Showing posts with label Autopsy. Show all posts
Showing posts with label Autopsy. Show all posts

Monday, November 7, 2016

Week Four; A Highly Esteemed Visitor, TAWREF, Another Hash (and another sit it out in a chair with a beer), and new swim suit

Trying to stay warm in the pool New "wet suit"  Not very warm!
This week seemed like it might be boring, especially as my knee is still killing me at every turn.  But, it turned was as usual was filled with interesting things!  John had to go to the US for two days!  So, he had four days on the plane, two days in Boston.  I hope the meeting was worth it.  The hotel greeted him with big "Thank Heavens you are here, because fourteen boxes of packages had arrived for him to bring back for many many people, and they were so glad to be able to empty out their closet.  At least, they were nice about the whole thing.  He was very happy to be home.
Manuela and Anne Nelson

Trish and Anne Nelson
It turns out that while John was away, we had a very esteemed visitor to A-5 and the KCMC/Duke project.  She is one of the most famous HIV and Infectious Diseases Pathologists in the world, and here she was staying with us.  She is also exceptionally nice, interested in everything going on here and very dedicated to the young people who are working with a new research project on autopsy.  It is one of the first projects of its kind in East Africa, and thus will be incredible however it turns out.  We had some fun, too.  We went to Pizza Night at Mukesh's Uptown Grocery which is always fascinating for the unusual people who hang out for a secret beer or whiskey before they go home, children who race up for a treat, and young people mostly who come to buy one cigarette.  It even brought a few drops of rain (not enough to call it a rainstorm, however).  We drove through the beautiful coffee fields to Kilimakyaro (KiChagga for Kilimanjaro).  We had a beer and begged the mountain to come out!  Recalcitrant as usual, we sadly had to have a gin and tonic to more strongly encourage the mountain to come out, and she finally did just as the sunset was through and it was nearly dark.  As usual, it was horrible driving in the dark down KCMC road as it is quite narrow and people walk all over the street.  I challenge anyone who has read this far to try seeing Africans in the street when someone else's bright lights are shining on you.  Fortunately we made it home in one piece, and I think Anne felt that her trip was a success.  She had been a part of four autopsies, figured out some things that need to be done, and will come back to visit not too far in the future.
New TAWREF Building

Mission Vision TAWREF Some Studies

Little TAWREF Store
My preachy part of this blog regards Volunteers and Non-Governmental Organizations and their value, and also their burdens.  A group of Tanzanian women founded an organization entitled KIWAKKUKI in 1990 with the help of a beloved Nurse and Devoted women Juliette Howlett.  Juliette was married to the only Neurologist and the first doctor who actually described AIDS in East Africa for the first time.  I worked with this organization for over five years, doing everything from writing and editing reports, editing grants, teaching English, and generally was the best "girl Friday" I could be.  It was all part of a Twinning NIH grant that paired an NGO that did Home Based Care for AIDS patients with our hospital KCMC.  I was the "twin" for KIWAKKUKI.  I came to love the women who worked there and they are still my best friends in Tanzania.  (Think Dadas).  Many of this group separated from KIWAKKUKI in 2010-2011.  They formed a smaller organization loosely dedicated to research, and the KCMC/Duke Collaborative followed them.

When you visit Moshi and the Kilimanjaro region, you will be impressed with the number of NGO's in Moshitown in particular.  There is practically one on every corner...sometimes more than one.  The problem with them is not their intent, the problem with them is that they often duplicate services that others provide and often die out when the donor runs out of money.

TAWREF/KIWAKKUKI was started by the Tanzanian women, for the Tanzanian people, both those with HIV/AIDS (UKIMWI) and those affected by the disease.  These women will be here until they are dead or retire, they go sometimes with no pay until a grant comes through, but they do the jobs that are greatly needed.  And I have seen them open their own pocketbooks to help out desperately poor people who come in crisis to the office.  TAWREF has a collaboration with the Vine Trust Scotland that involves wards choosing the most impoverished and needy families and putting them on a waiting list to receive a nice small safe house.  The experience is a little like Habitat for Humanity, where both the recipient family and the village will assist the builders with the completion of the house, either with pots and pans, some sugar or tea, anything including labor.  My illustration is just that, some very dedicated new volunteers to our area, could seek out existing NGO's started by Tanzanians, suggest their project to them, and offer to help fund it.  Since the entire region of Kilimanjaro knows TAWREF, here you have a perfect way to reach and meet the people who need to be reached, the best investment of money around.  I can say that I believe this to be true because I have been in Moshi since the end of 2004, and have spent countless hours with these women who started out just trying to find a way to stop so many people from dying of this strange disease (UKIMWI), and wound up helping orphans, widows, doing counseling and testing, doing longitudinal studies on their resilience and growth and develop in orphanages and out, providing cognitive related group counseling and support for families and caregivers in need, providing voluntary home based care services to HIV-infected persons who could not get to health care or needed visits between health care appointments, and doing outreach and HIV-education all over the Kilimanjaro region.  So, if you think you have some money and a project....go to an organization like TAWREF to see they feel it will work, or possibly have them help you and use their influence and name to accomplish huge goals.

Mateé at this weekend's hash
Each two weeks Sunday would be incomplete without a hash. (run or walk through the beautiful countryside that is Kilimanjaro).  This Sunday's was at a place that John and I had set two hashes in the past.  Kigomboni Guest House.  Sadly, I couldn't hike up to the fabulous vistas because of my knee but I did have a wonderful time visiting with some creative four year olds who had many things to tell me about fairies and ogres who eat little children at night, as well as their ability to swim with crocodiles who won't eat them because they think that these little girls are toys.
Anna and Mike Mayes farewell
Frequently, there are goodbyes at hashes.  Many people come for two year stretches and then leave.  Anna and Mike and their two adorable children will be leaving in January, and have been not only outstanding members of our project, but have gone down in history for allowing their little girls to experience Moshi mud, climb trees, run barefoot slide into any available pond, fall down (no problem).  I remember one party in which one of the girls said to me, "guess what we got from school!"  I demurred, and she triumphantly said, "Lice in my hair!!!!"  She was quite joyful about it even as her mother looked at me and shook her head, saying..."well it is true, but do you have to shout it out?"   New Zealanders for ever, they took advantage of every single possible thing that they could do with their sometimes reliable car and their camping equipment.  We will really miss them.
 Beautiful yellow flower by the Guest house
Chicken House (nearly nicer than the guest house!)

All kinds of Brush and trees that the runners headed out to see.

Kilimanjaro shining through the trees
So nothing would be complete without the greeter at the house when we returned from the hash.
This bored tabby cat just glanced up at us and let us go on in the house!
PRAYING FOR HILLARY WITH EVERY WAKING BREATH--


Saturday, November 15, 2014

Graduation Weekend KCMCollege, Moshi Tanzania

Dedication of 3rd Floor of the College to John, MEPI team party, Night of Inspiration


Plaque Veiled

Plaque unveiled
I could write a long blog here, but instead will mostly post pictures.  Yesterday was a full and amazing day.  My heart is full yet again for the friendships that John and I have developed here in Moshi over the past 10 years (for John 13).  We have a marvelous team in the Collaboration with the leadership of Dr. Blandina, we have the best accountants in Frank, Francis & Vera, and team of researchers and lab research team, students and staff are skilled in handling the Standards of Practice that are required by the National Institutes of Health.  It is not easy to handle dollars converted to Tshillings when the conversion rate changes daily.  It is not easy to provide excellent quality control quality assurance when the research protocols add amendments, require drugs that come in the milligram sizes not available anywhere in this country, lab results when the power surges fry even the best surge protectors, the browser corrupts and looses data for months, the toilets break, the mud is thick, the best vehicles have a hard time getting to the field sites, the babies are born at midnight, and some staff are injured in motor vehicle accidents.  This group laughs hysterically and then puts the hard work of figuring out the way around.  What a blessing.

John with collaboration and MEPI Team

John with Plaque

Black dots are Nairobi Fly
At the presentation, there were so many of these horrible Nairobi Flies that they were falling from the ceiling and like a moving carpet on the floor.  In my sandals, I had to walk on my toes to try to avoid any of them crawling across my feet and wash my sandals when I got home!

The Bishop gives a short word of thanks to John

Ahaz and others in the dedication


The young MEPI gang
Something funny at the end keeps us laughing

Just what is going on?????Sijui (I don't know)

Carol our fab driver takes the MEPI Bus for students to go to the field
Then the MEPI (medical education partnership initiative) team, led by Ahaz Kukulanga the DeputyVice Provost is just amazing. Most are young and energetic.  They grew up in the age of the internet,and that gives them something the rest of us could only dream of. The older folks had to learn after years of hand-writing or if lucky, typing.  Raised during or just after colonialism, they were forced to work harder, prove themselves more, and know what it was to deal with struggles every single day. I am quite sure that thoughts entered their heads of giving up, but they did not.  To see them celebrating again, and to be in some way the focal part of it was really incredible, and humbling. 
A Toast to the MEPI team members who are missing
Because some team members are studying abroad, or busy winning the "best poster award" (AKA Charles) the team toasted them saying "Mitwara" for the best beef sausage around!
Each department in MEPI described John in relation to their speciality

Ahaz notes he bought penny loafers to look like John

The cane award
John and I had a happy day

Our lovely MEPI team

I even got a Kitenga and toast!
 The changes at KCMC College are equally astounding.  It is true that the MEPI NIH grant supplied the cash for much of the infrastructure development, but it was the vision of the Provost Kessy in particular and Professor Shao in the early stages that allowed the dream for the college to become a reality.  Their sometimes brutal honesty is actually a huge relief in a world that often puts roadblocks in place for more transparent people.   
Ha--It is time to start + 30 min.  The platform is not yet built!
As usual timing is everything in Tanzania.  It all started 2.5 hours late!
The MC's were great--even though they broke the steps to the platform
John, Kessy & Shao discussing.  Note Sprite bottle

Dr. Mallya, Blandina and William will debate specialities soon!

Rose and Dean Deo sharing a word

Prof Lavina shares life as she studies in Russia!

Prof Shao shares life as he studies in Cuba

Provost Kessy's Chagga Name "Kazi Ngumu" Work Hard!
 The first speaker Provost Kessy, shared his life as boy in Mamba in a one room hut with 8 brothers and sisters, school barefoot and being caned for nearly everything, but his passion for Math and Medicine.  The second speaker Prof Dr. Msuya spoke of her growing up and her training in Russia where she had to learn the language, and cope with the cold and her passion as one of the first female MD's in Tanzania.  The third, the Honored Guest Professor Shao, spoke of many challenges from boyhood to adult, but each with a message of hope and determination.  "What I learned, What message can you take?"  I am so eager for someone to write a book about the life of Professor Shao.  His experiences are incredible, unique and ground breaking.  Life in Castro's Cuba, life in Uganda, experiences with Apartheid Africa and Steve Biko.  Just incredible.

The medical students and the faculty who spoke at the Night of Inspiration were both hysterical and seriously amazing.  The Rappers, also medical students were creative and funny.  Whether you like rap or not, you would have to be impressed by their ability (even while secretly thinking that their parents are so glad that they finished medicine and have a great career ahead of them). And the MC’s were perfect, playing off each others’ strengths and providing just the right amount of humor.
The MED Boys Dream of the Night of Inspiration
The MED girls describe the first autopsy

 Faculty Prof Mallya, Prof William and Prof Blandina nearly took the house down describing why they deserved the one parachute as their theoretical Indian AirLines plane crashed.  Their ability to think fast is legend, but we were all astounded!
Children will lead tomorow

You have to walk to run (fix the broken bones)

I am the one up here who took care of the Pope

My John gave an equally inspiring talk, using parallels from his parents and us, and as well the love of Global Health and seeing the changes that have occurred despite the challenges.  I agree with Ahaz, that his ability to put the perfect “spin” on something that seems impossible is unique.  And, if he promises something, he will deliver, and if it is bad news, he will give it honestly but kindly.
Ahaz introduces John

The screen for the slides is behind--No slides
 Note that the screen for the slides was made from 4 sheets pinned together and as the wind blew the sheets billowed, the slides disappeared. Not to mention that as the wind blew, the projector reverted to "input A"
John really inspired

So the day of the plaque, and the night of inspiration were an event that even as I become more forgetful, I know will be with me forever.