This week we've had multiple field trips around Arusha for our public health course. On Monday, we visited the Arusha City Council to talk with the city health officer in charge. We asked him many questions pertaining to environmental sanitation within the city, health education, and the role of the council in promoting health within the city. After listening just to the city health officer, one would think that Arusha did not have any problems. He made it sound like clean water was not an issue, citizens disposed of their waste correctly, and that communicable diseases were not as big of an issue as "some people" made it out to be. 

But when we finished our meeting that morning, we decided to drive around the outskirts of Arusha and to compare what he told us to what we found. As we drove, we saw large piles of garbage that were communal dumping sites.The garbage was burning (but the council member said no one burned garbage because it was strictly illegal) and made the surrounding village smell. As we walked through the village, we walked on old railroad tracks over a river where women were washing their clothes and getting drinking water. That river apparently runs by a brewery and a textile factory where tons of harsh chemicals and pollutants are dumped before flowing to where the women were washing their clothes. As we kept on walking, we passed another small village where the communal water source was boarded up. The water is controlled by the city and people can only get water twice a week. During the dry season, citizens of that village do not get water from that site and have to travel to the next village to pump water out of a well that may or may not be clean. But the city doesn't have a water problem. 

After our tour of Arusha, we traveled an hour outside of the city to a rural health center that mainly serves the nomadic Maasai population. The clinic was small and had only two doctors that serviced it. Dr. Simba was the only doctor there when we arrived. It was the day after the national Vitamin A immunization day, so there were many children there to get their immunizations. The health center had one labor and delivery room, one recovery room, and one large inpatient room with six beds. There was a small child there suffering from pneumonia, but Dr. Simba said there were doing much better than the day before. After taking a tour, we sat down with Dr. Simba, two nurses, and two traditional birth attendants from the Maasai community. The women were highly respected in their community because they helped to deliver all of the babies. 

We learned from the women that they deciced to become traditional birth attendants because they were able to get the finest cut of meat from the slaughtered cow to celebrate the birth of a baby. Also, the women were allowed to eat the banana and yogurt soup specifically saved for the mothers in labor. In the Maasai community, pregnant women are not allowed to eat much during pregnancy because the community fears that a large baby will result in a complicated birth. But by the time the women go into labor, they sometimes are too weak to push. This is where the traditional birth attendants come in to help the woman push (see the picture below). I asked our instructor to ask what happens if a woman is bleeding and the TBA's can't stop it. It turns out that the Maasai women will use a special arrow to puncture the neck of a cow. A liter of blood is then taken for an "oral transfusion" where the woman bleeding is made to drink all of the blood. It was a very enlightening day, and we learned a lot. 

Yesterday we visited a traditional healer up in the mountains surrounding Arusha city. We only spoke with the man for a short while, but we learned he had been practicing since he learned at age 12. We watched as he interacted with an elderly woman, asked her what was wrong, then proceeded to rip pieces of newspaper and place various powders inside. It was challenging because we do not speak Swahili, so we could not understand exactly what he was saying. But we learned that he treats a variety of diseases such as diabetes, hypertension, malaria, fertility problems, and STI's.

Today we are going to KCMC, but it will be interesting because there is a physician's strike going on in Tanzania. Hopefully we will be able to speak with a couple doctors and find out why they are striking and what they hope to accomplish. 

Women washing their clothes in the water from a polluted river

A sewage treatment pond. The smell was absolutely horrible, and on the other side of the road from the pond there is a village. I can't even imagine living there. 

The labor and delivery room

The recovery room

The cooler to hold immunizations

A traditional birth attendant showing how they help the weak women push during labor

Our group at the rural health center with the doctor and nurses

Another traditional birth attendant for the Maasai

Children at the clinic to get their immunizations

Lake Manyara and Ngorongoro Crater

This weekend we began our safari to Lake Manyara and Ngorongoro Crater. Our first stop on the three hour drive outside of Arusha was Lake Manyara National Park. The drive to the lake was through a pretty rural stretch of land. As we were driving, we passes Maasai villagers herding their cattle. We also passed a group of Maasai men dressed in complete black with white face painting. We asked our driver why their faces were painted white and they were dressed in black. It turns out that Maasai young men are circumcised close to puberty and it is seen as an entrance to manhood, so they wear the black to signify that they had been circumcised.

Lake Manyara was beautiful. It was quoted by Ernest Hemingway as "the loveliest [lake] in Africa." As soon as we entered the park, we were met by a herd of elephants in the trees. It was so cool to see the elephants about five feet from our truck. During the trip we also saw hippos in the distance, zebra, and a ton of baboons.

That night we drove to Karatu to stay in a hotel until the following morning when we would go to the Ngorongoro Crater. The hotel itself was OK. We all shared rooms so it was pretty inexpensive (about $7 U.S. each for our room since we had three people) but it was right across the street from a bar so it was pretty loud all night. Needless to say I didn't get much sleep that night, especially since we were waking up at 5:45 am the next morning.

When we arrived at the gate, we were all pumped to see the crater and all of the animals that lived there. But when our driver went to go pay the entrance fee that we had originally paid in our program fee, the people at the gate said there was an error with his card. They said the only solution was for each of us to pay the fee again in U.S. dollars, but none of us had any money. So the only solution at the time was to go home. We were all upset because of all of the other problems we were having with our program. But fortunately our driver was able to get money sent to him to cover the fees. After two hours of driving back to Karatu and to various ATM's, we were finally ready to enter the crater.

Our driver left us to go back to the gate to pay the entrance fee, so a couple girls decided to go to the bathroom while we were waiting. I stayed in the car with six of the other girls and we were listening to our music and relaxing in the cool weather. I was listening to my iPod when I heard a loud thump towards the front of the car. I looked up and saw a HUGE male baboon coming through the open window of our car into the front seat! We all sat still for about ten seconds then screamed and piled out of the car. We sat outside the car and watched as the baboon went through our stuff, smelling wrappers and looking for food. Thankfully one of the guys chased the first baboon out of the car, only to let another huge male baboon come in the window again. He chased that one out too, but the baboon was able to run off with Whitney's toothpaste from her bag. I couldn't stop laughing at that moment, seeing the baboon with a big bottle of Colgate in his mouth hissing at the worker who helped us out. I even think a driver from another truck pulled out a machete from under his driver seat when the baboons came towards their car. We all finally go out of the car (which then smelled like a monkey) and were able to go into the crater. When our driver returned we told him what happened and because he could see we were fine, all he asked about were our lunches for the day.

The crater was gorgeous and there were so many animals there. We saw wildebeest, zebra, gazelle, rhinos, and lions relaxing in the sun. For awhile we watched a female lion laying in a ditch watching prey go by, waiting for her kill. But she had been there for at least an hour and a half and we waited, but eventually moved on.We spent six hours driving in the crater and seeing all of the animals. We were all pretty wiped out by the end of the day but had a very fun time.

Tanga!!!

We finally got our residence permits in order on Thursday evening so we were able to go to Tanga. We took the 6:30 am bus on Friday for what we thought would be a five hour drive. Nine hours later we were sweaty (no air conditioning) and tired (apparently not many people know about personal space on public transit) but we made it to Tanga. We were then picked up by a friend of our coordinators who drove us to the Peponi Resort. It was a beautiful resort owned by a British couple that has lived in Africa their whole lives. We all shared a banda or chalet.

On Saturday, we woke up to see the sunrise then went out on the Pepi boat. We met a family from Alabama that lives in Moshi and another family from St. Louis. We all went out snorkeling. This was my first time snorkeling and I was kind of afraid. When we jumped into the Indian ocean from the boat, I think my body kind of freaked out. I just couldn't get the hang of floating on the water and breathing through the snorkel. It must've been too counter-intuitive because I kept swallowing salt water or holding my breath when I had the snorkel. I took a break and got back on the boat. After awhile, the others joined us on the boat and we journeyed to the sand island for lunch. When it is low tide, the sand island is a great place to stop and rest.

The employees on the boat asked us if we would like to try snorkeling one more time before lunch, and I thought I would give it another try. Apparently that was a bad idea because as soon as I jumped in the water and started swimming towards the coral, a boy from the family from St. Louis yelled that he was seeing a ton of jellyfish. I did not want to get stung, so I started swimming for the ladder on the boat. As soon as I was five feet from the boat, my arm ran right into a jellyfish. It stung my arm and both of my legs. I kind of flailed to get out of the water and into the boat, and in the process of frantically trying to get my fins off to climb the latter, I must've pulled a muscle in my back. Boy was I a sight to see. I had a blistering sting on my forearm, two stings on my thighs, and I could hardly breathe because my back hurt so bad. I got back in the boat and used some of the medicine they had on board to soothe the stings. It still hurt pretty bad, but we went back to the sand island for lunch. Luckily, laying out in the sun must've helped my back because it started to feel a little better after awhile. We ate lunch and then journeyed back to the resort.

All in all, this weekend was an adventure. It was really fun to relax with the girls in the program, but getting stung by a jellyfish wasn't the best thing in the world. We took another bus back last night and the trip only took seven hours this time. The second bus we took didn't stop every five minutes to pull over to the side of the road and ask people if they wanted to get on. It felt good to be home and to sleep in a familiar bed.

Our Tuna Banda!

Our awesome rented shoes to walk to the boat

Me attempting to give a thumbs up while snorkeling

Ouch! My jellyfish burns a couple hours after being stung

The Peponi Resort Bar

Sunrise at the beach

The view from our bus home