A baby shower and more updates

My friend adopted a baby last month, so of course we organized a baby shower! (The collective we, because my roommate did most of the work). It was particularly special because the latest addition to our Moshi family, Thomas, was present for his shower -- and was a most willing participant in the opening of presents and being passed around, to the delight of Lena and Alya -- our budding pre-teen moms :)

I knitted a hat for Thomas -- because, even in Moshi, it can get cool! (though you wouldn't know it from all my complaints about the heat.)

He'll grow into it, I swear!

In other news, I organized another blood drive last month -- less fanfare than our first drive in November, but 12 more units and a few first-time donor colleagues of mine! A grand total of 73 this time...

Our administrative assistant donating AND chatting on the phone - typical Tanzanian-style :)

One of the Obs/Gyn consultants -- the fruits of my powers of persuasion!

Would you believe it, I'm also finding time to work :) Actually, I've been quite busy lately -- as I'm watching my time dwindle away, day by day, I'm trying to get at least 2 papers out by the time I leave, plus another reflective piece on ethical issues in women's health. Translate that to do list into what I actually do? Read and write sana (alot)! Reading old papers, analyzing our data in new ways, writing the interpretation of our results, sending to my mentors, aaaand back to square one. It's an iterative process to say the least, but at least I'm learning how to think more critically about research -- which is what this year's all about! So I can't complain..

Last but not least -- I decided! I'm going to apply for a residency in Ob/Gyn :) So I'm trying to spend more time on the wards in between all this reading, writing, and analyzing. Although I keep wanting to DO a delivery, the patients I take interest in always seem to need a C-section, so instead I assist -- but that's pretty fun too :) And I'm kind of learning vaginal ultrasound, seeing a few more 'interesting' patients with Jeff, and I even got to scrub in to a case the other day!

Life is good :) Off to start another busy week...

Camping!

I think I've camped more this year than I ever have in my lifetime!

In order to actually complete my 'to-blog' list, I'm combining both camping trips here -- the first in January to Lake Challa, on the Kenyan border northeast of Moshi, and the second to Engaruka, on the border of Rift Valley Escarpment between Lake Manyara and Oldoinyo Lengai (active volcano!)

Rift Valley Escarpment

Lake Challa -- my first and only overnight camp-hash, as it's a twice-yearly event. Since it's been so long, I'll stick to the salient points. First, I climbed the steepest hill I'd ever climbed, on my hands and knees, hanging on to thorny bushes and roots to propel myself forward... steepest I'd ever climbed, that is, until 2 weeks later when we scaled a cliff in Machame on a separate, 'slightly rigorous trail,' according to hash-setter Nebraska Bob.

Why doesn't it look so steep in the picture? :/

But in both cases the climbs were worth it -- at Challa, we climbed to the edge of the lake, a crater lake, with sparkling blue water (albeit infested with crocs, rumor had it), walking along the lake edge until a sunset return home. Just in time to start the barbecue (of veggies, for me), open the beer and wine, and hang out by the bonfire for the rest of the night. It was an awesome weekend because most of my friends from Moshi were there (including some I hadn't met at the time). I'll let the pictures speak for the remainder of the trip...

Lake Challa from our campsite

As the sun is about to set and the hash about to end..

Kibo peak of Kili as seen from the east side...
now do you believe the ice cap is disappearing?

Mawenzi peak of Kili -- looks totally different from here!

Engaruka -- a few weekends ago, so I actually remember more! Then again, who could forget the naked old men (yes, plural), but I am getting ahead of myself! The Moshi Mountain Club, which, despite its name, does NOT climb mountains, is a group of older European men who have monthly talks about the jihad, female genital mutilation, and HIV, and commune with nature -- literally, as it turned out. Confused? Me too. But I decided to go along, because I had nothing to do and because I knew I'd have fun with my roommate and 2 guys my age -- Rick, who does malaria/mosquito research, and Freddy, who flies planes.

We set out at 630 am on a Saturday so that we could buy food in Arusha at a real supermarket -- it has aisles and signs and everything! -- and meet up with the mountain club to caravan to Engaruka. Seconds after we arrived, we convened a Mountain Club Council Meeting to discuss the options for the weekend -- who was hiking where, when, what time we were eating dinner, who wanted goat for dinner, what time we were waking up the next morning, etc... I've never experienced so much ... anal-retentiveness on a trip! Rick, Freddy, Holly, and I were pretty much the youngest people there -- after us, the next youngest age was mid-50s!

Of course pitching our tent lent itself to hours of amusement to Rick, Freddy, and even the mzees (mzee=old man in Swahili).. because it's a net tent, ie, see-through! With rain and thunder threatening over the Rift Valley Escarpment... lucky for us, we made it through the weekend unscathed...

impending rain... but crisis averted!

Engaruka Village..

Maasai market

Isn't she beautiful?

After lunch our Saturday afternoon 'walk' was to hike to some ruins of the Iraqw people, a tribe that hails from Ethiopia, legend has it -- they certainly don't look Tanzanian, with their high cheekbones, and speak a very different language. The ruins were.. underwhelming, to say the least.

Dumbfounded...

A pile of rocks in a circular fashion where 2 large metal spoons had been found. I guess you had to be there, but we laughed so hard when we thought, "THIS is what I hiked to see??" Of course, one of the European mountain club members demanded with indignation why there was no sign marking the ruins and, more importantly, strictly prohibiting local tribes from taking the stones for personal use!

We made ourselves scarce after this, hiking on our own for a bit before returning to the campsite and starting our feast, complemented by prosecco (gotta love Arusha!), wine, and Sambuca (gotta love Freddy!). With reticence, we joined the mzees, though ultimately it turned out to be very entertaining.. until Holly and Freddy went to the restroom, only to see a naked man squatting and grunting on the toilet, wielding his flashlight whenever anyone approached. Strange Mountain Club, wouldn't you say...?

But the insane stories continued.. the mzees woke up at 6am to go hiking... and starting singing as they got ready, to our consternation -- "Oh, what a beautiful morning" it certainly was NOT, for us. We got up at 9, did their 3 hr hike to a caldera (where a meteorite has struck the earth, leaving a crater) in 1.5 hours, returning in time to see another naked man... Would you believe it?! This time in plain daylight! I'm convinced this club is just an excused for old men to take their shirts off (and sometimes more, apparently!) -- just because it's hot doesn't mean you should take your shirt off!

The CalderaBeing silly at the Caldera.. can you guess which shadow I am?

Impressive mountains abounded..

It was payback time for us.. kind of. After an agonizing 2 hr dirt road drive back to the main road -- slowed down considerably because one of the other passengers in the car had malaria 25 years ago so now she gets car sick if one drives too fast... another wtf moment -- Freddy decided to moon tourists going on safari :)

See? I knew I'd have fun with this group!

Rick making fun of my sunglasses :(

Freddy being... Freddy

And Freddy, making fun of my sunglasses :)

Kilimanjaro Half Marathon Weekend

Ok, so I'm backtracking and skipping around a bit in my updates... the half-marathon was February 28th... essentially the peak of the hottest time of the year. Even after going to Zanzibar (a future post), some days in Moshi I feel like a chicken in a broiler, just going round and round and slowly being cooked. Would you believe that I am the same person who, as a child drank probably ~500 mL of water a day, to the consternation of my parents, and today drinks 3L a day... at least!! My friends and colleagues noticed and have slowly, one-by-one, started asking why I drink so much water (I'm sure the doctors among this group are thinking... diabetes insipidus??).. it doesn't help that I run early most mornings and start my day thirsty... but a nice segueway into talking about the marathon weekend...

An annual tradition in Moshi. The 42km marathon course: run around Moshi town for 21km before running up and down the mountain for 21km. The 21km half course: run up the mountain for 10.5 km, run down the same way. So which did I choose to participate in? The Moshi 5K fun run -- which was the only race that did sound like fun!! To many of my half-marathoner friends' disappointment, I chose the easy way out. But not being a runner and not having attempted to train for a long-distance run, never mind the small omission that it is an uphill course for 50% of the race, the 5K seemed like the only rational choice. And for once, I made a rational decision :)

It was quite the talk of the town, the week leading up to the race. Rumors of free t-shirts for the first 2500 to finish the 5K, medals for the half-marathoners and marathoners, and a huge party at the end!

Thanks to a constellation of events, on race day, I missed the ride to the starting line! Thankfully, a pick-up truck from the International School (whose 'team' I was running for) half-full of chairs and tables accomodated us -- so rather than starting the day by stretching, we started by squatting and contorting, attempting to avoid the shifting chairs with every speed bump and potholed dirt road. Then, our makeshift ride dropped us off about 1km away and 1 min before the race time... so Andy and I, the only ones in our group taking the 5K seriously, ran to the start line (at least it was downhill!), only to be reminded again about Swahili time... of course the race had not begun! We caught our breaths in time to hear the gun fire!

Off we went at a ... crawling pace. Because there were about 3000 people there (literally -- and 2500 of us wanted free stuff at the finish line :)), many of whom were little Tanzanian children, and because on a normal day no one understands the concept of respecting other people's space or giving way, let alone a day like race day. I finally started jogging, weaving in and out of people who would stop at inopportune times, mostly because they received a phone call or SMS. Again, who stops a 5K for a phone call?!?! Only in Tanzania...

The race course was quite pleasant, through the streets of Moshi which were thankfully devoid of cars for our race, down by Pub Alberto (hopping spot in Moshi), near the Vodacom store (major sponsor!), up by the grocery store where our savings seem to be depleted (but at least I can buy walnuts and blue cheese!), and uphill to the stadium at the business college. That last 1 kilometer, uphill of course, was bearable mostly because Kili came out from the clouds to welcome us to the finish line... I finished in 31 minutes, not the best time but I was happy -- it was my first 5K, after all, and technically, it was actually a 5.2km (per my Garmin-wearing friend). I got the free Vodacom t-shirt, too :)

To the consternation of us 5K-ers, about 2 minutes after I finished, the first half-marathoners were returning, 1 hour and 15 minutes later.. Kenyans, of course. We all milled about the stadium for a few hours, eating iced fresh pineapple, congratulating everyone on a job well done, until the heat got the better of me and I walked home -- another 3K, I'm quite sure -- mostly so that I could shower and play Wii Fit for the rest of the afternoon... just in case I hadn't exercised enough :)

Props to my friends for running a real race: Suzanne, Jen, Martin, Liselotte, David, Rick for the half-marathon, and serious props to Richard, co-med student at the Duke project here, who ran the. whole. marathon. It was worth every second of walking like an 80year old man the following week, I'm sure!

and no, no pictures, because unlike some people, I did not stop my race to either answer my phone or take pictures!! Guess you'll have to come for the Kili marathon 2011 to check it out! :)

March 8: International Women's Day

Today is International Women's Day. (Dear male readers: please do not groan, "Why do we not get an international men's day?" Every other day is men's day.) The 100th International Women's Day, to be specific.

A day to honor the important role women have in each of our lives, our society, our world. A day to remind ourselves to help those women who continue to be oppressed, be it by culture, family, poverty, lack of opportunity.

And for us, a day to speak out against maternal death, which exacts a staggering toll on women's lives -- an estimated 500,000 deaths a year. Deaths due to antepartum & postpartum hemorrhage, infection, pre-eclampsia/eclampsia, not to mention unsafe abortions.. the list goes on.

Sumera with the organizer of the event

Our posters advocating for the government to invest into Emergency Obstetrics

The Tanzania chapter of the White Ribbon Alliance for Safe Motherhood, an international NGO dedicated to safe pregnancy and childbirth, organized a rally to raise awareness about women's health and women's rights, in nearby Arusha. Hundreds of women (and men, though mostly women) marched through Arusha before gathering in the football stadium to deliver performances and skits, showcase traditional dances, and listen to both invigorating and sobering speeches by various governmental officials and personal testimonials from those touched by maternal diseases, including a man who lost his wife to PPH.

As the only health care providers partaking in the program, our group, the KCMC-Duke Collaboration, chose to focus our time in the spotlight on post-partum hemorrhage, the #1 cause of maternal death in Tanzania. PPH has a multitude of causes (I can spare you the details), but what's important to know is that many of the causes can easily be addressed with simple interventions AND critical knowledge on emergency obstetrics. Because 54% of Tanzanian women have home births (due to distance to a health-care facility and cost of delivering there), we started our skit with a traditional birth attendant (as interpreted by our fantastic Head of Labor Ward, Sister Meleo) lamenting the death of a mama whose flowing blood she could not stanch -- because the evil spirits wanted the mama to die. Sumera and I played wailing relatives -- our lines consisted of "he!", "nini??" (which means what?!?!) and "uuuuuuu-wiiiii" (which is a very typical Swahili wail) -- while Bariki and Sister Dora (midwife extraordinaire and ringleader of roleplays) played the angry husband and despairing mother of the dead patient, respectively.

Very intense, I know -- I'll confess the death scene was my contribution to conceiving our skit -- but important to showcase honestly how suddenly death happens and how, with the very same mama in the next scenario, management by a midwife (played by Dora) trained in emergency obstetrics leads to an efficient, skillful resuscitation and a mama who lives to take care of not only this new mtoto (baby), but also her many watoto at home. (And hey, it worked, because our entire presentation is to be on Tanzanian TV!!)

Dora concluded our role-play with a touching speech reminding all of us to think of all the mothers who die (needlessly), consequently the motherless children, and how emergency obstetrics training is a necessity for all Tanzanian health care providers.

It was a wonderful day for all of us, and for me, renewed my commitment to continue to improve the lives and health of women -- especially in a place like Tanzania, where maternal mortality is anywhere between 500 (gov't estimate) to 900 (more reasonable estimate) per 100,000 live births.

I'm alive!

It's been... 3 months? I don't even really want to check...

But believe it or not, I AM still alive, still in Tanzania, and still loving life!

Here's my reminder list of all the things I need to blog about:

--International Women's Day in Arusha

--KCMC Day

--Kilimanjaro Half-Marathon weekend

--Camping in Engaruka

--Safari to Serengeti, Manyara, and Ngorongoro

--Zanzibar music festival

--Lake Challa camp-hash

--my new obsession with Wii Fit

--Blood Drive

--Super Bowl party in Moshi

--Swahili lessons

--research updates

--spending time with patients!

See, I've been busy!! (and, the internet connection hasn't been the best either, especially for pictures, of which I have MANY since I have a new camera!!)