Friday, February 26, 2010

The Hostel

A little bit about where I am staying…The Hostel Hoff.
The hostel was thought of and is run by a woman in her late 20’s, Sarah, from Ireland. She set up the hostel mainly for people wanting to do volunteer work but not wanting to pay a lot of money to do it.
The hostel is really cute and has a nice yard with mango trees and hammocks. There is view of Kilimanjaro from the yard. We have two dogs, Butter and Carlos, but I am scared to pet them because they look sort of dirty.
Right now I am in a room with one other girl, Laura, from England. She is awesome. Last week we had two boys sharing our room.
We have a common living area with a tv and tons of books and DVDs and an eating area outside under a tin roof.
We keep track of who is staying here by using a blackboard and writing everyone’s names on it, we also have a calendar on the blackboard that has information for the next two weeks written down.
It is a really neat environment, because most of the people staying at the hostel are in Tanzania volunteering but almost everyone is volunteering at different projects depending on what they are interested in. There is a wide age range and many people from England some from Ireland, three from the US, some from Germany, Canada, Tanzania, Norway, Scotland, etc. Everyone is a lot of fun we all get along very well and enjoy partying together too.
I introduced them to the game Set that my parents gave me a few years ago for my birthday…everyone loves it and we play it all the time. Laura is getting really good and is able to beat me now but I think it’s because she practices every morning.
We have three women who clean, do our laundry (except underwear), and cook us breakfast and dinner. Two of them are around 19 years old and one is older and has a 18 year old daughter who also helps out sometimes.
We also have two Maasai men that are our ‘guards’…they are both really sweet. There are other people that also work here…Richard, an adorable man with one missing tooth who does yard work, and Ally and others.

So anyway, the hostel is a great place that I enjoy coming home to and I would definatly recommend it to everyone.

Monday, February 22, 2010

sick kids and home visits

Friday was pretty busy. I started off at the hospital with one of the boys to have his skin checked (he goes every month to get a new prescription) and we waited for about five hours before seeing the doctor. Then we went back to Amani just in time for lunch when all of the kids swarmed the health room for medicines and band-aids. I was super hungry so I made them all leave and told them to come back after lunch. Halfway through lunch, when I was in my Swahili lesson one of the teachers came and got me because one of the boys got kicked and was bleeding and really upset. While I was tending to that boy another one came in and had a mango stuck in his throat, he was breathing though and able to talk but I couldn’t understand what he was trying to say (because of my lack of Swahili) so I asked Chelsea, another American volnteer to come talk to him. She gave him some water and he started throwing up. He said that the mango still felt like it was stuck in there and was really upset about it but he was breathing fine and hopefully the uncomfortable feeling went away by the end of the day. Then four or five of the boys had really high temoeratures. One was 103.5 degrees Farenheit. We sponged them with cool water and gave paracetamol and brought the fevers down slightly but they were still pretty sick by the time I left to go home. A group of us went out on Friday night to a place with a rooftop bar and met up with some of my co-workers and other people that are volunteering in Moshi. It was fun. But after being at the bar I always want to eat a lot of food when I get home…it is difficult to do here though. I usually end up with ants crawling all over my hands and jelly dripping down my arms. It was definitely a fun night though.
I took Saturday pretty easy because I was not feeling great. Four new girls arrived at the hostel and two are staying in the room with Laura and I. They all seem really sweet.
Sunday I went with two of the men that are staying at the hostel (one is Tanzania and one is American) and I went to their projects with them to see what they did. They work with a group called Jipo Moyo which is a support and educational group for women (and a couple of men) with HIV/AIDS or other illnesses (although some members are not sick. The two men from the hostel do home visits for the members that are ill and the man from Tanzania does the translating for the American. The American man is HIV positive himself but is doing extremely well and is really healthy right now…in fact he has run in 6 marathons since his diagnoses. So he basically serves as inspiration for many of these women that see HIV as a death sentence…he also helps them realize the importance of taking their ARVS correctly.
We went to three different houses in a village area of Moshi which was really interesting to see. There were children playing everywhere and women outside doing laundry etc it was cool to see a community that is so close to where I am staying that I did not even know existed. Anyway…the first home we went to was really nice and we went inside and talked to the lady there for a bit. She is one of the members that does not have HIV but she was just getting over malaria and typhoid. The next home we went to was to see a woman who has HIV and about three weeks ago had a hysterectomy because she was having very heavy bleeding. The woman looked like she was in extreme pain and she told us that her staples were removed but now she is having pain and pus is coming out of one area of the wound. She also was having fevers and feeling ill so she went to a clinic a day before and was diagnosed with malaria. Before we left the two men from the hostel gave her a bag of sugar and a bag of rice. She was extremely thankful that they stopped by. The next home we went to was of a 30 something man that had cerebral syphilis and had been bed ridden for the past two years. He is also HIV positive. Amazingly enough he was able to sit up when we arrived and he was so happy to see that the two guys had come back to visit him. He had a physical therapist that came to see him but had not been in a while and nobody was sure why they had stopped showing up. He was standing at one point but said that he has been too weak to stand recently. The men brought him sugar and rice and also newspaper articles about football (soccer). I think they are going to try to find him a walker so that he can start to get some strength in his legs and get moving around a bit.
It was truly amazing to see how much the visits meant to these people. In Tanzania the government pays for ARV’s but only if your T Cell count is below 200. So basically you don’t start taking the medications for HIV/AIDS until you are very sick but for some people even though they start late it is able to do amazing things but I still don’t understand why they can’t just start taking the drugs right away.
Anyway it was really interesting to follow the two guys around and I would love to go back and do it again.

Sunday, February 14, 2010

Lake Chala

Saturday a group from the hostel went to Lake Chala which is a lake that is between Tanzania and Kenya. We rented a dalladalla (mini-bus) for the day because they don’t run there and we agreed on a price the night before with the driver. After arriving a half hour late the driver told us that he was going to charge us more than what we had decided because we wanted to stay at the lake until four. We said no and he basically was unwilling to change his mind so we all got off of the bus and started walking back into the gates of the hostel. Then he realized we were serious that we weren’t going to be paying anymore than we agreed on and he decided to take us for the original price.
It only took about an hour or so to get to the lake but the last half of the drive was on dirt roads that were incredibly bumpy. I think I hit my head on the ceiling of the dalladalla four or five times. The lake was gorgeous. Across the lake from us was Kenya and we were thinking about walking there (probably a few hours hike) but decided against it because we did not bring any food and did not have enough water. To get down to the water we had to walk down steep rocky narrow slopes.
There were two boys fishing off of a log when we got down there. I tried to talk to them but I think they had a hard time understanding my broken Swahili combined with English. The were using a stick and a string as a fishing rod. They also had a net that they put in the water and were able to catch a couple of tiny fish with.
Another group of boys came over from another area of the lake and one of the younger ones attached an empty container/jug to his back and used it as a flotation device so that he could swim. He was adorable but I was worried that he was going to get too far away from the rocks and his flotation device would fall off and he wouldn’t know how to swim.
A few of the girls from the hostel went swimming and a few of us walked around a little bit but it was hard because the rocks were slippery and loose. It was really gorgeous though and I definitely would like to go back there.
On the way home I covered my face with my bandana (like a cowboy) to keep the dust out of my nose and mouth. There was so much dust that I thought my arm had gotten a lot of color because it looked like I had a tan line where my watch was but after I showered I realized it was dirt that was making me look darker…gross.

busy friday

Friday was a super busy day for Anna and I at Amani. Rovina, the nurse, had the day off so it was just Anna and I and we had so many sick kids. There is a cold going around and sore throats going around. One of the boys vomited and another one was feeling really nauseous. Two of the new boys (that we brought to the clinic on Thursday) still had fevers. Kabila, the one with typhoid, malaria and worms was doing really poorly. Anna knows a lot about malaria which is really good but neither of know much about typhoid. He is on medications for all three and looked like he was in so much pain. He said he was really cold and that his head and stomach were really hurting. He would sleep for a bit and then sit up and flop around but could not seem to get comfortable and we were unsure of what we could give him, as far as pain killers, with the medication he was on. I let him put his head in my lap and sleep for a little while. He was crying a lot and at one point seemed delirious (which from what I understand can happen with typhoid). I felt so bad for this little boy he was just so miserable. At one point Kabila sat up and started gasping and seemed like he was having trouble catching his breath…Anna and I looked at each other and both started panicking and we were both thinking “oh god…not again.” But luckily his panting only lasted a few seconds and we did not need to do another rush to the hospital with mouth to mouth etc. A
It is scary being there when the children are so sick without Rovina because I don’t feel like I know anything about the illnesses that they have or about the medications they are on.
Also, Anna got a paying job in Arusha (a bigger city in Tanzania) where she will be doing something with public health and AIDS and ARV compliance. That means she will be leaving Amani in two or three weeks. I have no idea what I am going to do without her. She has been so helpful and I can’t imagine doing anything without her. She knows the names and personalities and histories of each child and she knows all of the staff and how everything works. I am so excited that she got a job but it still is scary that she will be leaving me.

Friday, February 12, 2010

hospital and trip to clinic

So…the past few days have been interesting. The boy that was sick ended up back in the hospital. Anna and I went to see him on Friday Saturday and Sunday to make sure he was doing okay and was being fed and given water etc. Two of the older boys from Amani were there with him. They brought food for him and fed him and were taking good care of him. When I was there with the three boys another man died and the family had to drag the dead boys mother out of the room crying and then took the body out covered in a blanket. The boys were just staring at the body until I told them to look away…nobody else seemed phased by the dead body or the crying family.
Anyway, he ended up getting discharged on Sunday night but spent the night there and came back to Amani on Monday. He was still weak and shaky on Monday but by Tuesday he was back to normal, smiling and in class.
On Tuesday five boys came to Amani from the streets of Arusha. One of which has been to Amani several times. Each time he comes he convinces other children to return to the street with him. Amani came up with a new policy that limits the amount of times a child can come and then leave again. All five of the boys appeared really sickly. The one that comes and goes often had a fever of 102.5, they all had swollen glands and bad coughs and one had sores and cuts in his mouth. So…Wednesday Anna and I took all five of them to the clinic to get checked.
One of the boys was completely healthy the other four have malaria two have worms and one has typhoid and one has a UTI. Anyway, after getting their diagnoses and medications we all piled back into the taxi but instead of going back to Amani we stopped at a juvenile delinquent home. The social workers decided that this was best place to put the boy that was constantly coming and going. None of the kids realized what was going on but as soon as the social worker started to take him out of the car he started crying and the other boys were trying to hold onto him so that he would stay in the car. It was really traumatic and I almost started crying and after we pulled away one of his friends started crying. The social worker had to explain to them that he cannot come back to Amani until he stops the bad behavior.
Once we all got back to Amani all of the kids started asking where he was. They were really really angry that they thought we were going to the clinic and coming back but that we had gone and one of the kids was left behind.
I feel really bad but I think the social workers know what they are doing and what is best for this boy and for the other children.

Saturday, February 6, 2010

scariest day at amani - mouth to mouth

Thursday was a really scary day. It started off great. We had a group of Canadians come visit Amani and donate over 60,000 dollars!! The children performed circus (acrobatics) for them and then the Canadians set up a bunch of games for the kids. All of the children loved it. They did rely races, tennis balls in spoons, etc.
Towards the end of the day just as I was getting ready to leave, one of the 15 year olds came into the health office complaining of a cold. We gave him some cold medicine and he came back a little later saying that his throat felt funny. It was hard to understand what was going on with him because of the language barrier (also the Amani nurse was out because she has malaria). We had a staff member translate and ask him what was going on and he complained that he smelled something weird whenever he breathed out. He smelled like eucalyptus, which is the main ingredient in the medication he was given. He said he wasn’t having trouble breathing and his tongue didn’t look swollen and he seemed to be breathing just fine. We decided to wait just in case something was wrong and about fifteen minutes later he was obviously in distress I walked him outside of the health room so that we could find a ride to a hospital. Unfortunately, Amani’s driver was in Arusha and there were no spare keys and the ambulances in Tanzania are slower than the taxis from what I have heard. He started to get worse and I gave him two benedryl but it did nothing. One of the staff members called a taxi and we were waiting for the taxi and I was getting more and more worried and he was getting worse and worse. The mama’s and other staff were trying to force him to swallow milk and I tried to tell them that they shouldn’t but they were convinced it was going to help him. About five minutes later (it felt more like 4 hours) we found someone with a car and one of the teachers carried him out to the car. Once he was in the backseat he was not breathing adequately and became unconscious. I started doing mouth to mouth without even thinking about using a barrier because we did not have any. Anna and I took turns giving him breaths and soon enough he was conscious but still breathing really really rapidly and shallow. When we got him to the hospital he started to go into convulsions. The doctors at the hospital were taking their time and finally told us to put him on a bed and open a file and pay for him…I went back into the room after paying to find the doctor massaging his chest while he was laying there convulsing and scratching at his throat. He started to get really agitated and ripped off his rosary beads and was still having trouble breathing. After about ten minutes they gave him a cortisone injection and then tried to funnel water down his throat and he started making gargling noises and I had to leave because it was upsetting for me to watch them do this. They had no oxygen for him, no sort of monitor, nothing except cortisone. And a nurse came in a put her hand on his neck and started yelling out, “jesus jesus something jesus”. The doctor than told us that we had to take him to another hospital KCMC which is a bigger and better hospital. We had to find another taxi and then the teacher carried his limp body out to the taxi. He was unconscious for most of the ride but toward the end started getting agitated again and convulsing a little bit. His breathing was doing better though. When we got him to the ‘emergency room’ they asked us to sit him a chair…he was obviously unable to do that and they realized that pretty quickly and had us bring him to a room with three other beds. We put him on a stretcher and he came back to and started thrashing around and acting possessed. The doctors sent me out to get more doctors which I did and they gave him valium which knocked him out. His breathing began to even out and became normal again. They were concerned about cerebral malaria but he tested negative. I initially thought he was going into anaphylactic shock but because he wasn’t wheezing and nothing seemed swollen and benadryl didn’t make a difference something seemed off. I felt so much better though having him at this hospital where I knew they had equipment if needed and where the doctors seemed good and concerned with him.
Anyway, they eventually moved him upstairs to the men’s medical ward 1 where he was on a stretcher in the hallway. Of course they were bringing a dead body out of a room with about 10 other people in it on our way in. The power was going on and off but mostly just stayed off. We were in a dark crowded hallway with tons of sick people around. The patients here were not like any I have seen at Overlook because not one of them was complaining and it seemed like very few were being seen in a timely manner. We left a few hours later and another boy that was there watching his father kept an eye on him and promised to call or text one of us if anything changed. He texted saying that he woke up and was able to talk and complained of a headache. We returned early the next morning as they were wheeling another body out. He woke up and was responsive but couldn’t speak more than a whisper and seemed super anxious. Rovina, amani’s nurse brought him tea and he was able to drink a little bit. Anna and I left and went back to Amani. All of the kids were very concerned and worried about him. At the end of the day Anna and I went back to check on him and he seemed sort of confused. He said he remembered us and he remembered Rovina but when we mentioned the names of his friends he said he couldn’t remember them. I was worried that something had happened to his brain but I made him tell me the names of animals in Swahili and I thumb wrestled with him and he seemed to be doing okay but occasionally he would zone out or start twitching. Something was going on neurologically, when Rovina got back Anna and I mentioned it to her and she said that they diagnosed him with seizure disorder and then it all kind of made sense. Maybe the smell he was complaining of was an aura and when he was unconscious in the car he was postdictal…I don’t know. They discharged him and he got back to Amani where according to Anna he recognized all of his friends and started smiling.
Hopefully he will be alright and he is doing so much better but I felt so bad for him he was so confused and I have no idea if Rovina explained anything to him or not but I hope he doesn’t remember Anna or I doing mouth to mouth because he would probably feel really awkward. Also there is no public display of affection in Tanzania and because he looks like a teenager…and so do I…I felt like I was getting weird looks because I was holding his hand but I didn’t care because he just needed someone to comfort him.
So this incident brought about a few ideas for the health clinic at Amani. First of all, we are going to try to get at least three barrier masks donated incase we are in another situation requiring mouth to mouth. We are also going to work on getting epipens or epinephrine injections because we do not know if these children have any allergies and we are giving them medications and antibiotics etc that they could have reactions to. Without a quick ride to the hospital or an ambulance service having an epi-pen would make a huge difference if needed. Rovina is also going to talk to the staff about first-aid and what to do and what not to do (i.e. funnel milk into someone’s throat) in these situations. If anyone wants to donate for this please let me know or feel free to send pocket masks etc.

health education - teaching about germs

Anna taught a few of the kids about germs and hand washing. We used glitter to represent germs and bacteria and had the kids shake hands and open the door and then look at the germs on their hands. They then washed their hands properly and were able to see that the germs were gone. All of the kids here eat with their hands so it is important for them to know the benefits of hand washing and I think they understood it after this game.
Two of the boys had bloody noses today. One was worse than the other and the nurse immediately tilted his head back and it was weird for me to watch because I have always been taught NOT to do that because of swallowing the blood. I asked her about it and she said putting it back is better for at least ten minutes. I don’t feel like I am in the position to tell her what to do but it was hard for me to watch her do that and not do anything about it but luckily it was not too big of a deal in this situation.
I also finally bought a fan!! It is so nice to have a breeze while I sleep so that I don’t always wake up sweating in the middle of the night and I no longer have to freeze my bandana to sleep well at night.
There is a rumor going around town that the water supply is going to be turned off for three days so we have filled up buckets at the hostel just in case. Hopefully it will end up as no more than a rumor.
The differences between the hospital here and the hospital at home are amazing. The hospital here reminds me of the one in Vietnam. There are many patients to a room and the nurses and techs don’t take care of the patients the way we do in the US. The family has to bring clothes, towels, food, and drinks for the patient. The family does the laundry at the hospital and hangs it up to dry in the hospital courtyard. Women were walking around with infants that had i.v’s in their scalps. The doctors and nurses wear flip-flops. The bathrooms are obviously not western style and there is no toilet paper…, which is expected. Everybody is aware of what is going on with everybody else…confidentiality does not exist. I also feel bad for the people that do not have family members. I want to go to the hospital on weekends and volunteer and take care of the people that are there by themselves. I don’t know if I have time to do that but I would like to. Anyway this blog entry was totally random but I guess it doesn’t matter.

Wednesday, February 3, 2010

Joe's goodbye party

Friday was a pretty busy day at Amani. The last Friday of every month all of the children, staff, and volunteers clean Amani from the top to the bottom. We all split into groups and I was assigned to the boys changing room, time out room, and one of the sleeping rooms…all of which were filthy! I was covered from head to toe in dirty water by the end. Also one of the little boys that just came back from being on the streets was showing me a cut on his heel and his toe was not in his sandel properly so I asked him to fix it and he looked at me funny and then I realized that he had a sixth toe on each foot and it was the sixth toe that was sticking out of his shoe. When I went to trim his finger nails I noticed he had six fingers on one hand too. I felt bad after. I also noticed all of the other kids are always touching his extra finger and toes. Hopefully he is okay with it and it doesn’t upset but I was not able to tell. One of the boys had a pretty high fever and there were a lot of cuts and scratches but besides that there was not much else happening in the health room.
After a morning of intense cleaning and we had a going away party for Joe and Libby. The party consisted of giving the children soda and dancing. Some of them are awesome dancers. It was pretty entertaining. I tried to add a video fo the kids dancing but the connection here is so slow that i just waited a half hour and then decided to cancel because it wasnt even half way through.
For my orientation I stayed until about 9 pm to see what the night caregivers do. The kids were fighting a lot and one of the older boys punched one of the little ones in the head really really hard. I was really angry at the older kid but it is hard to discipline and to stop them from fighting because I still can’t understand Swahili really well. One of the girls came downstairs and started to cry. I tried to talk to her and figure out what was going on but she wouldn’t talk and just kept sobbing. I just sat with her and hugged her and then I went and talked to the night worker because I was concerned that maybe the boys were doing something to her or someone was hurting her but the caregiver told me that she has a lot of anger and does that at night sometimes. I really wish there was more I could do for this girl but I have no idea what she has gone through and also can’t erase anything that has happened to her.

Amani Children's Centre

I will explain briefly what Amani does. Amani is a home for street children that (I am copying this part from a brochure thing) is committed to reducing the number of children living on the streets in Tanzania by providing a nurturing place for homeless children to heal, grow, and learn. In addition to providing long-term care, Amani aims to reunite children with their relatives when possible and to equip their families with the thools they need to be self-sustainable. Amani is dedicated to creating a path for each child that leads to a future filled with hope.
All of the staff and volutneers at Amani work together to provide the children with the best care possible. Unfortuantely, recently some of the children have been running away and taking other children with them. When they run away they basically just go back to living on the streets but they come to Amani and will steal clothes and other things before leaving again. Everyone has been working with the kids to figure out why this is going on and how to stop it.
A lot of the children started living on the streets because their parents died or their relatives were abusive or there just was not enough food to eat at home. Amani sends social workers out to work with the children on the streets and to gain their trust. If the children agree to they are welcome at Amani where they can find a safe place to live where there is always enough food, healthcare and education and where they cannot use substances such as glue and were stealing is not allowed. Everything from the clothes that the children are given to the meals they are fed are carefully thought out. The cooks aim to make the meals nutriticious but also similar to what they may be eating once they are reunited with family members. They children are given clothing but are not provided with new clean shoes every month because when they are reunited with their families they will not have the luxury of wearing new outfits and shoes every few months.
A lot of the kids act up and some are very emotional but whenever I start to get frustrated I try to make myself remember that they have been through more than I can ever even imagine and that while they look like and act like little children most of them have not had a real childhood. Some of the children are fourteen or fifteen years old but are smaller in size than my seven-year-old cousins. I still do not know every child by name and I do not know most of their stories or history but I do know that these children are so strong and so determined and each child is truly amazing.
My role at Amani is as ‘health assistant’ so I am working with the nurse, Rovina, and with the other health assistant, Anna. My work is basically similar to that of a school nurse. I provide the children with first-aid, medications and a lot of TLC. Anna, Rovina and I are also in charge of sorting medications and other donations and are responsible for doing physicals on all of the new arrivals as well as taking them to the clinic or hospital when necessary. Educating the children about health and hygiene is also part of my job. I have been doing a lot of ‘pedicures’ recently because a lot of the boys have really dirty feet with deep cuts between their toes and on their heels. Today I scrubbed one boys feet with disinfectant soap for about fifteen minutes then tried to clean under his toenails and clip his toenails but they were as thin as paper and just bent when I tried to trim them. I tried to explain to him that he needs to wash his feet every day and keep them dry and that he has to has to has to wear shoes. I don’t think his feet have ever been so clean.
Anyway I am not sure how well I explain Amani Children’s Home but hopefully I described it well enough and if not the website is very informative.

lake manyara national park

This weekend I went to Lake Manyara with some of the kids from the hostel. After a bouncy two hour bus ride to Arusha we took a three hour daladala to Lake Manyara. Upon arriving we were swarmed by locals trying to sell us their Masaai statues and offering to show us around. We eventually found someone to take us in a van around the park, although every few minutes the car would stall out and he would have to restart it. He took us on safari for an afternoon and we were able to see elephants, zebras, hippos, giraffes, baboons (a lot of them), flamingos, warthogs, etc. It was really amazing. I think I was spoiled by the south African safari though because there we were able to go right up next to the animals but here we have to stay on the road. Nonetheless I was still fascinated by all of the animals. We stayed at a campsite on top of a mountain overlooking Lake Manyara. The view was absolutely breathtaking!! Sleeping in a tent (although not as comfortable as my bed) was very nice because it was cool at night and I didn’t wake up sweating profusely. We were able to do all of this in under 75 US dollars. I am excited to come back to this place and explore.