It has been over a month since I blogged, and it feels like a lifetime has occurred during those weeks. November really was a dichotomy, it was full of social gatherings, parties, beer and laughter; yet it was also had a sprinkling of frustration, incomprehension, sadness, and loss.
My month started with the surprising arrival of Uli, a lovely German girl from Munich who works the lab we send our tissue biopsies to. I had been aware from an offside conversation with the administrator a month after I arrived that she may be coming, but I had no warning of when and for how long. To add to this the Tanzanian time for going on holiday for 28 days straight was fast approaching, and so our staff numbers were dwindling! Also my colleague Monica was going to be away for another course. Therefore, I had to use my noggin and quickly arrange a timetable and find someone in the lab able to communicate with broken English, and reciprocally understand her broken English too!
It was rather difficult, and although the staff tried hard, Uli would often return to the office to find something to do. I asked her what objectives she had for during her month here, and she said she wanted to see tropical diseases and their diagnosis. I explained that although the lab had some automated analysers, the work was very simple, and for a trained western scientist, it would soon become mundane. She took to reading malarial slides very well, and was very helpful in that department, but I think she was surprised that not everyday is filled with a multitude of strange tropical diseases caused by intestinal worms, or blood parasites. However, she found enlightening enjoyment by joining our outreach team on trips around the area testing for HIV. Soon her thoughts changed from wanting to work within the laboratory, to experiencing the surroundings and culture that the outreach visits provided. It was great to see how her expectations altered with each experience, and in her final days here she said that she really had no concept of the work here, and she truly believed that you could never understand it until you experienced it for yourself. I had to agree wholeheartedly with her.
I was also excessively busy. It seems after 3 months, I had finally settled in enough, and understood enough about the lab to fully comprehend the extent of the work I had to do. It is tricky because there are lots of ideas I have to help in small ways to improve the services and the working environment for the lab. Yet often extraneous circumstances draw me away to other problems! November was definitely a month for them!
I had aimed to write what we call standard of operations for each test we do in the lab. I was able to complete a few, but without the presence of my colleague Monica. I had hoped to teach her the finer details about writing such things, but as ever she is very busy with supporting the work within the laboratory. I also created a new disinfection protocol for the laboratory, and trained people on how to make control slides for all microscopy tests and how to use them. Writing this now, I feel better as that sounds quite good, but as ever here, things take form slowly, and reiterating the importance of it and following up things continuously is required. It is not because the staff are uninterested or are lazy, but people are creatures of habit. Therefore, you must make an action habitual before they routinely remember it.
During trying to do these things one of our donors decided finally to give us a supply of very needed reagents, but with the arrival of some, the need for others took their place, and thus I was in constant contact trying to arrange for these items to be bought. They call it emergency procurement, but due to disputes about lack of monetary transparency, and political wrangling, some items have been requested for nearly a year and still there is no sign of them. This is coupled with some people’s inability to reply to emails in less than two weeks! I realised however that they often call Monica, instead of replying to emails. It makes me realise even more how important she is to the effective running of the lab. I may be here to assist her on certain things, but she truly has ways of getting things done that I would never be able to achieve…she is truly the boss, and I call her that. She laughs at me and says I am…but I am really am not in the slightest!
Aside from reagents, the main blood bank in Mtwara had difficulty collecting last month due to school exams. Collection is normally from school children, as their blood is often the safest. Therefore, more donations from patient’s family members had to be conducted. However, we ran out of Hep B rapid testing kits, and thus donation was occurring without testing for it. I found it very uncomfortable and still do, but as our surgeons and doctors stated in life and death situations, such problems become insignificant. I now am starting to understand and adjust my expectations to reality, just like Uli!
To top the lab problems off, our CD4 machine used to assess the CD4 type of white blood cells in HIV patients started to become sickly. We tried very hard to make it better, and during this time, I have become an expert in this machine! Monica and I then had to find out about if we could obtain a service contract from the Ministry of Health for this and another analyser, as currently there is none. Therefore if they need repairing we would be unable to fix them as the hospital is unable to pay. We are getting somewhere slowly between Monica and I, but are still waiting, and praying the machine can keep working for a little longer.
Even through all these little problems the staff still keep me smiling. I really feel at home with them now and I am able to understand enough Kiswahili now to join in with the jokes and some conversations! This part is very important to me, because I want to come away from this experience knowing that I tried my hardest to be part of something both practically and socially.
Away from work, November saw the month long goodbye celebrations to Barbara and Tony. They have been here in Nyangao for just under two years, and decided to go on Safari before returning to unsure lives in England. One weekend we had a lovely leaving dinner in Ndanda with other volunteers. We all contributed a dish, and it was sooo good; I was in heaven! I had not felt that full in eons! The next weekend Tony, Barbara, Uli and I went to the beach house in Mtwara, and treated ourselves to full English breakfasts, nice dinners, ice cold beer, swimming, snorkelling, and most importantly sleeping! I really needed the break, and it was great fun to be able to show Uli around, and with her there I had more confidence to try my Kiswahili, and explore the shops and even go to the post office! It is strange, but when your in a pair, even if the other person has less of a clue than you, it seems to make everything less intimidating!
The next weekend, the hospital staff laid on the official leaving party for Tony and Barbara. It is much like the birthday parties I described in my earlier blogs. We all sit facing the head table where the guests of honour site, including the doctor in charge. Then the MC says a lot of thanks in Kiswahili, and each department of the hospital presents a zawadi or present by dancing in a conga formation up to the guests of honour. It was really special, and everyone had a few drinkies and a great dance. I ended up staying later with Monica and her husband, and I was complimented on my dancing ability! I was quite pleased for the compliment, and now as I can identify more songs, and have seen the local dance moves, I think I can improve even more!!!!
Tony and Barbara left on the 1st of December, but I will see them in two weeks when I get to go to Dar es Salaam for our annual volunteers conference….and maybe Zanzibar. I can not wait. I think it is time I leave the South for a little while. Then I can fall in love with it again when I return!
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