Archives for posts with tag: church partnerships

Alice leads us into the simple classroom and forty, six- year olds jump to attention at the side of their simple wooden desks.

“Good morning, honored vee-see-tors,”, they chorus at a signal from Alice.

A slight young woman, Alice is the lead teacher for the brand new Makumira-Kilala English Medium Primary School.  Built by the Diocese with funds from a congregation in California, this is phase one of the development.  Three classes, pre-school, kindergarten and standard one,  have been recruited to inaugurate the school.  Each year at least one more standard will be added as the children progress.

Alice introduces us as visitors from America.  The children continue their greeting in perfect unison singing/shouting songs and verses in English. “For God so Loved the World……”,”you are very welcome visitors…”

Delighted, we clap, say asante sana, thank you, thank you and marvel at their energetic performance in English, a third language for them after their local dialect and Swahili.  They are given permission to sit down.

Now it is our turn, we say our names and where we are from.  They are polite but do not register much until we ask if we can teach a song?

Lined up along the front of the room, ten Americans begin to sing, “Head, shoulders, knees and toes.”, touching our heads shoulders, knees and toes and “eyes and ears and mouth and nose.”  The students look first at their teacher before grinning broadly. Then they are on their feet, singing along as we go through the song, one time, two times…until the children collapse in giggles and the Americans catch their breath.

We have connected across age, culture and language dividing us.

As first time visitors to this culture, we sometimes feel like intruders, sometimes like voyeurs to their struggles, all the time as separate from a way of life we do not understand. We try not to bring too many judgments to a context so different from our own. In observing, we are aware of how much divides us, how much we do not know. Yet, this simple encounter reminds us that children everywhere like to move, to sing, to see adults being foolish. They have learned the English for head and shoulders, we have learned what we have in common. It is a joy.

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P1060670“Meru changes you and calls you back”. An acquaintance in Seattle made this observation after a repeat visit to volunteer at Ailanga Junior Seminary in Meru, Tanzania. As we prepare for another visit, I have been thinking about how has it changed me? What is calling me back?

The people are calling me back. Last night an e-mail came welcoming our group from the Women’s minister of the Diocese, Mrs. Ndefisio Pallangyo. The first time I met Ndefisio, she was a guest in our home, on her very first visit to America. Her smile and her openness to all that was different from home crossed the bridges of time and place. When,a few years later, we made our first visit to Meru, she was there to greet us.  She has prepared a visit to a women’s group while we are there.  She has expanded the circle of her hospitality.

Tomorrow, a group of us from the Waukesha and Milwaukee area will travel to Meru. For many of us it will be our first experience in Meru. For others, it is a repeat visit. We will each have our own unique experience but we will all be changed. We will come back knowing much more about life in a developing country. We will have met new people and done some good work. We will experience radical hospitality. We will see a part of God’s creation with animals and vegetation so different from ours. Some will climb Mt. Kilimanjaro, a wonder of nature. These experiences cannot help but change us.

As I think about how my repeated visits have changed me, the most important changes have come through people. Our official Diocese hosts have worked with me to plan a full itinerary but the people who effect us most will not be just those who plan to be with us. We may find that the driver for safari connects with us in a special way. We may be moved by a child who sidles up to us when something else is going on. It may be a fellow traveler. It may be our own reaction to what we are seeing and doing.

My first trip, I thought I knew something about poverty and Tanzania is one of the world’s poorest countries. I learned that I didn’t know much about how to live daily in the richness of their culture while dealing with a material poverty that makes children malnourished and subsitence a day to day question of survival. I learned about generosity and hospitality, I learned that as a privileged American, I need the bottled water that they make sure we get. I need a driver and an interpreter. I am dependent, not my usual self-image.

The friendships we will make, with our partners in Tanzania and with each other will be powerful. Shane Claiborne put it this way, “We will not ‘Make Poverty History’ until we make poverty personal.” The problem with the divide between America and the developing world is not that we don’t care about each other, it is that we do not know each other. We don’t know the people who make our clothes or pick our coffee. On this trip we will get a glimpse of that and of our assumptions.

In a couple days, we will be met with warm smiles and cries of Karibuni, welcome. From time to time I will post something about those experiences so that you too can accompany us. God be praised for this opportunity to have our hearts and minds open.

Wanted:  A Miracle

Today we stop at the District office to see the bags of maize that have been purchased with money donated from concerned people in the Greater Milwaukee synod.  We meet the pastor who will be with us when we distribute sixty 100 kg bags of maize to people who are trying to subsist in an area that has received almost no rain for nearly 3 years.  The pastor,  Zakiya from Patanumbe tells us that 400 people have signed up for food and that there will not be enough.  My heart breaks a little but I have been here long enough that I am not shocked only discouraged.  Zakiya tells me that these bags of maize are very important, that even though they are not enough, it gives people hope.  He is a kind and gracious man.

The economics of this drought and resulting famine are that donated dollars do not go as far as they once did.  When maize was purchased early last fall, it cost 45,000 TSh, $30 approx., per 100kg bag.  These bags cost 60,000 Tsh per bag.  Our donations do not buy as much even as the need deepens.  Tanzania is experiencing 17% inflation.

Our day continues to visit the Eastern District of the Diocese.  We do not have many partners there.  It is a beautiful place with bougainvillea, hibiscus and yellow flowering trees punctuating the dry mountainside.  We see wilted coffee bushes with small green beans on them,  more bone thin cattle and some goats along the way.  We are greeted by a dozen or so people representing the three partner parishes in the Eastern District.  Our agenda is to talk about partners,  what is going well, how the partners support one another and what could improve.  We get into a long discussion about communication.  Eventually this brings us back to the economics of drought.  Since this area is comprised almost totally of subsistence farmers,  there has been diminishing money to pay school fees as season after season crops fail.  Because  there  are few people with English skills to communicate with partners.  In addition, where there is no water there is also no electricity to charge cell phones and computers.  It becomes expensive for the few English speakers to walk or pay for a ride to a place where there is an internet café or to even charge the cell phone.  In addition there is a shortage of pastors who may have some English skills to serve these remote and struggling parishes.  From the meeting we visit a sub-parish  where we come face to face with the problems we have been discussing.  As is their custom in hospitality,  we start with sharing bottled water and/or soda in the stick and mud church that they started their parish in and now  use for kindergarten.  The elders and evangelist who are there to greet us know that they would like an American partner but they have no concept of what our lives are like.

As we talk about what they would like an American partner to know, we hit on some ideas.  Since they are all peasant farmers, we wonder if dairy goats would be a good thing for them to consider.  A pastor who is with us, becomes quite animated about the idea as dairy goats reproduce quickly and their milk is very nutritious.  Some goat milk in porridge is enough to sustain a child for the day.  Survival is the most basic issue of the people and those who are trying to minister.  It is a Gordian knot of need.

On Thursday, we leave as promptly as anything ever leaves to head south, an area so dry that even the acacia trees are uprooted by the wind because their long taproots have given way under years of little rain and searing heat.  This is the area near KIA airport where wind shears due to extreme heat and resulting dust storms make landing and taking off an adventure.  We bump along the rutted dirt road with the lorrie carrying the 100kg bags of food following.  In the car is the general secretary and relief coordinator, a pastor who is on the Diocese relief committee, Walt and I.  We stop at Canaan parish to pick up the pastor who is a cheerful man, welcoming us many times.  From there we head further south to the sub-parish which serves a clan of the Maasai who moved south many years ago and became more pastoral. We are led by the Assistant District Pastor in his pick-up truck.

When we enter the church yard, it is filled with people dressed in the bright Maasai traditional dress of purple and red.  As we descend from the Land Rover, first the children crowd around,  Muzungu, wazungu , the buzz rises.  All are finely boned, shaved heads and scrawny with the potbellies that mark mal-nutrition.  The girls are dressed mostly in dusty skirts and dresses, those with skirts wear the ragged second hand t-shirts that the US floods the clothing markets with.  There are little boys too, one with a  toy,  the round ends of something make the wheels and sticks hold together his makeshift car. The children part as women surround me,  they want to shake my hand and say karibu,  welcome, or asante, thank you.  As woman after woman grabs my hand,  all my detachment about failed economic systems,  the inadequacy of our relief efforts and post-colonial injustice dissolves,  the tears flow down my face.  The graciousness of these desparate people,  the light of interest and hope shining from their eyes connect with my soul, woman to woman, mother to mother.  God help us all.

When the ritual greetings are over, the truck arrives to a round of applause and people gather round as the sacks of maize are offloaded onto big tarps spread on the ground.  Two tall, slender, fierce looking Maasai men in traditional garb,  red print robes tied at one shoulder, deeply pierced ears and beaded neck and head jewelry signifying their status, have taken command of the on-the-ground organization.  Meanwhile, Walt has taken the opportunity to take some pictures of the kids and the Mazungu  grandmother who has appeared.  One little girl, maybe 2 or 3 years old,  is in a dusty floral print dress that reminds me of Emilia, our grand-daughter.  While the others gather in groups to have their picture taken and marvel at the miracle of seeing themselves instantly in the digital camera, this one stands to the side quietly,  watching and solemn.  This child and our privileged grandchildren should all be able to grow up in a world where there is enough food, a decent school to go to and health care when they need it.  The differences between the life circumstances of these children and our grandchildren is so vast that I am sure many will say,  you can’t compare,  and yet, the commonality of the hope and joy that shines in these young lives cannot be denied.  

The men who rode on the truck are continuing to heave the 100kg bags off the truck.  Nearly all the labor here is manual, only a tiny percentage is mechanized, not including relief operations.  Our hosts lead me to the benches and plastic lawn chairs that have been placed under one of the few trees for resting and watching.  There is a party atmosphere as clusters of women from different  shambas catch up on gossip, keep up on the proceedings and watch the children.  At some point it is time to go into the small mud church.  It is the evangelist who serves this church under the supervision of a pastor who has organized the day.  Everyone files into the church except those who are working to organize the maize.  The prayers are said, we are assured that all have been welcome whether or not they are members of the church.  We are introduced and applauded,  Walt must talk because I am once again crying, overcome with the color, the hope in the face of futility,  the humanity of it all.  A hymn in full harmony is sung and everyone moves back out into the church yard for the distribution to begin.

The two Masai men now stand atop the pile of maize with all the authority of some ancient chiefs.  All they lack is their spears which I am sure are around somewhere.  I ask one of our translator hosts who these young men are and he says that they are “elders” of the church, men who have been given leadership roles because they have brought their whole shamba into the church.  I note that is a difference from years ago when this was a mostly a female event.  The pastor replies that it is a mark of their evangelizing efforts but also of the desperate times.  It has been 5 years since this area has had a harvest.  Only 4 of the 5 hand-dug wells,  also financed by American church donations, are producing water. Some of their cattle, their only assets,  are dying of starvation and lack of water.  If they can get the cattle to market they can buy at most a bag of maize per cow.  I ask why the people stay here under such impossible circumstances.  My host laughs, almost a bark of frustration,  where would they go?  What would they do?

At one point the Diocese relief coordinator,  Mr. Nnko, steps to the front of the crowd surrounding the tarps of maize and says,  “see me?  Line up here.” And they all line up.  Two very old, stooped women are pushed aside as the line forms.  Mr. Nnko brings them to the front of the line.  The bucket that contains approx. 10 kg of maize is filled and poured into the bags that the mamas have brought.  The distribution has begun.  We watch and Walt takes pictures for a while and then it is time to visit another sub-parish a few miles away.  We will return after that short side trip.

We are part of a ritual that has grown out of too many times that such a distribution was required,  everyone seems to know their role except the visiting Americans who follow where led,  speak when asked to and are humbled by the honor given to us on behalf of the many donors from southeastern Wisconsin.  We walk through structures that now have roofs by the grace of God,  peer down wells, and encourage the evangelists and pastor who care for this flock.

When we return to the distribution,  most of the maize has been distributed.  Here and there we see women,  heaving bags and baskets tied with colorful but faded Katanga cloth onto their heads to begin the 3 or 4 kilometer walk back to their huts.  The procedure is that everyone who showed up will be given the first portion for as long as it lasts.  If there is enough,  a second round of 10 kg portions is given.  That is underway.  The loaves and fishes have multiplied.  “Extra” baskets have been set aside for the workers and the choir waiting to honor us at yet another outpost.  For today, the miracle has been given.  Thanks be to God!

There was a doctor volunteering at Nkoaranga hospital who developed a problem and needed surgery.  He arranged to travel to the States to get treated.  Within two days he was home and the surgery was scheduled.  A woman in Ngarenanyuki delivers a child and develops profuse bleeding, a serious but treatable complication in most places. This woman is taken to the Dispensary which cannot treat her. The untrained nurse attendant on duty assesses that patient must be taken to Nkoaranga Hospital. This new, bleeding mother waits for transport to the Hospital. The clinical officer on duty locates a vehicle, then a driver and sends it the rutted rock strewn roads to the dispensary.  Several hours pass and the patient is growing weaker.  Nkoaranga does not have an ambulance and the only vehicle that can safely travel the rocky dirt roads to this outpost of the Masai is a Land Rover.  Finally, the woman arrives at the hospital.  She is assessed and they are not able to treat her. She needs a transfusion and perhaps a D and C.  Nkoaranga can hydrate her but she must now be transferred to KCMC the nearest hospital that can do these procedures. She dies on her way to KCMC.  Dr. Mollel who is telling this story, shakes his head and asks,  how can this be that my colleague whose condition is serious and cannot be treated in Tanzania receives treatment while the woman who is treatable but poor and living remotely dies?  What good does training do if it is undeliverable?

We are on a crash course of the issues of delivering health care in the harsh and unforgiving environment.  In three days we visit the far Northern dispensary at Ngarenanyuki,  the far Southern dispensary at Velasko,and those at Leguruki, and Kikatiti.  We also visit Maangashiny Dispensary which is closed.  Each dispensary is located some distance from the hospital in underserved areas.  They are intended to provide first line treatment of malaria, typhoid and diarrheal disease ,first aid for injuries.  They also have limited nurse midwife capabilities and provide mother child clinics. HIV testing, diabetes and hypertension screenings are also available.  Each dispensary has some major issue in fulfilling these fairly simple functions.  Chief among these issues is qualified staff.  Because these areas are remote and the salaries are low, not many people are eager to serve.  In addition, only a few have any staff housing which is essential to recruiting qualified staff. Competition for trained staff is high in more desirable locations.  Much like rural U.S.  but more so.  In addition, the government has begun to inspect the facilities, particularly the laboratory test areas that test for HIV, typhoid and malaria.  Not one of the Diocese supported dispensary laboratories meets standards.  To the dismay of the people, some have been closed and others are operating without meeting standards.

We ask Dr. Mollel why we are going to Maangashiny if the dispensary is closed?  He laughs and says we will understand the challenges better if we go there.  It is around 8 kilometers from the tarmac road on a rutted path to the dispensary, shorter if you walk cross country.  We bounce along raising clouds of dust. You can count the ribs of the cattle that we see, goats are not quite so scrawny.  We pass only one green patch the entire way.  We drive past the partner parish of First United Sheboygan,  up a hill to a relatively solid looking building of painted brick and mortar, unlike the mud and stick huts that serve as homes in this area. When we park outside the clinic, a group of children magically appear.  Dr Mollel has a cheerful conversation.  He is clearly a compassionate caregiver who clearly enjoys people.  Then we turn to the hard realities of running a dispensary here.  The minimum requirements are a water supply, electricity, food for staff and housing for staff.  The nearest water is several miles away and must be hauled by buckets on donkeys.  The nearest fresh vegetable market is equally as far away.  Electricity would be possible only with a generator, (very expensive to maintain) or solar power(expensive to install), as Tanesco does not reach this far. Since schools are few and far between and fees have become almost impossible to pay due to the drought and famine, qualified staff must be recruited to live and work here from somewhere else.  This makes staff housing essential. It has become clear to us that these are interrelated issues that are not easily resolved.  Yet, there are people here who need health care.  No easy answers here.  Dr. Julius clearly is troubled by this dilemma.

The afternoon is spent at the hospital which has its own set of complexities.  We meet the management team,  the Hospital Secretary who serves as the chief administrative worker, the Treasurer (who must track expenses but also revenues from the patients, the government, from NGO’s and from church related partners such as us), and the Director of Nursing.  Patient revenue is its own story, as there seems to be very little that is charged for and no health insurance system to provide payment. To be seen by a doctor in the Outpatient clinic is 2000 TSh for the first visit and 500 for subsequent visits.  There is a one- time charge of 5000 TSH for linens if you are admitted.  Many procedures are free by government or sponsor mandate. The more questions we ask the more overwhelming it becomes.  Yet, these are dedicated people, they persevere even as they know that they are not meeting any kind of business plan or many basic standards.  On our tour, we see renovated and new facilities, an important component in recruiting and retaining qualified staff.  Dr. Mollel is Chief Medical Officer, the chief clinician,  the only MD to supervise clinical officers( a kind of physicians assistant), and runs both inpatient and outpatient medical care. He is the only MD on staff and has new contracted MD for back-up.  Because he is required to go to Dodoma for some meetings, he has been living at the hospital and on-call for 4 days.

As we tour, I ask Neema, the director of nursing what the most common reasons for admission are.  She responds that by far, malaria is the most common.  An average stay of 3-4 days is the normal stay for treatment to work. Others are typhus and minor injuries.  Pregnant mothers can deliver at the hospital without charge so for those who live near the hospital it is sometimes a good option. The government supports this option with the hope that some basic neo-natal care can be given and that the mothers receive some recommendations for nutrition and infant care at home.  All children under 5 are also to be treated without charge.  What the government pays the hospital for these services does not cover the costs but they are provided as best they can.  In talking with a nurse-midwife,  I learn that a big issue related to the drought are the number of malnourished children who are underweight at birth and fail to thrive due to the malnutrition of the mother.

There is a family atmosphere at the hospital. Patients must bring their own clothing and food.  Family members accompany them to provide this so in one room there is a small group having afternoon tea.  Outside the new pediatric unit, there is a laundry area where women are vigorously doing laundry.  When I ask about the posted visiting hours, I am told that they are only enforced for local people as some people have come some distance to be treated and it is not practical for them to leave and come back.

The tour is completed and our heads are about to explode with all the sights and sounds and information we have experienced in 3 days.  We agree to return for a follow-up visit and to tour the orphanage which is also administered by the Hospital.  After saying her farewells to us,  Neema sprints over to the orphanage to check on something.  The treasurer retreats to his office where he keeps manual records because his computer is so old it cannot take the programs needed.  The hospital secretary Jeremiah makes an impassioned plea that we tell their story well in Milwaukee and Dr. Mollel escorts us back to the Guest House before buying his bus ticket for the 12 hour trip to Dodoma.

The spirit of these workers is humbling.  They keep on going even though they know it could be so much better trusting that little by little they will be able to fulfill their calling.  The gap is wide between what could be and what is,  but the spirit is strong.  Mind the Gap!