Thursday, August 16, 2012

Almost finished

Sorry friends and family...I've been really bad this past month at keeping everyone updated. I've been living at Nkoaranga Hospital, where there is no internet, sio the time I have been able to spend online has been brief, and necessary to do research and check emails...pole.

So this past month has absolutely flown by. There are many details that I'd like to share, but for now I will be general...

First of all, our accommodations have been so fun. We have been staying at a guest house at the hospital with other volunteers. It's been so great to spend time with people from all over the world, interested in helping in lots of different ways. The orphanage draws some volunteers, as does the hospital in many capacities. I've been blessed to get to know people from Germany, London, Italy and the USA. It's also motivating and encouraging to spend time with these people...not to mention, the food is usually pretty good!

Now that I have to leave, I feel like I'm finally getting the hang of things at Nkoaranga Hospital. We have spent a lot of time getting to know the staff, how the hospital functions, and the necessary fixes that we need to do. It has also been invaluable to live with some volunteer medical students, who openly shine light on the needs of the hospital.

Some things that we've encountered:

-The most important devices in our hospital are: the pulse oximeter, blood pressure cuffs, oxygen concentrators, and lights. If nothing else, these are the most important! 

- Oxygen concentrators! These machines can concentrate oxygen straight up from the air, which is what they will use here because oxygen tanks are scarce. We had access to an oxygen meter to check on the output of the oxygen. A lot of the operational oxygen concentrators in our hospital are running really low, from 30 to 60%...while idealy the output would be 90%+. Anyways, I've done what I can, and I can't seem to get it much higher. We need to find a better or more thorough way to improve these machines!

-Infant warming beds: a local hospital has designed these infant warming beds, which simply use light bulbs to warm this little box. These are not practical all of the time, because generally the baby will use a kangaroo method of being close to its mother to stay warm. But for situations like birth, or C section surgery, this could be useful. The problem that was with these machines was they came with these exposed foam mattresses....which is not practical for a drippy baby! We found an abandoned plastic adult mattress in one of the stoo's and used the material to tailor mattress covers for these little ones. We're hoping to introduce this and help them put these to use!

-The Storage Containers: there are 4 large storage containers on hospital grounds. Recently we decided it would be a good idea to check them out. We have found piles of old equipment, new equipement, smelly chemicals, lab stuff, crutches, walkers, IV poles, training dummies, ultrasound parts, etc. We find it interesting that this exists in such an unorganized way. We feel like a little more organization, and knowledge of what exists out here would be helpful to meet the needs of the hospital. For all they know, they have everything that they need there!

-Incomplete donations: it's been frustrating to see that some groups have come to donate hospital equipment, and haven't completed the process. For example, there is a perfectly good dental x-ray, that a group has put on the wall in the dental clinic. It didn't even turn on, so we decided to check it out. Upon opening it we realized that no one connected it to the power supply! On top of that, it's missing the exposure switch, which is only the most important button to run the device. We can't seem to find it anywhere. The other problem with the donations is that they are not necessarily meeting an actual need. For example, there are probably 20 nebulizers in storage, but our hospital doesn't use nebulizers!

-Billi-lights meet x-ray film viewer: We had a moment of resourcefulness. We discovered a set of Billi lights that was perfectly fine, except we had no way of getting UV bulbs for it...only fluorescent bulbs. So we converted this into an x-ray film viewer and installed it in a ward that was lacking this. We used the remaining Billi-light stand to hold another set of Billi-lights that operate at the proper wavelength. It's nice to be able to meet two needs with one stone....

-Sustainability: we realize that we're only here for one month, we're not going to be heros, but we do want to think about sustainable solutions. Lauren and I have designed some dust covers for some machines. It is so dusty here, and whenever you open a machine, dust is usually coating the electronics. We designed these dust covers as a sort of experiment. I'm not sure how practical it is for the staff to put on and take off a cover. As well, who knows how much improvement it will create. But if it is a good solution, perhaps this could be a good secondary project for next year.

-Teaching! Our knowledge here is helpful for a month, but the staff here will be here all the time. We spent a morning teaching about the power difference between different countries, and how this causes problems with the donated equipement. It was an interesting lesson, because it is so important here...the power here is 230V and 50Hz, whereas in Canada for example it's 120V and 60Hz.  Transformers are needed for the equipment donated from North America. This lesson was interesting because a lot of staff actually were not aware of this. I also feel that teaching a critical way of approaching things is worth time in this culture.

This weekend we will have a conference and everyone will be back together. Our separate hospital groups will be presenting about our separate experiences. I'm looking forward to this weekend, which is concluded by over 24 hours of travel. I'll be home on Monday August 20th. :)

Saturday, July 21, 2012

Open Door Policy: Nkoaranga Hospital

This past Wednesday we finished all of our course work at TCDC. On Thursday, we said goodbye to our colleagues and headed to our separate hospitals. I've been very lucky in my hospital placement...not only to I continue to be partnered with my roommate, Lauren, but our hospital is really close to our school, TCDC.

Nkoaranga Hospital is a Lutheran mission hospital that is located at the base of Mt.Meru, just a little higher in elevation than TCDC (and therefore a bit colder...) In the first two days, we have been able to claim keys to our new 'workshop'. It's basically a small empty room, but we are really excited about it. We have an electrical outlet and a place to keep our tools...what more could we ask for?! We have decided that we will have an open door policy in our work space, hopefully get to know the hospital better!

We have also been able to make connections with some key people who will make our stay and our work here more productive. Jeremiah is the head of the hospital, and you can just tell he genuinely loves his job. He has made us feel so welcome, by threatening to hold on to us by stealing our passports...always a good sign.

We were also able to meet some of the electrical contractors that come to do work at the hospital every week. We were excited to find out that one of the workers was trained by EWH's BMET program in Rwanda. He has given Lauren and I a good orientation, and we will be working with him when he's at the hospital.

We have also started to notice the legacy of EWH at Nkoaranga in general. Not only do people remember the EWH students from past years, but everywhere we look there are quick start guides, maps, and documentation signed off my EWH. The impact of EWH on this hospital is still shining, giving us a lot to live up to!

We have already been able to prepare an oxygen concentrator and a suction machine for surgery. The to do list is long though. I know that we are not experts, and therefore I want to make sure that I am praying about our work here.

There is also an orphanage associated with the hospital for kids under school age. We got a brief introduction from some other volunteers. Lauren and I were swarmed with hugs and requests to play or be held. Quite possibly the cutest kids...ever. (Besides Emmy) I hope that throughout the month we can get to know these kids better! There is a girl who will be staying with us that is really involved with the orphanage. You can read more about what's going on there at this site:

 I can do all things through him who strengthens me. -Philipians 4:13

Mt Meru

Last weekend, a group of 12 people from our EWH Summer Institute program set off to hike Mt. Meru. Mt Meru is a volcanic mountain reaching 4566m, only a kilometer short of Mt. Kilimanjaro. About 100 years ago, half of the mountain slid away in a land slide, creating a mirage of lakes at the bottom (only one is left), and a beautiful crested half cone inclining to the peak. From our school, usually at about 5:30-6:00pm, the clouds burn off to reveal the beautiful monstrosity that is Mt. Meru.

People generally hike Mt. Meru in 3 or 4 days. There are two lodges on the way up to stay at. Since we only had three days off, our itinerary was this:

Day 1: hike from base to the Miriakamba hut: 5 hours
Day 2: hike from Miriakamba to Saddle hut: 4 hrs. Followed by an afternoon hike to the peak of Little Meru: 2hrs.
Day 3: hike from Saddle hut to peak: 5hrs. Then all the way back down: 8hrs.

These times were all very idealistic....

Initially we had planned to do this trek on our own, carrying all of our food and water and bedding. Thankfully we decided last minute to book our trip with a company. We traveled with a ranger (who had a gun in case of animal attacks), as well as a guide. A team of ten porters and a cook went ahead of us, probably beating us to the destinations by hours, carrying likely twice the weight that we were carrying. (Crazy Africans). I still carried all of my stuff, besides food and water. I felt like this was excessive at the start, but at the end I was so grateful! 

Day one was a fairly easy day. We ascended 1km gradually. We passed through some really interesting vegetation...each day revealed a different ecosystem. At one point, the landscape was speckled with beautiful yellow and orange flowers. We saw lots of animals on day one: giraffes, monkeys, buffalo, birds, and were welcomed to our hut with hot chai and fresh popcorn. That night we were in great spirits, enjoying each others company, playing cards...

Day two we started early. We spent the whole day above the clouds. The path was definitely more steep, but it was also still a path. We ascended some stairs that seemed to be never ending. We eventually made it to Saddle hut without realizing how deceiving these trails were. After we dropped our stuff at the lodge, we ascended Little Meru, a side peak. This was recommended to get to this altitude to acclimatize. We all enjoyed a stunning view just before dusk. After another fabulous meal, we headed to bed super early. The hardest day was ahead.

Day three: Monday morning, we woke at 12am and were on the trail by 1am. In the pitch dark, with head lamps and jackets, we moved together as a group. The trail ended early on, and we found ourselves scaling windy mountain crests and scrambling across what seemed to be the edge of a cliff. The air was cold and the altitude made it difficult to breath. On top of this, our group was plagued with problems: altitude sickness, diarrhea, food poisoning, swollen ankles, and general fatigue. What was supposed to be a five hour climb took our group 6.5 hours. But we all made it to the top and were able to see the sun rise from behind Kili! I was a mix of emotions and adrenaline, feeling on the verge of bawling but also so happy. We kept saying that it was the hardest thing we've ever done. I'm so grateful for the encouragement of our group. I don't think we  would have all made it solo.

Once at the top, the sun had risen and we descended on the trail that had given us grief in the dark. What had scared us so much was now laughable. We had to book it on the way down to make up for our polepole ascent. The bus ride back was quiet and it's taken me a good three or four days to feel normal again.

Before we left for the trip, I was encouraged by the passage Philipians 2:1-11..specifically 1-4:

So if there is any encouragement in Christ, any comfort from love, any participation in the Spirit, any affection and sympathy, complete my joy by being of the same mind, having the same love, being in full accord and of one mind. Do nothing from selfish ambition or conceit, but in humility count others more significant than yourselves. Let each of you look not only to his own interests, but also to the interests of others.

The more I reflect about this experience, the more I learn. It was amazing to be a part of a group, and to accomplish such an amazing thing. It definitely required us to look beyond our own interests and keep encouraging each other and pressing on as a group. In light of this passage as well, I have a new appreciation for Jesus...he didn't have to come and climb the mountain of life with us, but he humbled himself, and he walks with us and encourages us.

Accomplishing something is sweet. Accomplishing something together is sweeter :)

Our group, day one, under a crazy tree

Day three, looming there, from the peak of Little Meru

That's not a path.
The view of Kili, above the couds

At the top! Everyone wanted to take a picture with my Canadian Flag ;)

Monday, July 16, 2012


I’m an engineer…I like numbers. Here, in no particular order, are some of my observations.

The conversion rate from CAD into TSH (Tanzanian Shillings) is approximately $1:1,600TSH.

Last Wednesday, our Swahili class went to Tangaru market. Each student was given 2000TSH, and we were instructed to buy fruits and vegetables to practice the language, and our bartering skills. With this amount of money, I was able to buy:
-2 avacados
-6 passion fruit
-8 tomatoes
-4 small red onions
-4 green peppers

Minimum wage here is 58,000TSH/month. This works out to less than $3/day. Often people are paid in cash, like at the market. I’m sure this rule is not strict.

The mosque, which is a few feet away from our bedroom window, performs its first call to prayer at 5am each morning. Except when the power is out.

There are likely 100 dogs within a 1km radius of our house howling right now.

The sun sets at about 6:45 each evening. By this time, everyone is in our compound for the night. It’s not that safe to be out past dark.

James, our host sisters’ son, was born in Nkoaranga Hospital, where Lauren and I will be working. It cost Maxima 10,000TSH to open a file here.  Even though it’s a private hospital, this is the only fee that she has to pay to use this hospital. It must be funded through donations. If she were to want to use another hospital, she would have to pay another fee to register there.

On our walk to school, Lauren and I get called ‘mzungu’s at least twice. If we’re lucky, a kid might come over and touch us, to check if we’re different I guess.

It takes me two full buckets of water to wet my hair during a bucket shower. I likely use about 1/5th the amount of water I would normally use to shower at home.

Ben, the ground coordinator for EWH Africa, pulled up some stats the other day comparing US to Tanzania. Some that interest my include:
                                                USA                 Tanzania
Life expectancy                     78.2                57.4
Adult lit rate                          99%                73%
Access to internet                  79%                11%
GNI/capita PPP (USD)          48450                        1420

Power outages occur on a daily basis, and can last from a few seconds to a day and a half, as far as we’ve experienced.

There is always enough food for another guest.

The word “karibu”, meaning “you are welcome”, can be used in every scenario.

There is no upper limit to the amount of grass you can transport on the back of a motorbike (aka pikipiki).

Number of cats Lauren has put into her jacket since arrival: 4.

Average cups of tea per day: 3.65.

This weekend we have Monday off. A group of us will be heading to Mt. Meru to trek to the top. This is a three day journey, and we expect to experience Canadian conditions on the top of this African mountain. I’m so grateful to be able to experience nature on this side of God’s globe. 

Tuesday, July 10, 2012


Time in Africa is difficult to explain. In some ways it is totally flying by...we're already over half done our training! And in someways it is creeping by, polepole. We had a lesson in time in our Swahili class yesterday. Our teacher, Kisangi, told us that time here originated as they followed the sun, the crow of the roosters, the brays of donkeys, etc. Because of this, times of the day were not very exact, which causes people to just estimate the meeting times. Sometimes we refer to time here as TFT. Tanzanian Flexible Time. 

This past Friday, our class spent the day once again at Mt Meru Hospital, which is in the city Arusha. A group of us set out intending to finish working on the giant autoclave that we had started last week. This endeavor led us into the city in search of parts. We had a glass cylinder that was broken, and we needed to find a peice of plumbing to patch it with. Our trip into town proved to be very educational. It made me realize that our purpose isn't just to fix the equipment, but to also overome the obstacles that make this work difficult locally. We walked down the main road, in and out of many parts stores: electrical, plumbing, carpentry, hardware, etc. Most of these stores had the common thread of being really unorganized (to the untrained eye). I'm sure that efficiantly finding parts for repairs is a constant barrier for the local fundi's (technicians). In the end, we weren't able to fix the autoclave, but what I learnt was invaluable for my future work at Nkoranga Hospital.

Each year, when EWH Summer Institute students are finished with their terms at the hospital, they donate their tools to their respective hospitals. This year, our coordinator is taking it to the next level and is purchasing the tools locally. This is a positive idea, attempting to ensure that the right tools are accessible for fundi's here, and also that we contribute to the African economy. However, this task was underestimated, and our coordinator has had a hard time finding good tools for a good price for our group.  

This past weekend was wonderful. It was actually the last full weekend we will get to spend with our African families, and we were so grateful. 

First of all, our Baba treated us like gold this weekend. On Saturday he took us to meet his Canadian friends. We've been hearing a lot about them, and finally we had the morning to go and visit. We met Darryl and Shirley who are from Winnipeg, Manitoba. They've moved to Tanzania and have started to build what will soon be a beautiful resurt. Theyown lots of beautiful land with amazing views of Kili and Mt Meru. They have created a very comfortable and welcoming place, and hope to host people who come to visit Africa! You can check them out here:

Back at home, Lauren and I took big steps in our relationship. It's called laudry day. We washed our laudry by hand with the help of our African sister, Christina. At this point in time, pretty much every peice of clothing I have here was in the laundry. I will think twice before I let this happen again. After an hour and a half of back breaking labor, we were finally able to hang our clothes on the line. No one has ever been so intimate with my intimates! All you people out there with machines, you take your clean clothes for granted! 

Maxima, one of my host sisters, has her own beauty salon on our compound. Obviously she specializes in the coarse hair of Africans...but she confidently took me on as a client. I've never recieved such a fast hair cut in my life. With spray bottle and kitchen scissors, she finished my hair within ten minutes. Not only that, but she charged me 2000TSH. Aka, $1.30. I obviously paid more than that, but I'm continually blown away by the cost of living here.

On Saturday night, we lived every students dream and had a party in a classroom at school! We had projector and speaker hook ups, and had a great night of bonding. I must give fun credit to our very own DJ Ray, as well as Shakira. :)

On Sunday, Baba James took us out for lunch! He really treats us like his watoto. In the afternoon, Christina and Zubeta walked us through dinner preparations. From 4:00 until 7:00 we were in the kitchen preparing different dishes. We made an African favorite, pilau, as well as a beef stew, veggie soup, and fresh fruit juice. I'm picking up on some trends in African cuisine: lots of oil and salt, animal fat stays on the meat, and you boil the heck out of everything. Maybe it would have been better if I didn't know these things... Still, the food is really tasty! 

My roommate, Lauren, is a really amazing girl. I'm so happy that I get to spend so much time with her, and look forward to working with her!  She also keeps a blog and is a little better on the details.

I continue to feel privileged to be here. As our time of training and education goes on, I'm grateful for this time to adjust to life here before the real expectation begins. As I'm anticipating our second month of field work, I'll request some prayers for my group:
  • That we can work together constructively to solve problems.
  • That we will be able to communicate with the other staff well, and gain their respect.
  • That we would be able to see the needs of the individual hospital situations.
  • That we could rely on God's strength in the problems that we face.

Lauren and I, cooking pilau

My African father, Baba James. He's amazing.

The plumbing parts store...kuna shida!

Working at Mt Meru Hospital. Some of my classmates fixing a  hospital bed.

Wednesday, July 4, 2012

Adventures of Week Two

It's about time for another post. I realize that weekly blog posts will be pretty long, I might have to try the biweekly post.

Since last post, I feel like I have three sides to my story:
1. Tanzanian culture and Swahili class.
2. Engineering class and hospital application.
3. Safari Time!

First of all, I am so grateful for Swahili classes. We have divided into three small classes with three fabulous Tanzanian teachers that rotate through the classes.  We are learning in a way that we can practically apply the things that we learn in the places we are exposed to, like at home, at the hospital, the market, etc. I am so thankful for this opportunity to communicate with the local people, and have a chance to understand them as well!

Our home, where Lauren and I stay, has been amazing as well. It is wonderful to return home after a day at school and have a family to practice our Swahili with. Every day, Lauren and I pull out our books and do our homework with Baba James. It is nice and helpful to be immersed in the language and have so much opportunity to practice. I find myself spending lots of time with Brenda (4 years), getting her to teach me simple words in Swahili. She's more at my level...

I also want to say how grateful I am for my Tanzanian family. Besides taking care of our immediate needs, they have really made us feel like part of the family. Baba James often refers to us as his daughters, and lets us know that he is happy to take care of us.  Everyone here is always taking into account where we are and what we might need. I know that he would come and rescue me if I was ever in trouble. This feeling of home and family means so much tome; especially now that I am so far away from my own family. I am totally blessed.

Secondly, the technical side! First of all, I've been interested to learn how the health care system works in Tanzania. One layer of the story is that there are private hospitals and there are public hospitals. Public hospitals are open to the public, and receive their funding from the government. Private hospitals are obviously run privately, and cost money to use. Although I haven't seen with my own eyes, I've heard that the care a patient receives is consistently better at a private hospital considering the resources, facilities, prescriptions, etc that they might have on hand.  The hospital I will be working in next month is a private hospital, and was planted by Lutheran people from German.

In addition to this, there is also a hierarchy of hospitals. In the smaller towns and villages, there will be small hospitals, or dispensaries. It is rare for these to be staffed at all times. From here we have clinics, which are still small. There are bigger hospitals, called regional hospitals. These are better equipped in terms of staffing and resources. Beyond the regional hospitals there are national hospitals, which are the best hospitals in the country. Someone might get referred from a clinic to a regional hospital to a national hospital.

This past Friday, we spent the day at Mt. Meru Regional Hospital. We will be spending several days here as a big group to get some hands on experience with supervision before heading to our placement hospitals. Already the experience from this time here has been invaluable to me. Some things I noticed at the hospital are:
-it is definitely a hub of energy: people are everywhere, there is a lot of activity, and a central part of the town.
-it is mostly outdoors. Separate one story buildings are used for different wards, there are walkways and gardens from one ward to the next.
-it is difficult to find what you need. For example, we wanted to clean a machine, and basically just needed a bucket, cloth, soap and water. The nearest water was 200m away it the closest bathroom, and we had to improvise with a cup and tissue. It will be my goal to create an inventory of tools and supplies when I move to my placement.

We discovered a back room away from the bustle of activity that contained a lot of buried hospital equipment. It was fire fighting time. We were able, using simple skills we've already been over in class, to put several things back on the floor. These included two oxygen concentrators, three wheel chairs, three blood pressure cuffs and a surgical lamp. We have a couple projects on the go that we can revisit this coming Friday, including a hospital bed and a couple of autoclaves.

It has been eye opening to do this work. We were surprised how much we were able to accomplish in our first day. It was also encouraging to directly see the need that there is for better resources and working equipment. For example, as soon as we returned the wheelchairs to the staff, there were patients to sit in them. It was also good to experience a taste of what we came here to do. As a big group it is easy to settle into enjoying each others company, but the quality of hospital facilities here is real.

Lastly, I wanted to mention safari! Our group of twenty two headed out this past weekend on safari. The thing is, we're in Tanzania, the safari hot spot of Africa. We had to go. We were able to find a safari company that would take us all out on a two day safari for a decent price.

On Saturday we say Lake Manyara. It was a beautiful forested area filled with ancient dusty trees, and we saw lots of animals enjoying the vegetation. One of our cars was cut off by an elephant! We slept in a tent 'hotel' and spent the next day in Ngorongoro Crater. It is no wonder this is one of the 7 wonders of the world. The crater is basically a huge sunken volcano that has turned into a self contained ecosystem. Here we saw herds of animals: zerbra, wildabeasts, elephants, hyenas, worthogs, ostriches, to name a few. We even saw a couple lions, enjoying the afternoon sun.

We did also gain a bit of wisdom...don't go for the lowest price on a safari. We had some significant car trouble, and would encourage future safariers that it's worth it to spend money on a safari from a respected company :)

It is really great to get to know our group better. The more time we spend with everyone, the more I realize how great our group is! This is going to be an amazing summer.

Monday, June 25, 2012

In Africa

I have finally arrived in Africa! I've been here for a few days now and have been made to feel so at home. It's so incredible to be here. As we descended into Kilimanjaro airport, we could see the monstrous snow cap on Mt. Kili over top of the clouds. Several of the other EWH Summer Institute participants were on my flight as well. We have been welcomed over and over by the local people and our trainers here in Tanzania.

For now our EWH group is taking courses at a training compound called MS-TCDC in Usa River. We spend our mornings learning Swahili taught by a handful of local teachers. Their enthousiasm and love for their language is energizing. Swahili is unlike any other language I know and is taking a while to get used to. The afternoons are spent getting organized with biomedical engineering and what to expect in the hospitals. I feel so honoured to be learning at such a great facility, and know that the information we learn now will be critical for our projects during the second month.

My new friend, Lauren, and I are staying with a local family, the Shikobe's. We have been welcomed with unequaled hospitality. Our African father, James, has a beautiful family of children, grandchildren, friends, children of friends, friends of children, etc. Christina and Mbete prepare the most delicious meals and are planning to teach us how to cook. We bathe with hot water using buckets and scoops, and our house has running water. We share a room with separate mosquito princess canopies. We are also blessed to be entertained by some kids. James (4 months) and Brenda (4 years) bring us lots of joy. James was actually born in the hospital that Lauren and I will be working in! 

We live about two kilometers from the school and are able to walk to school and really enjoy settling into the culture here. We actually feel really safe. 

I'm very happy here and thankful for all the support and preparation I've had in coming here. I've been having difficulty in the past month finding a computer base to send updates from. To give a brief summary, I have been privileged to join and meet friends throughout Switzerland, France, Spain and Turkey. I've had many conversations and experiences along the way affirming and preparing me for this time in Africa.

I hope to be able to update you with more details and pictures soon!