Giraffe at Lake Manyara

My Awesome Safari Group: Farah, Bob, Ruvi, Andrew, and Myself

The stream I walked by everyday to work

Simba

I’ll post a link to an album shortly. Lots of small things to take care of at home; driving my brother, DUMUNC, meeting friends, and just getting back to not speaking Swahili (its surprisingly tough!)

Thanks to everyone who read my blog, kept in touch this past summer, and kept me feeling at home!

Its a strange feeling sitting in my living room with my family, talking about Tanzania as if it were a million miles away; less than 24 hours ago I was living there.

Coming back, I feel great to see familiar faces and services, but it doesn’t feel right. This must be the reverse culture shock they warned us about. Hopefully it doesn’t last too long, I’m ready to get on with my life.

Of course,that doesn’t mean the end of this blog. Many of you have requested photos and such, so I’ll be shortly posting a bunch of pictures and what not as I get over my jet-lag and some work I need to get out of the way.

Kwaheri Tanzania (Good bye Tanzania)

EWH Summer Institute program is meant as a way to bring together eager engineering students who want to work for one summer in the developing world (and all the cool experiences that come with it) with hospitals that have lots of broken equipment. Our purpose isn’t only to go and repair the equipment, but also train the staff in how to properly use it while working with the fundi to help him continue the work we do after we leave. This is to work towards removing the dependency these hospitals have on NGO’s coming in and fixing their stuff. We strive to create self-sufficient hospitals by doing things all locally, that’s why I haven’t just ordered an intercom system off of Amazon.com (which has been really tempting) and spare parts from other medical stores.

So how do we help create a system of sustainability? I think the first step has to be with the staff of the hospitals, teaching them how to properly use all this donated equipment. All too often, I’ve seen staff members either abuse the stuff to the point where I’m surprised it still works, while at the same time watching staff cower in fear of pressing a button they haven’t been taught to press. Some of the work Nabil and I have done is training staff in order to maximize their use of the equipment. Whether it’s through basic maintenance or troubleshooting, we have always tried our best to explain what we discovered the problem to be, and what to do if the same thing happens again. Whether or not the staff understands will be seen by next year’s group and the amount of equipment they have to look at again.

After the staff, we were instructed to work with the fundi (what they call the engineers/technicians, anyone with technical skills). Some of the hospitals have fundis that have been working closely with the EWH volunteers, and I’ve heard some great stories of how their combined efforts have solved previously abandoned problems. I really wish we had someone to work with, but our ‘fundi’ Evans has been basically nonexistent. Before today, I had seen him at the hospital about 2 weeks ago. Throw in the fact that he has been a driver most of his career and learned some electrical work that got him promoted, he doesn’t have the expertise or the interest in working with us, so unfortunately a lot of our work has been flying solo. It isn’t unfortunate that we had to work alone, Nabil and I work great together and have had a ton of fun, but unfortunate that a lot of basic skills that could have been taught or developed are now lost.

Finally, there has to be a mindset in the hospital to create an environment where equipment is essential for patient care. For Marangu Lutheran, the fact that they don’t have a real fundi is a big reflection on this idea, you can make your own conclusions.

Marangu Lutheran is part of the ELCT, Evangelical Lutheran Churches of Tanzania. This group is HEAVILY supported by a German charity organization, and so we see nearly 95% of the equipment at the hospital being donated (and German). Because nearly all the equipment is donated, its old. We recently repaired something that was manufactured in West Germany. That’s before the Berlin wall fell. Before I was born. It’s OLD.

So out of this system of the charity donating equipment to the hospital, you can lay a lot of the problems you see in the hospital to either side of this relationship. The donor groups often don’t do a good job donating (I’ll expand on this later), and the hospital doesn’t take care of what they do get.

I’ve already elaborated on a lot of the problems the hospital has with equipment maintenance, repair, and training. You need more fundis, and you need to create an environment where equipment is necessary for patient care. We don’t have that environment where the doctors respect the equipment, and you don’t have the hospital willing to spend any money on maintaining it. There are two traveling fundis (one of whom we worked with today, GREAT guy with lots of insight; a lot of what I’ve written is biased by his observations) that are hired by ELCT to go around to the hospitals to repair the equipment, very similar to us. They do offer maintenance services, but the hospitals either can’t afford it or don’t want to spend money on it (I’m not really sure which it is, I’ve seen too much evidence for both cases). The fundi, whose name eludes me, was only at the hospital today because the German organization paid for him to go to the hospital and fix some of the stuff the hospital wanted donated again. Perhaps I’ll relate the awesome fix we did later.

So apart from the hospital having issues with money and culture, the donor groups aren’t completely in the clear either. Marangu Lutheran is fairly lucky that their equipment comes from Germany, because Germany has very comparable voltage/frequency as Tanzania (except for the random power outages and power fluctuations). A lot of stuff donated by American hospitals comes as is, which means that the equipment would get fried by the 220 V trying to power a 110 V system. Usually you only need a single step down transformer to convert the voltages (you can’t change frequency, but except for motors, many systems aren’t heavily affected by a different frequency), but hospitals are almost never supplied transformers and don’t want to buy them.

So, problem 1 from the donors is ignorance of the operating conditions. Its not entirely their fault, because it is a donation after all, but a lot of stuff gets left in the storage closet as a result, and you almost create a black hole of medical equipment as a result. Problem 2 would best be characterized by disposables. Recall the last time you were at the doctor’s office. For almost every thing that came into contact with the human body, you have something that needs to be tossed out. The cover for the ear lamp, the needle for the injection, etc. A lot of the advanced equipment, like ECGs, have similar disposable parts (disposable pads), but disposables are almost never included with the donations. As a result, you either have something that can only be operated for a few weeks, or something that never sees the patient. Very similar to problem 1.

Finally, all these machines come with manuals. I’ve tossed too many of them out in all my electronics shopping to believe otherwise. However, when you ask for a manual when trying to troubleshoot a machine, you rarely find one. And if you do find one, its an User’s guide that gives rudimentary instructions on how to operate the machine. We encountered a dryer last week that kept giving an error, Drive System Fault, which really means nothing to me (or Nabil, Larry, and Gordon). The user’s manual had no section on troubleshooting error messages, and the internet had nothing. A lot of fixes could be easily remedied by supplying these manuals; but rarely do they make it to the benefactor. There are now organizations that have created manual libraries for this purpose, but we don’t have a fundi that would have the initiative to contact them.

This system is clearly broken on both sides. The donations are often incomplete or missing a critical component that can’t be readily acquired. The World Health Organization wrote up some guidelines on donations back in 2000, but clearly they haven’t been followed, and there is no real effective enforcement of these ‘guidelines’. What equipment the hospitals are able to get, they don’t know how to take care of it, and sometimes it feels like they don’t really care. From EWH, they are getting free labor (the hospital really hasn’t provided us anything, DukeEngage, through EWH, has paid for basically every aspect of our visit here. Thanks!), and the ELCT fundi only comes when ELCT pays for it. There is reportedly a year old invoice for the hospital that the fundi is still trying to get paid for.

Perhaps its the job of people like me to fix these problems. Perhaps they are beyond my control. All I know is, this system is creating a dependency for Africa that won’t help them develop further. I’ve heard that in parenting, if you realize a child is dependent, you take it away and help them cope. But these organizations would be hard pressed to simply stop donating equipment, because then the patients would suffer. And these hospitals have been chanting “No money” for years. I was looking at a broken infant incubator that is powered by lightbulbs. I needed to replace four, and asked if the hospital had any. “No money”. I went to town that afternoon and spent 1000 Tsh (less than $1) for four lightbulbs that now allow the ward to use this machine.

This is an incredibly complicated problem, with no clear solution. The days when these problems bog me down, I walk into the wards and see some of the machines I worked on being used to help a patient. That makes this entire trip worth it. But for how many patients it can serve after, that is the problem that worries me.

This past week we had the opportunity to start wrapping up on a lot of the equipment we had difficulty with. We were finally able to find a replacement backup battery for a pulse oximeter (measuring the oxygen concentration in the blood) that was then placed into the ICU the hospital is trying to start. They still need some ECG’s and a respirator before they feel comfortable calling it an Intensive Care Unit. We are still working on developing some replacement ECG pads. We have two working machines, but no pads. Disposable parts are a huge reason why a lot of the machines that have been donated don’t get used. Because the hospital can’t afford the machines, they generally can’t afford money on disposables, and so there are some projects working on developing pads that can be built from local materials. Unfortunately, ours haven’t worked out so far.

Larry (our professor) and Gordon (his British friend) also made another stop at our hospital this week to help us with some of the equipment that we couldn’t finish ourselves. We looked at a heat therapy machine, laundry washer, and a surgical bed. Unfortunately, we went 0-3. As sad as telling the staff we couldn’t repair the machines was, internally, I felt good knowing that Nabil and I had developed a good sense of what we could and could not repair with our knowledge and that we had been able to work pretty self sufficiently up until this point. While its a shame that Larry and Gordon couldn’t help us finish repairing all the equipment, an important part of this trip has been learning my limitations given my knowledge, tools, and time.

After their short stop at the hospital, we had a chance to swing by Moshi to pick up wire for our intercom system. After spending the day bouncing from shop to shop, following strange little boys who told us their older brother had exactly what we wanted (I heard that one, one too many times), I was extremely pumped to start putting this intercom system up across the hospital. Its the project we have spent the most time on, mostly because the hospital was really small and didn’t have a ton of machines in general. Also, because last year’s group probably did an awesome job, most of it was working, so our time has been spent working on this secondary project.

Friday morning I jumped out of bed, really excited to start wiring the hospital (ok, I wasn’t excited to do the physical wiring, but was excited that our project was going to start wrapping up). When we got there, I had to make a quick tour of the hospital, testing an sterilizer with a broken pressure gauge and looking at a water bath that wasn’t boiling, while Nabil finished installing the little Barbie buzzers we found in town into the phones. Surprisingly, things like simple buzzers and wires are not easy to find, and a store like Radioshack would have made this project a joke. But alas, we don’t have all those luxuries. As Nabil and I like to say, Karibu Tanzania (welcome to Tanzania).

When I got back to the office, we started to test the wire, before we put it up. Half the wire couldn’t short from one end to the other. So half our money spent on this wire was now junk. We would have to cut open the wire to find that opening. Not fun. OK, with the wire we do have, let’s test how loud the buzzer can get. We set up a mini system in our office, with wire going all over the place. We press the switch and….nothing. We test all the wiring again and try again…nothing. Turns out the wire had too much resistance over its entire length. This meant that someone on one end of the hospital could not phone someone on the other side, because the wire would eat up too much power for the speaker to work. AAARRRGGH (insert random expletives here).

Things were starting to look down for us, when the canteen manager walked into our office. Babie (pronounced Bobby) was actually a local hotel owner. I didn’t believe him at first, because he looks like he is 24 (he’s actually 26), but he inherited it from his mother when she got sick; leaving school in Nairobi, Kenya early to do so. He took over the business of running the canteen at the hospital as a project to expand. He told us the hospital then started changing the rules on the contract, increasing rent, changing regulations, and doing things to the point that it was running a loss each day it was open. So our canteen, where we had lunch every work day for the month, would be closing our last week on the job. AAARRRGGH (insert more random expletives here).

He was closing shop for the day and was waiting for a final sit down with hospital administration, so we spent the next hour talking. Nothing in particular, but enough so that he invited us for dinner that night at the hotel. Things started looing up. After a little more brainstorming for our intercom system, we headed home, hopeful that the night would make up for a really frustrating morning. We got to the lodge (Babylon Lodge) and had a few drinks, talked for another good hour, and headed down for dinner. Because we were dining with the boss, Nabil and I got the full treatment, with a 3 course meal, waiters there for our every whim (we didn’t have any though, so it was kind of a waste) and a great conversation with a young Tanzanian man, really hoping to change the community around him. It was really refreshing to talk to someone who had hope for the country that wasn’t trying to sell us a hike to Killimanjaro or get us into a taxi. I felt at ease, and the western dinner he made us felt almost foreign to my mouth. Delicious.

It was an interesting day that started off extremely hopeful, dove into failure, but finished off real nicely with a new friend. Almost like this entire trip, I could talk another couple paragraphs about the parallels of the day to culture shock. But, now I’m off to Moshi to see what we can do to get this darn intercom working. I’m almost tempted to buy them walkie-talkies and call it a day. Who knows what will come out of it. With less than a week remaining, I gotta make every day count.

6 Days Left!

Furnace: There was a tiny furnace in the dental lab, which they told us was used to melt metals. When we got it, it wouldn’t turn it on, so Nabil and I took it apart, couldn’t find anything wrong, and put it back together. Tada! Working furnace. Then we sat around for an hour watching it get up to 900 degrees Celsius (!), just to make sure it wouldn’t blow up or anything. I appreciate the fact that sometimes, all the thing needs is a little maintenance, which most of the time means tightening a few screws and readjusting a wire here and there. No big deal.

Curtains: There were some curtains in the general wards that had broken wheels. Among the two that we found, both had separate, but irreplaceable issues. So we used the parts for one and were able to the other. One working curtain is better than two dead ones.

Suction Machine: During Inventory, we found another suction machine in the major operating theater. Turns out the knob for the vacuum power needed to be tightened. The sad thing is, they didn’t want to touch it; so while it was a simple fix (and we taught them what to do if it happened again), we were needed for that one.

Mercury Sphygmomanometer: It was missing the little bulb used to pump air into the cuff. Found another bulb in storage. Good to go.

Just a couple of the things that we did. Notice, none of these took incredible engineering skills. Just a screwdriver, some patience, and the courage to take something apart you have never seen. It makes me realize a bit about why technicians are so difficult to find here. The stuff that we do isn’t high skilled labor, but there aren’t people who want to do that for a living. Anyone who does learn the technical aspect of it will probably continue their education and either work in a bigger hospital (I hear KCMC, the biggest hospital in the region, has a team of 20 technicians), or will be intelligent enough to find their way into administrative jobs where they get paid more. The current technician at our hospital is just a electrician, who used to be a driver, but somehow got the job of electrician. Puzzles me as well.

On the more technical side, we were able to come up with a solution to the intercom problem the hospital gave us. To those I haven’t mentioned it to, last year’s group installed 6 telephones in order to help different hospital departments communicate with each other. Unfortunately, when they pressed the ringer for one, the entire hospital would start ringing, so they wanted us to install something which would signal only one other person. We came up with a pretty simple solution, but we needed 30 switches and about 250 meters of speaker wire. We were basically going to run a separate wire on each phone and some switches. I’ll put up a diagram sometime this weekend.

Anywho, we had a huge problem finding these simple switches; with no DIY culture here, things like Radioshack (or I think they have changed their name to ‘The Shack’) don’t exist, and the normal hardware/electronic stores here have the standard wall switches and what not. We had already spent a day in our town of Marangu looking for them with no luck; and had wasted a day last week fruitlessly looking. Yesterday we went to this one store we had become friends with, owned by a Mr. Shah. Mr. Shah (his parents were Gujurati -or Indian-, but he we brought up in Tanzania) was a pretty nice guy with a lot of good stuff in his store for us, and yesterday he basically closed down his shop and walked with us around town, taking us to the shops of all his friends to find us the switches we need. After about an hour, we found 17, which should work for now.

That’s one of the things I will miss about Tanzania in the US, is that when you can’t find something in one person’s store, they will gladly walk you over to someone else’s store to help you find it. Whether they end up getting a little commission on it, I don’t know, but it still has been extremely helpful, especially when we aren’t adept at the language. Sometimes, they end up leeching onto you and won’t let go of your hand (guys feel comfortable holding each other’s hands while walking down the street, one part of the culture that hasn’t grown on me), but for the most part, people here want to help you.

Today we are going to finish up a couple fixes with the supplies we bought yesterday, and hopefully start figuring out how we are going to get this intercom system set up. Only 2 weeks left in this country, so I gotta make it count!

Sunday, after having explored Moshi for the weekend, Nabil and I went to a local pub to grab some dinner. While waiting for our French Fries Omelets (which was delicious), some random drunk guy walked through the bar, stopped at our table, and started yelling at us in Kiswahili. We had no idea what he was saying, so it was pretty easy to ignore him, but some of the local men got angry and chased him out. On his way out, he drunkenly pointed to his skin, pointed at us, and made an angry face. Universal sign of racism. This trip to Africa has been absolutely incredible so far, but to say it was without scary moments and challenges would be an absolute lie. But it all comes with the trip, and really makes meeting the nice people so much more…nice.

On the hospital side of things, we have been progressing fairly slowly; things like no power, lazy doctors, and a very laid-back environment have made getting equipment to work on a very slow and almost painful process. However, we have had the good fortune of returning nearly every piece of equipment we have touched. Since the last post (which was technically yesterday, but count it for last week), we fixed and tested an oxygen concentrator (remind me to show you a video of that, very cool results from our test), figured out the wiring on the intercom system, repaired more microscopes and sphygmomanometers, and even looked at a few computers (though most of them were dead, nothing to do).

My favorite project to work on has been the suction pump, used to suck away flowing blood and other bodily fluids during surgery. When the doctor gave it to us, it was dirty and rusty, from having sat in the corner of a closet for what seems like years. After replacing the plug, we got it to turn on, but no pressure was being generated. Nabil and I went right into the machine, removing all sorts of screws and plates and looking for the answer. Turns out it was nothing internal, but a broken jar they were using for it. Imagine a large clear cookie jar, about 1.5 feet tall, 6 inches in diameter, with a special plastic lid that provides the gateways for the tubing. Now add about 4 large cracks around the jar from someone dropping it, and the 3 pieces of glass being held together by surgical tape.

Nabil and I were able to pry the plastic housing off the jar, and have retrofitted it against a plastic cookie jar we found in Moshi over the weekend. Normally in the US, doctors would accidently drop the jar and order another one, but the special jar with its specific height and diameter would cost several hundred dollars. In Tanzania, it would be nearly impossible to find that jar because the equipment was donated, and so production of its components stopped years ago. We could have called some guy in Dar Es Salaam to make a new jar, but the costs would have been too high, and the town is nearly 9 hours away by bus. So, we cut a hole in the top of the cookie jar with our soldering iron (we don’t have any saws, and the box cutter wasn’t cutting it), and epoxied the plastic top of the jar into the lid of the cookie jar. After waiting a day for it to dry, we are testing today to see if it works. A cheap solution; a little messy, but effective.

We were going to test it yesterday, but it was Saba Saba, or 7/7; a Tanzanian public holiday. That meant most of the doctors didn’t show up to the hospital, and the doctor-in-charge told us to go home. Disappointed (yes, we were actually disappointed from having been sent home from work), we took the time to explore the waterfalls in the area. Nabil and I basically have the most gorgeous hike to work, a 20 minute walk through a forest, where we pass some streams and a large waterfall, before being dropped off in front of the hospital. There had always been some other paths that deviated from it, but we never had the chance or time to explore them until yesterday. We spent a few hours just taking random turns at forks, making our own paths, climbing rocks and falling into water, just to find some spectacular views of the water that runs through the town. I felt like an 8 year old, with absolute freedom to go anywhere and no schedule of any kind for the day. We found some great hiking trails, and plan on inviting some friends over this weekend from the other hospitals and taking them on the same hiking paths we found.

But now its time for breakfast and morning prep before work. We are testing our ‘Frankenstein’ jar for the suction machine today and doing some inventory; which will give us a better idea of the hospitals resources, and maybe find some more projects on the way. All in all, life is good.

Also, shout out to my mom, July 1st was her birthday! Happy birthday mom, sorry I wasn’t with you to celebrate!

After waiting nearly 6 months, I have finally arrived in Marangu, Tanzania; home of Marangu Lutheran Hospital, where I will be working for the next month.

This morning, we boarded the buses at MS-TCDC, said a sad farewell to our host families, exchanged gifts, bid adieu to our friends, and departed to different parts of this beautiful country.

Marangu is a town high up near the slopes of Mt. Kilimanjaro, which means an extremely rocky/uphill road to the city from the base of Moshi. As one of the major departuring points towards the peak of Killi, the small town is a major stopping point for would-be climbers. All in all, its an extremely beautiful (but very small) town boasting two waterfalls and lots of natural greenery. Definitely not a bad place to be working.

After dropping Ruvi and Hannah off to their hospital in Rhombo, we set off towards Marangu Lutheran, where we met with Njua, the secretary. Technically, Njua means secretary in Kiswahili, but since he has never really revealed his name to either Lora or ourselves, that is his name! He was extremely friendly and polite, and gave us a quick tour of the facilities. It seems like the last group of students who were here last year made some incredible repairs, and so there are some high expectations for Nabil and myself.

One of the more interesting things is that last year’s group, as part of their secondary project, built an intercom system for the hospital. Well, maybe I should back up a bit. The secondary project is something every hospital group is supposed to endeavor in their ‘free time’ at the hospital. It can be anything from painting the children’s ward, to organizing storage closets and buying extra furniture for the hospital. Basically, its our non-technical contribution for the hospital, and we have been given a $100 stipend by EWH (thanks!) for this project. Now, last year’s group devised an intercom system between the different levels of the hospital (remember, its on the hill, so almost everything is built vertical), which was a hit for two months, before it failed. Nabil and I are probably looking to repair the system and perhaps expand it for our own project. But who knows, depending on the situation we see, we might see something else.

After the quick hospital tour, we were taken to our magnificent house. At our house, we were lucky to be offered a home with 3 rooms, 1 bathroom, a living/dining space, and a fully equipped kitchen. Score (thanks EWH!). We definitely have some of the nicest living conditions this month, which is a nice turn of events since I think we were with one of the poorest families for the first month. While they provided an excellent stay and experience in Makumira, I won’t say it wasn’t without complaint. Anywho, we met Tea (pronounced Tay-uh) the housemaid and Shao the security guard. Shao is provided by the hospital, since the adjacent home is occupied by a doctor, but Tea is an optional helper, for about 5000 Tsh/day. Nabil and I are currently figuring out how often we want her here. Probably twice a week.

After we acquanited ourselves, we tried having a short discussion with Tea, but quickly realized the limits of our Kiswahili. Seems like we still have a long way to go. After trying to communicate with her to have her cook our dinner that night, Nabil and I headed out into town to buy a powerstrip (so we could charge both our computers at once) and some food. Once we had picked everything up, we went to open the door to our house to realize…it was locked. We waited out on the patio for Tea to return from her grocery shopping for about an hour. Smooth.

After learning how to cook beef stew (we will be cooking some days ourselves) and eating, we cleaned up and unpacked. Later in the night, when I went around the house turning lights on to figure what did what, I accidently overloaded the home and the fuse switch went off. While the house is real nice, we’ll have to be very mindful of what is on and what is off, to avoid that happening at random times. I think it was the fact that I was boiling water for tomorrow that really pushed the breaker.

Actually the water heater was broken. They fixed it for one day, but its still broken. Back to the bucket baths for a week until the hospital can get a new one.

Lots to learn, loads to do. I’m super excited. We have a huge task ahead of us in trying to help our hospital out, and living in Tanzania with only each other will be a touch task in itself. I’m looking forward to the challenge.

PS – Because I know everyone was super concerned about it, my bed is big enough! YAY!

PPS – After two days in the hospital, we had fixed an incubator, dentist chair, blood pressure monitor, and a microscope. The biggest thing hindering our ability to work is the lack of electricity. And Africa Time.

On Friday, we did do our second hospital visit. I wasfinally able to get into a tour of the facilities and saw some pretty dismal conditions. For example, the difference between the dirty outside and the ‘sterile’ surgery rooms was a solid white line. In order to cross it, I had to change my shoes. Seriously, it was a great deterrent for any potential dangerous activities I may have pursued (though if anyone reading this really knows me, they know I’m pretty risk averse). We decided as a group that none of us want to have any type of medical procedure done here if we had the opportunity.

In more positive news, Roshan and I were able to sit down with a centrifuge. The lab technician told us it was turning on, but the motor wasn’t turning. Turns out, there are small carbon ‘brushes’ that rub up against the sides of the motor to drive current so it rotates. They weren’t making good connection to the actual motor. Normally, we would have outright replaced them, but because we were only there for one day, we didn’t have time to go to a hardware store to get two more outfitted, so we simply switched the two existing one as a temporary solution and left a note on the side of the object for the next people. This way, they could quickly repair the known problem, as opposed to troubleshooting it all over again.

I also got the opportunity to look at the bedside monitor I was working on last time. After deciding it wasn’t a mechanical problem with the cuff, and once we got the power going, Michelle and I took it apart thoroughly. After poking around for a half hour, Larry helped us figure out that the pneumatics (the air/electronics interface) were broken. These parts were crucial to help the machine measure things like pulse and blood pressure. They are very specific parts, and even if we were able to miraculously find them, it would have been nearly impossible to replace them on the machine with the tools we had. My first triage case where we decided that this piece of equipment had to be marked as unrepairable. Sad.

As for the weekend, I went to Lake Manyara and Ngorongoro Crater. We saw elephants, zebras, wildebeasts, giraffes, hippos, lions, flamingos, monkeys, antelopes, hyenas, scenery, mountains, lakes, and some of the most incredible natural views in the world. Really, come find me and look at my pictures. Even without a fancy DSLR, I was able to capture some incredible sights. I can’t say enough how beautiful the place was, and I wish I had the words to describe it, but alas, I’m only an engineer, not a poet.

Ended the weekend with a chance to give my dad a call for Father’s Day (I hope you remembered!) and watched some more World Cup Soccer. I’m geared up for my last week at TCDC, with the beginning of my actual hospital work starting next week in the city of Marangu.

Below is an entry I wrote last Thursday; but being gone Friday [Another successful day at the hospital. I fixed a centrifuge!] and the weekend at the Safari, I didn’t have a chance to upload it. Enjoy.

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There’s a cricket in my room

Seriously. Every night, around 3 or 4am, it starts going off. Real loud. Its been driving me absolutely wild. I can deal with the roosters outside, the dogs barking, or even the chorus of crickets that are far away, But there’s a cricket in my room. And I can’t find it. And as a result, haven’t been sleeping awfully well. It has mad me really grumpy and angry and hating crickets in general. A ton. [EDIT - Nabil found it underneath his suitcase. Win.]

In other news, we had a mini Kiswahili test today at the soko (market). Basically, we were each given 1000 shillings (about 70 cents) to go buy fruits and vegetables from the native folk, who have no idea we are bunch of students trying to learn swahili, they only know that we want their produce. I was able to do some simple bargaining, although many of the prices were very standard, and with some of the fruits being so cheap, there wasn’t really too much bargaining to be done. But, I did have an interesting experience with the tomato lady.

To preface, there is a popular epithet for all those foreigners who come to Tanzania: Mzungu. To the Hindi-speaking folk out there, it is the literal equivalent to Ghorra (spelling? Not the horse), ie white person, foreigner, idiot.

So I approach the lady with 500 shillings in my pocket, and there are some piles of tomatoes I want to purchase. Note that this entire exchange happens in Kiswahili:

Me: How are you today?
TL: Excellent. How has your morning passed?
Me: Nicely. I would like some tomatoes. How much do they cost?
TL : One pile is 200 shillings.
Me: That’s too expensive. How about 100 shillings?
TL: No, I give you a good price. One pile, 200 shillings (she starts to get frustrated, because she has to repeat herself like 5 times because I can’t understand her dialect).
Me: 2 piles, 300 shillings?
TL: No. 2 piles, 400 shillings.
Me: I have no money. I am a ….(searching for the word for student in my mind)
Roshan (walks up behind me with a big grin):: Mzungu!
[At this point, there is a large crowd behind me, watching this awkwardly tall Indian man try and bargain in Kiswahili. They all explode in laughter at Roshan's comment]
Me: No no no! I am a student. Not mzungu, not mzungu!!

It goes back and forth for a little while longer, and she eventually gives in to giving me 2 piles of tomatoes for 300 shiillings. Not bad for only studying Kiswahili for 2.5 weeks. Bargaining success!

World Cup fever has also gripped the area, though my host family doesn’t seem largely interested in it. They still prefer their spanish Telenovellas (which I have now weened myself off of). Instead, I find myself reading at night, something I haven’t really enjoyed doing in a long time. Currently working on the Three Musketeers by Alexander Dumas. Really well written, engaging from the beginning, and I really enjoy the fast pace, even though it does span over 700 pages. And although D’Artagnan isn’t a Musketeer (yet), why is it called the Three Musketeers? I feel like D’Artagnan is as skilled as Athos, Porthos, and Aramis, and so it really should be called the Fourth Musketeer, or something along those lines. Or maybe I’m not far enough into the book yet to make that judgement. Who knows.

Taking a bus in the morning from TCDC, we arrived around 8:30 in the morning, to a small hospital campus. All one story buildings, many of them disconnected, it wasn’t nearly as impoverished as I had expected. One of the head administrators was waiting for us, and greeted us with a pile of broken equipment.

I first started on an Oxygen Concentration Machine, used to increase the oxygen concentration of normal air to nearly 95% volume. We turned it on to hear very little output air, but the intake fan was working. So, good power supply. We opened it up, turned it on, and found that the air was getting plugged behind a closed filter. According to Larry, its an extremely common problem, but we still had to clean it. I was able to pry the filter off the stand, but the soft piece of foam had turned in to black rock of dirt, dust, and bacteria.

After cleaning a couple of those filters, I left Roshan and Nabil to finish the rest as I was reassigned to work on taking two torn up and broken wheelchairs and turning it into one working wheelchair. Our finished project 20 minutes later was a Frankenstein of a machine which sported 3 different types of wheels, two different brakes, and a lawn chair as the main seat. Yet, it worked, and I know it was an important addition to the hospital’s inventory.

After that, I helped out with finishing off some oxygen concentrators (again), and then started off on repairing a bedside blood pressure monitor. First, the machine wouldn’t start working, so the first thing to do was make sure all the plugs and cords into the machine were working (they were), and then open it up and see what I could do. Yea, that was the mindset. With only one electronics course and a week of training under my belt, Larry truthfully described this as good guesstimation and creative McGuyver thinking.

Michelle and I spent the better part of the day trying to figure out which screw we hadn’t taken out and trying to pull the power supply out so we could test it. After a good hour or so, we got it out, tested it, and really couldn’t figure anything out. We put it back together, turned it on one last time, and…IT WORKED! Or rather, it turned on. We have the display turning on, and the machine is able to activate the blood pressure cuff, but testing it on myself, it maintained a 170 mmHg presure on my arm, and kept it there. No reduction in pressure. 1 minute later, my fingers were turning blue from the lack of oxygen, so now our issue is figuring out why the machine is trying to amputate my arm.

All in all, the day was a success for our entire group. We repaired 4 oxygen concentrators, 2 wheelchairs, a bench, a ventilator, an anesthesia machine, suction pump, blood pressure cuffs, and a teapot. Not bad.

Caught dinner that night in Arusha at this nice Indian restaurant, Big Bites. Came back, danced at the party held at TCDC, and called it a night.

Saturday and Sunday were real chill, finally got the chance to take things slow and easy after a really intense first week and a half. Caught up on my e-mails, some of my DUMUNC work, read a bit of the Three Musketeers (really good book!).

Other than spending all day Saturday watching the World Cup, the other highlight was grabbing lunch with Roshan, Christine, and Larry. We went off to this sketchy roadside restaurant, ordered in Kiswahili, and ate a really (cheap) good lunch. Aside from getting a fried fish (literally, nothing had been removed. I swear they just took the fish, dumped it in oil, then put it on my plate), we heard a ton of stories from Larry’s youth, about his adventures as a TV Repairman, as well as his numerous times hitchhiking across the US. If I were to ever describe the quintessential American to someone overseas, I would give them Larry.

But now its time to start week 3 here in TZ. Hope everyone at home is having an enjoyable summer/winter (depending on which side of the equator you are on!)

AJ