On to rural Tanzania

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I havenโ€™t been able to blog for a while because of the lack of internet connection in Machame โ€“ the small town where I am teaching in rural Tanzania. A lot has happened since my last blog post โ€“ I completed the public health policy class at Kilimanjaro Christian University College and started the second part of the program, which consists of an internship in a Tanzanian organization. Completing our case study โ€“ which consisted of an analysis on reducing patient waiting times at Kilimanjaro Christian Medical Center was a challenging but rewarding experience. During the three weeks we had to research our topic, survey the hospital and come up with feasible policy options, I was able to gain an in-depth first-hand perspective of health system challenges in Tanzania. My group and I interviewed patients, doctors, nurses, clinical officers, hospital administrators as well as hospital staff in the medical records and  accounting departments. Talking to all these different factions which constitute the health system really allowed to me to take a analytical and all-encompassing look at improving hospital service in a resource-limited setting. My group and I were able to come up with suggestions such as strengthening the referral system of care and improving relations with lower-level health facilities that try to work beyond the shortage of funds that the hospital currently faces. We were very proud when we finally presented our case study on the last day. I was also able to form strong friendships with my Tanzanian colleagues โ€“ though cross-cultural collaboration can be challenging during a fast-paced project, my group strove to work out all the challenges we faced together. At the end of our project, we were all proud of  what we had accomplished during the short time span and expressed hope to continue this collaboration of other research projects in the future. 

                After completing the course and present our policy case study, I was off to rural Tanzania with three other Cornell students. The first thing I noticed about Machame โ€“ a small town that is about a thirty minute dala-dala ride outside of Moshi โ€“ is that it is significantly colder. In fact, all the teachers at the school Iโ€™m teaching in wear winter coats even though itโ€™s only about 60 degrees Fahrenheit.  One of the teachers, Teacher Hilda, even bundled up her seven month old baby Abby in about seven layers of clothing.  Teaching at the school has been a lot of fun. To give you a bit more of an idea of our daily routine, I will include a journal from one of my days at the school:

As Matt and I walk up to the school in the morning, we pass by faces that are already becoming familiar โ€“ the retired pastor and our neighbor greets us from the veranda of his house, the three little kids in tattered clothes point and giggle, walking with us for some of the way and the farmers chopping wood within the banana trees exclaim โ€œhabari!โ€ As we approach the school, children in matching uniforms stop what theyโ€™re doing and say โ€œgood morning teacherโ€ in complete synchrony. We walk across the field, playing soccer with an old thermos cover with the kids.  In the school, we chat with the teachers in the staff room, a cramped room consisting of a few tables and piles of books and papers. After completing some data entry for the teachers, we take a tea break where the teachers generously insist that we eat at least four mandazi each. After tea, we are told that we are to teach a lesson on โ€œInformation, Communication and Technology.โ€ As soon as Matt and I walk into the classroom, all the students get up immediately and greet us with a โ€œGood morning, teacher.โ€  One of the Tanzanian teachers hands us a textbook and tells us to teach the section on television, leaving us with a classroom of about forty fifth graders.

We go over the definition of television and different computer exercises for the next forty minutes until it is time for English class but the English teacher never shows up. โ€œShe is not going to be coming,โ€ one of the students tells us. Matt and I have to improvise and think of more lessons on the spot so we go outdoors to do a science demonstration using coke and mentos that we had planned for another time. The students are excited, clapping and cheering when the mentos and coke react and a mini fountain of coke bubbles up. We then discuss some of the mechanisms that underwent this reaction and we struggle slightly to explain terms such as catalysis in simpler terms. We hear the school bell ringing, indicating that itโ€™s time for lunch and some of the students come up to us after class, asking us to come back and teach after lunch.

After lunch, we get a visit from some British nurses who present a first aid class on burn prevention. While they obviously had good intentions, I realize that they had underestimated how much knowledge the children already have, which I want to be careful not to do in the future. I also have a conversation with one of the teachers on disciplinary action when I remark that the children are very well behaved. The teacher indicated that it is only when the kids fear the teachers that they behave well, which I disagreed with.  Lunch usually consists of wali maharagwe (rice and beans) and avocados. After lunch, we visit teacher Hildaโ€™s home โ€“ it consists of a small room where she and her seven month-old Abby live. Abby is bundled in seven layers of clothing as it is โ€œwinterโ€ for the Tanzanians. After playing with Abby for a bit, Matt and I make our way home โ€“ content after a long day.