I am enjoying my R&R, I have been sleeping 12+hours a night, and napping each day, maybe that tse tse fly did affect me!  I do think it is just the exhaustion. : )

Zanzibar is incredible.  It is an island off the Tanzanian coastline, still part of Tanzania the country, but so much it’s complete cultural self.  It is 90% Muslim, whereas Arusha is only 20%.

Ramadan is on!  I happened to hit Zanzibar right in the middle of it.  Ramadan is where the Muslims fast from EVERYTHING! from sunup to sundown.  Food, water, sex, impatience, bad tempers, etc.  It is a time for them to purify themselves from man’s more carnal natures.  A really cool idea.  And the most important time of the Muslim calendar year.  Too important to even call it a holiday.

But — we Mormon folks think we have it tough fasting one day, once a month.  But Ramadan goes on for an entire month!

Can you imagine fasting from everything from sunup to sundown every day for an entire month?   And they do it.  With faith, reflection, and whole heartedly.

What that means in practicality for us traveling folks is that very few things are open.  No restaurants, no little food stalls, nothing.  Not until the sun goes down, but then things start to happen!  It is still a very reflective time for the Muslims, but the food appears!  What it also means, is even the non-Muslims are encouraged strongly not to eat or drink in public during daylight hours.  It is considered very impolite and unkind.  So, no drinking a bottle of water while you are walking around.  That may sound like no big deal, but when you’re in incredibly hot weather it is!  As I explored the labrythine streets of this old ancient town, I became incredibly thirsty.  I finally went behind one man’s counter, and he kindly let me guzzle a bottle of water, hiding in a corner.   I don’t know how they do it!

This is a witch doctor’s stall.  Yes, witch doctors  are alive and well here.  They call it “traditional medicine”.  Those are snake skins you see hanging.

Zanzibar is a very interesting mix of Arab, Indian, Portuguese, and African.  Very, very old and ancient.  All those nations occupied it at one time.  

Note the guy in both pictures.  That is Hadi.  I met him at the market.  He ended up being a fantastic guide.  Knew the history, the winding little streets.  But best of all he was excited to teach me more Swahili.   A wonderful find.  He gave me his email and he will be an incredible teacher Eric and I can skype with to perfect our Swahili skills before we come back next year!

The saddest part of Zanzibar history though, is it was a holding place for slavery.  The raiding parties, after capturing Africans from the mainland, would stop here to auction off their captives to the sea captains plying the oceans to take this human cargo to their future “homes”.    Another atrocity Africa offers us.

But what we, in the U.S. were fully complicit of.  These “slaves” fed right into our southern plantations.  If there hadn’t been a market for it, it wouldn’t have happened.    There is a memorial musuem here to this terrible time.  I must say very similar to holocaust musuems I have visited.  Is there no end to man’s inhumanity to humanity?

The island itself is gorgeous!  Blue topaz seas, white talcum powder sands… a dream of anybody who loves that kind of thing.  And who doesn’t?   I snapped this picture when I woke up this morning.  What a beautiful sight to greet me.

The people here are friendly, but I have to say, not quite as friendly as Arusha.  That place was incredible.

I will rest, read (I’m catching up and re-reading a lot of the old classics – Annelisa’s advice!  and swim in the sea.   I am reflecting on Arusha and St. Elizabeth’s and all my experiences there.  I miss them!  I’ve had e-mails from Alodia’s daughter already begging me to come back.

So, Eric and I are already making plans for coming back next year some time.  Don’t know for sure when or how, but Eric too has caught the excitement and intoxication that is Africa.  Wait until he gets here!

Thanks once again, all, for following this blog.  This will be my last entry.  All take care, and I will see most of you again soon!

Tuta-onana!  Badaye!

How do you say good-bye to people who have become your family?  How do you say good-bye to a country that is now part of your heart?  How do you say good-bye to your new soul sister?  You don’t.   You say Kwaheri kwa Sasa.  Simply “Goodbye for now.”

It was difficult at the hospital today.  Alodia was on a countdown.  She would say, “only 4 more hours until you leave me”, then, “only 3 more hours until you leave me”, and so on. She actually drove me a little nuts.  Just before I left the hospital for the last time,  the nurses all gathered and gave me some very sweet going away gifts.   Alodia had given me a Kenga, the cloth that the women wrap around themselves for the local dress.   She had tears in her eyes giving it to me, and I couldn’t help but cry too.  Alodia said, “I know you love the mothers and babies like I do, you and me, we are the same.”   And its true. How can it be that there are people in the world you have never met, then meeting them know you are of one heart, and feel like you have known each other forever?  Crazy!

Ingali (Dr. Happy), who has been another good friend, gave me a Masai blanket.  It is brightly colored and very warm.

Anna, the nurse from the ward where they give babies their injections, gave me a Tanzanian calendar with baby African animals.  She knows how I love babies!   Violet, who is a sweet girl who runs a little stand outside the hospital, and I have got to know quite well, insisted on walking me all the way to the daladala, and gave me such hugs before I left.

These are just some of my new friends.  How can you make friends like this in 3 short weeks?

I think…… by really living life at its most basic level.  Unencumbered by all the strictures and pleasures and conveniences of modern life.  I think….. living life at its rawest is the real stuff.

It’s hard to express my life and experiences here.  But, I am a changed person.  I just don’t know what to say.  I can’t express it well enough to convey the emotion.  Here are just some of my memories and thoughts as I think over these last weeks as I pack and prepare to leave Arusha:

How every morning when I enter our little ward’s waiting room, full of expectant mothers, Alodia always does a little African type dance welcoming me, and she grabs my hand, having me join her.  It has become  “our dance”.  We wiggle and waggle our way up and down the aisle between the chairs, jiving to the clapping beat of all the laughing mothers.   The mothers laugh and clap, and sing away,  “Mama Anna, Mama Anna.”   They all laugh at this funny white woman who has come from so far away to share her life with them.   And they do seem quite surprised this funny white woman has a bit of rhythm in her.  I think they think that’s the most hilarious of all!

Or, of looking into the eyes of these expectant mothers every day as I measure their bellies.  Up close and personal, face to face, my hands on their warm flesh.   And when I tell them, “Nzuri sana”, (Everything very good) and see their smiles, and hear their sighs of relief.  It is a woman to woman, mother to mother moment.  Something that is understood through all cultures.

And then also often the babas (fathers) have come to the appointments with the expectant mothers.  When I have the father’s listen to baby’s heart beat through the funky 50’s era fetalscope, to see their eyes pop open with surprise, then their huge grins as they hear their baby’s heartbeat for the very first time.

But the best really, especially, is sharing tea at the end of a long hard day with Alodia, sitting side by side on the exam table, in warm quiet companionship, just she and I, and not even needing to talk.

And then coming home, after walking through the colorful market, and surviving yet another harrowing DalaDala ride,

and meeting with my new soul sister, Mary Ann.

We laugh and cry ourselves silly as we discuss our separate work days.

She knows how I feel.    She knows how this country gives back so much more than we can ever give it.   She knows the contrast and contradiction of this people and this land.  She too will return.  She knows and understands how we are truly changed.

These are just some of my memories here.  Can you not see what this must do to my heart?

Me and Mary Ann laughing our heads off doing a selfie on our last DalaDala ride.  I look like Ollie of “Ollie and Hardy” and Mary Ann has a mohawk!  We had some good laughs over this picture!

I do need to express my thankfulness.  I am so very grateful I have been able to experience this life.  And grateful to all who have made it possible.  My sweet husband, who is my biggest champion and fan.  I especially love his “rose colored glasses” and that he sees me as a better person than I actually am.  I am truly blessed to have him in my life.  I appreciate my family with all my heart, my wonderful family who has cheered me on.  Also, Sigrid, who has shared the blog with her classes, and loves to enrich their lives with our expanding world.  I thank my work at home, Willamette Valley Hospice, which gave me the time off to come, and donated supplies for St. Elizabeth’s.  And again, I’d like to express my gratitude to all the many friends who have read this blog and supported me along with their kind thoughts and comments.  I do truly appreciate it.  It means something to me that others have shared my life these last few weeks.  Thank you.

Africa.  It is addicting.  The people are the most beautiful, kind, welcoming, generous people I have ever met.  The country itself is beyond amazing.

School children going into our little lane to our volunteer house.

Masai in their Masai village  

But they live in a very challenged world.  Often heart breaking.  The contrast between the beauty and the sorrow is beyond measure.

Walking up the street to St. Elizabeth’s Hospital.

A typical scene walking down the street in Arusha.

I have only mentioned the very tip of the tip of the mountain of this place and my experiences here.

All, I can say, is I will return.  Eric and I will come together next time so he too can know and feel Africa.

Inside the crater at Ngoro Ngoro Conservation.  I love the tranquility of this scene, of all the animals grazing peacefully together.  See the hippos in the center.

I leave my heart here, amidst the love, the hunger, the beauty, the poverty, the rawness of it all.  My heart is seared.  No better word for it I can find.  Seared and branded to this brave land and people.  That’s all I can say.  Kwaheri kwa sasa, good-bye for now.

I will post some pictures from Zanzibar.  It’s supposed to be an incredible island.  But my heart does remain here, in Arusha, and St. Elizabeths.

So, today was HIV mother day.  Every Wednesday is.  All our moms have HIV.  And you can’t believe how many mothers there are.  It is one of our longest days.  What it is, the HIV mothers that have been coming to clinic for their prenatal care, who have now delivered, need to come back for a check up for both them and their baby.  They do this until the child turns 2 years old.   They are to do this monthly.  First we weigh the babies, then the moms, then they go into one of the exam rooms and see Dr. Moshi, our OB/Gyn.   Also, and this may be the sad part, and it is likely judgemental of me to say that, but most of them are pregnant again.

On top of that, we have the newly diagnosed pregnant mothers with HIV status.  As you can see, a long long day.

So many dilemmas.  Each individual woman has the right to a say to her own life.  Our integrity as human beings want to give that right.   And we do.  And cherish the individual.  My brother informed me when reading the blog that Tanzania has the 11th fastest growing population in the world.  If it continues at this rate, and who’s to say it won’t, it will have doubled population in 20 years.  And quadrupled in 40 years.  And it has very, very limited resources.

I did a “no-no” today.  We are instructed that we will hear many sad stories, but never give anyone any money.   One of the HIV mothers today, when Alodia was doing the intake, broke down in tears.  Her husband had deserted her.  She already had a little girl at home, and now pregnant again.  She didn’t know what to do.  Tanzania does not have services for this.  When she came back into my exam room, I just looked at her kindly, and said, “Pole” (sorry)  and with just that little bit of kindness, she fell into my arms sobbing.   She told me, “The rent man comes tonight, I have no money to feed my child, I don’t know what to do.”    This was in no way a scam.  This was this woman’s reality.

I did my examination.  She calmed down.  As she was leaving, I took all the cash I had in my pocket, and slipped it into hers.  I tried to do it without her noticing, but she did.  I told her, “Hapana kusema”.  (Say nothing).  She nodded tearfully and left.

Now, all I had in my pocket was about 17,000 schillings.  About maybe $8.  That’s all.  Pretty much nothing for me.  Less than what we pay for a 3 entree fast food at Panda Express.  But it may feed her and her child for a week or more.  Was that wrong?  I don’t know.  I could get in big trouble for it.

Oh, the contrasts of Africa.  And the dilemmas.  As I leave the hospital tomorrow, I will think on that.  My time at St. Elizabeth’s is coming to a close.  I will be going to Zanzibar for my last week here in Africa for a very much needed R & R.  In all honesty I am exhausted.   I will be returning to Oregon soon, to pick up that hectic life.   But, what is life here?  I keep asking myself that.

What is genocide?  What a strong, frightening word.  Wiki has it as a “deliberate killing of a large group of people, usually ethnically motivated.”

Last week, after work, some of my Tanzanian hospital co-workers gathered for tea in one of the exam rooms.   I was getting to know one of them.  A very sweet serene woman, in her 50’s.  She works in the maternity ward.  I was asking her about her life.  I asked her if she was married, she answered that she was widowed.   She said that she had been for “twenty years or so”.   I guess it was nervy of me, but I’m used to asking people questions when I do intakes, so I asked her, “do you mind if I ask how he died?”  I have found most people like to share past griefs and it gives them comfort talking about it.   But, her serene expression left her countenance, and her face became very cloudy.  She grimaced deeply.  “I don’t like to talk about it” she said with finality.

I quickly changed the subject, I hoped to a more pleasant topic.  I asked her, “do you have any children?”  She brightened slightly, but said briefly, “Yes, but they have returned to Rwanda, I am Tutsi, you know.”

Now, I may be adding 2 + 2 here, and getting 5, but I would think it would be safe to assume this quiet lady may well have been involved in the Rwanda Genocide.  Rwanda is next door to Tanzania.  In fact, the Rwanda Genocide Trials were held, and are still currently being held right here in Arusha.  Many Rwandan refugees came to this country of Tanzania to escape the terror of this genocide.   In 1994, in 100 days, approximately 900,000 Tutsi’s and moderate Hutus were wiped out in a ethnic war between the Hutu’s and Tutsi’s.   This was 5 times the “killing rate”, if you can use those despicable words, than the rate the Nazi’s used during the Holocaust.  And most of it was done by neighbor to neighbor, using machetes.

I was aware of this event when it happened back in 1994.  I was safe in my home in Salem, Oregon, raising my sweet little family.  My youngest just 4 years old.  I watched the news as the events came out slowly and was horrified.  But — it was a horror watching the events from my TV, sitting in my soft armchair, secure in my own small isolated world.  Then when the movie, “Hotel Rwanda”, came out, I was again struck by the tragic events.  It made it seem all the more real to see this “Hollywood” version.  Hollywood often exaggerates stories to make a more dramatic movie.  But certainly not in this case.  Nothing could make it seem worse than it really was.

But here is reality.   How can this beautiful, beautiful place, meaning East Africa, and sweet loving friendly people, devolve into such atrocities?   This is Tanzania, not Rwanda, but it too is strongly affected by this past.  That event was long boiling, for many historical reasons which I won’t go into now.   But, to look at this woman, her life changed forever, and feel its absoluteness.  Again, words fail me.

Yesterday we had another HIV mother diagnosed in my exam room.  This one broke down in tears.  She clearly had been in some state of denial.  Denial of both her pregnancy and possible HIV status.  She has 2 little babies at home, age 9 months and 20 months.  She didn’t know how far along she was, I measured 29 centimeters, so likely about 6 months.  Bruises on her face and body.  She said her husband doesn’t want this baby.  Alodia comforted her and tried to counsel her.   All I could do is look on and say, “Pole, pole” (Sorry, sorry)

You know, I can come here, spend my 4 weeks here, give what care I can.  But, I am going home.  Again, to my soft armchair, sweet little family, and watching world events on the TV.   The people here live their lives.  Go on.  Smiling.  Laughing.  And crying.  I know my impact is small in their lives.   But, their impact on mine is beyond measure.

One of the highlights of each day is coming home from work and reconnecting with my fellow volunteers.  Here we share tales of our experiences of the day,  These stories we share make us laugh, and they make us cry.  They draw us closer and closer as we experience the joys and sorrows of Africa, be it stories of harrowing DalaDala rides, to experiences with the African people in each of our own volunteer assignments.

We are staying at a volunteer house here in Arusha.  Now this house is very simple.  Basic would be a kind word.  We do have a few modern conveniences, well, when they are working anyway.  The electricity often goes off.  When that happens we also don’t have water.  But then sometimes the water still goes off and the electricity remains!  Go figure?  Most the time we don’t have hot water.  We have learned if we have the magic three: electricity, water, and hot water! Wow!  The stars have aligned and grab a shower, quick!

We don’t really have a kitchen either, no stove, no sink, just the aforementioned table we gather around.  There is an elderly refrigerator that beeps, 11 times on the minute.  We have timed it!  It either doesn’t keep things cold, or it freezes thing solid.  We now have a cucumber we can use as a hammer!  

The biggest challenge is the very spotty internet.  We grab it also when we can.

The propane “stove” used for cooking all meals.

What we do have, is each other.  As we leave each morning, we each take a big breath, bid a farewell, and head off our on our different ways, each catching our own different DalaDalas, going on our separate pathways to take on our day.  We then, after a long, and often difficult day, greet each other as we return.  We share our lives, and our stories.

Let me tell you about my fellow volunteers:

First of all there is Mary Ann.   Mary Ann is from Australia, sounds like she is some big muckity muck at one of the biggest hospitals in Melbourne.  A very educated, experienced, talented woman.  Her heart was touched years back in Zambia and she travels there every year to volunteer.  This year the program is Zambia was not available so she came here to Arusha instead.  I’m so glad she did!

Mary Ann is working at St. Lucias’s.  It is an orphanage that houses 20 children, ages 3 years old to 14 years old.  All these children do not have parents.  What they do have is HIV.  HIV is the shadow that looms over every subject here in Africa.   You cannot get away from it.

These are some of the stories she tells:

The first week Mary Ann volunteered at St. Lucia’s, they had her scrubbing floors, washing shoes, and doing the laundry.  Mind you, there is no running water or electricity at this home.  She was doing all this in an old fashioned wash-tub with scrubbing board.  I imagined in my head, this highly respected, highly ranked nurse in Australia society “reduced” to scrubbing floors and dirty orphan children.

She would come home each day covered in mud, and regale us with tales of these experiences, having us roll with laughter.  She approached all this with grace, humor, and acceptance.   She felt this was “the gauntlet” she needed to go through to gain the trust of the caregivers who ran this orphanage.  And she really didn’t mind, because she was serving the children, and that is what she came here to do.

Well, how could anyone go too long without understanding and knowing  Mary Ann’s pure heart?  The next week they “elevated” her to the actual care of the children.  She now plays with the children, reads books to the children, take them to school and their doctor’s appointment.   Each day she comes home, and tells us stories about these children, some humorous, some heartbreaking.  She names each child by name as if they are her own.  There is Jackie and Patrick, the two 3 year old twins,  Emanual, Nicholas, and and Peter.  There is Margaret, who she calls “bossy boots”.  And on and on the names go.  Last night, she told us about Jennifer.

Jennifer is a child who Mary Ann says she has not been able to reach.  Mary Ann thinks she is about 13 years old.  She always hangs back and will not interact.  Whereas all the other children are always climbing all over her, and begging for any attention they can get, Jennifer always keeps a distrustful distance.   However, yesterday, that changed.

This is the story Mary Ann told us.

“Today, after I had got done giving the little ones their baths,  (in a tin tub outside), I  sat down for one second to rest on a bench.   Jennifer then came and sat down on the bench also, but as far away from me as she could get.  I just played it cool, and just hummed quietly to myself and stared ahead.  Jennifer then began to scoot slowly closer and closer to me.  When she was quite close, Jennifer asked in a very quiet voice, “Mama MaryAnn?  Do you every get tired?”.  I answered, “Yes, Jennifer, I do.”  Jennifer then laid down on the bench and put her head in my lap.  I began to gently stroke her shaved head as it lay in my lap.  Every time I stopped, her little hand would reach up, and cover mine, and have it keep stroking.”

Ben is another Aussie.  He is an EMT, going to Med School in the fall.    He works at St. Elizabeth’s with me.  He works in what is equivalent to our ER.  We often ride to work together on the DalaDala.  It is a real experience to see him try to fold his 6’4″ frame into the van and squeeze in with all the other people.  He laughs, they laugh.  It really is quite a hoot!

Ben sees many heartrending things in his department.  Yesterday he told us the story of a 5 month old baby that came in with seizures.  They suspected cerebral malaria.  The baby died after a few hours.

All they have to give anybody when they come to St. Elizabeth’s for pain is acetaminophen.  Nothing else.  And even that supply is running low.

Ben also told us about Joseph.  Joseph is a 7 year old burn victim.  He has burns from his chin, down his neck, into his chest and belly,  He has to come in each day for debridement.  What debridement is; when a burn is healing, the old dying tissue must be removed so the new tissue can grow.  This “old tissue” is literally scrapped and picked off.  You can imagine the extreme pain that this will cause.  Ben’s job is to hold Joseph down while this is done.  The child screams and writhes each time with all the strength his little body can manage.   I asked Ben, “You do pre-medicate him, don’t you?”   Ben just shook his head at me and asked, “with, what?”

Ione is our newest volunteer.  She hails from England.  She just got here a few days ago.  She is working as a volunteer at a woman’s shelter.  This shelter is for women who have been rescued from the sex traffic trade.  Yes, that really does exist!  These women have been rescued and are now being taught trades so they can support themselves and their families.  Each woman is allowed to stay in the house for one year to complete their training.

Ione is to work in the day care for the children of the women.  Today was her first day.  She came home tonight so shocked she could barely speak.  She said it is her job to care for 30 children in one room with 4 mattresses on the floor.  No water, no toilet.  The children are aged 3 months to 3 years.  One other caregiver.

Ione is really just a young girl herself.  So sweet, so giving.  This will be a huge challenge.

We have a new volunteer arriving tomorrow.  She comes from the Netherlands.  It will be fun getting to know her, and hearing about her day.

The closeness I feel with my comrades-in-arms is unbelievable.  I guess it’s true what they say about soldiers who fight together.  You form ties in such unique ways.   Only my fellow volunteers know exactly what it feels like, only they can really grasp the scope of the joy, the fear, the love we each feel each day.   It’s a sharing that goes beyond words.

It’s as Mary Ann says after telling us about Jennifer, “To have that sweet little girl place her trust and her head in my lap.  It was forever more worth all the floor and shoe scrubbing ever.   Nothing, nothing, is worth more than that.”  We just all looked at each other and nodded.  Her words exactly.

Slide show coming!  Still trying to figure out how to do it!

June 3rd – Darn it!  I’ve found with my Chromebook and our very spotty Wifi (Or Wee-Fee here as they call it)  at the volunteer house, I’m not going to be able to do it.   I may be able to go to a local Internet cafe and try, we’ll see!

There are 22 orphanages in Arusha.  This is in a large part due to HIVAids and the death of both parents.  One of the orphanages is the Good Hope Orphanage.

This is a privately funded non-profit school/orphanage/Boarding School.   My sister Genie volunteered here for the last 4 weeks.

So, what happens to the children if both parents die of HIV /Aids in Arusha, Tanzania?  Either they are lucky enough to be taken to one of these orphanages, or they live off the streets.

I found out today that the little children that sell the plastic bags at the stalls in the market are street children.  They are hired by the stall owners to sell these little bags.  Whatever profit is made over a certain amount from the bags, the children may keep.  I had no idea.  When I asked, “Where do the children live and sleep and eat?” I was told, “Wherever and whatever they can find”.  These are little children from the age of 5 to 12 years old.

These orphanages are incredible.  They provide living arrangements, an education, food, and safety.  What they don’t provide, and how could they? Is a loving family.  My dear sweet sister Genie provided that.  

Genie in the back of her class.

I stopped by on the way home from my work one day to meet her “kids”.  I could see right away that these children loved her.  They ran up to her, hugged her, called her “Madam”, and joy shone in their eyes when they looked at her.

Each day she would come to this orphanage school and teach, help decorate the classroom from it’s previously bare walls, and brings pencils, crayons, paper, scissors, and many other school supplies that our children here take so for granted.  But I think most of all, she would love these children.   Not only did she bring color into their classrooms, she brought color into their lives.  As only a most loving and kind motherly-type woman could.

She made friends with the orphanage’s teachers, very hard working dedicated women, she shared her wealth of knowledge with them.  

This school houses over 1,000 students.   Some are boarding students, some are day students, but the rest are orphans.   Genie says that when the day students go home to their families, the rest are left at the school.  They spend another hour at their desks doing their homework.

They then go back to their dormitories.

These are the lucky ones, these orphans, I mean.  And I suppose the orphans at the other 21 orphanages in Arusha.

Tanzanian Children.  The most beautiful children in the world.

Good Hope is privately funded, as again are the other 21 orphanages in Arusha.

When Genie brought in all the school supplies she had brought from home, she said the teachers rushed these school supplies like they were “sharks in a feeding frenzy”.  For example, Genie said the children have to share one pencil between 2 children, and at that they wear that pencil down to the tiniest stub.  The teachers are desperate for any school supplies they can get.  Even the desks the children use are a plank of wood with 4 sticks holding it up.  The chairs, plastic lawn chairs.

See the beautiful decorations Genie put on the wall?

You hate to think of orphans in an orphanage being “the lucky ones”.  But then again, you hate to think of children living on the streets too.  But this is only too true of what is going on in Tanzania.

All I can say, is when I buy my lovely fresh produce in the market tomorrow on the way home from work, I will give extra smiles to the child that sells me my plastic bag.  And maybe slip a little extra schilling or two, if no one is looking that is.  

You have to be careful with that I’m told.  If other children notice one child having any money, it is quickly stolen from them by a bigger child, and not in a kind way either.   It is survival.

I don’t know the answer.   And even the world’s health organizations, and all the governments in the world don’t know the answer.  I guess one little step at a time.  One thing would be to help educate people about HIV.  To stop these useless deaths.  And maybe also, one sweet grandma from Utah coming to spread love, attention, pencils, and coloring books.

Addendum:  By the way, we are still out of Malaria tablets at the hospital.  And we ran out of the Tetanus vaccine on Monday.  We wait for both to be delivered soon.  

Today, back at work.  So happy to see my friends.  They greet me with such love.  A very busy day.  First the mamas about to burst, 36+ weeks, then the “new” moms.  Victoria came back to help we were so busy.  I’m not sure I’ve talked about her.  She is a pre-med student who has been here already for 3 months.  She is from Montana.  A super girl, and now a new friend.  She loves Africa.  And she fits in and communicates like a native.  I so much want to be like her by the time I leave.

I have put up a “cheat sheet” for me for words I use all the time on the wall.  Alodia thinks its funny.

But the happy thing!  A young mother came back that we had examined prior!  And with twins!  Two sweet little baby girls.  So very tiny, but very healthy.

That was a happy, happy time.

But then, the sad thing:  My last mama of the day.  With our new moms (Not that this is their first pregnancy, it is that they are new to us.  The percentage of mothers actually coming into the hospital is very low.)  we always do 3 blood tests.  HIV, syphillis, Malaria.  We actually ran out of the syphillis tests last Friday.  But, luckily they were restocked today.

Anyway, these tests are immediate tests,  I just prick the mama’s finger and apply the blood to the testing strips.  And yes!  I wear gloves!  I then apply the reagent to the strips.  Within 5-15 minutes we have the answer.  Very much like a pregnancy test.  One stripe you’re negative.  Two stripes, positive.  (Although I believe that’s reversed on the pregnancy tests?)

I do the tests as soon as the mama comes in the exam room.  After I finish starting the strips,  I proceed on with the physical exam, measuring the bellies, palpating to see baby placement, and listening to fetal heartbeat.  This allows the time for the tests to process.  By the end of the exam, I give the mama her tetanus shot, then whatever pills we have available. (Still out of the malaria tablets) .  I then can glance back at the strips on the table, and give the mothers the results.

All afternoon, each test was negative for all the mamas.  I had seen 9 mothers so far.  Yay!  One line on the testing strips.  No HIV!  I could tell the mama, “Omnamatata” (All is good!)  They would smile, and say, “Asante.”  (Thank you)

But my last mama.   As I turned to look at the strip on the table, my heart fell.  Two stripes.  Two ugly glaring stripes.  HIV positive.  Darn it!

I tried to keep my face unemotional, I smiled at the mother, said “Kusibiri” (Wait) And took the tray into Alodia in the other room.  I didn’t have to say anything, just show the tray to her.  She was busy with another patient, but glanced down into the tray.  Her face also dropped.  And she let out a deep, deep sigh.  She then got up, and we went back into my exam room where my new mother was waiting quietly and patiently.

There is another second test you give to verify if the first test is positive.  We did that, and yes, it was positive.  Alodia then very quietly and gently told the mother.  My Swahili isn’t good enough to understand everything Alodia said, but I got the gist of it.

The mother’s reaction was very African.  She smiled softly, and just said. “Asante”  No crying, no hysterics, nothing.  I asked Alodia later if she thought the mother already knew, and that why hardly any reaction.   Alodia said, likely not.  This is just very African.  Stoic.  Brave.  Taking life as life hands it out.  Not showing sad emotions on the outside.

We then took the mother over to the CDC department located in the HIV outpatient building so she could get started with her meds.  She is early enough there likely won’t be any transference to the baby.  One good thing is the mother actually came into the hospital.  She can get treated, and so can her unborn child.

I had seen 9 new moms that afternoon prior to my last one.  All negative.  And this last mother positive, 1 out of 10, so 10% HIV positive rate.  I asked Alodia if that was a good number, a good day.  Alodia said, and this struck me to the core.  “The only good number is 0”

This mother has 4 other children at home.  The father and last baby will need to come in to be tested too.  The truth of the matter is, many mothers do not even come into the hospital to have their babies, they have them at home, alone, or accompanied by a family member, so are not even being tested.  So, of course, not getting any HIV medications.  And HIV spreads.  On and on and on.

HIV is rampant here.  The reported numbers likely aren’t accurate.  You hear from 10-45%.  My personal anecdotal day today was 10% of mothers that come in to the hospital that is.  But who knows what the numbers really are?  Wednesdays are our HIV mother day.  And all I can say is, the waiting room is full to overflowing.  And mothers waiting outside in line wrapping around our little building.   Breaks my heart.

But this is life in Africa.  And life for me at St. Elizabeth.