27 June 2005

Maasai village


Between safaris in the Serengeti and Ngorongoro Crater, we stopped at a Maasai village. We visited a school and the children were really impressive - nursery class counted to 40 (made me realise how little I had taught my class!)

Thoughts, reflections and things left unsaid

I've only been back a few hours but it already feels like my time in Tanzania could have been a dream. I think the most significant lesson I learned is that maybe the most important thing in life is your attitude. It was easy to be narrow minded and not think about the struggles of people around me: to feel frustrated at hustlers trying to sell their wares instead of respect at the persistence with which they try to eke out their minimal existence. On days I allowed myself to feel irritated, everything seemed to build up becoming more and more frustrating and alien. On days I thought more about the position of people around me, I felt humbled and extremely lucky. My trip was a truly amazing experience and one that I was only able to indulge in because of my extremely privileged background.

One of the things I will remember and admire the most about Tanzanians is their kindness and generosity. Travelling by myself in a strange country was perhaps the most daunting thing I’ve ever done, but I met such astonishingly good people my journey was much easier. Everywhere I went along the way I was invited into the homes and lives of people who had to nothing to gain from their kindness. People offered to help me find hotels, meet me in air and ferry ports, take me around town and even to stay in their house when they weren’t there!

I’ve read sooooo many books and studies on Africa, but nothing compares to actually seeing the everyday struggles of people. Being in a village that is only connected to minimal health care facilities through dodgy dirt roads and seeing the huge obstacles people face every day just to get to work things make much more sense. If nothing else, I come away from my stay in Tanzania with the overwhelming sense that infrastructure (roads, buildings, access to clean water) must be improved first and foremost. Children can’t go to school if they have diarreah from unsafe drinking water, the school is too far away for them to travel, or the roads are so dangerous they cause an accident that kills them on the way. Women would have more time to study if they spent less time fetching unsafe water; the more educated a woman is the less likely she is to catch HIV. I keep hearing that throwing money at the problem won’t help, which is true to a certain extent: throwing money at corrupt officials won’t help at all. But cutting off funding when so much needs to be done is not the solution either: development aid needs to be effectively spent so that people have a fighting chance of improving their lives. I’m not sure if my students learned anything during my weeks with them, but they (and everyone else I met) definitely taught me!

24 June 2005

scooting round Stonetown

The past three days have been a blur - literally. I've had so much sand and grit in my eyes from zooming around Zanzibar on the back of a scooter that most of the time I haven't been able to see a thing. The first two days I really enjoyed it, but today, 1/2 way into the journey to Nungwi beach at the very tip of Zanzibar, I felt so sore I would have gladly given up the convenience of scooting for the "comfort" of a dalla-dalla. On the way back, I would gladly have paid big bucks for the dalla-dalla comfort, only the fear of offending my host that kept me glued to my rock-hard seat (for those of you that think I'm exaggerating - I have bruises!).

Despite my discomfort, Zanzibar really is paradise. I thought all beaches were pretty much the same, but today I was astonished. The sand was white, the water warm and turquoise, and the waves broke so gently next to the shore it was impossible not to dive in. I've never understood why people are so obsessed with going to the beach, but after Nungwi, I get it. I toured a spice farm early in the day, afterwards we 'sampled' some of the most heavenly fruits I've ever eaten. Starfruit, mangoes, tangerines and many more which I don't remember the names of, but after all the rice and beans I've eaten over the weeks, it seemed a world apart.

I keep seeing signs for WHO, ActionAid, Save the Children, et al's Zanzibar office and thinking what a blessed existence the staff must have to get posted here. It's hard to remember with the seeming abundance that poverty is much more rife than you'd at first believe. One rather sordid measure of this is the plentiful sight of middle aged muzungos cavorting with teenage prostitutes in just about any bar you go to in town.

23 June 2005

Nungwi beach


All the way at the top of Zanzibar, Nungwi beach was gorgeous and well worth the harrowing journey.

Mtoni Palace Ruins


This is where the Sultan Said lived briefly. He kept his favourite of the 99 concubines (slaves) here to be used at his pleasure. The ones that fell out of favour would be returned to the auction block and replaced quickly.

Stonetown coast

20 June 2005

ICC Arusha

Monday morning I sat in on the one of the courts for International Criminal Tribunal for Rwanda and heard a woman talk about the genocide. She testified that one of her family members had convinced a group of Tutsi's to come out after a week of hiding because peace had been restored. When she and the others came out and registered the men were immediately killed by machete's and clubs. The ones that had any money paid soldiers to shoot them so they would die by gunshot instead. The women and children were rounded up and handed over to armed soldiers who gang raped the women repeatedly. It was heartbreaking to hear her testimony, especially as it was continually interrupted by objections from the defense. The prosecuter asked for a closed courtroom because she was going to name people who would know her identity and it could be dangerous for her as they were out of prison. After strenuous objections from the defense it was eventually granted by the judges and I had to leave.

This morning I went back for a couple of hours before my flight left Arusha. I met Lincoln, a reseacher from NY, who saw the initial cross-examination yesterday after I had left. He told me the defense had really been badgering the witness, especially about inconsistencies in the French and English statements she signed. The witness spoke Kinyarwandan, and couldn't read or write: how she was expected to spot inconsistencies in two languages she didn't speak when she is illiterate is beyond me. Today the defense continued to berate the witness, calling her a liar and at times yelling at her. I know it's their job, but it was very frustrating to watch the defense attorney's treatment of the witness. I felt that most of the questions the lawyers asked the witness were designed to be misleading. My overall impression of watching (admittedly very little of) the trial, was that justice really fails the poor and uneducated.

19 June 2005

the Serengeti

When I started planning my time in Tanzania, it never occured to me to go on safari. My goal was to help the children and learn as much as possible about poverty, HIV and just life in general in a developing country. After much encouragement from my mum, and a mass decision from the volunteer group, I left on Thursday morning for the Serengeti. It was a wonderful experience and something I will never forget. We spent two days in the Serengeti and a day at Ngorongoro Crater. The animals were beautiful and it was so nice to see them in the wild. I don't think I will be able to go to the zoo after seeing a lioness play with her cubs a few feet away and a herd of giraffe happily eating together on the Serengeti plain. The safari was an extremely different reality than what I had experienced for a month in Mwanza. Instead of being the only cluster of Muzungos in town, the only Tanzanians we saw were 'servants'. After being used to beans and rice (or ugali) for weeks on end, the buffet table had every Western food you could imagine. Instead of walking or catching dalladallas everywhere we had our own driver. It was quite surreal to for us (the volunteers) to be able to enjoy ourselves to such an extreme extent after witnessing the every day struggles of most people here. It was a fabulous experience, but one that I am extremely glad I had after seeing what Tanzania is really like.


The Serengeti wildebeest migration


Duma (Cheetah and Cub)
Our guide in the Serengeti told us he had been doing safari's since 1978 and never seen a Cheetah in a tree before!


Twiga
The Giraffe was one of my favourite animals.


Simba
This lion was rather shy and hid from us as soon as we approached, the lioness was inches from us and didn't move when we approached!

15 June 2005

Goodbye Mwanza

Sadly, after a month at the orphanage, most of the other volunteers and I were concerned about the accounting and felt that the director was not being entirely straight with us. Although it must be emphasized we have no proof of any wrong doing, the prices Fred quoted us for things seemed to be extremely high. Whether the reason for this was because he assumed we had loads of money and wasn't bargaining or something more sinister, I didn't feel comfortable handing over cash to Hisani. I decided it was best to give things, not money, to Hisani. The children loved the toys and colouring supplies I brought with me. Unfortunately, the dresses I had made for the girls weren`t ready on my last day, so Rachel has promised to pick up the dresses next week and take photos so I can post them on here. Over the past few weeks I have talked to Joseph at length and seen how transparent his accounting and fundraising is and that his participation in the community is truly making a difference to so many lives. I decided that the leftover money I had fundraised would go much farther at Fonelisco and gave him US$100 for his orphans.

Although there were times I felt I was loosing an uphill battle, I learned so much at Hisani and I will always treasure my time there. The memories of the children's love, hope and resilience in the face of such overwhelming hardship will continue to inspire me. I loved teaching and playing with them, and saying goodbye on Wednesday night was one of the hardest things I`ve ever done. To be completely honest, I only lasted an hour at the goodbye dinner because I was too upset to stay any longer.


Biala and Matungwa at the goodbye feast
Our last night in Buswelu - Biala clearly had enough to eat!

14 June 2005

Streetkids

I wandered through the market trying to block out the noise of all the onlookers screaming at me. I was in no mood to try and fend off the enterpreneurs, taxi drivers or beggars all trying to catch my attention in hopes of making their evening meal. I repeated hapana, hapana, hapana (no) as I walked with my eyes down trying to keep the attention I was getting to an absolute minimum. I was so in my own world that I almost snapped hapana at a little boy who came up to me asking for something to eat. I bit my tongue just in time and did a double take. The reason I came to Tanzania was to try and help children like him, and yet I almost dismissed him out of hand. He had sulked back into the shadows, expecting me, like everyone else, not to help him.

I told him to njoo hapa (come here) and three more little boys came out of the shadows and started following me. I took them to the pizzeria place down the street and after washing we all sat down for dinner. Nickolas, Jameson, Ngusha and Samwel (10-12) were soon joined by Brian (9) and were all very sweet and told me they wanted to come home with me. I explained that I couldn't adopt them (legally, the government of Tanzania won't let people adopt unless they have been a resident here for 2 years - so all of you back home can breath a sigh of relief!) but that they could go to an orphanage if they wanted a place to stay. They all told me they wanted to go, so I called Joseph who said he would be happy to take them in. I gave them all Fonelisco's address (it is close to the city centre) and they promised me they would go - I just hope they do.

Spending an hour with the boys made me feel so much better. It made me realise that even though being asked for money all the time is really frustrating, and feeling like I am constantly being ripped off is a bit frustrating, I am so lucky. I can't imagine the resilience of being nine years old and trying to scrape together my next meal every day and a place that's safe to sleep each night.

13 June 2005

Mwanza -> Missungwe -> Ngudu -> Mwanza

I left Mwanza very early and arrived in Missungwe at 9 o'clock yesterday to find all the dispensaries (local doctor's offices) closed. After walking around the village for a bit Patrice and I finally found someone that worked at the dispensary, who said he would go off and find his boss and open the office up. While we were waiting for him to come back, we hopped on bicycle dalla-dalla's to the hospital in search of their VCT (voluntary testing and counseling) unit. We were told again that as it was a Sunday, the VCT unit was closed, but the doctor on duty talked to us about HIV in the area and estimated that about 1/3 of the people in Missungwe were HIV positive and as yet, there was no provision of ARV drugs in the district. Anyone who's t-cell count was low enough that they needed ARVs would either need to pile into a dalla-dalla for over an hour to reach Mwanza (not very feasible in the advance stages of HIV disease [AIDS] when diarrohea is often present) or have to pay for the medications themselves at retail price (not an option for the vast majority of the very poor district). When we returned to the dispensary, we talked to the head of the lab who had come into work especially to talk to us. He told us that the local dispensaries (which due to the sparsely distributed population are usually the only health facilities most people in Tanzania can access) are not able to talk to people about HIV, test for HIV, or prescribe ARVs.

The bus to Ngudu was the biggest vehicle I've traveled in yet, and easily the most frightening! By the time we arrived in Ngudu I was worn out by all the travel, but still had many people to meet. The first person I spoke to was the District officer in charge of AIDS, who told me that the only ARV medications available to people in the district were a single dose used to prevent mother to child transmission, there weren't any drugs available for ongoing treatment of AIDS patients. Again, people that needed ARVs had to travel to Mwanza (2.5 hours away on the fastest route) or buy them themselves. I spent just over 24 hours in Ngudu and met the chief executive officer, his secretary, the district commissioner, the executive officer of the hospital, the chief medical officer, the head of the VCT programme, a few patients, and a group of traditional healers.

I was primarily interested in access to treatment and in an area where treatment options weren't available it was not necessary for me to talk to patients. Despite me saying this several times, the doctors insisted that I speak to two female patients. One of the patients was in the final stages of the disease: she was suffering from diarrhea and abdominal pains, had lessions all over her body and under the sheet was clearly little more than bones. Through my translaters and the doctors I couldn't work out if she actually knew about her HIV status, or if it was just her father that knew. The second lady I talked to was a mother of eight children and came to the hospital complaining of abdominal pains, the doctor told me she did not know she was HIV positive and hadn't gone through counseling yet. It made me extremely uncomfortable to talk to both of these women who were suffering a great deal and know that I knew more about their medical status than they did.

It was a whirlwind visit and one that left me feeling really exhausted. I came back to Mwanza feeling very worn out and depressed.


Ngudu hospital women's ward


Illomba traditional healer

12 June 2005

Reasons my mum's glad I'm in Tanzania

1) I've started praying regularly - The roads are so horrendous here it's hard not to. Although cars, buses and dalla-dallas are normally flying down the road at such speeds it's terrifying, when they slow down I am even more frightened. A sudden stop means we're about to hit something, there's a 'puddle' in the road, or we're about to hit a pothole so massive we might capsize.

2) I'm getting more exercise than I have in my life - I'm lifting, carrying or picking up children all the time, I walk everywhere I possibly can (see above), and my stomach muscles are getting a massive workout going over all the bumps in the road.

3) I don't want to have sex - Spending as much time as I have recently visiting hospitals talking to patients (all female) and health workers (all male) might be the best abstinence programme ever.

10 June 2005

4 weeks

There are something like 50 children that show up for nursery class every day, ranging in age from three to seven, and in ability from not knowing how to count in Kiswahili to being able to think in English. The ones that are really naughty in class are almost always the brightest children who are really bored by the slowness of the other students. Over the weeks I've learned a lot about the children and managed to put together a group that works really well together. One community boy, Dayo, was absolutely demonic when I taught him the first week in a massive nursery group, but this week he joined my morning class and was incredibly well-behaved and respectful... in the smaller class size I was able to give him enough attention and challenge him so he wasn't bored.

This morning I taught my last class at the orphanage. We spent an hour writing, drawing and colouring, then left for the field where the boys and I played football. I was wearing a skirt and flip-flops, not the best gear for running and kicking (I can imagine my brother laughing at me as I write this) but I really wanted to get the girls involved and thought if I was doing it in a skirt they might join in too. No matter how hard I tried I couldn't get them to join in for longer than it took me to turn around, so after about 1/2 an hour I took them all to the shade and read "The Cat in the Hat" and a few other stories and told them it was our last class together. The children were so sweet and all gave me a hug, I cried when it was time for them to go :(

I can't believe I've been in Tanzania a couple days shy of a month and only have two weeks left. I've gotten used to being called muzungo all the time now. I realise that it isn't meant to be rude, just that people here aren't used to seeing them. Over the weekend when we took the kids to the dance off, Biala was sitting on my shoulders. All of a sudden he says "Madam! Madam! Muzungo!!!" then points at some other white people. Rachel and I asked "Biala what are we?" and he says "Rachel! Tasha!" (pointing at us) then "wazungos" (pointing at the other white people).


Last class at Hisani Posted by Picasa


Biala Posted by Picasa

09 June 2005

Dirt Rollercoasters

I stopped by Fonelisco today. Joseph and the children gave Max and I a phenomenally warm welcome: the local volunteers sang for us and the children ran up and hugged us when we arrived. Joseph invited me to join him on a trip to one of the rural villages near Mwanza to hear from traditional midwives, so a short while later I jumped into a 4 wheel drive with a Dutch researcher, Joseph and a local translater.

It took about an hour to drive out to the village. I have to say that all my previous reports of awful road conditions were blissfully naive. This was the road to end all roads. There were potholes covering the entire road for the entire journey. We had to drive through giant muddy "puddles" on about a dozen occassions, knowing if we got stuck we'd be the ones to jump out in at least knee deep mud and push the car out. I was extremely grateful to be making the trip in a 4-wheel drive and NOT a dalla-dalla!

When we reached the village, we learned that the women had been waiting all day for us and had just given up and left. We tore off in the direction they had gone to catch them, and spent about an hour rounding them all up again. After so many delays, they were finally able to begin their performance. The women had recently undergone a two week residential training programme through CARE International, during which they had put together skits which warned of dangers in childbirth. Maternal mortality is a major problem in Tanzania, and our long journey to the village showed one of the main reasons: most of the women are spread out really far from hospitals. A contributing factor, is that when women start to have difficulties in childbirth, they are far more likely to consult the local 'witch doctor' than go to the hospital. The witch doctors can't help and often end up delaying the woman so long that she doesn't reach a hospital in time, if at all. These traditional healers acted out the dangers of going to witch doctors and when women should go to the hospital immediately. Their performance was wonderful, drawing a large crowd from passers-by and a very warm response from the onlookers. Work like theirs is a really effective way to educate people and they are doing their communities an enormous service.

08 June 2005

Condom holes, stigma and 2nd class citizens: AIDS in Tanzania

I've spent most of this week talking to lots of doctors, nurses, specialists and local people about AIDS in Tanzania. For my masters dissertation I'm trying to gather enough information to compare access to ARV treatment (AIDS treatment drugs) in Mwanza region to Metropolitan Washington DC. Getting anything done here takes far more time than I had imagined, and it is only after being here for a few weeks that I am just now managing to successfully meet with people. This week has been an eye opening experience.

On Monday I met with Singira, a doctor at a local dispensary, who told me that the biggest problem by far is that people are afraid of the stigma associated with being HIV+. Singira said that men who contract HIV are usually affluent and well connected. They fear that the community will discover they have AIDS and shun them, so they don't seek treatment even when they obviously have AIDS. When they become very sick, they would rather stay home and die than have the communities know they have AIDS and get treatment. Biologically, women are two to six times more likely to be infected through heterosexual sex with an infected man than a man would be with an infected woman. This usually (although not always) means that men infected with the virus have access to sexual relations with more women because they are wealthier and can attract more partners or can pay for sex, and have therefore been exposed more times. It also means that once they are infected, they can spread the virus more easily to more women.

In Tanzania, women are made much more vulnerable to infection through lack of empowerment and cultural practices that render women more at risk. Women’s initial biological risk increases with each cut or scrape that occurs during sex. Patrice, a staff member of Hisani, told me that FGM (female genital mutilation) is common in rural areas, that 'dry sex' is encouraged to increase male pleasure, and that forced sexual encounters is the norm. These practices are often caused and encouraged by the belief that removing women's desire for sex will keep them faithful. According to Dr. Kabole at AMREF, HIV prevalence rates in Mwanza region are something like 2-4% of all men and about 16-20% of women.

Patrice, two local health workers and I discussed trying to stop the spread of HIV over lunch. I was shocked when the men told me they had never used condoms and asked whether or not they were effective. In the region with one of the highest HIV prevalence rates in the world, health workers didn't believe themselves that condoms worked, and wanted to know what they could tell people who asked the same question. They were dubious about the effectiveness of something that could be destroyed by oil and told me that when you fill a condom with water, some water would form on the outside so there muct be holes in the condoms which the virus could pass through. I tried to explain that water on the outside was most probably caused by condensation, like a glass of water on a hot day, and that condoms are the most effective prevention technique we have. I asked them was it better to use something that has a 3% failure rate or something that has 100% failure rate. They were not entirely convinced so I have promised to bring condoms and air temperature water to the office to try and prove that the water does not go through holes in the condom. We talked for several hours, and all of us agreed that effective prevention techniques were missing and necessary to stop the spread of HIV.

Despite all the depressing things I've heard this week, Dr. Kabole made me feel hopeful this morning. She told me about an exciting microbicide pilot programme that is about to be started in Mwanza region. Microbicides are not yet available, but would prevent the sexual transmission of HIV and other sexually transmitted diseases when applied topically. They would give women the power to protect themselves, and have been very well received in Tanzania, with 98% of the women surveyed enthusiastic about participating in an effectiveness trial. Let's hope development can be sped up and microbicides in general use as soon as possible: millions of lives are at stake.

For more info on anything in this post, please email me: I would be more than happy to answer questions.

06 June 2005

Snake Charmers

I picked up the clothes I had made on Friday, I've been wearing them ever since and feel much less like a tourist! I am so impressed with them I've decided to have dresses made for all the girls at the orphanage by the same tailor. I hope that they will be ready before I leave so that I can post pictures of them.

On Saturday we loaded up all the children in two dalla-dallas and drove out to Bujora to watch the annual dance off. Unfortunately, as seems to happen with depressing frequency here, the date had been changed from the one posted... so we had 2 dalla-dallas, 2 staff, 13 volunteers and 30-odd children in the middle of nowhere with not much to do. We decided that rather than go home again without seeing anything the children should take a tour of the museum, which they thoroughly enjoyed.

We headed off again on Sunday and arrived with plenty of time to gt comfortable before the dances began. A few minutes later some scraggly looking drummers showed up and pounded out an amazing rhythm... only dissapear again shortly. We were beginning to think the dancers weren't coming when they suddenly pitched up in bright matching costumes. Two troupes were competing against each other, trying to attract the biggest crowd. For three hours we ran back and forth between the two groups... but the tribe that brought out giant snakes to dance with at the end must have won - noone could look away from the spectacle!


Bujora snake-charmers Posted by Picasa


Bujora drummers Posted by Picasa


Bujora dancers Posted by Picasa

03 June 2005

Takwa Hopital

This morning the newer volunteers and I visited the regional hospital in Mwanza. Today the doctors weren't in meetings and were able to give us a tour of the hospital. They have no computers, the files are all done by paper that spills out in an enormous room. The equipment they are using is fairly primitive, and very costly for those that don't qualify for free health care (children under five and pregnant women). One of the doctors told me that they would be greatful for any donations of childrens medications, the need is too great for the meagre funds of the hospital and they cannot afford to stock the necessary medications. We visited the mens ward, and saw the men lying two to a tiny hospital bed. Most patients didn't have sheets, and those that did were lying on dirty ones. The hospital doesn't provide food for patients, so unless you have family that can afford to and live close enough to bring you food, you scrounge other people's left overs or starve. The majority of patients were hopitalised from malaria, a disease that can be prevented by US$10 mosquito nets.

I visited the STI/AIDS/TB ward and spoke to the nurses there for quite some time, and was really inspired by their passion. Tanzania has recently received a lot of funding to combat AIDS (and to a lesser extent TB). The TB programme at the hospital is funded through the Stop TB programme at the WHO. The nurse on duty told me that MDR TB (multi-drug resistant TB) is really low in Mwanza and that patients are usually very good about taking the full course of medication under DOTS (directly observed therapy shortcourse) which is 2 months of coming to the hospital every day and then another 6 months of drugs. TB is the leading cause of death for people with HIV. The hardest thing for people is to pay for transport to and from the hospital, so smaller community programmes are being developed to enable more people to be treated. The ARV nurses spent a long time talking to me and were very helpful. Since October Tanzania has been rolling out a national programme to treat AIDS patients. The nurses told me that the treat under 200 people at the hospital, and that they are trying to scale up the programme as quickly as possible. The major obstacles they have are getting people to the hospital (transportation costs are expensive), the regimen is very complicated and some drugs must be taken with food and some without (for poor people with little resources eating at the right times is difficult), and the stigma attached to HIV makes people less likely to get tested even when they are sick. Despite these obstacles, local people are working really hard to get people treated and keep them alive. The resounding message this morning was: people here know what to do and are trying to do it, all they need is the funding to do it properly.

02 June 2005

Johanes' turns 10

Today was a really long day, but very inspiring. A few days ago I met Joseph, the director of Fonelisco, another orphanage in Mwanza for street kids, at the internet cafe in town. He was looking for a new volunteer and thought I was her. I told Joseph what I was doing in Mwanza and he was very enthusiastic insisting that I must go and visit his orphanage and meet his kids and also offered to put me in contact with people for both the sex ed programme I am putting together for the orphanage and my dissertation research on ARV treatment.

Max and I went over in the late afternoon. We had no idea where we heading but saw a huge crowd of children and jumped out of our taxi. The children swarmed us immediately and talked to us loads, they wanted to know if we would be their teachers and if we would stay and all sorts of things. We went to Joseph's room and he showed us all the things he does to help the orphans: he paints and sells cards, gives drum and dance lessons, assists researchers and has this amazing plan to expand Fonelisco and build a modern hospital which could support far more orphans than he can at the moment. We asked Joseph why he started his orphanage and he answered simply "it is what I can do to help my country."

Max and I trekked back to Hisani in a couple of dalla-dalla's (with her encouragement I stayed on the whole way!) and arrived at 7 just in time to celebrate Johanes' tenth birthday. Some of the children don't even have birth dates, none of them have celebrated before, so this was a big evening. We played musical statues and gave the children biscuits (cookies), bananas and peanuts to celebrate. I've never seen English children dance the way the orphans did! :) Despite our best efforts, we couldn't find a cake anywhere. We had a really nice evening, it was lovely to see them all enjoying themselves so much.

01 June 2005

quiz: What's the leading cause of death in sub-Saharan Africa?

Yesterday the newer volunteers and I went to the main regional hospital, although the doctors were too busy to show us around (we will go back on Friday) from what we saw of the place it was staggering that people could go there and get better. It was really dirty and open, it seemed impossible that it ever could be clean enough to help people that are ill. Unless you have (and have been tested) for HIV/AIDS, you must pay for medical treatment. In Tanzania, about 20% of the population live on less than US$1 a day, the World Bank's official definition of 'absolute poverty'. Having lived here for a few weeks now, it seems unbelievable that people can survive on that little, and even more impossible that they could pay for medical expenses. I would say on average I'm spending about $15 a day and I don't think I'm spending a huge amount (that's not including travel costs or accomodation).

After the hopital visit in the morning I taught my afternoon nursery class. This class is a lot bigger than the morning class and much harder to keep them all focussed. I am really happy that I have Matungwa, Joyce and Molokus, all Hisani kids, in the class and I'm getting to know them much better. Matungwa is painfully shy and extremely skinny, but he really beams whenever he's given the slightest attention. He's been at the orphanage since the beginning of the year and despite eating tons according to Grace, he's not putting on any weight. Marwa) is also in my class and he's really been coming out of himself this week. Before the volunteers arrived at the Centre, Marwa used to just sit on the ground every day and not really communicate with anyone. This week he's joined in quite a lot and has coloured in some really wonderful pictures in class.

Last night 11 of the 12 volunteers went out to the Chinese place for dinner, which made me feel guilty again, for the above reasons. We had a really nice meal together and piled into two cabs home to go home. Our cab driver seemed fairly relaxed and friendly. We asked him to stop somewhere so that the Irish and Ozzie contingent could buy a few beers for the road, and set off again. As we wound through the backstreets of Mwanza I asked the others what the driver was smoking, as it seemed a bit stronger than a cigarrette. A little while later on the main road my question was answered. We were flying down the road, when all of us spotted a car stopped on the road, all of us except the cab driver. He continued to accelerate towards it until we were a couple of hundred feet from it when he slammed on the brakes. It felt like everything was in slow motion as we skidded towards the car in front, our driver jerked to the side and over the concrete barriers missing by centimetres the open drain on the side of the road and the car in front. We all thought we were going to die so were very relieved to come out unscathed... it wasn't until a few minutes later we realised the cabbie was driving the wrong way back to the compound: through the worst of the damaged roads. The car tipped and swerved around the huge gauges in the dirt road, but we eventually made it home safe and sound. Phew.