BACK HOME!!! AT LAST!

So I'm home again and it feels great.

My last day in Tanzania was on Sunday, August 18th. After collecting all the necessary paperwork from my students and writing my final evaluations, I was all set to go home.

So my itinerary included a 2 hour flight from Kilimanjaro to Addis Ababa, Ethiopia. Then, a 2 hour layover in Ethiopia. Followed by a 15.5 hour flight from Ethiopia to Washington D.C (with a refueling layover in Rome). It was such a long flight I was dying by the end of it. I was also getting really annoyed because every time I fell asleep, I was getting woken up by the flight attendents trying to serve me food. Sorry, but I just don't have an appetite at 3 AM. I honestly would have preferred to skip the airplane food for sleep, which I desperately needed. The flight was also very hard on me, my feet especially. I didn' leave my seat the entire flight (not even to use the restroom) so when it was time to leave the plane, my feet were so swollen I couldn't put on my shoes without loosening them as much as they could go. I felt pretty stupid because it's so unhealthy to remain sedentary for that long (blood clots)!

My mom greeted me at the airport and the first thing we did was stop by Costco so I could get some grapefruits and smoked salmon to appease my cravings. When I got home my Grandma already had borscht ready for me. I pigged out on all the foods I loved when I got home and it was wonderful.

Anyway, my plans are to come back to Duke on Thursday after a short rest. I have a couple of research days I need to do before school starts. I still haven't figured out where I'll stay yet since I'm not allowed to move into my room till Friday. I'll just be playing by ear :)

CLOSING WORDS:

Thank you all for reading my blog this summer! Knowing that I have such a large support group back home helped me extraordinarily, especially in my most stressful of days! Hopefully I will be returning next year. We will see how things go :)

End of Program Conference

The end-of-program conference was a success! In case you are curious as to what the schedule was like:

I really enjoyed watching all the students present their work from the second month. I feel so great knowing that the program was a success and the students accomplished the work EWH is out to do!

I just did the math after looking at the students' work summary forms. This year, the students returned 271 pieces of broken medical equipment back into use!!! I couldn't be any more proud of them :)

Last Day of Hospital Visits!

On my last day of hospital visits, I went to see the KCMC/Mawenzi students. Since I saw them the previous day at KCMC, I though it would be more useful to go to Mawenzi today. When I got there, my students were telling me about how they were having a hard time finding a 6V 20W halogen bulb for a microscope. They checked the stores in Moshi but couldn't find it. I wish they had told me about this bulb earlier because I knew where to look! Moshi has a great facility called Health Care Technical Service (HCTS), http://hcts.elct.org/. It was founded by Lutheran Germans and its purpose is to fix/maintain medical equipment for the hospitals in the area. All the Germans left and it's interesting to see how HCTS continues over the next few years because now it is being run by local Tanzanian engineers. One of them is actually and EWH BMET program graduate! (More info on the BMET program: http://www.ewh.org/programs/bmet-training-program)

I sent a few of my students to HCTS to look for more specific parts when they asked me for help. You might get lucky and find parts that you need because HCTS imports an assortment of bulbs and fuses and other supplies that can't be found in Tanzania. I really love this work shop. I came here last year to work on a Vitals Monitor and the people still remembered me from then! They were so happy we stopped by that they insisted we take a picture!

Had I known that these students were looking for the bulb I would have told them to come here days ago! Luckily, we still managed to get get the bulb and put the microscope back into use even though it was the last day.

While today was my last day of hospital visits, it is far from my last day of work. I still have to tie together loose ends for the end of program conference (on Saturday) and finish up all the paperwork for Duke Engage/EWH! Ah!!

Distinguished Visitors

Today, I spent my time taking the EWH CEO and COO around Moshi. First of all, it was so nice to have a personal car to take me around to the hospitals for once. I was getting pretty tired of taking public transportation.

We first went to Machame hospital. The CEO and COO were able to talk to Bob, an American who's been working at Machame hospital for the past 9 years, to get some feedback on the EWH program. They got the grand tour from the EWH students currently working there and asked them about their experiences. Overall, Machame is an ill-equipped hospital but very well managed. I think it was interesting for our guests to see.

SIDE STORY: At Machame, we walked into the sterilization room (where all the autoclaves are) and we found these precious gems sitting in bowls . We asked the doctor what they were and he said they were removed from some patient earlier that day. Tumors, I'm guessing? Wow. This can't be hygienic.

After Machame, we went to KCMC, which is the national referral hospital. While the head of the engineering department (yes, they have an engineering department!) was away at a funeral, we still got a VERY thorough tour by the electrician. It was almost too thorough because the electrician was taking us into the ICU and even into patient wards. It's very interesting (and sad) to see such a lack of privacy in hospitals.

I've included a couple pictures of our tour:

First, the area where the sheets are hung up to dry. Note how huge this hospital is!

An X-Ray!

An ELEVATOR! An amazing find in Tanzania!

I had such a great time showing our guests around Moshi town. At the end of the day, we stopped by the airport to drop of the COO who had a flight back home. Our CEO is going to stay until the end of the program to help with the end-of-the-program conference and the student exit interviews.

Last Week!

I'm wrapping up my last week with the EWH Summer Institute program. Throughout this week I will be visiting the Moshi hospitals for the second time.

Monday: Kibosho Hospital
Tuesday: Huruma Hospital
Wednesday: Marangu Hospital
Thursday: Machame Hospital
Friday: KCMC/Mawenzi Hospitals

So far I have 3/5 of the hospitals done!!

Below are some pictures of the students and their fundi at Huruma hospital. In the pictures, they are testing out a new transformer for the American delivery beds in the hospital. Huruma hospital currently has 4 electronic delivery beds out of use because they are 110V and the hospital did not have a transformer for any of them. The students were able to contribute 2 new transformers with their parts budget. The hospital was very excited for their contribution.

I am very impressed with the Huruma students. They also fixed an ultrasound that their hospital only recently bought for $38,000. The software on the ultrasound got corrupted after a power surge. After some serious research and luck the students were able to reinstall the ultrasound software and put the machine back into use! They also made sure to plug it into a UPS to protect from future power surges. The hospital is very thrilled with their work here.

Today, I visited the Marangu girls. They are the ones I spent a lot of time with my 3rd week in Tanzania because their house was burglerized. They had an interesting experience at their hospital. The picture I have of them is in their office. While a little cramped they were still very productive. I'm very happy with all my students accomplished :)

Tomorrow I will meet up with the CEO and COO of EWH who have just arrived in Kilimanjaro Airport today. They spent their last 2 days at Bugando Hospital in Mwanza (by Lake Victoria). They are looking to establish a BMET program there which trains local Tanzanians to become Biomedical Equipment Technicians. While the EWH program is great for the hospitals, the downside is that we are only here for a month out of the summer. The BMET program provides long term engineering presence in the hospitals.

Updates Finally!

So now that I have some time, I have some updates for you. In a previous post I talked about the surprise visit I planned on the Arusha house. Since I was tipped off that some students had been sleeping in late and leaving work early, I had to put an end to that behavior and explain to them how serious the consequences were. Without hesitation, the students would be terminated from the program. If terminated the would need to pay for the airfare back home (roughly $1000) and pay back the financial aid they received for the program (and that adds up to multiple thousands with Duke Engage, around $6000, if I am not mistaken). Again, this is serious and I don't want to send anyone home.

Imagine how surprised I was to find ALL of the Arusha groups in the house at 9AM that morning. Busted. They all thought they did not have to go to work that day because it was a holiday (Nane Nane, a farm holiday). However, the day before I made it explicitly clear that they still had to go to work and the hospitals don't just "shut down" on holidays. Despite my warning, I still find them at the house at with some students still sleeping. I gave them a very stern lecture on their work commitment to EWH and emphasized that this behavior was not acceptable. I told everyone that it is expected that they work from 8AM-3PM (really should be 8 hours though) at a minimum.

Since I was heading to Karatu Hospital that morning (about 150km from Arusha), I left immediately after my speech and told everyone that I expected they go into work that day. I got some VERY apologetic texts from two of the four groups. I was glad that they took my warning seriously and I was happy with the apology because it was the first offense of those two groups anyway.

I'm very happy my talk with the students resonated and they took their work seriously from that point on. Some of the students that I knew were guilty of sleeping in came clean to me and admitted that they made a mistake. I really appreciated the honesty and there is no longer a need to pursue disiplinary action with them as long as they keep up the correct working hours.

So on Friday, ALL of the student groups went to work at 8AM...except one. He apparently went out the night before and got drunk. He was so hungover the next morning that he did not go to work until 10:30 AM on Friday. I couldn't believe it. After I made it so clear at how serious this situation is. I was furious. This student also tried so hard to hide the fact that he wasn't working that I had to resort to another surprise visit to catch him off work.

As punishment, I asked him to come in on Sunday and make up the day that he missed. He did not take that well at all. He accused me of targeting him and said how unfair it was to have to come in a whole extra day for just being 2.5 hours late...Well, to EWH, extreme tardiness has the same consequences as an absence. Unfortunately, I can't even confirm that we went into work after my surprise visit to the house on Thursday. Having him come in that extra day is very lenient compared to the other option of sending him home.

I'm writing this from a coffee shop in Arusha right now. Since today is his make up day at work I've been checking up on him to make sure he is there. It really saddens me that I can't trust him and need to check up on him like a mother would. But I've been given too many excuses and been lied to too many times to trust that he makes up his honestly.

NOW, the post that I would have written had this mess not happened:

I visited Karatu hospital and that really good visit with them. The students there are doing so well. When I came by they were working on their secondary project: installing a laundry room for the hospital. Before they put this washing machine back into working order, the hospital would wash everything by hand.

The hospital also had another washer (but not spinner) that they Karatu boys had fixed. The fix included just cleaning a very clogged pipe. I want to point out that the water for this machine is heated by burning wood. The amount of smoke in this room was almost blinding. It's amazing that this washing machine exists. Even still I'm learning so much about the third world.

Here are some views of Karatu hospital. The landscape is very different here. It is VERY dusty. Among our group it holds the nickname "The Red Planet" because the dust will turn your clothes and shoes red and Karatu hospital is so isolated from the other hospitals.

Another shot of the hospital.

I noticed so many animals around here, much more than in Arusha. Here are some puppies and their parents hanging around on the hospital grounds. They are cute but extremely unsanitary. The laundry unit used to put out their clothes and sheets out to dry on the ground, over the dog poop. The Karatu boys installed clothes lines so now the hospital can hang the things they just washed instead of putting them out to dry on the ground.

The Karatu boys found an owl the previous day at their hospital. They found it lying on the ground with a broken wing and most likely a concussion. They kindly took it back to their house and tried to nurse it back to health. Here they are trying to feed it an egg. It was not really receptive to the egg, but it drank the gatorade we gave it later.

It's a very cute owl. They named him Goodwin. In Tanzania owls however are a very bad omen that means death. When they showed the owl to the hospital staff, they were met with screams and the staff running away!

Unfortunately, Goodwin died the next morning :( It's okay because he was unlikely to ever fly again since his wing was broken at the joint. We looked up online how to treat him and we found that it was better to euthanize the owl because it would never get better from this kind of injury. Very sad because Goodwin was so beautiful and soft.

Going back to Arusha from Karatu I usually take a NOAH. It's a car that comfortably seats 7 passengers (but they try to get in 8) and makes the journey non-stop. With the NOAH I can make the trip in 3 hours while if I took a dala dala it would take 7 hours. The NOAH is a little more expensive, 7,000Tsh versus 4,000Tsh but the extra shillings are well worth it.

Here's just a picture I snapped while driving back to Arusha. You can see some of Lake Manyara National Park in the distance. Last year I did a 2-day Safari there and the Ngorongoro National Park. 

This morning, on my way into Arusha I ran into a puppy. I stopped to pet it but then it started to follow me! I guess if you show an animal around here kindness, you instantly gain a friend. Wow, it was so cute. I wish I could take it with me but I slipped through a fence and closed it before the puppy could follow me further. I never saw such a look of disappointment before :( Poor little guy.

I'm safe! Just taking care of some things...

I thought it would be better to write up a quick post than no post at all. I've been dealing with my students for slacking off work and it's been time consuming and stressful. I will update on the situation when it's more or less resolved.

Other than the disciplinary problems I've had to deal with, things are good :)

Here, have another kitten picture for checking the blog!