Hospital Architecture

(1. General Ward with three phase construction: New shower area, three new exam rooms and new reception 2. Maternity Ward with four phase construction: red-first phase with 8 new delivery rooms / green - new neo-natal rooms / blue - 10 year master plan expansion with two new theater rooms / yellow - 25 year master plan construction for new patient room)

Help, Help, I'm being repressed!

As our time in Haydom is drawing to a close Betsy and I have been waxing nostalgic about our time here… wait, what, not us! Ok, that part about being sad is a total lie; I can’t wait to sink my teeth into a bag of cassava chips. That being said, we have to give a shout out to all of you who sent us packages, you’re the best! My parents, Betsy’s parents, my sisters, Ryan and Tamara in Tampa and I can’t forget my aunts, Kathi, Mary, Patti and Vicki, THANKS; you all ROCK! Since the packages arrived, as you all know on Christmas Eve (“a Christmas Miracle” exclaimed by both Betsy and my Mom), we have been pretty much eating exclusively from said boxes of goodies and we don’t feel the least bit guilty!

In one of those boxes came a giant bag of Hersey’s chocolate (thanks Mom and Dad) and in another was a package of balloons (thank you Zillig girls). At my first point of reflection these goodies are relatively un-noteworthy until we realized that our family has never had balloons or chocolate in their lives! We gave our family a sizable bag of chocolate, among other things, which their four and two year old children commenced consuming as soon as we handed the goodies over. We tried to stress, in vain, that they should eat the candy pole, pole (very slowly). Within the hour Upendo, the four year old had a tummy ache and Wesley was bouncing off the walls! We went over to have dinner with our family that evening to see that Upendo and Wesley, normally in bed at this time of night, were still up running around with the balloons, which were in and of themselves a HUGE hit! Stefano asked if we wanted to take Wesley for the remainder of the evening, we politely declined, sorry about that, no more sugar for our family. All in all our Christmas was a good one, I having just recovered from the flu was elated by the plethora of snacks, thank you again!

Time has been passing by rather slow lately, but passing which makes me think of my sister, Sarah and my Mom. As look in the mirror and brush my hair, yes it’s long enough that I need to brush it daily now, I am constantly reminded of Sarah; essentially as my hair grows longer I look more and more like her. It doesn’t help that Betsy keeps calling me “Sarah”. Also, I feel like I’m turning into my mother, I’ve been eating white bread, with butter on it, chocolate (since the boxes arrived), and candy! I know, I can’t believe it either, but I guess that’s what you do when the only other option is ugali.

That being said, the eight guests, who were staying at our family’s 750 square foot house, have left. This is a great thing for Betsy and my personal hygiene since we have had to resort to using scrap paper as toilet paper as of late. Since the family friends were in town we have had a drastic shortage of usable TP, luckily they left and we didn’t resort to Betsy’s surveys, but it was close!

Speaking of being disgusting, one of our research assistants mopped our floor for us. She came over to transcribe with Betsy and was apparently disgusted enough by our American filth, apparently people here mop their floors every day, not once a week like us, that she had to stop and mop the floor. I loved how someone who bathes twice a week was telling Betsy and I how disgusting we were because the floor wasn’t clean enough to eat from… oh well, we have freshly mopped floor so I won’t complain, too much.

As Betsy’s survey is coming to a close, she only needs seven more to hit the 300 mark (100 more than she originally planned) she’s been getting more adept to entering the data. Drastic increase of data entry efficiency has afforded her time to play Mine Sweeper, the cheesy little game that comes with Windows, non-stop! I really think by the time we head out from Haydom that she will be a grand-master of Mine Sweeper, if there is such a thing. I’m constantly reminding her to return to her data-entry which I receive the response, “I am doing data entry, I just needed a little break… ok only 10 more tries at the advanced level, I have to beat 200 seconds!” I think this game has created a monster.

Out in the village this week we spied a woman stacking mud, yep Monty Python and the Holy Grail style! The initial reaction was that she must be doing this for some reason but neither Betsy nor I could find any discernable rationale. She was just in the middle of her yard, digging mud and stacking it into nice little piles. This display of non-sense made us run home and check out our copy of Monty Python and the Holy Grail, the part where Arthur is speaking to the communist “mud-stackers”. We’ve decided to stop being oppressed as well, on to eating more Honey Wheat Pretzels, yum!
-Ryan

The Christmas Miracle

We’ve both been feeling a little dumpy lately, mild to moderate tummy issues, missing the holidays at home, and our coveted fan is breaking (somehow, after 2 months!?). Today, Ryan came down with flu-like symptoms, and was achy with a slight fever (the same symptoms as one of my research assistants, Valentina, we’re blaming her). I was sick earlier in the week, and Ryan took over the role of Anthropologist in my absence. This morning, I left him at home while I went to the hospital to meet my research assistants, and head off on yet another day of interviewing adolescents. The novelty has worn off, and it’s gotten a little mundane asking kids about how often they eat ugali.

Since we arrived in Haydom at the beginning of October, we’ve been pestering the head secretary, Eliwaza, asking if there are any boxes for us, and making her call the post office in Mbulu several times a week. Well, this morning, when I was meeting with my research assistants, she came RUNNING up to me (Eliwaza is overweight, about 45, and normally does not move quickly in anything that she does), yelling “Eliza! You have packages!” (also no one in Tanzania gets my name right – the majority of people think I’m “Besti”, but at least they don’t think I’m Chinese). There was a mail run from Mbulu that arrived late last night, and there was not one, not two, but FIVE packages that arrived for Ryan and I!!!

I told my research assistants we were doing something different this morning: carrying boxes to my house. These were not small boxes by any means. In total, they represented over $400 in postage (thanks everyone for spending so much on us!), so I was definitely going to need help. I carried the largest one, Peter carried the next 2 biggest, and Regina put the last 2 on her head, and we headed off. As we were leaving the hospital, we passed the head of the transportation division, Wilson Jackson (by the way, he has a brother named Michael Jackson). He saw that we were struggling under the weight of snack foods and reading material, and offered to give us a ride in a hospital car. I returned home to my bedridden fiancée/(slacker) research assistant to exclaim, “A Christmas Miracle has happened!!!” In which case, he was momentarily cured, and jumped out of bed to check out our loot, yelling “Thank you, Baby Jesus!”.

A special Pu-Blog shout-out goes to Ryan’s parents, Betsy’s parents, Ryan’s sister Sarah, all of Ryan’s aunts, and our amazingly awesome friends Ryan and Tamara! We got some good stuff!! Aside from the 80 AAA batteries from Ryan’s parents (yes, that’s right, EIGHTY), we got multiple bags of beef jerky, honey wheat pretzels, trail mix, cookies, crackers, cereal, spices, bug spray, hand sanitizer, Neosporin, football/frisbee in one (it’s awesome), books, magazines, Scrabble, candy, slim jims (with the cheese sticks), saline, etc, etc….you can see from the picture.

On a sad note, the only thing that broke in our shipment of goodies was the one bag of Doritos. It somehow ripped open in the box, and this being Tanzania, and it being sent over 2 and a half months ago, we decided (after quite a bit of deliberation, and maybe a few tears shed by Ryan) that we had to throw them away. Sorry Ryan (Richey, that is). The other sad note is that we didn’t get this amazing haul of stuff 2 months ago! We only have a little time left in Haydom, so it’s going to be a snack orgy until then. We sat down today for a lunch of tuna salad with crackers (thank you Sarah), slim jims with cheese sticks (thank you, Ryan’s aunts), Oreos (thanks Betsy’s parents), and honey wheat pretzels (thanks everyone!).

Merry Christmas!
Betsy and Ryan

(Pictures: 1) the Christmas tree our family made for us out of tree limbs, fake flowers and ribbon, 2) Betsy’s research materials, aka Simba’s doggy bed, 3) our loot)

Chino-Latino, Wazungu?!

Recently, the locals have started to call me “mchina wazungu”; my first thought about this is that since plain old “wazungu” wasn’t working in getting my attention that they would add a little something to it and maybe, just maybe I would show some sort of reaction. I told Betsy what the people were saying to me and she told me that this is the word they use for Asians. Apparently, they think I’m Chinese, mainly because they don’t differentiate between any other Asian culture and every Asian is Chinese to them. At first I thought, they must be semi-retarded to think I’m Chinese, but upon further contemplation my hair is pretty dark and since all of the other wazungu here are from Norway, they all have light brown or blond hair, it started to make sense. They probably haven’t seen an Asian, so I’m assuming they just went with it. Even though it could possibly make sense, I still think they’re idiotic. Although one of our research assistants thinks we are from Japan, the other wazungu don’t think that I’m Chinese, yet…

Being the project architect of the hospital has been going well so far, although they had about 15 projects in the queue, so Anders and I have been plenty busy. This is a great thing since it keeps me occupied and at the hospital, allowing me to successfully dodge data-entry with Betsy, muhaha! We just finished up designing the master-plan for the Maternity Ward Expansion. In our first meeting to discuss the design the only feedback I received from the local nurses is that they will no longer have a dedicated room to put their shoes. Apparently, this is a major issue for them, since every subsequent meeting we’ve had the issue continues to circulate. I would have addressed this issue but I have explicit directions to omit these design changes from the man at the top. This is in part because the hospital currently has over 5,000 deliveries per year with four delivery rooms; it is exceedingly taxed right now so every bit of additional space is imperative to be used for services, not shoe collections. Below is the current design for the expansion, the Red is Phase I to start construction January 16, Green is Phase II to be completed immediately after Phase I. Blue is Phase III, which will be in 10 years to keep up with increased demand, and Yellow is Phase IV which will be added in 20 years, give or take 5 years.

Last week Betsy and I went to the “Supermarket”, yes the supermarket, that’s what the locals call the semi-monthly market that comes to town. We were dismayed by the fact that the circus only stocked things you can already purchase in Haydom, only at an increased price which doesn’t make much sense to us. Either way, one stand was selling machetes which were inexplicably bent at the end; which confused the two of us for weeks. Confused us until just the other day when I saw a man cutting the hospital’s grass with it! Since the only place in Haydom with any grass is the hospital, I’m sure they’re the only one’s purchasing these “bent-grass cutters” (I apologize for the ridiculous pun).

Passing the time on the weekend has become difficult to say the least. Especially now that most of the Europeans have departed for Christmas back home, it’s pretty much just Betsy and I here. We went to a salt harvesting lake at the base of Mt. Hanang (see our last posting of pictures). It was great to get out of Haydom for a little while, even if it were only to watch a bunch of guys shoveling bottom of a murky lake into giant sized piles. The salt itself is quite tasty, which is what the locals use to salt their food here which we unwittingly ate before knowing its origin. We also stopped by the hospital’s farm, which consists of 15,000 acres of farm-land and about 100 goats imported from Norway! Not much to say about the farm, it was pretty unspectacular aside from its shear enormity and the fact that they imported goats; as all of you already know, goats are everywhere here, seriously!

Speaking of people being stupid, we’ve come to the conclusion that people here don’t know where they’re walking. They drive on the left side of the road, fine, just please walk and ride your bike accordingly! Everyday it seems as though people run into us or near-misses occur. Betsy and I have tried to make sense of it, our longest running hypothesis was that they are like water, taking the path of least resistance but that has since been disproven. Just yesterday I had a man run his water cart into my leg as I was moving to get out of his way. I think it could be that they stare so intently at us “wazungu” that they completely forget to walk the tangents, or something of that sort. Betsy has the Ludacris song “Move Bitch” (sorry everyone) on her iPod, which plays through our minds every morning while dodging the shotgun scatter of people, potholes and puddles which line the roads to the hospital. Some may find that Betsy having Ludacris on her iPod is absurd but I would say that’s just about right, watch for her to pimp her ride out when she gets home...
-Ryan

Finger Lickin' Good

Ok, not finger-licking good, especially since giardia is one mis-placed lick away...
(1 - Betsy learn to cut the pumpkin, 2 - Me cooking up something fierce!, 3 - The finished product, pumpkin ugali! For all of those who want to try making it, ie Joel Holtry, start with a pumpkin. Cut it into bits, throw into a very hot pot. Stir for one hour, or until mushy. Add maize flour and mix until stiff, enjoy!)

Salty Lake

(1 - Bets and I with the lake & Mt. Hanang behind, 2 - where our salt comes from...)

Thanksgiving Photos

(1 - me taking it to the chicken, 2 - Betsy hesitating before the kill, 3 - Betsy reveling in the kill, 4 - the FEAST!)

These white people not know to cut the pumpkin

Today started off like every day in Tanzania, where we woke up feeling a bit ill, and not wanting to go too far from the choo (toilet). Although not that unusual, it was especially bad because Regina, one of my research assistants, had invited us to her house to meet her parents and see their farm. We both decided that we weren’t feeling up to it, and would tell her we couldn’t go. She doesn’t have a phone, so we had to wait until she came to our house to pick us up. When she got here, she was wearing a new dress and new shoes. She was so excited we didn’t have the heart to bail on her, so we grabbed some TP and the camera and headed on our way.

Regina had told us her house was about a half an hour walk from Haydom, so we thought this would be a fun little morning trip. When we started on our way, she looked at my watch, and seeing that it was 11:15, said that we would be there by noon. Ryan and I both sighed, not wanting to walk too far with questionable bowels, but set off on our hike. We walked ….and walked….and walked….past the secondary school that we drove to for the study, past one of the villages we interviewed in to get a comparison to Haydom, past 2 rivers, and finally arrived at her parents house at 12:45.

When we got there, her mother, father and countless siblings (she is the second oldest of 12, her youngest brother is 5 months old, 2 months younger than Regina’s own baby) greeted us with open arms. They had prepared a pumpkin, one of the staple foods in the area, and wanted to teach us how to cook pumpkin ugali (kind of like polenta). Ryan and I have decided that Tanzanians generally think we are semi-retarded. Their logic goes that since we don’t know how to cook ugali, the most basic and easy food here, that we must not know how to cook anything else either. Regina started the lesson by showing us how to cut up the pumpkin into chunks. When I offered to help her, she gave me a look that said, “I’m not sure you can manage this without major injury” and handed me a knife. I’ll admit I wasn’t that adept at squatting and cutting up a hard pumpkin placed on a tarp on the ground. In my defense, the knife she handed me was truly the world’s dullest knife, where you couldn’t really tell which side of it was the sharpened one. The family that we live with lets the local herd of toddlers play with sharper knives (more on that later). Everyone thought it was hilarious to watch the mzungu mangle the pumpkin, prompting her mother to observe, “These white people not know to cut the pumpkin! Hahaha!”. Gee, thanks.

While the pumpkin was cooking, Regina’s father took us on a tour of the farm. We saw where the goats sleep (in the room adjacent to where the people sleep), the cow pen (a circle of acacia limbs), and how to feed chickens (yell “kuku kuku kuku” and toss corn at them). Regina said that they are able to grow all the food her family needs as well as all the feed for the animals, and never have to buy anything. Albeit, they only eat maize, eggs, beans, greens and milk most of the time.

After the pumpkin cooked and mixed with maize flour and a dash of oil it was ready to eat. Basically, you roll a ball of ugali dough, then dip it in whatever sauce comes with it. Today it was melted animal fat. Ryan and I tried one dip, both gagged a little, and then stuck to the plain ugali. As far as ugali goes, pumpkin ugali is pretty good – meaning that we wouldn’t touch it with a 10 foot pole in the states, but after walking for an hour and a half on an empty stomach it was edible, which is more than can be said for regular ugali. They also gave us fresh milk for lunch. This sounds wonderful and quaint, but if you’ve never tried fresh milk, there’s a reason we don’t drink it in the states. It’s sour, and has chucks on curdled fat floating on top. Unfortunately, a storm was rolling in, and we had an hour and a half walk ahead of us. As we were left, Regina’s parents gave us some fresh eggs and told us “karibu tena” (welcome again!). We hurried back as quickly as possible to Haydom, and straight to Samjo, our favorite restaurant for some meat and rice, and to get the taste of curdled milk out of our mouths.
-Betsy

Pictures!!!

Chickening Out

Happy (belated) Thanksgiving! Ryan and I decided to celebrate Turkey Day by buying the family some chickens, and helping them cook a pseudo-Thanksgiving meal of chicken, potatoes, rice, and banana bread. There aren’t any turkeys in Haydom, so we had to settle for chickens. They are very expensive for most people here, so it was a special treat.

Relatives from the country had given them two chickens, but being Americans, and this being Thanksgiving, we decided that two chickens were definitely not enough for 17 people. We headed to the market with Lucy, one of the kids, to pick up three more. Word had gotten out that the wazungu wanted chickens, and a few steps outside of our gate we were met by people with armloads of chickens ready to sell. Lucy bargained for us, and $12 later, we were the proud owners of three live chickens.

That afternoon, we invited our friend and research assistant, Prisca, over to help us cook and to have Thanksgiving dinner. We started by making banana bread. I didn’t have a recipe, or measuring cups, or really any idea what I was doing, so I just started mixing flour, eggs, sugar, oil and bananas in a bowl. When it looked remotely like banana bread dough, I scooped it into a loaf pan, and stuck it in the oven. The ‘oven’ is a wood burning stove, with a chamber for baking, so there no telling how hot it is or if the temp is constant, so I just put it in and hoped for the best. While the bread was baking, we decided it was time to ‘deal’ with the chickens.

The family was convinced that two chickens were enough for everyone. These are scrawny, natural, African chickens, that spend their lives running around scavenging for food, not big plump American chickens who spend their lives getting fat and juicy. There was no way two chickens were enough, so we compromised and settled on three. With a parade of kids behind us, we grabbed a (rather dull) kitchen knife, and headed out back. Ryan and I had made a pact that if we were going to eat the chickens, we would each kill one, but neither one of us really knew how to go about doing it. Prisca (wearing nice shoes, a tailored dress, and perfectly braided hair) however, got right in there, and taught us to stand on the wings with one foot, their legs with the other, then grab their head and pull it back with one hand, and slit their throat with the kitchen knife, then hold it until it bled out and stopped flopping. At this point, I decided I was just going to have potatoes for dinner, and I was fine with that.

Ryan was up next, and without hesitating, positioned the chicken, and with Prisca cheering him on, started cutting. It seized, it flopped, and it bled just like it was supposed to. Two down, one to go….my turn. Ryan handed me the bloody knife, and I was on my way to vegetarianism. I begged and pleaded. I said I just wanted potatoes for dinner. I said I’d lived for 27 years having other people kill my meat for me, I didn’t see any reason to change. But Ryan, Prisca, and the kids wouldn’t back down. They were all teasing and laughing at me, and finally, my pride got the better of me, and I decided to go for it! I stood on its wings and its legs, but couldn’t bring myself to hold the head. Emanueli, one of the kids, held the head back for me, and with Ryan, Prisca, and all the kids cheering for me, I got in the zone, and cut its throat. It actually wasn’t as bad as I thought it would be, the chicken died a rather painless death, and probably had a better life than most of the chicken I eat in the states. However, I will forever be thankful for Hy-vee and its saran-wrapped boneless skinless chicken breasts.

Turns out that killing the chickens is just the beginning of the work. Next, they are dunked in boiling water and plucked. We found out is that rubber chickens look amazingly like the real thing. Who knew? Then we seared them over the fire to burn off any remaining fluff, and we washed them, cut their necks more cleanly, and cut off their feet. Simba, the family puppy, was one lucky dog, and ended up eating all three chicken heads and some of the feet. Then he passed out, in a puppy version of the Thanksgiving turkey-coma.

When it was time to cut them up into pieces, Prisca again got right in there and started hacking. It was really more of a biology lesson for Ryan and me. We learned what eggs look like inside the chicken (they look like yolks), that the gizzard really is full of pebbles, and that unless they are American freak chickens, they don’t really have much breast meat.

That night, the family invited us over to their house, and we all sat down together for our feast. Three chickens actually make an amazing amount of meat, especially when you use ALL of them. Two chickens probably would have been enough, but three allowed it to feel like Thanksgiving, where no one worried about taking more than their share. We had broth from the chickens to put over rice, boiled potatoes, and banana brick. I forgot to put any sort of rising agent into it, so it was a bit dense. Besides being a masonry material, it was acutally pretty good. Being polite Tanzanians, they all said they loved the bread and wanted the recipe (but then they started talking in Iraqw, so who knows what they actually said about it.) At the end of the meal, we were all full and happy (tumeshiba sana).

We’re thinking about getting a goat for Christmas….
-Betsy

Witchy Woman

We’ve figured out some of the sounds Tanzanians feel represent the local wildlife; I feel the most interesting of descriptive sounds to me is the bee. Apparently, Tanzanians think that instead of bees “buzzing”, as Americans would assume, they produce a “sucking” sound; which is best described as the sound you would make sucking on a dry straw. This isn’t a bad thing, just a strange observation that I happened to remember this morning.

Also, we have met some friends; well I have more or less from playing futbol on Tuesdays and Fridays at the hospital. They’re all Europeans but they sort of share our culture, sort of. We coaxed them into meeting up with us at our favorite restaurant, Green View Garden Restaurant. Well, the Green View definitely doesn’t have any green “views” nor does it have a garden. We think it should be called, Cell Tower View Concrete Restaurant, that’s the best description one could make. View or not, it’s the best place in town so we are regulars, John, the owner and Jacob, the maître d' restaurant, are great! Anyway, we met up for a drink with our new Euro-friends this past weekend; Green View is also the only place in town with wine. Well, this wine thing was a spectacle to say the least, luckily they actually had wine glasses to drink from but had a smaller wine glass in which they actually measured the drinks. Jacob came out with the box of wine and the small glass to measure out the glasses one by one, it was quite an experience. By the end of the night, Jacob was falling over drunk (literally); Betsy and I figured he was getting drunk because we bankroll their restaurant so they could afford a drink or seven. On a side note to drinking I’ve noticed that when I drink Castle Lager, my favorite beer here although I probably wouldn’t drink it back home, my ears begin palpitating. We were trying to figure out why this happens, the jury is still out, so if any of you have any ideas, I’d be open to hearing them.

The next morning I decided, since Betsy had recently had a dress tailored, that I would get a nice button down shirt tailored myself. We went into a local tailor that specializes in men’s clothing and had them take my measurements. They said to return in four days and the shirt would be ready. Four days came and it was time to return for my newly tailored shirt or garbage bag, whatever you want to call it. I tried it on and felt as if they took my measurements in centimeters and cut the fabric in inches, the shirt was HUGE! Also, the arms were about two inches too short so we tried to get them to take it in and decided the sleeves were ruined; we had them convert it into a short-sleever. I’ll keep you updated with this but I plan on having a suit tailored while I’m here, should be an interesting process, especially since it will be in local fabric…

To adequately describe the type of care people receive from the hospital here is hard to pin-point. Seems as though the “western” doctors that are here do a fine job but some of the local health-professionals are somewhat lacking. Regina’s (our female research assistant) boyfriend was having what we thought were epileptic seizures, hence one would diagnose him with epilepsy, not here. Apparently, he’s not taking any medication for his episodes, which I’m pretty sure is not a good thing, because the doctor he visited told him it was the work of a witch. They ran tests on him, which were inconclusive, so their only explanation was that someone in Haydom is apparently performing hostile witch-craft towards him. We thought it weird to hear from a hospital, albeit in rural Africa, staffed with western doctors.

Hope all is well back in the States and that everyone had a great Thanksgiving free of witch-craft and hob-goblins!
-Ryan