetica; mso-bidi-font-family: Helvetica;"></span></div>
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<span style="font-family: Calibri; mso-bidi-font-family: Calibri;">One more laptop sits on our desk… I wonder who will be the recipient…
I can hardly wait to find out.</span><span style="font-family: Helvetica; mso-bidi-font-family: Helvetica;"></span></div>
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<span style="font-family: Calibri; mso-bidi-font-family: Calibri;">And for you who might have taken the time to read this I would like to
invite you into the joy of generosity… it will leave you smiling and it will
bring joy to the very heart of God.</span><span style="font-family: Helvetica; mso-bidi-font-family: Helvetica;"></span></div>
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<span style="font-family: Calibri; mso-bidi-font-family: Calibri;">Gary & Carol</span><span style="font-family: Helvetica; mso-bidi-font-family: Helvetica;"></span></div>
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Kenhttp://www.blogger.com/profile/08062952252731045537noreply@blogger.com1tag:blogger.com,1999:blog-2838753680231483798.post-4931896415018306862013-01-23T03:29:00.001-08:002013-01-24T05:57:03.577-08:00Worlds ApartWell, I am not even sure where to start. My failure to blog is a reflection of the jam-packed, action-packed past week I have had. Has it truly only been a week? That seems impossible.<br />
Last Thursday I went on home hospice visits to a nearby village. We crammed into the hospital's van and set out to check up on patients who are unable to come to the hospital for care. The van bounced along the dirt road, gospel blaring with the 3 nurses singing loudly along. Anne, Kari, Mary, DeDe and I hummed along and I studied the roads. A very simple thing, yes, but it symbolizes so much about my journey thus far. The roads are a rich red/orange color, constantly changing in width and texture, winding beautifully around small mud huts and excited children. These same roads offer a soft surface for my morning runs, a bumpy washboard for our road trip to Ruaha National Park, and narrow paths reaching the most rural and most vulnerable populations. As many of these experiences are, the home visits were difficult to grasp. The most amazing part of the whole visit was finding out what the purpose of the home visit actually was: spirit. We had a box full of pain meds and antibiotics, and while we assessed the patient's physical conditions, much of the visit was spent laughing and singing with the patient and their families. The visit ended with a prayer to continue to protect the sick patient, and we would be on our way to the next home. Such an incredibly powerful experience. Three of the patients greeted us with "oh, white people are here, god must still love me." This of course, was translated through the nurse, but I couldn't help but to feel uneasy by this comment.<br />
We were out in this village for about 6-7 hours, and returned to quickly inhale food and go on to the next emotional experience: Amani Orphanage. 55 children greeted us, one being the 2 year old, Henrietta, that was a living example of the power of a nutritional supplement, Plumpy'Nut. Tears filled my eyes when I saw this child, hearing stories of her fragile body just a year ago when Ken saw her, staring back at me with plump cheeks and lively eyes. I have the children on video singing and dancing for us, which again, brought more tears. The orphanage itself was one of the most impressive places I have ever been. The kids and staff live completely off the land, with a beautiful farm behind the buildings. They have pigs, cows, chickens, they grow their own mushrooms and vegetables and fruits. The methane from the cow manure is transfered through a pipe to cook the food. I was in awe.<br />
<br />
Friday was travel day. We woke up an hopped on the bus to get to Tungamulenga (sp?), a village about 2.5 hours away. Bega Kwa Bega, the organization through which this entire experience is possible, provided support to these villages for building wells, churches, or schools. These congragations were companion congregations to many congregations in the Twin Cities. We visited 4 villages to see the progress. These visits unbelievable. The first village, the Masai men and women performed a jumping/vibrating dance that I could have watched for hours. The Masai women are simply stunning. We were given food and drink at every church and the last church even auctioned off a chicken in our honor. Pretty awesome.<br />
<br />
The next morning we set off to Ruaha National Park for a Safari. Every day of this trip seems to get more surreal. We were treated like royalty (I never got the hang of having my chair pulled in and out) and stayed in the most whimsical quarters. We had open air bandas with a tent that zipped during the night. The safari animals were sometimes spotted outside the quarters, and we even had a bamboo steal on of our traveler's sugar jar on the coffee tray. And the food, oh the food. We all had not seen fresh vegetables for days, so we piled our plates high. We then set out to see animals! Zebras, elephants, lions, a jaguar, giraffes, they just kept coming. To see these animals in their natural environment was just incredible. I felt like I was in a movie. I do not have the pics uploaded to my computer yet, but hopefully can post come later. We had 3 4 hour trips of this excitement, giggling all the way, trying to sight the tiny "Dik-dik" and getting roared at by protective elephant mothers.<br />
<br />
Every time I step out the door here, there is a chance to learn. Whether it be the gestation of an elephant (22 months!!) or the symptoms of dysentery, it is never ending. I feel so incredibly lucky every moment of being here and even more lucky to still have 2 weeks to go. We lost about half our group this morning. It was so sad to see all of the amazing doctors and nurses leave, but we still have good old Ken and Gary to guide us through.<br />
<br />
This morning during rounds, I distributed my first packet of plumpy'nut. The two year old had malaria and did not have an appetite, so hadn't eaten for the past two days. While he was not noticeably "wasted," it was almost guaranteed he was malnourished. Of all the dreams I have already accomplished being here, this experience was very powerful because I felt like I made a direct impact on this child's well-being. My innate need to nourish was fulfilled and I felt complete. However, the next patient was not as easy to treat. A 4 month old with a hemoglobin of 2.8 gm/dL (normal is around 10-14)<br />
Her little chest was rising and falling so fast I could not stand it. With a Hb this low, they perform blood transfusions here. The only problem: there was no donated blood. I immediately offered mine, and the doctors joked I would turn her into a mzungu (white person). After further assessment, turns out I am not allowed to donate since I just received vaccinations for this trip. Laura, the pharm resident, did not receive vaccinations this trip, so was able to come to the rescue. I can rest easy. I am going to check on the babe after this.<br />
Well, that is the tired version of my past few days (we are all exhausted!) but hopefully I will have more energy to contribute more later. What beauty there is in this life and culture. I am, as always, unable to fully articulate the admiration and appreciation I have for these people and this experience.Anonymoushttp://www.blogger.com/profile/04799493982350374480noreply@blogger.com1tag:blogger.com,1999:blog-2838753680231483798.post-34973420305890662772013-01-21T05:27:00.001-08:002013-01-21T05:27:59.021-08:00Iringa
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<b>Sunday, January 20, 2013</b></div>
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First of all, Happy Birthday Mom!<span style="mso-spacerun: yes;"> </span>I hope you had a great time at Champp’s!<span style="mso-spacerun: yes;"> </span>I know you are 78 or 88, but I cannot
remember which.<span style="mso-spacerun: yes;"> </span>If I am nearly 65, I
suppose it isn’t 78, since I think I would have heard about it if you were 13
when I was born.<span style="mso-spacerun: yes;"> </span>No, wait.<span style="mso-spacerun: yes;"> </span>I must be 55.<span style="mso-spacerun: yes;">
</span>Hmmm.<span style="mso-spacerun: yes;"> </span>Then I was 13 when Chris
was born.<span style="mso-spacerun: yes;"> </span>But he cannot possibly be
42!<span style="mso-spacerun: yes;"> </span>Yikes, let me out of here before I
get in real trouble!<span style="mso-spacerun: yes;"> </span>Happy Birthday
anyway!</div>
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Mwa Moody (a name bestowed by the Tanzanians) and Dr. Saga
picked me up at 8:30 this morning.<span style="mso-spacerun: yes;"> </span>We
managed a cup of kahawa at the Lutheran Center before we went off to Kihesa to
church.<span style="mso-spacerun: yes;"> </span>The service was to start at 9:30
am, but “TIA” (this is Africa).<span style="mso-spacerun: yes;"> </span>So we
listened to a terrific Young Womens’ choir and a kids’ choir for about 20
minutes before the robed officials came in.<span style="mso-spacerun: yes;">
</span>Dr. Jane Casselton, MS4 at Tulane traded the title of Dr. for Mchungaji (Pastor)
for the day.<span style="mso-spacerun: yes;"> </span>She was also made an
honorary member of Kihesa, having been to Tanzania and her church’s (St.
Mark’s, N. St. Paul) companion congregation 6 times, first when she was 15!</div>
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The Youth Choir was truly joyful, with choreographed dance
steps with their songs before church started.<span style="mso-spacerun: yes;">
</span>They danced to the songs the Young Women’s Choir sang too.<span style="mso-spacerun: yes;"> </span>They had the moves!<span style="mso-spacerun: yes;"> </span>The kids of each choir could really belt it
out.<span style="mso-spacerun: yes;"> </span>What fun!<span style="mso-spacerun: yes;"> </span>I always love to hear our kids sing at home,
but I think they could really take a lesson.</div>
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The kids started out very quietly for one of their songs
then really sang jubilantly, dancing with great joy.</div>
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<br /></div>
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We all got to introduce ourselves.<span style="mso-spacerun: yes;"> </span>I can finally say, “Jina langu ni Daktari
Ken,” without stammering.<span style="mso-spacerun: yes;"> </span>Besides
English, many know my only other fluent language is, uh, Pig Latin.<span style="mso-spacerun: yes;"> </span>“I-may ame-nay is-way Octar-Day En-Kay.”<span style="mso-spacerun: yes;"> </span></div>
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It was a relaxing day, a walk with friends, a nice
conversation on the porch of the International School and some time to do some
work and thinking.</div>
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<b>Monday, January 21, 2013 </b></div>
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One fairly frequent but still disconcerting thing happened
yesterday.<span style="mso-spacerun: yes;"> </span>A young Tanzanian man
followed me a ways, then started up a conversation.<span style="mso-spacerun: yes;"> </span>This is the standard way this is done.<span style="mso-spacerun: yes;"> </span>Ultimately, he asked me for a job because he
wanted to go to school.<span style="mso-spacerun: yes;"> </span>I have no jobs
to offer.<span style="mso-spacerun: yes;"> </span>I did tell him he should go to
DIRA (the diocese office) to ask for help.<span style="mso-spacerun: yes;">
</span>Naturally he said he had already been there.<span style="mso-spacerun: yes;"> </span>We parted ways as we walked on, but this left
me with a twinge of discomfort, perhaps somewhat due to my Scandinavian
heritage.<span style="mso-spacerun: yes;"> </span>He was able to ask, despite
knowledge I was unable to offer.<span style="mso-spacerun: yes;"> </span>There
is no end to need here.<span style="mso-spacerun: yes;"> </span>Some of those
who receive are scammers – I don’t believe the young man was, but I do not
know.<span style="mso-spacerun: yes;"> </span>I do know that most are not.</div>
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<table cellpadding="0" cellspacing="0" class="tr-caption-container" style="float: right; text-align: right;"><tbody>
<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhdQ0nz7d540EslbzC3-8Wg8yWOpdK_18YTBLaXPi5kw_1Jt4CNE2kbcr06tVYSK3RlEwzzoAWM0uu2c6Mw0awuomGY_F-4BVc9u599dmtWFElK6peYZ6xwsevfuLpKdWGdOW1WLzSer3k/s1600/Scaffolding.jpg" imageanchor="1" style="clear: right; margin-bottom: 1em; margin-left: auto; margin-right: auto;"><img border="0" height="320" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhdQ0nz7d540EslbzC3-8Wg8yWOpdK_18YTBLaXPi5kw_1Jt4CNE2kbcr06tVYSK3RlEwzzoAWM0uu2c6Mw0awuomGY_F-4BVc9u599dmtWFElK6peYZ6xwsevfuLpKdWGdOW1WLzSer3k/s320/Scaffolding.jpg" width="240" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">Modern Tanzanian</td></tr>
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Here is another example.<span style="mso-spacerun: yes;">
</span>One of the visitors here was approached by the fiancé of someone he
knows and trusts.<span style="mso-spacerun: yes;"> </span>The young woman called
and said she was very sick with malaria and needed some money.<span style="mso-spacerun: yes;"> </span>The amount was not consistent with malaria
treatment, however.<span style="mso-spacerun: yes;"> </span>What she really
needed it for, under the guise of illness, was to pay her tuition.<span style="mso-spacerun: yes;"> </span>It is sad that we need to keep our guard up
so tight. </div>
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Here is a photo I hope you appreciate. </div>
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Kenhttp://www.blogger.com/profile/08062952252731045537noreply@blogger.com1tag:blogger.com,1999:blog-2838753680231483798.post-53750905562794146222013-01-20T02:12:00.000-08:002013-01-21T05:29:42.687-08:00Day of Grace<style>
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</style> Iringa, January 16, 2013<br />
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It is 10PM in Ilula Tanzania and a large portion of the
world.<span style="mso-spacerun: yes;"> </span>It is quite dark under the waxing
moon, almost half.<span style="mso-spacerun: yes;"> </span>You will see the same
moon I do later tonight, since where most of my friends and loved ones are
under Central Standard Time (GMT+6, I believe.)<span style="mso-spacerun: yes;">
</span>We arrived at Ilula after Day of Grace (DoG) 2 of 3, around 8 PM.</div>
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DoG is a big deal.<span style="mso-spacerun: yes;">
</span>Pastor Tom Hansen conceived of the notion several years ago and this is
the second DoG.<span style="mso-spacerun: yes;"> </span>Tom saw a need for the
Iringa Diocese Pastors to “kick back” and have a little fun as well as have an
educational session without the stress of some synodical requirement.<span style="mso-spacerun: yes;"> </span>The pastors simply don’t get together for
fun.</div>
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One essential component of this conference is a medical
one.<span style="mso-spacerun: yes;"> </span>Dr. Randy Hurley and Tom wondered
if the pastors would appreciate a screening physical exam.<span style="mso-spacerun: yes;"> </span>After a little stuttering for a couple years,
last year it came to be.<span style="mso-spacerun: yes;"> </span>The Pastors,
men and women were examined, blood sugars and blood pressures were checked and
recommendations made.<span style="mso-spacerun: yes;"> </span>We learned some
things.</div>
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For one, pastors’ spouses need the same things.<span style="mso-spacerun: yes;"> </span>Of course, they enjoyed the educational and
worship sessions and why not examine the spouses, mostly wives, next year?<span style="mso-spacerun: yes;"> </span>Next year turned into this year and here we
are.<span style="mso-spacerun: yes;"> </span>Today we did about 80 histories and
physical exams, including cervical cancer screening exams, with the blood
pressures, blood sugars, vision screens.</div>
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<b>Ilula, January 17, 2013</b></div>
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It is good to be back to Ilula!<span style="mso-spacerun: yes;"> </span>So much of interest!<span style="mso-spacerun: yes;"> </span>Saw a small guy with kwashiorkor, 17 months,
puffy face, hands and feet, drowsy and hard to arouse.<span style="mso-spacerun: yes;"> </span>Here is a photo too.<span style="mso-spacerun: yes;"> </span></div>
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiAHQVHdCTdn3h3BHiYcYoz75pq0lCKKsu5Fdpo_uap7zmj-xiC7QcnFTxR8s5RRtxsWjUZueryteGnyrpJAcSc942OKCQwp2ZeYbyhseiytqO8K7AgEn-9AY68CVaUwvSkQAJezP6npd4/s1600/Kwashiorkor.jpg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" height="320" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiAHQVHdCTdn3h3BHiYcYoz75pq0lCKKsu5Fdpo_uap7zmj-xiC7QcnFTxR8s5RRtxsWjUZueryteGnyrpJAcSc942OKCQwp2ZeYbyhseiytqO8K7AgEn-9AY68CVaUwvSkQAJezP6npd4/s320/Kwashiorkor.jpg" width="240" /></a></div>
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We gave him the Plumpy’Nut.<span style="mso-spacerun: yes;">
</span>First, we do a food trial.<span style="mso-spacerun: yes;"> </span>If he
will take the P’N avidly, he stays on it.<span style="mso-spacerun: yes;">
</span>If he cannot take it – too weak, uninterested (hey, who doesn’t like a Bit-O’-Honey?),
he needs a different formula, F 75 or F100 until the appetite comes back.<span style="mso-spacerun: yes;"> </span>He took it.<span style="mso-spacerun: yes;">
</span>(Hey, who doesn’t like a Bit-O’-Honey?)<span style="mso-spacerun: yes;">
</span>We will watch him on the P’N for as many days as his family will let him
stay or until we see reversal of the kwashiorkor.<span style="mso-spacerun: yes;"> </span>Unfortunately, this is a bad disease because
it may have associated organ damage, like kidney disease also.</div>
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This afternoon we will see another index case from last
year, Harriet at Amani Orphans Home Mbigli (AOHM).<span style="mso-spacerun: yes;"> </span>She quickly recovered and was growing well
and developing well last summer when last Birdie and I saw her.<span style="mso-spacerun: yes;"> </span>She should be about 2 years old now.</div>
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For my friends and fellow parishioners at St. James, I got
simple preliminary plans for the dispensary enlargement at Idunda.<span style="mso-spacerun: yes;"> </span>Perhaps I can photograph it and put it on the
blog.<span style="mso-spacerun: yes;"> </span>Dr. Saga is going to send rough
budget plans for it too.<span style="mso-spacerun: yes;"> </span>Off to class
for some learning!<span style="mso-spacerun: yes;"> </span>Done.<span style="mso-spacerun: yes;"> </span>Three great lectures:<span style="mso-spacerun: yes;"> </span>Post Exposure Prophylaxis for HIV (Ally
Liou); Geology of Tanzania (Moody); Proverbs of the Hehe (MwaMoody).<span style="mso-spacerun: yes;"> </span>Who is MwaMoody?<span style="mso-spacerun: yes;"> </span>Kihehe for Dr. Gary Moody.<span style="mso-spacerun: yes;"> </span>All three were terrific.</div>
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We went to Amani Orphans Home Mbigili this afternoon.<span style="mso-spacerun: yes;"> </span>And folks were enthralled. The children
danced and sang for us.<span style="mso-spacerun: yes;"> </span>We toured the
campus and looked at the farm.<span style="mso-spacerun: yes;"> </span>They have
cows, pigs, chickens, rabbits, turkeys and probably others.<span style="mso-spacerun: yes;"> </span>They are getting electricity soon, but they
are already nearly self-sufficient.<span style="mso-spacerun: yes;"> </span>They
make biogas from the cows’ and pigs’, uh, uh, oh yeah, manure and are able to
do their cooking with methane. They grow a nut for biodiesel also.</div>
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My little friend Harriet looks good. She is a bit shy around strangers, but a live-wire otherwise. Our friend Beate from Amani asked us to look at a couple kids with interesting
problems.<span style="mso-spacerun: yes;"> </span>We may have helped. I hope so. I should find out before I come home.</div>
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Kenhttp://www.blogger.com/profile/08062952252731045537noreply@blogger.com0tag:blogger.com,1999:blog-2838753680231483798.post-49391648643052593202013-01-15T09:40:00.000-08:002013-01-15T09:40:10.358-08:00To say Tanzania is "everything I expected" would be inaccurate. I knew there was no way I could prepare myself for this experience, though I tried.. hard. I tried to imagine the breathtaking scenery, I tried to imagine the infectious energy of the Tanzanians in their joyous, "haberi," greeting, I tried to imagine the smells, the sights, the feelings of Tanzania, but I couldn't. Until I stepped out of the airplane. "Africa," was all Ken needed to say to nearly bring me to tears, which would later slowly stream down my face on the bus to the hotel, overwhelmed with joy that the magnet pulling me to this very spot could finally rest. I was finally breathing the thick air, hearing the symphony of bullfrogs and crickets, and smiling so big for so long that my face started to hurt.<br />
I still have to pinch myself when I awake to this environment. The chiming bell outside our guest house wakes me up at 5:45, followed by the roosters close to six. I begin my morning with a run down the valley, waving to the farmers in their "shambas" hoeing their fields, or a yoga sequence on the front porch, performing sun salutations to the rising sun over the mountains. It is truly surreal. Our cook, Ana, prepares a delicious breakfast of doughnuts, perhaps eggs, fruit, and something else fried, in which we all manage to comment on the "carb content" every time, though happily ingest all of the deliciousness.<br />
Hospital rounds begin soon after that. We all shuffle behind a lead Tanzanian doctor who guides us through the patients, their current condition, and how they are progressing. This part of the day is obviously a wealth of information for me, as I scramble down as much medical terminology as possible while trying to contain my emotions. This entire experience has been such a roller coaster of emotions, <span style="background-color: white; color: #222222;"><span style="font-family: Times, Times New Roman, serif;">devastation, disbelief, joy, guilt, gratitude, heart break, humility, appreciation, happiness, soulfulness. In just a matter of a week, I have also spent time in the Pediatric HIV/AIDS ward, watched a C-section being performed (again, more tears of joy), helped perform a health screening on nearly 50 wives of pastors (with more to be seen on Wednesday and Friday), and simply tried to soak in the food and culture of Tanzania. </span></span><br />
<span style="background-color: white; color: #222222;"><span style="font-family: Times, Times New Roman, serif;">Tomorrow will be another "Day of Grace" health screening with around 50 more women where I will help take blood sugar readings. This weekend we wil head out for a Safari!</span></span><br />
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjIt1yCOttBdd1-PD8eXRhZmqlyLfIIxwp3t6LVAQtcFH32-UhkmZ2JNS6RSj1lt0CjMbqYwR-kiaVYWeZ77QyR10zccHGah0obU-7kX25VWez7HLN5AsUe8NNaB9JyqrcqTrM_GYxxsSI/s1600/IMG_1706.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="320" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjIt1yCOttBdd1-PD8eXRhZmqlyLfIIxwp3t6LVAQtcFH32-UhkmZ2JNS6RSj1lt0CjMbqYwR-kiaVYWeZ77QyR10zccHGah0obU-7kX25VWez7HLN5AsUe8NNaB9JyqrcqTrM_GYxxsSI/s320/IMG_1706.jpg" width="239" /></a></div>
<span style="background-color: white; color: #222222;"><span style="font-family: Times, Times New Roman, serif;">Tanzania could not be "everything I expected," but it surely is everything I have wanted. How incredibly grateful I am for the opportunity and the fact that I still have three weeks ahead of me!</span></span>Anonymoushttp://www.blogger.com/profile/04799493982350374480noreply@blogger.com3tag:blogger.com,1999:blog-2838753680231483798.post-74129542116820586772013-01-13T06:28:00.004-08:002013-01-13T08:20:49.764-08:00Iringa<style>
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We all got to our destinations safely.<span style="mso-spacerun: yes;"> </span>You knew that.<span style="mso-spacerun: yes;"> </span>No news is good news!<span style="mso-spacerun: yes;"> </span></div>
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We left the Landmark after waiting quite awhile for the
manager to arrive to unlock his office where it was being kept.<span style="mso-spacerun: yes;"> </span>We got it loaded and left.<span style="mso-spacerun: yes;"> </span>It ‘s a long drive to Iringa from Dar.<span style="mso-spacerun: yes;"> </span>We made a bio break at Chalinze.<span style="mso-spacerun: yes;"> </span>Laura was standing at the table first looking
through her wallet for Tsh, then set it down for an instant,<span style="mso-spacerun: yes;"> </span>You can guess the rest.<span style="mso-spacerun: yes;"> </span>Fortunately, she did not have her passport or
other valuables in the wallet.<span style="mso-spacerun: yes;"> </span>You won’t
guess the rest.</div>
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About ten minutes out of Chalinze, Peter, our favorite bus
driver, got a call.<span style="mso-spacerun: yes;"> </span>The wallet was
found!<span style="mso-spacerun: yes;"> </span>They turned around while the
second bus went on.<span style="mso-spacerun: yes;"> </span>Quite a happy
ending.<span style="mso-spacerun: yes;"> </span>I would love to have you think
that it was the milk of human kindness that saved the wallet, but no.<span style="mso-spacerun: yes;"> </span>I found out a little later that Peter had
talked to Dennis Ngede.<span style="mso-spacerun: yes;"> </span>Dennis suggested
Peter talk to the manager with a message.<span style="mso-spacerun: yes;">
</span>This message was in quite definite tones describing the economic
consequences should the wallet not turn up.<span style="mso-spacerun: yes;">
</span>I think it may have been along the lines of “no more business…” etc.,
etc.<span style="mso-spacerun: yes;"> </span>All’s well that ends.</div>
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Day of Grace folks and I had a nice dinner at the Lutheran
Center.<span style="mso-spacerun: yes;"> </span>It was pork off the loin,
potatoes a salad and dessert: pineapple drenched in warm syrup. (“How was it?”)<span style="mso-spacerun: yes;"> </span>Why do you even need to ask?<span style="mso-spacerun: yes;"> </span>Petro is a great chef and you know I would
not have mentioned it otherwise.</div>
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I am gathering my thoughts about our approach to the
Nutrition Project, i.e. that is how I refer collectively to all the functions
we are doing around the subject of nutrition.<span style="mso-spacerun: yes;">
</span>There are so many contacts to make already here and doing similar
things.<span style="mso-spacerun: yes;"> </span>This does not remotely imply
that there is no room for us to work!<span style="mso-spacerun: yes;"> </span>It
does mean that greater success will involve more than our project.<span style="mso-spacerun: yes;"> </span>I am learning.<span style="mso-spacerun: yes;"> </span></div>
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I asked our “first-timers” their impressions after we had
only been on the road to Iringa for a short time, having stopped for lunch at
Tan-Swiss, a restaurant and lodge, operated by a Swiss family.<span style="mso-spacerun: yes;"> </span>Good food, a Serengeti and a breeze.<span style="mso-spacerun: yes;"> </span>One of the students said she was already in
love with Tanzania.<span style="mso-spacerun: yes;"> </span>Another agreed with my
adjective “surreal.”<span style="mso-spacerun: yes;"> </span>I will be curious
to hear reports tomorrow after they have been here a couple days.</div>
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The road to Iringa, so nice a couple years ago, is now
showing its wear.<span style="mso-spacerun: yes;"> </span>There are grooves from
the huge amount of truck traffic.<span style="mso-spacerun: yes;">
</span>Crossing them to pass slower traffic, of which there is plenty, is
wobbly in a bus that needs shocks.<span style="mso-spacerun: yes;">
</span>Around Morogoro is a mountain range called the Uguru Mountains or Uguru
Milima.<span style="mso-spacerun: yes;"> </span>They are quite beautiful.<span style="mso-spacerun: yes;"> </span>From Morogoro on, the mountainsides are
studded with baobabs that currently have leaves, so different from the dry
season when they resemble trees that have been upside-down, with their roots
showing.<span style="mso-spacerun: yes;"> </span></div>
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The more I am here, the more I realize how much there is to
see beyond what we have seen so far, things both far and near Iringa and Ilula.<span style="mso-spacerun: yes;"> </span>I truly hope there will be an opportunity to
see more of Tanzania!<br />
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<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEheRjIvwom17LRT14ABZfh7IJlKa9KLsHqPI6XBhEzlxKvATA3eaSK4_9oL1QjiL72XAPhavFSk_6tEGafKYh9TadJvNP5yy2x7F0-XKEsIRSipXR6ANKR1rZHptovUVSrETvdUKp7Oq44/s1600/IMG_0415.jpg" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" height="240" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEheRjIvwom17LRT14ABZfh7IJlKa9KLsHqPI6XBhEzlxKvATA3eaSK4_9oL1QjiL72XAPhavFSk_6tEGafKYh9TadJvNP5yy2x7F0-XKEsIRSipXR6ANKR1rZHptovUVSrETvdUKp7Oq44/s320/IMG_0415.jpg" width="320" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">The cathedral, Iringa Lutheran Church</td></tr>
</tbody></table>
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I went to church today with Tom and Beth Hansen, Ken Smith
and Lyn and Mollie MacLean.<span style="mso-spacerun: yes;"> </span>The service
is in Kiswahili (Swahili to us Wazungu), but it was all Greek to me!<span style="mso-spacerun: yes;"> </span>I still find it fascinating to sit in a
Lutheran service and realize the differences and similarities.<span style="mso-spacerun: yes;"> </span>They use the tune at least to “Faith of our
Fathers” in the liturgy, but the syllables I utter when singing sound like
Greek rather than English or Kiswahili.<span style="mso-spacerun: yes;">
</span>But then, I don’t know Greek either.<span style="mso-spacerun: yes;">
</span>They also sang “How great Thou Art.”<span style="mso-spacerun: yes;">
</span><span style="mso-spacerun: yes;"> </span>Same issue, Greek.<span style="mso-spacerun: yes;"> </span>But here are some photos, in pretty clear
English.</div>
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<br /></div>
<table cellpadding="0" cellspacing="0" class="tr-caption-container" style="float: left; margin-right: 1em; text-align: left;"><tbody>
<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiRxiFqiB0B9w-OVNiDmIV9l7ofboAQMXf2s6tXvJn1ColO7LYL1Z6fjTAHqxG_NuD23i6jLYBwdHzkYypvcWlVmaGgsb4ogOYpXm1hhYEOVHZAPc-SyFG2-NZl5_rlVqEQYoy_Y9Za-cI/s1600/IMG_0417.jpg" imageanchor="1" style="clear: left; margin-bottom: 1em; margin-left: auto; margin-right: auto;"><img border="0" height="240" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiRxiFqiB0B9w-OVNiDmIV9l7ofboAQMXf2s6tXvJn1ColO7LYL1Z6fjTAHqxG_NuD23i6jLYBwdHzkYypvcWlVmaGgsb4ogOYpXm1hhYEOVHZAPc-SyFG2-NZl5_rlVqEQYoy_Y9Za-cI/s320/IMG_0417.jpg" width="320" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">Don't complain about hard church pews. These have no pads on the kneeler</td><td class="tr-caption" style="text-align: center;">s and straight backs!</td></tr>
</tbody></table>
<br />
<table cellpadding="0" cellspacing="0" class="tr-caption-container" style="float: right; margin-left: 1em; text-align: right;"><tbody>
<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgn8TJZ0PKePu00hgKUQqDTO_oIe2UHMl1uPojF82CLBs1zK6WuycPT7ysO6ckJrcNTatKEPhEVoygA30U3YhUZQiCINAOmnNdincjBvDlRjGbnzaAtvNPQOAp_QvyySfBgJZ0gQCJYrew/s1600/IMG_0419.jpg" imageanchor="1" style="clear: right; margin-bottom: 1em; margin-left: auto; margin-right: auto;"><img border="0" height="240" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgn8TJZ0PKePu00hgKUQqDTO_oIe2UHMl1uPojF82CLBs1zK6WuycPT7ysO6ckJrcNTatKEPhEVoygA30U3YhUZQiCINAOmnNdincjBvDlRjGbnzaAtvNPQOAp_QvyySfBgJZ0gQCJYrew/s320/IMG_0419.jpg" width="320" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">The Choir after church, before the auction.</td></tr>
</tbody></table>
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Kenhttp://www.blogger.com/profile/08062952252731045537noreply@blogger.com1tag:blogger.com,1999:blog-2838753680231483798.post-65573829752623135422013-01-09T23:16:00.000-08:002013-01-09T23:16:19.964-08:00Schiphol Airport, Amsterdam
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We are sitting in Schiphol Airport in Amsterdam.<span style="mso-spacerun: yes;"> </span>People are trying to get their devices hooked
into the free wifi with varying degrees of success.<span style="mso-spacerun: yes;"> </span>I thought I would write a note before I blow
my free wifi.</div>
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<br /></div>
<div class="MsoNormal">
Everything has gone smoothly to here.<span style="mso-spacerun: yes;"> </span>I played “sweeper” and arrived last, my
lovely wife and granddaughter dropping me off at MSP.<span style="mso-spacerun: yes;"> </span>Just to maintain the pattern, the TSA decided
to examine the contents of my carry-on: two motherboards, two processors, two
hard drives, my pill bottles, tea light candles, M&Ms and Hershey’s
Kisses.<span style="mso-spacerun: yes;"> </span>Must be some miscellaneous stuff
too.<span style="mso-spacerun: yes;"> </span>Probably the Hershey’s Kisses that
got me flagged.<span style="mso-spacerun: yes;"> </span>I promise they won’t be
coming home with me.<span style="mso-spacerun: yes;"> </span>I am guessing I
will have a backpack inside a duffel inside a bigger duffel on the way home.</div>
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<br /></div>
<div class="MsoNormal">
Dr. Randy passed out an article on travel hazards.<span style="mso-spacerun: yes;"> </span>Pastor Tom passed out the final program for
Day of Grace.<span style="mso-spacerun: yes;"> </span>I am tired, catching no
zzzzzs.<span style="mso-spacerun: yes;"> </span>Some did, some didn’t.<span style="mso-spacerun: yes;"> </span>Everyone is still smiling!<span style="mso-spacerun: yes;"> </span>Ally made it up from Rochester on the
shuttle.<span style="mso-spacerun: yes;"> </span>She asked me about the “Yellow
Card.”<span style="mso-spacerun: yes;"> </span>I have the feeling we have been
drilled about how important it is to have the standard Yellow Card, but her new
ones are short and less comprehensive than mine, so there wasn’t anywhere to
record a couple she has had.<span style="mso-spacerun: yes;"> </span>Then she
asked me what vaccinations are required?<span style="mso-spacerun: yes;">
</span>I dunno.<span style="mso-spacerun: yes;"> </span><span style="mso-spacerun: yes;"> </span>We tried to look on the CDC site and the
Tanzanian web site, but I could not find the list.<span style="mso-spacerun: yes;"> </span>I have never had it checked.</div>
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<br /></div>
<div class="MsoNormal">
We start the check-in process in another half an hour so I
will upload this now.<span style="mso-spacerun: yes;"> </span>Most of you should
be sleeping at this point.<span style="mso-spacerun: yes;"> </span>But if you
happen to be driving, WAKE UP!</div>
Kenhttp://www.blogger.com/profile/08062952252731045537noreply@blogger.com0tag:blogger.com,1999:blog-2838753680231483798.post-40389566110216878602012-12-27T14:28:00.000-08:002012-12-27T14:28:48.271-08:00Contact Numbers in TanzaniaDear Friends and even Relatives,<br />
<br />
Here are some helpful things to know about contacting any of us.<br />
<br />
Email is best. It is available almost all the time at Ilula Lutheran Hospital (ILH). Avoid images, which are band-width intensive. Remember the time difference.<br />
<br />
I have two cell phones. I will carry mine. I will ask one of the students to carry Birdie's, both of which will stay with the group. <br />
<br />
Ken Olson's Tanzania Cell Phone #: 0785 211 864 Remember the time difference!<br />
<br />
Birdie Olson's Tanzania Cell Phone #: 0785 210 536<br />
<br />
Dr. Mufwimi Saga is the contact person at ILH. The address is Ilula Lutheran Hospital, Ilula, Tanzania. Any snail mail you send will get here a week or so after we leave Tanzania, if you send it about the same day we depart the US. Stick to email or phone.<br />
<br />
Don and Eunice Fultz will be the Bega Kwa Bega coordinators while we are at Ilula. They receive email at begakwabega@yahoo.com .Kenhttp://www.blogger.com/profile/08062952252731045537noreply@blogger.com0tag:blogger.com,1999:blog-2838753680231483798.post-49321208417688113762012-12-25T10:32:00.001-08:002012-12-25T10:32:41.172-08:00Preparations and Beginnings<style>
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Dear Readers,</div>
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<br /></div>
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It is Christmas Day, one of my faith’s holiest of days, and
that of one of the non-governmental organizations (NGO) closest to my heart,
Shoulder to Shoulder, the one supporting and sponsoring the medical trip to
Tanzania and supporting Ilula Lutheran District Hospital (ILH).<span style="mso-spacerun: yes;"> </span>I hope you will look up <a href="http://ilulahealth.org/">http://ilulahealth.org</a> to get plenty of
detail about the organization and Bega Kwa Bega, the organization that spawned
it and several others.</div>
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<br /></div>
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So on this Christmas Day, now that the hustle and bustle
leading up to this holiday will be winding down after one more sweet
gathering.<span style="mso-spacerun: yes;"> </span>But my attention is already
drawn to the poorest of the world’s poor.<span style="mso-spacerun: yes;">
</span>The average per capita income is about $485/year (2008).<span style="mso-spacerun: yes;"> </span>Take a look at this web site for some up t
date info: <a href="https://www.cia.gov/library/publications/the-world-factbook/geos/tz.html">https://www.cia.gov/library/publications/the-world-factbook/geos/tz.html</a>
.</div>
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<br /></div>
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ILH is situated in a resource poor rural area about 25 miles
from Iringa, a city of probably 200,000.<span style="mso-spacerun: yes;">
</span>More on that in the next few weeks.<span style="mso-spacerun: yes;">
</span>The US<span style="mso-spacerun: yes;"> </span>Gross Domestic Product
(GDP) is roughly 630 times that of Tanzania.<span style="mso-spacerun: yes;">
</span>I cannot quite get my head around those huge numbers.</div>
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<br /></div>
<div class="MsoNormal">
Or these:<span style="mso-spacerun: yes;"> </span>HIV
prevalence is nearly 15% in Iringa.<span style="mso-spacerun: yes;">
</span>About 30% of patients admitted to ILH have HIV.<span style="mso-spacerun: yes;"> </span>At least 1400 attend the HIV clinic at
ILH.<span style="mso-spacerun: yes;"> </span>Somewhere around 60% are
women.<span style="mso-spacerun: yes;"> </span>Most men do not want to hear
about HIV.<span style="mso-spacerun: yes;"> </span>Nearly 100% of people with TB
at ILH have HIV.<span style="mso-spacerun: yes;"> </span>Over the next few
weeks, I hope you will hear the stories from the friends and acquaintances you
have at ILH, the students and faculty visiting ILH and not only me.</div>
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<br /></div>
<div class="MsoNormal">
Ken </div>
<table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto; text-align: center;"><tbody>
<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhL0JXLBHXDQzvul0dpPjTUmAKudBJpE9KccVuR2K9McnbXKv8_qlh844pNRxPLAuJj_v_u6DDGkLlmU7Fnb2OdmhBcWN4e5wqcNjYPfwn0fZ6Kb_8kFV5SM-meJTGQ0NTYMQMNxoqDF4Q/s1600/Ilula+Blog+Background.jpg" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" height="266" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhL0JXLBHXDQzvul0dpPjTUmAKudBJpE9KccVuR2K9McnbXKv8_qlh844pNRxPLAuJj_v_u6DDGkLlmU7Fnb2OdmhBcWN4e5wqcNjYPfwn0fZ6Kb_8kFV5SM-meJTGQ0NTYMQMNxoqDF4Q/s400/Ilula+Blog+Background.jpg" width="400" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">The view from ILH Guest House 2011</td></tr>
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Kenhttp://www.blogger.com/profile/08062952252731045537noreply@blogger.com0