Visiting Amizade in Northwest Tanzania

21 June 06

Karagwe sits on a 4,000 foot mountain ridge in Northwest Tanzania. It is dry, breezy, and temperate – similar, said my friend John – to Palo Alto, California. Except it is not congested – a run on the dirt road out of town immediately brings uninterrupted views of valleys and mountain ridges.

I met up with a group milking cows this morning just before sunrise. The smell took me back to Pennsylvania, on Slab Road between McKinley and Johnson, where cows are gathered tightly in the shadow of a red barn.

But these cows were on the grounds of Nyakahanga Hospital – a series of buildings housing patients, offices, doctors, nurses, and guests. There is a large tent in the center of the compound now, as there is every year during the malaria outbreak. About 200 kids and mothers stay in the tent. Every few days the foam mattresses are pulled out, a new layer of straw bedding is put down, covered in canvas, and the mattresses go back on top again, stuffed side by side.

This morning I went for the first part of rounds with the head doctor, Dr. Nyirende. He emphasized the need to diagnosis here without machinery – without numerous MRI machines and the like – and bragged about wowing German doctors with his diagnostic abilities when visiting Berlin. 12 beds are in a room, sometimes two kids to a bed. A few people are on foam mattresses on the floor. Mothers stay with kids – sleeping in the same beds or on the floor next to them if the bed is already shared. And of course, extra people go to the tent. Several days later I would hear a story about Dr. Nyirende visiting a veterinary hospital in Europe – essentially staring in shock at the amount and expense of equipment dedicated primarily to pets.

As afternoon neared I visited the Amizade work site – the students have been helping with the construction of an orphanage. They were putting sealant on the rafters and finishing some digging for drainage ditches: mostly having a good time getting dirty. The local workers seemed not to fully share the load – meaning not giving the students enough responsibility. It takes a particular skill set to figure out how to most productively use heaps of unskilled labor for two weeks on a construction site. I’ve seen great management of students by local masons in Bolivia, but here the relationship was a struggle.

John and I walked into town – there’s a huge coke bottle at the only crossroads, a small opening to sell coke and snacks. Several miles outside town the electricity grid ends, a police escort is needed to drive into the bush, rebels and guns from Burundi and Rwanda may lurk, and the space is open.