My Time in Tanzania. Eric Stern Canaan Fellowship 1 Final Summary

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Ashlyn Riley
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1 Eric Stern Canaan Fellowship 1 Final Summary My Time in Tanzania Thinking back to this summer, it s hard to grasp that I spent nine weeks living and working in Northeastern Tanzania. Being back at Cornell, I see the other eleven students that I shared this incredible experience with and as I get back into my normal school routine, my everyday African life seems so far away. This summer is like a dream that took over my memories of the normal summer I would have had in the States, a dream that I will try to summarize for you now Everything started on May 26 th when I boarded a plane to Amsterdam from Atlanta. After about a nine-hour ride, I landed in the Netherlands and met up with the eleven girls that I would be spending the majority of my summer with (I m not sure why, but I was the only male in the group). We all got on the flight to Kilimanjaro International Airport and after many sleepless hours, we finally arrived in the small town of Moshi, in the United Republic of Tanzania. The first night we stayed in a relatively nice hotel and I took what I would later find out was my last hot shower of the stay (it s the small things that I seemed to miss the most). The next morning we met the Cornell professor who was on sabbatical in Moshi and would be teaching our four and a half week class. As it was a Sunday, Professor Stolzfus decided that we should go on a little tour of the town and get a taste of the local culture. Situated about a half hour from the entrance to the Kilimanjaro National Park, Moshi is a relatively small town in the northeast corner of the country. With busy streets and a bustling population, the town center seemed like any normal sub-metropolis area, only a little dustier and with no sidewalks. After our town adventure, we headed to Prof. Stolzfus s house for an orientation of the program and then finally to our home stays. In order to really appreciate the Tanzanian culture in the short time we were in the area, every student was placed with a local host family. All but one of the girls were placed in pairs, but to avoid any cultural misunderstanding, I was placed in a home stay by myself (unlike America, men and women do not share living quarters if they aren t married. The college students I worked with all lived in gender-specific housing). Unfortunately, I didn t become as close with my host parents as did most of the other students. It s not very common for men and women to have friends of the opposite sex, and as my host father was a climbing guide he

2 2 was away for up to seven days at a time) my host mother often left me to my own devices. However, I did become close with my two host siblings. The eldest was a sixyear-old girl who loved to yell at me in Swahili, and the youngest was a one-year-old boy who loved to eat. Every night, he would run / waddle around the house asking tam?, which I later deciphered to be his way of asking for food. My host family was very gracious, loving and always welcoming, and I hope that I will get to see them again soon. The program was divided into two segments. During the first half, all twelve of the Cornellians took a class with thirteen Tanzanian medical school students at the Kilimanjaro Christian Medical College in Moshi. The class focused on general health and nutritional policy issues of Sub-Saharan African nations. The majority of the class consisted of Tanzanian and Cornellian comingled groups of four to five individuals, each developing case studies of specific problems affecting the Tanzanian population. My group chose to write our case study on the cultural, economic, and medical effect of obesity on the Tanzanian public. Unlike American culture, which views obesity negatively, Tanzanians see obesity as a positive contributor to social status. As more and more processed foods are becoming available and more individuals yearn to gain excess weight, health concerns new to the area such as diabetes and hypertension are increasing at rapid rates. The case study is available upon request. My favorite aspect of these initial weeks in the country was getting to know the Tanzanian students in my class. While in the class, there were often instances where I was the only male among eleven females and I often looked toward the Tanzanian males for friendship and general male camaraderie. I became particularly close with two of the Tanzanians, Honest and Eliezer, whom everyone called Chibwe. Honest and I worked together on the case study and became close very fast. A twenty-four year-old native of Moshi, Honest seemed to know everyone there was to know in town and often unconsciously demanded respect from older Tanzanians. Always willing to share whatever he had, I think Honest will make a good doctor and has a great sense of what the Tanzanian healthcare system needs. The second individual, Chibwe, has a very different story. Born as the third son to the first wife in a pastoralist tribe, Chibwe had spent most of his youth tending to herds of cows and goats. Around the age of ten, he began formal schooling and started to excel

3 3 immediately. In his last year of primary school, he was the only student from his distant public school to be selected to attend secondary school in the town of Arusha. A year or two before his graduation from primary school, Chibwe witnessed the death of his cousin during childbirth. From then on he knew that he wanted to become an OB/GYN and deliver the new daughters and sons of Tanzania. Chibwe also ran the entire 26.2 miles of the Kilimanjaro marathon without training. Overall I enjoyed my time in Moshi. I ll always remember my classmates at KCMC, the local restaurants, and the people I met during those initial weeks. After the class ended, the Cornellians all decided to travel together to the island of Zanzibar off the eastern coast of the country. We took a public Greyhound-like bus to the city of Dar Es Salaam and then a two-hour ferry to reach the island. Arriving to the port of Zanzibar with the sun setting off in the distance, I could tell that this was going to be a great two days of vacation. My time in Zanzibar was my first experience in a Muslim dominated atmosphere. Most of the women were wearing durkahs and the minarets of the mosques called and chanted five times a day. Although I wasn t able to visit a mosque while I was in Tanzania, I feel that I am more comfortable with the religion and the East Africans that practice it. On our last day on the island, we drove up the northern tip and spent the day relaxing on white sand beaches and swimming in turquoise waters. Although it was a little overcast, the day was great and a few of us decided to pay a few of the locals to ferry us out to a reef to snorkel. On the way back into shore, we got to witness the allure of riding in a dhow (traditional Zanzibar sailboat) as it cuts through calm water. Once our few days of travel had ended, everyone split up and traveled to their respective internships. I was paired with Brenna McGuire, a senior Human Biology Health and Society major in the only medical internship placement of the trip. Reflecting on my entire summer experience, I would say that the internship was the most rewarding aspect. While taking the course at the beginning of the semester, I learned a lot about how to help individuals in developing nations, but in the hospital I was actually participating in life-saving activities. At the Machame Lutheran Hospital, I received clinical exposure that I would not be able to obtain back in the U.S. Starting the first day I arrived on the hospital grounds, I

4 4 was welcome within any of the wards and encouraged to view as many operations as possible. By the end of my four weeks at the hospital, I witnessed over twenty surgeries, culminating in my most incredible experience of the trip during the second to last surgery. After the first few days at Machame, Brenna and I developed a weekly activity agenda based on the schedule of the hospital. On Mondays and Fridays, we would watch orthopedic surgeries, Tuesdays we would spend the day in the delivery ward, Wednesdays were OB/GYN surgeries, and Thursdays were the orthopedic clinics. During the last Monday at Machame, two of our Cornell colleagues joined us at the hospital to get a taste of our internship and witness the procedures we had eagerly talked about. After one surgery, the two girls asked to see the delivery ward and hopefully catch a mother in labor. I hinted at Brenna that she should take our peers and leave me in surgery, as she was much more inclined to spend time in the delivery ward than me. As they were leaving, one of the nurses, Margret, turned to me and asked why I never scrubbed in and assisted in the surgeries. Slightly shocked at the idea of scrubbing in, I paused for a second and then replied that I had no formal training and had never scrubbed in before. Oh it s ok, I ll ask Dr. Lyimo and see what he says. Before I knew it, I was learning how to wash my hands and forearms properly and put on a surgical gown. I was ecstatic at the opportunity to lend a hand in any way in a real surgery. During all of the previous surgeries I had witnessed, I would do little tasks like getting more gloves or help to move the patient from a stretcher to an operating table, but nothing to this degree. To outline the case: A young man, in his mid twenties or so, had been working in the fields and had cut his left hand with a machete, right below the main knuckle of his index finger. The blow had severed the extensor tendon, which made the man inept at extending the finger. The surgeon was going to make an L shaped cut around the thumb side of the knuckle, open up the skin, sew the tendons back together, and then close the hand up. One of the nurses said a quick prayer and within a few seconds, I was assisting an orthopedic surgeon in surgery. My job was to hold the skin open while the doctor sewed the two ends of the tendon back together. After he was done, he removed the patient s

5 5 arm tourniquet to see if he had accidently caused additional bleeding, and then began to suture the man s skin. As he was suturing, I used a bit of gauze to dab away blood so he could clearly see the patient s hand. The entire operation took maybe forty-five minutes and it seemed to end as quickly as it began. I ll always remember this event as the sole experience that made me extremely confident that I wanted to become a doctor. Apart from working within the walls of the Machame Hospital, Brenna and I went on two public health trips with members of the hospital staff. The first trip consisted of Brenna, the public health nurse, a Tanzanian student, and myself all traveling to the Maasai-land about forty-five minutes from the hospital. We met with health workers formerly trained by this particular public health nurse, and talked about the current issues for the Maasai in the area. The one major concern was lack of potable drinking water available. The water in the area had a fluoride level that was unsafe, and boiling the water only brought about more issues, such as inability to always have enough firewood to use for both cooking and water sanitation. To resolve the issue, the public health nurse wanted to install bone-char filtration units. This apparatus passed the water over char, which helped to remove a good portion of the fluoride. Although the first trip was very interesting, I thought the second was even better. During this excursion, Brenna and I went with a team of about twenty staff members to a Maasai camp that was about two and a half hours away to set up a one-day, free clinic. With a strong emphasis on pediatric care, the trip succeeded in de-worming over two hundred children and provided basic health services to members of the community that had been without local, modern healthcare for a while. Although my actual role in the process was very minimal, I still enjoyed seeing all of the children receive vitamins that would keep them healthy for months to come. As I ve stated throughout this summary, my time taking a class at the Kilimanjaro Christian Medical College, visiting a national park and the island of Zanzibar, and finally culminating in a great internship at the Machame Lutheran Hospital was phenomenal. I could not have imagined a better summer and I ll be sure to push my fellow brothers to apply for the Canaan Fellowship so they too can have a great experience. Once again, thank you very much for providing the resources that allowed me to partake in such an incredible opportunity.

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