Safari Scenes: Tarangire National Park

To see photos of our visit to Tarangire , click here or go to:

http://picasaweb.google.ca/crrfraser/Tarangire

“Dad, wake up!!” Sasha hisses from the front of the tent.

I roll over and ignore, seeking more sleep after many awakenings during the night. We are in Tarangire National Park, 250 km southwest of Kilema and I slept horribly but couldn’t be happier: lion roars, hyena calls, a symphonic array of birdsong and the grinding of cicadas. A joy to be awake to those sounds and be bathed in full moon blue light.

“Seriously, you won’t believe it!” Sasha’s voice low and hushed -- both highly irregular for him as most readers will acknowledge.

I sit and wonder if I am dreaming as, even in the predawn reddish light, there is a tree in front of the tent opening that certainly wasn’t there the night before. I remember enjoying the South African red with dinner but feel that cognition and memory should have been left intact. Rubbing my eyes, I alertly note that the tree , over a foot in diameter, is now moving!! What the…

“There are five of them”, Sasha reports, face pinned against the tent meshing.

Elephants!! Surounding the tent, contentedly munching on fresh acacia leaves , their ultimate treat, for which they will deforest a field faster than any industrial operation on the BC coast.

The “tree” has multiplied to a clump of four and, joining Sasha, I now look up to see an attached belly, head, waving ears, tusks and trunk. A baby elephant certainly sees the belly and slides forward to suckle at its mother’s breast, within arm’s reach of us. We hear the loud glugging down of milk and stare at each other grinning.

“Disgusting”, Sasha frowns predictably.

The large mother swings around the side of the tent and we move to a walled area of the structure, open to the outside beneath a thatched roof. The baby moves by and I feel an urge to stroke its fuzzy head, but am restrained by the four foot long maternal tusk gliding by within my reach. The baby looks up directly at us, long lashed and huge eyed, but does not react or communicate with its mother, perhaps looking at Sasha and entering into a silent contract of secrecy; two children agreeing yet again that it is best not to let the adults in on what’s really going on.

The lone wildebeest gallops at a good pace as the sun scatters long morning shadows across the fragrant grasslands. Not a casual canter this, and no herd in sight. We wonder if it is ill or lost or even frightened by its own morning shadow.

None of the above. The wildebeest’s purpose is much more practical: it is running for its life. Soon into view are six young lions, females in the lead, low to the ground, menacing focussed expressions, tails snapping hungrily and irritably at the air. The lead lioness charges rapidly toward the wildebeest, which in turn accelerates.

We all watch, breath held, caught in a mix of horror and fascination at this mini drama, somehow empathizing with both sides of the struggle, predator and prey.

The wildebeest reaches a gentle hill 300 metres past us and, through binoculars now, we see it steadily pulling away, its rangy muscles winning over the sprinters bulk of the lioness. Free to live another day, off to find its kin.

Soon fellow lionesses have reached the leader and, as if in consolation for the missed kill, begin wrestling and chasing games. This is reminiscent of what we sighted at close range the morning prior when, clearly well fed and post prandial, the lions lazed on their backs and wrestled in a kitten-like fashion, wearing gentle expressions that almost tempted one to come close and pet them.

Almost, until a closer look revealed fresh blood on forearms and bellies, not yet licked clean after the morning feed.

As accessible as those brown eyes appear at close range, we are nothing but prey to this ultimate hunter.

Friends We Are Making

Justin trying on Steph's readers

Tumaini and Justin hitch a ride

Helping to fill orphan food bags

Tumaini pre admission and starting ART

Giggles and flashes of coiled black hair announce their presence as I prepare my morning Bialetti, the Kilimanjaro coffee a daily must. The sun is hardly up but already fills the broad plain below and to the east, a yellow equatorial light which feels thick and textured: nature’s bandwidth beyond any we will ever conjure.

The boys are back: Justin and Tumaini now peering through the door, curious and broad smiles warming the day even before my first sip of coffee. As with all African children I have met , they are up long before my own, submitting perhaps to the dictatorial regimen imposed by the manic local roosters which crow relentlessly after 4 AM, ordering all to wake. And as the boys enter through the door, the unfolding of daily routine is confirmed, chatter from a bubbling group of children reaching me as they stream to school on the red dirt road below, fully animated, songs, shouts and laughter all round. It is only 7 AM.

Justin and Tumaini won’t be joining them for this particular parade , though their day will soon come. Both are admitted to Kilema Hospital and have adopted our wazungu (white folk) house as a respite from the grinding boredom of their hospitalizations and perhaps as well from the sights and sounds of a hospital that youth should rightly be spared.

Tumaini appropriately is Swahili for hope and this boy is blooming before us. Admitted against his wishes ( he ran away from the hospital for a day after my colleague Dr Nyaki said he should be in hospital), he has recovered from severe pneumonia, started HIV medications, gained 3 kilograms and become a daily presence at our house. An orphan and neglected by a despairing older brother who has succumbed to alcohol, Tumaini wouldn’t look me in the eye until our fourth encounter. That seems eons ago this morning as he grabs my hand with a dazzling smile, and covertly scans the room for books, pencils and other objects he can play with.

Tellingly, his art centres on beautiful houses with multicoloured windows and strong roofs. When asked why he is drawing houses, Tumaini’s face grows earnest, a new proud expression appears as he straightens, “I will live in a house like this one day.” He has a face typical of the Chagga and I catch a glimpse of the future and imagine a man of influence in his community as I engage his intense gaze.

I can see Ukimwi pushed to the sidelines and Tumaini racing ahead.

Tumaini’s new rafiki (brother) Justin has been in hospital for 2 months recuperating from severe thigh burns from a kerosene lamp used to light his small home. I had often spied him after we arrived, glum faced and sitting in the shade of a tree outside the hospital, on his own for long periods of time, bored and disengaged, not a book , toy or scrap of paper to occupy his time or imagination.

He lives a long distance from the hospital and I haven’t seen his home but can well imagine the scene as Justin tries to light or move the kerosene lamp in order to be able to study or read at night. Eleven years old, he clearly loves books of all sorts and drawing, but had been starved for stimulation until meeting me on rounds and craftily tracking me home, arriving on the porch without invitation but armed with a fearless temperament and bearing the gifts of an irresistible smile and giggle. The gift of the smallest stub of a pencil or loan of the most arcane magazine or playing of the most ridiculous game of cast off bottle caps with Lachlan will reignite that wonderful smile.

Justin shuffles around the hospital grounds with the stooped posture of an ancient one, shuffling gait faster when other children or a soccer ball is in sight. His extensive groin burns, still open and tender on the upper thigh, are starting to cause contractures in his skin and reduce his mobility. Clothed with an improvised sheet draped in toga fashion, he appears to be a wise elder bent in earnest missions. His wise elder persona is only enhanced when he appropriates Steph’s reading glasses and peers over the top of them.

Gratifyingly, Justin’s mobility has improved since Tumaini became his roommate and they jointly discovered our children , who have all been welcoming and friendly. We call out “pole, pole” (polay – slowly, slowly) as he joins in with Sasha, Eva and Lachlan for impromptu rambunctious soccer, concerned he will re open his wounds. This is a moment amongst many where we celebrate the connection of children across language and other innumerable divides.

Justin’s lack of visitors brought concern on my part and with help, I discovered a broken family history, mother long gone to Dar es Salaam and he alone of four children living with a father he described as sick and losing weight, the others with bibi (grandma). Fears of Ukimwi in our heads, the team arranged to have him tested him for HIV. The coin toss landed in Justin’s favour this afternoon, sparing him the burden of Tumaini. “Thank god,” we collectively exhale.

One less obstacle to navigate for a boy in whom one senses great promise and where, like with Tumaini, a few pencils, books and a safe home will give amazing results.

Further to our last post , for those wishing to donate to the Kilema Support Fund, you need the Scotiabank account number 20610 01101 24 when contacting the Oak Bay Branch (tel: 250.953.8100).

Kilema Days

Days begin when the sun starts glowing in the east beyond the Pares Mountains we see off in the distance. The roosters crow well before the sun, perhaps at 4:30, somewhat tentatively at first and then crescendo somewhere around 5:00, just when the first church bells start. The world is in full sunrise by 6AM and by then the soon to be poultry are fully warmed up and exuberant. These morning routines are well known to me, having sleeplessly waited for them, in the first 3 weeks of our stay at Kilema. My antimalarial, Mefloquine, is a complete bust. In fact, hopeless insomnia and other side effects may not become evident until well past the three week trial period. Now I’m off that dreadful stuff (off everything and taking my chances til the rains come)and sleeping like a baby. Enjoying fully my short and saggy bed, falling into it most days fully saturated by the general newness and immensely interesting aspects of life here.

Certainly the mental workout of Swahili is one thing that contributes to the deep slumber. We are all moving ahead with the language. The children are now saying Shikamoo deferentially to elders without me poking them in the ribs. ‘Shikamoo’ means I put my self under your feet and the only proper response, ‘Marahaba’ means may you not be under my feet for long! This morning Lockie was up greeting Anna and Amelianna ,who help to provide all of us here with very tasty and nourishing food, by saying Habari za asubhi?(How goes the morning?). And there is life even beyond Swahili! A few key phrases in Kchagga, the local tribal language, have produced gales of laughter in the same kitchen. Two of the local medical officers have come to teach us ‘correct’ pronounciation( very useful though way less funny) and more medically useful Swahili. One is learning French so we are exchanging services. Eva may be his French instructor.

Speaking of the kitchen… just a word about food. Thank goodness we do not have to hunt, gather and cook or we would be much thinned out by now. There are few to no snacks between meals(except fabulous peanuts) so we are hungry for the next meal. We see Anna cutting spinach in the garden next near us and then there it is, on the dinner plate. Never far from the source and always fresh. We all feel incredibly healthy, largely due to local vegetables that come out of the many well tended gardens of Kilema. The source of meat is more of a mystery and there is usually a bit of pork or beef in the stew, kuku(chicken) a bit less often. Fortunately no more feathery beheadings witnessed lately! Dessert is watermelon or papaya or terribly addictive little “bites”, like deep fried cookies. These go quickly, old and young participating in the orgy. My colleague, Rick, had me in a fit of laughter when reflecting on the ample food he muttered quietly “must not eat”, which pretty much sums it up here. We are proving one can gain weight in Africa.

Laundry is among the many aspects of daily life I enjoy, surprisingly. I have evolved a unique approach to it that works on many levels. First clothing must be red soil red with dirt. Then they get thrown in the plastic basin in the shower and then one stands in the basin churning the clothes around with your feet akin to one crushing grapes. So like the agitator go ones feet, then wash water out and rinse water in. A few cycles later and presto, clothes are ready for the line… and feet very clean. Eva is washing her own clothes and the boys help to hang stuff out on the line…”part of your curriculum,” I say.

Like the Mefloquine so too went Marangue Hills Primary School. The kids lasted about a week there and finally refused to return at all. The distance, bad roads, early mornings and the public floggings finally got to them together with over-stimulation and having their hair touched too much. So they spent last week home schooling and did very well with it except for Lachlan Fraser who did very little with great enthusiasm. Though he did amass quite a bottle cap collection which he plays with in many interesting ways, not unlike Playmobile. (Playmobile was not wanted on the voyage) This week Sasha, starving for more socialization, joined nearby Swahili parish primary school on his own accord and some encouragement from his friend Godfrey who also attends there. Monday morning at 7 am, Chris and I heard a little voice outside Sasha`s window calling to him. Sasha! Sasha! Come to school! And so it went all week, Godfrey coming down every morning for Sasha. Hopefully Eva and Lockie will follow his lead in the days to come. Interestingly, neither Chris nor I have had the time to go to the school to talk to the teacher and see if this is OK . Haven’t heard so guess it is. Fortunately all public primary schools (to standard or grade 7 ) are essentially free though there are fees for food, payments to the cook, uniforms, shoes etc. Secondary school come at a cost which can vary depending on the school, anywhere from 50,000TSH(40USD) to 250,000TSH(250usd)per term. After primary, schooling usually ends for most people and then work starts(well…continues) or perhaps waywardness. Secondary school funding is central to most support programs for poorer families and certainly some of the orphaned kids that CACHA and other organizations support.

What interesting days, one after the other. Some, feel challenging or move more slowly or circuitously or are overwhelming enough to make one uncertain about where to begin. Some days there are delays or changes in the plan, where the power is out or the internet down or people show late for work or there are rounds and then there`s not. (Johnny Lydon, remember when they used to say,”flexibility, flexibility”? )These are days that teach one to relax and go with it.

But most are exceptional for example last Thursday was a great day of home visits up to a hilltop village called Legho, west of us. The program coordinator Denis, three home based care workers(HBC), health worker (me) with charts and another CACHA volunteer squeezed into the 4WD and bolted down the red dirt road causing all pedestrians to stand aside or scramble up the bank! We then turned west and began climbing up very bad “roads” beyond the valley to the next hilltop. Weaving kulia na kushoto (right and left), the HBC’s guide us to shamba’s(farm plots) of people we know are having difficulty. Some clearly are having more difficulty than others though all are poor. Dr. Anna Nyaki at Kilema Hospital HIV centre says, “You’ll know it when you see it”, referring to families who are desperate and needing immediate supports and this is so true. Two of the families we visited were clearly having a tough time. At the first hut we were greeted by a Bibi who cares for four girl, one of which is her own daughter. The mother of the others has left to Dar es Salaam and the father died.

The husband of this Bibi also left because of to many troubles. Bibi is HIV positive and followed on treatment. Her daughter is also positive with a low CD4 taken over a year ago and many missed appointments since. Bibi gets around with a walking stick ,has swollen ankles and hypertension, can’t work, can’t walk to the hospital. Some neighbours help this woman from time to time but she is weakened and upset with worry. There are worries about her health. There are food fees for school due. And when we go enter the dim, cramped interior of her mud and pole hut the holes in the roof look like stars shining in the darkness. She has plastic pots collecting the drips and plastic sacking used as an extra barrier all above her bed. Two sleep in her bed and three in the other. So we will try to help this Bibi and her charges, with food fees and roofing, healthcare counselling and follow up.

The family in the shamba next to this is comprised of two aged grandparents caring for 2 teenaged boys who were asked to leave secondary school because they couldn’t pay for the school fees. One boy share a small bed in a very poor house with his grandfather and the other shares with his Bibi. The grandparents also care for another orphan girl named Ireni who looks about 5yr. Fully abandoned, she has only her first name, adopting her last two names from the Bibi and Babu. Difficult circumstances and living conditions. Hopefully we can help keep these boys in school and give some support to Ireni too.

So I have spent the last 4 weeks visiting vulnerable families and working on developing and growing the orphan program. Who, what, how much, how, when, where.

A lot of mentoring and planning for success once the mzungus leave. Very challenging, infinitely satisfying. I couldn’t be happier.

Bulletin!!! Hailey Philips, your letter just arrived to us this very minute in what looks like very good condition. This is the second letter received here and with great excitement. A reminder to everyone of the address that is now proven to work. The letter arrived to Moshi on Oct. 8^th and it is the 18^th.

C/O Kilema Hospital

Box 1080

Moshi

Tanzania

Soccer has ended for the day with the falling sun on the dusty red soccer field. Exquisite light and so much enjoyment among both spectators and players. Chris not biting too much dust, and enjoying all the soccer games especially the betting ones. But we are both ready for a nice cold Serengeti brew. So Goodibye! Goodinight!

Mwenana's Story

Original fiction by Eva Fraser; underpaid stenography services by Papa

A nine year old girl wakes up in her usual pitch black boma hut. He name is Mwenana. Mwenana’s mom, Kelesi is already awake with her little brother, Nicane, boiling the water that Mwenana fetched yesterday from the well one mile away.

Kelesi told Mwenana and her brother to wake up their father so he could talk to the chief. Mwenana said sure but she wanted to know why her father needed to talk to the chief.

So the children woke up their father and Mwenana followed him to the chief’s hut, without making a sound.

It was Mwenana’s favourite house. She loved it so much because it had the coolest cooking pot. It was bigger than hers and it had colourful beads on it in the shape of a star. Mwenana put her ear to the clay hut and listened to what they were saying. It was a bit muffled but she heard the word school. That had been her dream for some long time after her friend Sahati, the chief’s daughter, went there. She would of course give away her brother to go to school!

The chief did not give the school money but he did give a cow each term to pay for his daughter’s schooling.

Mwenana was dreaming about school when she heard her name being called. “Mwenana, Mwenana.” It was her mother calling she figured. She ran to her house. Kelesi said, “Where have you been? I called your name three times. Next time, come the first time I call your name. I need you to take the cattle out to graze.”

“Sure mother,” said Mwenana. She liked herding the cattle because it was the only time she got to be alone, unless her brother came.

“Oh, and bring your brother, “ said Kelesi.

“Oh fine” , she said, but in her head she thought, why do I have to. “Come on Nicane, what’s taking you so long? “

“I need to find my herding stick,” replied Nicane.

When Mwenana and Nicane finally left (after Nicane took forever to find his stick) they started across the plain toward the next boma.

“We have been walking so long” , said Nicane.

“Fine , let’s turn around then, “ said Mwenana. When they got back to their boma they had been gone a long time, the sun was nearly setting and Kelesi was worried.

“Where have you two been?”

Mwenana replied, “We went to the next boma across the plain.”

“You two worried me because this is the time when the hyenas come out.”

“Sorry” , the children said at the same time.

“Go get tomorrow’s water please” , said Kelesi.

So Mwenana walked for another mile to go and get the water. When she returned she fell right to sleep. She didn’t even hear the elephant stampede one minute after!!

Encounters with UKIMWI

To see photos of the orphans we are working with click here.

To see photos of the Kilema area where we are living click here

The female voice drifted gently at first, perhaps a prelude to the soft singing heard around the hospital as women move so gracefully about their tasks. But soon it hardened in tone and urgency, an inner cry beyond word or melody, drowning out the morning frenzy of birdsong in the bottlebrush tree. Growing further in intensity, the voice broke through the orderly recitation of medical morning report. Reporters and listeners paused, heads turns to see a woman, prostrate on the main hospital steps, clutching at the ground around her, gorgeous kanga quickly layering with red soil.

All nearby stopped to gaze, arrested in bowing postures of sympathy as the grief enveloped them, perhaps connecting to similar moments they each had experienced. It fell to the women to attend their sister, despite their own many burdens, coaxing her reluctant legs to move, wrapping her in a clean kanga, supporting her to nearby shade and whispering soothing words in Swahili or Chagga. What words might those be and how many sunny mornings like these had found need of them?

As rounds resumed the cause of the grief became clear; a sudden death of a male patient during the night, the woman’s brother, another lost to Ukimwi, Swahili for HIV/ AIDS. I had seen him on rounds two days earlier, impossibly gaunt and fighting for air, likely beyond the reach of the HIV medications he had started only a week earlier, years later than he ought to have. The ideal treatment for him would have included intensive care, theoretically available at a regional hospital in Moshi, a 45 minute drive away. But the public hospital is full to beyond bursting I am told by my medical colleagues, and he would have to pay for care at the private Christian hospital.

And so another family in rural Africa is unalterably changed: a wife now under enormous economic pressures to provide for her children. Or worse, children now fully orphaned and dependent on grandparents to provide for them, their chances of completing education and training drastically reduced. Or worse yet, young adolescents being forced to provide for younger siblings.

Ukimwi and its twin faces of desperation and inspiration stared me in the face yesterday in clinic. A ten month baby boy, Paul, weighing only 5 kilograms, visibly struggling with HIV and probable clinical AIDS, brought in by Grace, a woman living with HIV. Mother dead from AIDS six months ago, Paul was abandoned to die by an overwhelmed father, but rescued by his ancient and stooped grandmother who was determined that he should live. The grandmother had been threatened by the father who felt she should take care of the other surviving non HIV-infected children, but her love and instinct combined to drive her to wrap the babe on her back and walk many hours to a new village, where she had without question been taken in by Grace, who calmly related these events. Sitting with me, Grace herself appeared vigorous and well and her chart yields proof that her year of HIV therapy has drastically strengthened her immune system, letting her regain the 10 kilograms she had lost and work her shamba (farm), free of the fatigue and infections which had previously troubled her.

Paul will soon start his HIV therapy and as I write this I hope we are not too late and that the extraordinary love of his grandmother will win out against Ukimwi.

Paul is one of at least 700 orphans and vulnerable children in the catchment region of the Kilema District Hospital most of whom have no direct supports at present. It is to this group we will be putting much of our energy this year, together with the team assembled here by CACHA (Canada Africa Community Health Alliance). Stephanie is a key part of the team doing outreach and home assessments and we will be reviewing how best to be of support to these children and their caregivers, through linkage to community based supports and programs which provide them the knowledge and skills to move ahead with their lives.

We will be consulting with community partners here on how to best use the resources contributed by friends and colleagues to the Kilema Support Fund (an account at Scotiabank Oak Bay – call 953-8100 if you wish to contribute) and hope that future blog posts will give an update on what we have been able to do.