Every time I visit Tanzania I am reminded that I am from a different culture with a very different set of filters to how I see the world and think compared to the people here.  Back in the summer of 2012, the Kirua Public Dispensary received a very large donation of medical equipment through the implementation of a Rotary Global Grant.  If I were to receive a large donation of materials from a group I would immediately organize myself to look at everything and distribute the equipment and supplies to the appropriate people in the dispensary.  It seems obvious to me, that I would want to put the equip to use right away.   What is obvious to me is not how it worked.  When we visited the dispensary back on Monday we found most of the boxes still in storage and unopened.   

We began to ask the medical staff why were things not being used?  It soon became apparent that the one “Doctor”  (Clinical officer = advanced nurse practitioner) was overwhelmed.  The amount of supplies and the equipment was beyond anything she could imagine…too valuable to be used…it had to be stored for safe keeping.  Our local Rotarian hosts helped us to tell that staff that we wanted them to use the equipment to help make work easier for staff and improve the care they can give to their clients.  We could see that the “Doctor” was still overwhelmed but we didn’t have a strategy to help.  

When our meeting was cancelled on Wednesday we had a free day…we had an opportunity to go back to the clinic and work with the staff to unpack some of the critical equipment.  With the leadership of the nurse on our team Maria Lippa we worked through many boxes of supplies…with the local staff deciding what was immediately useful and what could be stored.  The staff were very excited to see all new items available and many were quickly put to good use.

How does Roger’s miracle birth fit in… Along with the many boxes of supplies there were a number of large pieces of equipment including 2 examination tables and another table which was sitting in storage.  The examination tables had been moved into treatment rooms but the staff were unsure how to use the hydraulic/pneumatic controls.  With a bit of show and tell were able to get the staff adjust the tables…up, down,  rails up and down and adjust the slope.  There was rush of staff to try the tables and show that they understood.  After our success with the exam tables we wondered why the other table had been set aside.  We quickly determined that is was not an examination table but a birthing table/chair.  Once we found the stirrups, we had to demonstrate…Roger volunteered.  Here he demonstrating his birthing technique…he was not successful in producing a child (probably age or some other factor), but the staff immediately grabbed the table rolled/carried it to the maternity ward to be put to use.

We spent about three hours with Maria leading the team, helping sort through the equipment.  Roger and I delved into the electrical equipment looking for the appropriate transformers to get the machines working.  A very successful morning…some very happy medical staff.

What did we learn?

• Being too generous with the materials/equipment is overwhelming when clinics have virtually nothing.  
• Follow-up and hands on “show and tell” can quickly help bridge the information gap.
• The way I might treat and use valuable “assets” is not necessarily how people in other cultures will see things.  

The Water Flows

After six months of heavy, back breaking work by the local Rotarians and volunteers the water is flowing today in the  Mtakatifu “Holy” Furrow.  The shambas (small farms) rely on water from irrigation ditches that divert water from the the river.  There are 10 furrows that provide water to the farms in the Kilema area.  The Mtakatifu furrow was built in the 1860’s to provide water for the construction of the church and provide water to the church garden. Over the last number of years the flow of water has been greatly reduced due to leaks. Over 600 meters of furrow and numerous culverts have been repaired. This morning Bwana Militi opened up the temporary diversion dam to test the extensive repairs for leaks. Together with local Rotarians we walked the furrow from the river inlet down to the church to check for leaks. The water moved very quickly throughout he channel and by this morning it should have travelled the 6 km to the church.

What’s different now?  Areas of the channel previously with leaks have been completely relined with cement slabs and sealed with special waterproof cement.  Over 500 meters of channel have been rebuilt.  All the materials for the job had to be carried in by hand, (cement, sand, gravel, cement blocks), prepared and mixed and finally built.  With all these repair in place the volume of water at the end on the channel will be many times greater and a new branch will supply water to the recently open vocational school. 

Driving on the bumpy roads everywhere, getting bounced around in the truck. The first stop was the Kirua Public Clinic. they have received all of their shipments but not yet opened them or used all of the new hospital equipment. The Rotary Group encourages the hospital staff to open 1-3 boxes each week. Next was the Kirua Catholic Clinic. everything seemed to be in order except part of the roof was damaged. The Rotary Group informed them that they will not receive their shipment of new hospital equipment until the roof is fixed up. The priest took a couple of people to look around at the church and the school. The children in Form 2 even sang for them. The final clinic was the Uparo Catholic Clinic. they seemed ready for their shipment. They had lots of animals; cows, pigs, chickens, roosters and goats. We even saw a dead scorpian! The last stop of the day was the Mrereni Secondary School. Their water tank was built and their garden was growing. The Rotary Group were very impressed seeing a day scheduled for educating the students about HIV/AIDS. overall it was a pretty exciting day!    

Meaghan Pickering 🙂      

 Meaghan and Mackenzie