Tanzania February 2008

  Saturday 23 February 2008
  The three 'girls' arrived early at Heathrow and arrived at the rendezvous point at Caffè Nero (where else!) and looked around for their fellow dental volunteers, whom they had not met before. The two trolleys, piled high with boxes bearing the words Bridge2Aid, rather gave the game away! This was the reason that each of the volunteers was only allowed ONE bag of 23 kg as the remainder of their allowance was made up of the supplies. Adds a whole new meaning to 'did you pack this bag yourself?'. In the case of the Knebworth contingent, these supplies had been paid for by many generous donations received over the course of the past few months.

Not all of the volunteers were there, as some are going via Nairobi but all of them will meet up in Dar-es-Salaam and then travel on together to Mwanza tomorrow.

They will be in two groups, some of whom will be based out of Mwanza and work in local clinics, and the others (including the Knebworth Three) who will be based out of a lodge near the Serengeti and then setting up 'Tooth Camp' each day in remote villages. They met others of the 'remote team' at the airport whom they had spoken to before on the 'phone.

All of them were given Bridge2Aid polo shirts which they will be sporting around Knebworth on their return.

Flight BA 0047 took off 25 minutes late at 19.10.

  Sunday 24 February 2008
  Tanzania is 3 hours ahead of GMT.

Little sleep on the 9 1/2 hour flight.

There were no problems getting the equipment on board or getting themselves or the equipment into the country. As they drove into town the first impression was of a lot of industry.

The team are staying for a few hours at the Kilimanjaro Hotel Kempinski to freshen up before flying on to Mwanza in the afternoon. They have been sitting in the sun and getting to know their fellow volunteers. They have the distinct impression, as they sit by the pool, that this is the lull before the storm!

The mobile seems to work OK but they are in the largest city. It will be interesting to see if they manage to get through from Mwanza or from the lodge.

Air Tanzania flight takes off at 18.00 and takes just over 1 1/2 hours to get to Mwanza, up by Lake Victoria, the second largest lake in the world.

  Monday 25 February 2008
  Well, the mobile does work in Mwanza!

Flight up from Dar was uneventful. Mwanza airport is very small, with loads of small planes in abundance. Luggage carousel comprised a suitcase-size hole in the wall with a man pushing bags through one after another!

Mwanza is very different, with loads of small shops on the side of the road and people walking around carrying produce on their heads.They visited the Hope Dental Clinic, run by Bridge2Aid, where the woman who had flown out with them immediately took up her locum duties. Massive dental decay seems to be the order of the day. There are two surgeries, one with ageing equipment and the other with modern equipment, provided by a major manufacturer. Patients pay what they can, if they can, but have to be careful getting out money in case they are mugged on the way out.

They also visited the hospital in Mwanza which serves a catchment area of .... wait for it .... 13 million people. Apparently there is a business in the car park, manufacturing coffins on the spot to order. Not quite the Lister in Stevenage !

They were having dinner on the shores of Lake Victoria, keeping well away from the water's edge as an 18 foot crocodile had been seen recently. Liz already in birdspotting mode, watching 100+ kites overhead and weaver birds in the trees.

They move to the lodge tomorrow, about 90 mins from Mwanza and will go out each to set up a clinic in a nearby village. After the weekend they are going up each day to a village in the hills.

  Tuesday 26 February 2008
  They set off from Mwanza at 06.45 this morning and drove along one of the only tarmac roads in the area to the clinic, passing many local villages en route. One of the vehicles developed a puncture which slowed them down a bit.

The clinic is a basic building with no water and no electricity but quite clean with painted walls and a concrete floor. There are six dentists, one to each trainee Regional Clinical Officer and four nurses who cover for them. They saw 50+ patients but, in the afternoon, it started to rain and the local people make the best of this time to work in the fields.

None of your plastic cups with pink water - just spit into a bag and use gauze to soak up any blood. The dentists use Maglites to do their examinations and Liz has a headpiece with a light on it. Everything (even needle cartridge) has to be thrown away between patients. The patients are reported as being 'stoic' in their tolerance of pain and extremely grateful. The team had a picnic at lunch-time and have been given water bottles. Liz gave her bottle to an old lady at the end of the day and it was if it were Christmas. Patients have been treated with babies still strapped on their backs.

The trainee who is working with Liz (Kanaligi?) failed his training first time and is doing it all again, which shows that they take the whole thing very seriously.

The lodge is basic with 10 rondavels and only the team are staying there. Lots of mozzies in evidence and the mosquito nets they have been given are not exactly hole-free! They have been given a spray ominously called DOOM, presumably because of its impact on mosquitoes, rather than on them !

  Wednesday 27 February 2008
  This morning saw fewer patients than before at the ‘clinic’ which was a surprise to the team. Apparently, during the night, a patient who had been treated had died. The locals decided that it was best to keep well away from the clinic until it was discovered that the ‘patient’ had not visited them to be treated but, instead, had been 'treated' by the local witch doctor. Cause of death is not known but one can only imagine the consequences of being treated with a non-sterile screwdriver! Once it became clear WHO had treated the unfortunate person, the clinic saw a return to normal in the afternoon (a safer bet than going to the witch-doctor). If nothing else, this shows the value of the more advanced treatment they are offering.

The team were not given the details of what had happened until the end of the day – in their de-brief – unless it affected them during the day.

Liz has described it as harrowing but rewarding. She was paired up with a different trainee today who was quick to learn and who, after only two days on the job, was pulling out teeth with aplomb. The nurses have been giving education on health, and the need to obtain some sort of medical history, to Joseph, one of the trainees.

One of the patients had asked for some of their water during the day but it has been made clear to them that they must keep this for themselves as they need to stay healthy. One of the dentists has already fallen ill and had to return to Mwanza.

They have been told that, if a patient should have serious complications (heart attack, reaction etc.) they should not try to resuscitate as the local culture is that ‘If your time has come …’

Liz has taken photos of her rondavel (inside and out) and said that she made sure that everything she needed was INSIDE the mozzie net during the night.

They all appreciate the irony that, whilst they are in one of the most seismically active areas on the planet (the Great Rift Valley) it was here in Britain who were woken up at 00.56 this morning by an earthquake !

I was able to pass on today that Toby Friedner from BBC 3 Counties Radio, who interviewed them before they went out, has confirmed that he would like to interview them again when they get back. Should be quite an interview !

  Thursday 28 February 2008
  Today’s call came through just after a tropical cloudburst which had impact on reception at the Tanzania end.

The rotation of dentists to trainees continues. Whilst they are back to a full complement, the dentist who is ill keeps clutching her stomach and is in obvious pain.

Today’s drama (and it doesn’t get much more dramatic!) was that one of the dentists managed to stab herself in the finger with an instrument AFTER it had been used to treat a patient. With an extremely high prevalence of HIV, there was an extremely anxious 40 minute wait, whilst the patient’s blood was taken and tested and, thankfully, found to be negative. Echoes of Dr Cameron in HOUSE. Each dentist wears two pairs of gloves and changes the outer pair between patients. The spittoon is a cardboard box, lined with a bin-liner. Useful ideas for saving money when they return to the Knebworth practice !

Weather is humid which some are finding difficult. The large containers of water are still de rigueur. The economic aspects of the situation come home when one hears that the large water containers, which they give away at the end of the day, would be the equivalent of TWO days’ wages at 51p (a dollar) a day.

Liz reported that the way that young kids sit there whilst being treated, without flinching or making a fuss, is quite amazing. Su and Tracey are really enjoying themselves and are giving sterilisation training to the six trainees.

The kit that they are using is laid out on a table and this is what will be handed over to the trainees at the end of the fortnight.

Tomorrow they move to another ‘clinic’ where they will also be working on Monday and Tuesday.

Last night’s meal was goat and banana curry.

  Friday 29 February 2008
  Liz tried to get through at about 20.00 their time but the reception was clearly not up to it and neither of us could hear the other. Until now they have been staying at the Serengeti Stopover Lodge ( http://www.serengetistopover.com ), about 1 km from the westerly entrance to the National Park. This evening they were joined by the other team, who have been working at the Hope Dental Centre in Mwanza and in Bukumbi. Together they were all due to go into the Park and spend two nights recovering at one of the tented camps there (see http://www.go-safari.com/Serengeti/Kijereshi.htm ).

Given the fact that they are now miles from anything, apart from herds of animals, it is not surprising that there is no reception. Perhaps they will be able to make a trunk call !

  Saturday 1 March 2008
  Confirmation received today from Toby Friedner at BBC 3 Counties Radio. The 'girls' will be back on the radio on Saturday 15 March just before or after 08.00.

Rather like that bit from Apollo 13, when they go out of radio contact during re-entry, all we can do is wait for them to get back into range of a cell-phone tower and break radio silence, but possibly not with the words "Copy that, Houston".

  Sunday 2 March 2008
  Radio silence was broken just before 16.00 UK time when they returned to the Stopover Lodge.

On Friday they had gone to a new clinic in a village about 30 minutes down a track from the lodge. In order to get there they have to pass loads of villages of huts with thatched roofs but in the middle of all of these is one that is different, with painted bricks, white with red and, incongruously on top, a satellite dish. This is the house of the local witch doctor, whom they have nicknamed 'Dr Death' (see Wed 27 Feb). Little wonder that he resents their being there; they've probably deprived him of income. Still, the patients are in much better hands. The new clinic clearly used to be some sort of medical centre about 50 years ago as it still has an old broken X-ray machine and a really old dental chair, which is missing one of its arms. One of the dentists is a specialist oral surgeon so she gets this, whilst the others make do with kitchen chairs and a table.

One patient who turned up was a beautiful local woman with extra teeth in the roof of her mouth which Liz extracted to the background music of Robbie Williams, Amy Winehouse and Frank Sinatra (interesting mixture) on an IPOD.  Sounds quite complicated dentistry to the non-expert but the music must have played its part. The trainees, each of whom has trained for about three years, all call her Daktari Liz.

The side trip into the park was, as expected, particularly good for those interested in wilfdlife. Those who wanted to set off at 06.00 in the jeep on Saturday and Sunday morning but others simply crashed out in the camp. Liz has used up two camera batteries! The highlight for her was three lionesses with seven 3-month old cubs and a wildebeest that had just been born and was finding its feet.

  Monday 3 March 2008

Today they have been back to the same place as Friday which appears to be in some sort of local health centre down an unmade up road. On Friday Liz had treated the daughter of the local midwife and today HE came in, resplendent in his uniform.  

There is a sort of canteen for the staff and the dentists were invited to share in a spinach dish. 

The local school-children came in today in their smart green uniforms and were peering in through the windows, saying ‘Jambo!’ (hello). The pride in simple things like clothing is amazing, even with the women in the fields, with buckets on their heads. 

Liz reported that she has treated quite a few patients whose teeth have been chiselled down for tribal reasons. Whilst on the topic of tribes, the Visitors Book at the clinic has a column for ‘Tribe’. Su, apparently has filled in her name and put ‘Essex’ in the Tribe column. 

One of the dentists felt compelled (don’t ask why!) to take a photo of the communal toilet that is shared by all of the staff at the clinic. More hole in floor than cistern-fed flush toilet.

The big news today is that the witch doctor has been arrested and is being held on suspicion of manslaughter (see entry for Wed 27 Feb). Apparently it is quite common to be held for seven years or so before the justice system gets around to a trial. 

Liz has been allocated to the same trainee and reports that it is amazing how much he learns and retains. Tomorrow is their last day and then they return to Mwanza in the evening. There are examinations and then a ceremony at which certificates are given out to those who pass. Emotions are likely to be high as they say goodbye to the trainees. Liz, for her part, is already talking about going out again next year. 

It looks as if the Knebworth Dental Practice will be able to present a cheque for about £ 5,500 to Bridge2Aid and the three of them have been talking about what can be bought with this money. Clearly dental equipment is the most obvious investment but, on Wednesday, they are visiting a village for leprosy victims and they may buy a specialist bicycle for use by the patients.

  Tuesday 4 March 2008
  Today's call came through just before 21.00 (midnight in Mwanza).

The day had seen the trainees sit their tests and all of them passed, although one of them will need to do some top-up training. After they had finished, they celebrated with Coke and chocolate cake.

As the training of the local Regional Clinical Officers was the main objective of the trip they can feel that they have achieved that aim, even if there is much more to be done. "How do you eat an elephant? In small bites."

During the day one lady had visited the clinic who had only one arm. Apparently she had suffered from red eyes over a number of years and was considered bad luck to the local village. The remedy to resore good luck (probably on the recommendation of the witch doctor) was to lop off her arm. Woe betide anyone who goes to Knebworth surgery with conjunctivitis!

Once they had made their way back to Stopover Lodge, they packed up and set off on the journey to Mwanza, which was to be a repeat of the journey out there, with one of the minibuses developing a puncture. One of the vehicles was paid for by a dental practice in the UK which holds a ball each summer and has so far raised £40,000 for Bridge2Aid. That practice is large, however, and one of the Bridge2Aid staff nearly fell off his chair when he was told that the Knebworth practice had raised so much. Many thanks again to anyone who contributed (and the donations continue to arrive).

The call came so late because they had been out for a meal to a Chinese restaurant on the shores of Lake Victoria (there can't be many of those, surely?). Jo, from Bridge2Aid had arranged for local craftsmen to turn up and sell their wares, cutting out the middleman, and so lots of items of local handicraft will be making their way back to Blighty with the team.

Tomorrow they visit the leper village where there also a number of albino families as albinos are, apparently, considered good luck by the local witch doctors and they live in fear of their lives. A small albino child was killed recently in the area for nefarious purposes and so this fear is justified. Yes.... your calendar is correct; this is the 21st century !

  Wednesday 5 March 2008
  They had just had a huge tropical (or should that be equatorial as they are only about 2º South of the equator?) storm when Liz phoned.

They went out to the leper village this morning and she reported that she found it difficult not to burst out crying at the missing limbs etc. Bridge2Aid had become involved in helping to paint the village and volunteers had been out there helping. The villagers had previously lived alongside the sewer on the road into Mwanza and had got washed away when the rains came. Liz has a photo of one of the specialist bicycles they intend to buy with some of the money. As anticipated they also met the abino family, who live there.

Tomorrow morning at 09.30 they fly back from Mwanza on the first leg of the return journey. They have a free afternoon in Dar and, from the sound of it, the gradual return to 'normality' will be required or the culture shock would be too severe. Liz sounded extremely tired.

  Thursday 6 March 2008
  They are back in the hot and sticky commercial capital of the country - Dar es Salaam - and staying at the Kempinski Hotel, which is reported as being excellent.

Farewells in Mwanza were really emotional and Liz reports that there have been lost of tears as the team-spirit has been intense throughout the two weeks. She is tsill talking about going out again next year.

They have to be at the airport early tomorrow for an early flighgt at 09.20 and should land back at Heathrow at 16.30.

  Friiday 7 March 2008
  Flight BA0046 set off on time from Dar and is due to land (early) at Heathrow at 16.12.

Flight landed at 15.58 and the Knebworth Three are now home.

Mission Accomplished !

Hi here, this is Liz. Thanks to everyone who has been following our progress. Can't wait to tell you all about it !