International Experiences

Weblog of the Organization of International Health

Pictures

Eugene: The personal side of my experience

A couple days ago, I met a young North Korean girl who was admitted to the hospital for a hepatitis B infection. Her family lives at the southeast tip of Korea and traveled almost half a day to bring the girl to the hospital in Seoul. Since her father works, he had to travel back the same day she was admitted. This left the little girl all alone in a hospital.

The VP of the NGO and I went to visit her the day she was admitted. We gave her our phone numbers and told her to call whenever she felt lonely. The very next day, we got several calls from the lonely girl. Unforunately, I have to travel with the VP to a remote site outside of Seoul, and we were not able to get back to her until around 5.

Here is a picture I took with her the day we first met:

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I have decided to bloop out her eyes for her safety. Anyways, she really likes giving the peace sign when she takes pictures and insisted I do so as well. She says it is a requirement. Of course, I quickly gave in to her request.

As we were going to visit her at the hospital today, we asked her if she needed/wanted anything. She asked for some slippers to wear at the hospital. The VP and I went to the market and bought her some princess slippers... take a look...

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Guess who picked them out? :) They are sparkly pink with pretty little butterflies on them. She was a little embarrassed when we first showed them to her in front of the other kids in the ward... but I think that she really likes them :) She wore them out as we were saying goodbye.

Lena: To Zanzibar By Motor Car

My favorite picture from my trip to the Coast:

Day 29-39 Mtoto 193.jpg

As part of our language practice, we visited a seaweed farm in Zanzibar. After 'touring' their one room facility, where they store a huge pile of seaweed to dry, we went out to the beach to see how and where they harvest the seaweed. As he showed us how they attach the seaweed to something resembling a very low clothesline, a crowd of children began to gather around. I am not sure whether they were interested in learning more about seaweed farming or were just fascinated by a group of white students listening to a lecture in Swahili. I opted to stay onshore while some of my classmates ventured out into the water to see the seaweed growing firsthand.

I quickly befriended this little girl (pictured above), or perhaps she befriended me and promptly attached herself to me. She never left my side and pretty much refused to give up my hand. Whenever I wasn't paying attention to her, or my hands weren't free, she would bury her head in my skirt. For those of you who know me well, you probably know that this was neither expected nor warranted. I never was able to figure out her name, in part because she had the habit of repeating everything I said: "unaitwa nani?"; "unaitwa nani?" she echoed back, instead of answering with her name.

As the crowd of children increased in size, they became more and more difficult to manage, so I began trying to teach them some of the simple Swahili songs and games I had recently learned. As I became more overwhelmed with all the children literally hanging on me, I reverted back to my familiar roots and began to teach them how to play some American games. We started with Ring around the Rosy and Follow the Leader, which went over relatively well.

When I tried to teach them how to play Duck, Duck, Goose however, I failed miserably. I'm still not sure if this was related to the age group or my poor Swahili abilities. I got them all to sit in a circle and then with another student demonstrated: "bata, bata, bata, bata" - I tapped each one of them on the head. All eyes were focused on me as they tried to figure out what I could possibly be doing. When I came to my fellow student, I called out GOOSE! and then began to run. When I turned around, not only was my American friend chasing me, but so were all my little Tanzania friends. I think my professors were all very amused.

After all the other students finally returned from the excursion out into the ocean, we headed back to regroup at the bus. Most of the children were disappointed to see us go, but my little friend seemed more adamant than most and kept hugging my legs. I finally allowed her to escort me to the bus; as we walked by people's homes, I wondered whether she belonged to one of them. I began to worry that perhaps the people we greeted as we passed would think I was trying to kidnap this sweet young girl.

Would she be able to find her way home if I led her too far from where I had found her?
Was someone worried about her right now?
Had she been accompanied to the beach by a sibling perhaps?
I began to wonder what her home life was like: was she so attention-starved that she attached herself to me of all people? When I said goodbye and gave her a hug, she made me it very difficult for me to put her down. She promptly proceeded to stand outside my bus window and wave. I told the other kids around to get her to move because I was actually afraid that when the bus started to move, she might get hurt. I almost took her home. Don't worry, all I actually took was the above picture.

Small town near the seaweed farm we visited:
Day 29-39 190 Palm Trees.jpg

Along the way we passed many sisal plantations:
Day 29-39 007 Sissle.jpg

Also part of the view on our 9 hour drive:
Day 29-39 008 cliff.jpg

Beach by the fish market:
Copy of Day 29-39 073.jpg

View from the rooftop cafe of our hotel in Zanzibar:
Day 29-39 097 Rooftops.jpg

Lena: Teaching nutrition

The classroom:
Day 17-19 Teaching.jpg

50 students per class:
Day 17-19 students.jpg

One of my students hard at work:
Day 17-19 student.jpg

Lena: Safari

And now, the moment you've all been waiting for: pictures for the animal parks. We went to Lake Manyara and the Ngorongoro Conservation Area. Conservation areas allow human habitation while providing protection status for wildlife.

Here you can see a Masai herdsman running along his cattle inside the crater:
Day 13-15 Masai herder.jpg

Ngorongoro Crater, which is the world's largest unbroken caldera, was formed by the collapse of a volcano into itself. The crater is 610m deep and there are an estimated 25,000 animals within the crater (see below). In addition, it has the densest known population of lions numbering 62 in 2001.
We must of seen at least 12 of the 62:
Day 13-15 Simba.jpg

Lake Magadi in the centre of the crater is a soda lake supporting flocks of flamingo:
Day 13-15 061 Flamingos.jpg

We also visited Olduvai Gorge (Oldupaai as it's called by the Masai, after the sisal plants that abound there). For those, who like me aren't anthropology buffs, this is where the Leakey's did the majority of their work: here they found Australopithecus boisei, Homo habilis, and Homo erectus. Also nearby they found a famous set of hominid footprints, the discussion of which I found fascinating because of the role anatomy can play in anthropology. The arch as well as the position of the big toe distinguished these footprints from those of apes and suggested that hominids walked upright habitually.
I wonder how they picked this spot to make all these important discoveries:
Day 13-15 Oldupai.jpg

Tembo:
Day 13-15 Tembo.jpg

Twiga:
Day 13-15 Twiga.jpg

Kiboko:
Day 13-15 Kiboko.jpg

Baboon:
Day 13-15 Baboon.jpg

Swala:
Day 13-15 Swala.jpg

Punda milia (striped donkey):
Day 13-15 Pundamilia.jpg

Bloody lion among the cars:
Day 13-15 Car Simba.jpg

Lena: Dispensary

Every morning we learn about a particular topic: the vocabulary, the grammar, and the culture surrounding it. Then in the afternoons we visit a place that exemplies that component of society.

Monday: We learned about "children from difficult backgrounds" and then we visited a home for street children.
Tuesday: We learned about weather and farming and then we visited a place for mixed farming.
Today: We learned about health and then visited a dispensary.

Just to clarify what a dispensary is: it's a clinic provided by public or charitable funds according to the Compact Oxford English Dictionary. I would say that it was sort of the equivalent of a walk-in outpatient clinic, where they also supply medications and fill prescriptions.

We were told to go into a random room to find the doctor we would be talking with. Upon knocking and entering, I was surprised to find he was with a patient and all my cultural knowledge of the importance of greetings in Swahili culture went out the window and I began apologizing and attempting to explain who we were.

The doctor would have none of this and interrupted me with the traditional greetings. As he asked to sit and we all introduced ourselves, I began to wonder if perhaps the woman in his office was not a patient at all.

Just when we all began to feel a bit more comfortable, he proceeded with his consultation, pausing occasionally to explain various aspects to us. Eventually it became clear that this women was having problems with her menses and he was going to give her some fertility drugs.

At that point, the three other students in the room became extremely uncomfortable. I felt the sames light unease that I usually feel when a large group of student is privy to the intimate details of a patient's personal life. After the patient left, he said you just observed aibu, or shame.

Afterwards, all the students could talk about was how awkward and uncomfortable they had felt and what a violation of patient privacy it had been. It seemed odd that if the doctor knew the patient was feeling embarrassed and ashamed, he should have done something to ameliorate that feeling, but proceeded with no compunction. In additon, he hadn't asked the patient if it was okay for us to observe beforehand, but then I began to think that even if he had asked her, she would have agreed despite her personal discomfort.

Unlike the rest of the students, I was struck by a number of other things. Firstly, the similarity in the way one takes a history and gathers information from the patient was remarkable. Despite all the differences in health status and disease profiles as well as all the cultural differences, this doctor was modeling the same kind of clinical thinking that I had learned in the past year. He used open-ended and close-ended questions, and things like how long as it hurt and can you point to the exact location with your finger.

He also talked a good deal to us about what the most common illnesses were and had a handwritten chart on the wall of the disease burden from 2003. Interestingly, malaria, acute respiratory infections, and minor surgeries (i.e. tonsilectomies) were the most common diseases seen in Usa River. I noticed that HIV was not on their chart, nor was tuberculosis, two diseases that I thought would be relatively prevalent.

He seemed to think nothing of it, opened a book and said that they have documented 84 cases of HIV. I asked what kinds of services they provide, he again seemed to think it was obvious that they provide treatment with ARVs (antiretrovirals) and home-based care including nutritional support as well voluntary counseling and testing (VCT).

All in all, I found it to be an enlightening experience, with several surprises.

The dispensary from the outside:
Day 11 Dispensary.jpg

The doctor's office inside:
Day 11 Ofisini.jpg

HIV/AIDS related posters in the waiting room:
Day 11 poster 1.jpg Day 11 Poster 2.jpg Day 11 Poster 3.jpg Day 11 Poster 4.jpg

Asya: Russian Summer

For updates on Asya's adventures in Russia, check out her blog at:
http://asyagu.blogspot.com/

If you want to see her pictures, go to: http://www.mumrik.us/

See excerpt from her blog below.

I've been in Russia since Monday and its definitely a very interesting country. I already have some stories, including grandma's selling flowers, policemen, and adventurous teenagers at their high school prom/graduation bonanza. But more of this later, when I get back from a much needed trip to a cooler, less crowded dacha (summer house) outside the city.

Impressions of Moscow:
Although this isn't typical (so I'm told), Moscow is HOT this time of year. It's hot, crowded, and there is no air conditioning for anyone but the very wealthy and the particularly picky tourists. The city streets remind me of pictures I've seen of busy Chinese cities: cars parked 3 deep so there's only one lane for the enormous amount of traffic, many people, pretty dirty. But despite this, Moscow is a beautiful city. In the center of town, everything is old, historic. I can walk around there for hours, given I don't attract the attention of a hungry policeman who wants some lunch money. So far, I seem to do ok blending in if I keep my mouth closed. As you know, this is sometimes difficult for me.

Anyway, I'll post more later, but if you're curious what Moscow looks like and where I live, go see my pictures at http://www.mumrik.us/ (don't laugh, my dad made the site, in dedication to my cat). Click on the photos link and then look at the Russia 2006 album. You can sort the pictures by date, etc on the upper right hand side. If you want to see what the life of high school students in Russia is like, click the Russia 2006: Sasha Graduation album to see pictures from our friend's high school graduation. There are some very interesting dresses. I will keep updating this page with new pictures, so check back later for more.

Hope you enjoy!

posted by Asya @ 12:49 AM

Lena: Market

Two days a week, near Arusha, there is a huge open air market that sells primarily vegetables and fruits. Our assignment was to go and practice our Swahili as well as our bargaining skills. They gave us 500 Tanzania shillings (Tsh), which corresponds to about approximately 40 cents, and 1.5 hours to spend it.

For the first 30 minutes, I simply wandered around, trying to get the lay of the land, and more accurately, being too intimidated and too indecisive to talk to anybody. That didn't stop people from talking to me.

One person called from one of the stalls, in perfect English, "I love you mzungu." I tried to ignore him, but a lady closer by said, "did you hear him, he says he loves you?" When I made eye contact, she said, "he's my husband." I couldn't tell if she was joking or serious... I replied, "Kwa nini? Hanijui. (Why? He doesn't know me.)" and continued on my way.

As I continued to wander, I noticed a small boy, about 9 years old, following me. I found this a bit unnerving and tried to evade him, but he stayed with me as I walked more purposefully.

I turned and said "mambo," a slang greeting to him. Now it was his turn to be taken off guard. He repeated my question back to me, and I responded "poa," meaning cool. He began to laugh and then disappeared, but this was not the last I saw of him. He returned with 3 other boys and whispered something to them. One of them tentatively asked "mambo?," I responded again, and they all doubled over laughing.

Still empty handed, I bumped into a group of 3 other students, all with hands filled with bags of vegetables. I decided to tag along with them for a bit, and with their encouragement, I managed to bargain for 8 tomatoes, 2 very large avocados, 6 lemons, and a bag of hot peppers for my 40 cents. My little friend from before reappeared when I needed a bag to carry my prizes, and I paid him 4 cents for it.

All in all, I would say it was a successful day in the market, and between the 15 of us, we brought back enough supplies to last the kitchen here for awhile.

My fruits (all for 40 cents):
Fruits from the market.jpg

Outside the market:
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Lena: MS-TCDC (Training Centre for Development Cooperation)

Our accomodations are much nicer than I was expecting. We have running water, private bathrooms, laundry service, 15 computers that are hooked up to the internet, wireless internet, and the list goes on. The downside is that we are in a gated complex 18 km from Arusha proper. The good part of that is that it's safe and I can run in the mornings without concern of being harassed, except by the monkeys.

See pictures below.

Here's the room I will be sharing with Leslie for the next 7 weeks (mosquito nets and all): Copy of Day 1 007.jpg

This is what the building looks like from the outside: Copy of Day 1 Blue 17.jpg


The monkeys joined us for tea:
Copy of Day 2 & 3 003.jpg

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