Tanzania - February 2013
Monday 4 February 2013
I delivered Liz and
her nurse, Tracey, to Terminal 5 at Heathrow where they met with the rest of
the team. This time there will be 14 dentists and 7 nurses, split, as
always, into two separate teams (of which more later).
Also flying out
with them today was one of the Bridge2Aid UK-based staff, who is primarily
involved in fund-raising around the country. It is important to remember
that, whilst the volunteers who go out on the training programmes, in which
Liz participates, largely pay for themsleves, there is a lot of other work
that the charity carries out, including giving a full set of dental
instruments to the clinical officers whom they train. As the girl put it, it
is difficult to sell a product if you have never seen it and so she was
going out to see the work of the Hope Dental Clinic (the permanent clinic
run by the charity) and to meet some of the clinical officers and the UK
teams who will train them.
volunteers (left) have made about 30 visits to Tanzania in aggregate. Most
of the others arrived after I had left, including one nurse who had very
little time between an arriving flight from Leeds and their flight to Da-es-
Salaam. As always they had to travel light as some of their baggage
allocation was taken up by a number of packages of dental equipment (gloves,
instruments, etc.) which arrived whilst I was there.
Liz phoned me from
the plane to say that it was not full but, unfortunately, she didn't think
they were going to be able to lay out to go to sleep.
Their flight - BA
047 - which was due to leave at 18.45, pushed back at 18.53 and was
airborne at 19.07 and is due to land in Tanzania at 07.24 (local time).
London: 30C Temperature in Dar:
300C Enough said !
Tuesday 5 February 2013
Good to see (from
feedback received) that the blog is already being read in some far-flung
locations. After sending out the email last night, I received emails from
Los Angeles (our nephew) and from a friend who is spending a few nights in a
very cold and windy Glencoe, in Western Scotland. I have also heard from two
friends from church who recently 'emigrated' to Lanzarote. When I speak with
Liz, I will pass on best wishes from everyone.
When she arrived at
Dar (early at 07.12), she texted me to say that she had, after all, managed
to find a row of 3 seats to go to sleep. They were waiting in an enormous
queue to get their visas. A couple of years ago Tanzania changed its system;
instead of going to the High Commission in London to get your visa in
advance, you have to buy the visa (ca £100) at the airport. As with many
countries, you have to make sure that you have a full empty page in your
passport for the official to stick the visa into. The charity have been
trying to persuade the government that they really should not require visas
to work but, so far, to no effect.
managed to watch the first episode of the new series of CSI on the
flight so I must watch out for that,
later text advised me that the flight to Mwanza with Precision (?) Air had
been cancelled and that they were catching a later flight at 15.00 (local
time). The website of Precision Air says:
Unfortunately, that did not include Mwanza this morning ! For the
first-timers the humidity and lack of organisation must be quite a rude
awakening. They were going off to a shopping mall, just to get into some air
conditioning and to have brunch. It will be late by the time they get to Mwanza as I cannot see
that there is a direct flight in the afternoon.
been asked whether Welwyn Garden City counts as 'far-flung'; I am afraid
that, remote as parts of WGC may seem, they do not compare with our son, who
emailed us from Phuket in Thailand. I also had an email from a friend I used
to work with who said that she had read today's blog whilst on Langkawi in
Malaysia, where she is on holiday.
If you have read
the blog in previous years you may know that they normally stay at the
Vizano Hotel, which leaves a lot to be desired. This time they are staying
at the hotel where they usually have the welcome dinner - the
Ismailo Lodge which is
shown on the right.
I phoned Liz when
she had arrived at the Lodge and she had just met with the whole team and
they were going to eat at the hotel. She said that Dar had been unbelievably
humid and that, bizarrely, a man in the shopping mall had tried to sell them
a laminated 'map' of the human body, which, together with a laminated map of
Africa, seemed to be his sole wares. One cannot help but conclude that,
somewhere, a classroom wall is missing two posters !
The flight up to
Mwanza was not full and they inferred that the previous flight was cancelled
due to lack of passengers. Dar is rapidly diminishing in importance as a hub
and BA are ceasing flights there soon.
Wednesday 6 February 2013
What I have not
mentioned so far is that, as last year, Liz and Tracey, her nurse, are being
split between the two teams. This is because the charity needs to ensure
that each team has experienced staff, who have been out before. Liz will be
with Judy, who has been out about ten times. They will be based in Musoma
(see map below) which means that, en route, they will pass the Stopover
Lodge where Liz was based on her first trip back in 2008. Musoma was the
birth-place of the founding father of Tanzania, Julius Nyerere. As you can
see, the town is on an inlet of Lake Victoria, near the border with Kenya.
By contrast, Tracey will be flying up to Bukoba, diametrically opposite
Musoma, near the border with Uganda and not that far from the border (to the
West) with Rwanda. To give you some idea of the size of Lake Victoria it is
about 140 miles from Bukoba to Musoma as the crow (probably the local pied
I received a very
long and detailed text from Liz which she had sent whilst being driven along
a very bumpy road, driving past fields of rice with cattle egrets in the
fields and kingfishers on the telegraph wires (for the non bird-watchers,
despite the name, not all kingfishers live or operate near water). They had
just crossed a river, prior to which the sign read 'Narrow and damaged
The view from
Ismailo Lodge over Lake Victoria was wonderful and this morning they had the
orientation session. One of her team has been working out at the Hope Dental
Centre for 6 months and lives in St Albans.
Facts from the
orientation session are as follows:
are lost in Tanzania because of toothache than because of malaria and
The ratio of
dentists to people in Tanzania is now 100,000:1 and in Musoma (where they
will be) the ratio is 400,000:1 (about 5 times the population of Stevenage
for each dentist)
The B2A Dental
Volunteer Programmes have trained 212 Clinical Officers since 2006 and
have treated approx 25,000 patients (but, of course, the main purpose is
Aim is train 86
COs in 2013
There is now a
B2A office in Dodoma (the new capital)
A pilot in Rwanda
will take place in June and B2A hopes to expand into another East African
country next year (I am currently writing a risk assessment for them)
HIV rate is now
at about 10-15%
(where the dentists are) = 800,000 whilst rural population = 45 million.
Whilst in Musoma,
Liz and the team will be based in the
Hotel (shown oin the left). As you can imagine, Liz has confirmed that
the emphasis is more on the 'Afri' part of the name than on the 'lux'.
I spoke to her when
they had just arrived at the hotel. On the way to Musoma they passed the
entrance to the Serengeti National Park and were able to see zebras and
wildebeest - just like rural Hertfordshire, really !
They are all
looking forward to their first day out at the clinic; Liz is paired with
Chris, a first-timer from Scotland.
Thursday 7 February 2013
had a rude awakening this morning as the call to prayer at the nearby mosque
started up at 04.30 and immediately woke up all of the dogs in the
neighbourhood. Apparently it is live and not recorded and so Liz is praying
for laryngitis to strike the muezzin. They drove out to the village of
Murangi, which is about 1 ¼ hours along a narrow single track dirt road. It
is on the shores of Lake Victoria, south of Musoma. Liz is going to try and
send me a photo of the clinic but, for now, I have found a photo of the road
to Murangi that was posted on the internet by someone who had been driving
around that area.
They first went to
the offices of the District Medical Officer, who welcomed them with a
prepared speech In English. There they met the District Dental Officer (Dr
Joseph) and the 6 clinical officers (5 men and 1 woman). Liz has been
training Mzalengo, whose English is not that good. He seemed a bit put out,
at first, that he was going to be trained by a woman but became more
impressed the more he watched Liz treating patients. With them also is
Stella, a permanent employee of B2A in Tanzania, who has been interviewing
patients as part of a Monitoring and Evaluation exercise ('feedback' to
those of us who hate jargon).
The clinic is a new
building with holes ready for switches and wiring and air-conditioning. Note
the word 'ready', though, because this is all set to be completed by June
(year not specified) and today they were sweltering under the corrugated
iron roof and made regular use of the bottled water that they always have
available. Liz says that these are the hottest conditions she has ever done
dentistry in. Sufficient to say, also, that any plumbing that may be
planned has not yet been completed and that the lavatory arrangements are
Friday 8 February 2013
When they arrived
at the clinic this morning they found that there were bat droppings on the
tables as bats have nested in the roof of the, as yet, unfinished building.
Luckily they had covered all of the equipment. They saw 107 patients and Liz
trained a clinical officer called Bonny (male!), who was excellent. The
clinical oficer who is based at Murangi was trained by B2A about 8 months
ago and he will be there tomorrow for a follow-up assessment. A friend of
B2A has been with them taking photos as well as two representatives from
Barrick Gold, the mining company that sponsors B2A as one of their community
projects. If you have read this blog in previous years you will remember
that they were billeted at gold mines before.
patients fainted in the heat today but that was probably brought about by the
fact that they had been up for a long time; one woman, who had a very
swollen face, had walked for 5 hours to get to the clinic. I let Liz know
that the forecast here is for snow over the next few days !
Liz's prayers must
have been answered because the loudspeaker system in the nearby mosque had
broken today and, whilst they could still hear the muezzin, it was just his
water in the Afrilux appears to be unreliable. Liz got a shower (no hot
water at all) at 06.00 but by 06.30 there was no supply to the floor above
hers, where some of the others have their rooms.
When she phoned
they had just been playing Jenga, highly appropriate as it derives its name
from the Kiswahili for 'to construct'.
Liz had tried to
send me a photo but without success. The kingfisher on the left (a woodland
kingfisher) is the type that you see on the telegraph wires
9 February 2013
was not a rest day for the team. I got a text from Liz at 18.05 (her
time) to let me know tha they were still at the clinic, waiting until Dr
Joseph (the District Dental Officer) had finished treating the last patient.
Just as well they are not about 1¼ hours from Musoma with a drive back along
a dirt road in the pitch dark !
I sent a text to
Tracey today, asking for a brief update on the other team; it will be
interesting to see how they are getting on.
I spoke to Liz when
they got back. Interesting to hear that they have been accessing this blog
themsleves on an iPad, using a WIFI
connection to avoid the data roaming costs. Dentists who have been out with
them before have also been reading it and I have duly passed on greetings
from whovever has contacted me.
Today Liz has been
training a lady with the imposing name of Theotister, who only qualified as
a doctor a clinical officer a year ago and is very good. The last patient
today fainted, which was why they were late back. Together they treated 119
patients today. It rained heavily at lunch-time, which eased the humidity
but, as always in the tropics, the ground soon dried out, although the road
on the way back was even bumpier than normal! The fields mostly contain
cotton (now about 1 foot high) and maize, although they have also seen a lot
of cassava (right) being sold, this being a shrub with a tuberous root, from
which we get tapioca. According to Wikipedia it provides a basic diet for
about 500 million people in the topics.
They all sent some
clothes off to the laundry yesterday and were surprised to get anything back
washed, given the absence of water yesterday. Liz's clothes came back minus
one T-shirt; good job she saves all her old clothes for the B2A trips.
Tomorrow is a rest day and they hope to go to a hotel near the beach
on the shores of Lake Victoria - I will try and find a good photo of a Nile
crocodile for tomorrow's entry !
Sunday 10 February 2013
a hymn at church this morning, I got a
text from Tracey. As you will recall, she is with the other team in Bukoba,
in the far North West of Tanzania, also on the shores of the lake. They have
two women and four male clinical officers to train, each of whom is learning
quickly. Their first clinic was in Kishogo, which seems to be a fair
distance from Bukoba, near to Lake Ikimba. Apparently the weather is much
cooler and they had thunderstorms on the first two days.
The area is different from anywhere they have been before, with the main
crops being bananas. There are also pine tree plantations for timber.
Today it was also their rest day and so they
went off to visit a waterfall and also a bat cave, which was amazing. Next
week they are at Kishanje, which is further North towards Uganda.
Liz and her team went down to Tembo Beach
in Musoma, after first visiting the local market, where Liz bought yet more
brightly-patterned material (we already have one bedroom full of batik
artwork on the walls!). Amazingly, I discovered that you can buy a
poster of the beach on Amazon (see left) although I have, howvere, also
managed to find a photo that someone has posted,
looking along the beach, which is presents a less idyllic image (see right).
When I spoke to Liz she said that they had already been onto the blog
themselves and had been amazed that I had found photo of the beach.
They went and sat
at the restaurant and, as always, had to wait ages for their food. They
watched the pied kingfishers hovering, the egrets and herons on the shore
and four fish eagles working the shoreline. When their food arrived, all of
a sudden a black kite swooped down and took the chicken off one of their
plates. Later the same happened with some fish.
Important news -
Liz got to have a hot shower today ! She also got some laundry back, only to
find that a pair of her socks were missing and had, mysteriously, been
replaced by a pair of No.6 football socks. The lady was distraught because
she had made a hole in Liz's socks whilst ironing them. At last they seem to
have found a way to get photos through to me; one of the team, Elaine,
emailed to me the photos shown below. Just click on any one photo to enlarge
it. Thanks, Elaine.
interesting to see the cycle of fund-raising and the delivery of the
training in Tanzania. I had an email today from someone who regularly fields
a team for the annual Quiz Challenge that we run, saying that they were
enjoying reading the blog and asking when the next quiz will be. The
answer is Saturday 28 September.
As in previous
years, I passed on a message about MANU's latest exploits, only to be told
that they knew, because they were watching the game !
Monday 11 February 2013
The most important
task for me yesterday evening was to ensure that nothing went wrong with the
recordings of Call the Midwife and Mr Selridge, or my life
would not be worth living when Liz gets back. During the evening I got a
nice email from Edie Allan, whose husband, Chris, is on the Musoma team with
Liz. She wanted to know if Tealing in Angus counted as 'far-flung'. Given
the snow that was falling at the time (there and here), it probably felt
pretty remote !
Today the team went
to a different clinic, this time in Kiagata. I have marked the location of
the two clinics on the map below, together with Musoma, where they are
based. As you can see, getting to Kiagata involves crossing the main road to
Kenya and the heading off into the bush towards the wildlide reserves.
More photos made their way through today...
The Kiagata clinic
is about 45 km away, half of which is along an unmetalled road. It took them
1¼ hours to get there. Bonny is the resident clinical officer at this clinic
and has 5,000 patients. The clinic is larger and has great potential:
showers, flush toilets and large sinks ..... just no water or electricity !
The main room was larger but, as it had the same bat problem, they set up in
smaller back rooms. The place should be finished 'later this year' but one
has to wonder about how quickly it will all deteriorate if water and
electricity do not arrive. They saw only 46 patients today, one of whom was
a 24-year old man who had a large tumour on his face (ameloblastoma for the
medically-minded amongst you) which is non-malignant and slow-growing (he
had had it for two years). He will have to go to a town to have it operated
on. Liz had been training Zacharia today and tomorrow will be training Paul,
who was trained by B2A four years ago but failed then, although Liz said he
is excellent now.
Their driver is
also a safari driver and advised them that the punishment now for killing a
rhino or elephant is 30 years. This had echoes of the final episode of
Attenborough's Africa series, which Liz has yet to see.
technological development is that they have sent through a small video clip
of the team in action. Click on the icon below to see the video; it may take
some time to open but gives you an idea of the set-up.
Tuesday 12 February 2013
They arrived today
to find that there were only 4 patients waiting but things picked up later
and they saw a total of 55 patients, including one patient who had a large
swelling on his face called a pleomorphic adenoma of the parotid gland,
which he had had for four years. As with the medical complaints yesterday,
Liz had never seen this type of condition before.
She treated a
20-year old today, whose teeth were fine apart from the fact that one of his
incisors was missing. The reason, which Liz had never encountered in
Knebworth, was that the tooth had been kicked out by his cow !
Whilst they were
having lunch a man came up to them and tried to give them a bag. They
thought, at first, that he was trying to sell them something and almost felt
like shooing him away before they realised that it was someone they had
treated before who was giving them a bag of corn-on-the-cob as a Thank You
present. Needless to say they felt awful and have now asked the chef at the
hotel to cook them for their dinner
They saw 4 green
vervet monkeys on the side of the road and, as I spoke to Liz, there were
upwards of 200 black kites circling overhead. Even as we spoke the pictures
below popped up in my InBox from Elaine.
They blew up a pair
of gloves and gave it to the little boy as a football for him to play with,
whilst he was waiting. Ian, one of the dentists, is showing the trainees a
walk-through on YouTube of the difference between baby teeth and
adult teeth and things to watch out for. There may not be any electricity or
water at the clinic (yet?) but this does not mean that they cannot use
technology to great effect.
Wednesday 13 February 2013
Today was their
last day at Kiagata and, indeed, their last day with the trainees. In the
morning they continued the training and saw about 47 patients. The trainees
then sat a 1 hour written exam. Each of them is given a certificate by the
charity in a little ceremony (left). They then had a cake and some soda and
Dr Joseph made a short speech, thanking them coming over from the UK and for
As the team clear
up each day they give their water bottles to anyone who happens to be
around. The lady pictured here was SO happy to be given some simple empty
What happened next
reduced a number of them to tears and Liz was tearful as she told me about
it. She had been wearing an old pair of trainers that, back in the UK, she
uses for gardening. I am not sure of the circumstances but she gave the
shoes to the girl seen holding them, who had been around for the last couple
of days, watching them work. This now means that
the little girl can go to school as she needs shoes to attend the school.
Cue lump in throat !
At the end of the
day they said farewell to the trainee clinical officers and drove back to
Musoma. Tomorrow they will set off for Mwanza at 08.00 and have the formal
de-brief with the B2A staff there.
Thursday 14 February 2013
St Valentine's Day
awoke this morning to find a text from Liz who was obviously in the jeep on
the way back to Mwanza. It had rained heavily last night and there had been
a power cut with the result that, mercifully, the PA system in the nearby
minaret was broken ! They stopped off at Stopover Lodge for a break; this
was where she had been based on her first trip 5 years ago. They saw lots of
people working in the fields, including a group of prisoners in bright
orange uniforms. There is a lot of sisal being grown, which is used, amongst
other things, for hedging. Ever the birdwatcher, Liz saw two hammerkops on
the road (right). This is an odd, squat bird which is actually a member of
the heron family - easy to see why it has a name that means 'hammerhead'.
They took 5 hours
to get back and were stopped en route by a police patrol and the vehicle
license papers were found to be slightly incorrect. As Liz said, she did not
see any money change hands but has her suspicions.
The Bukoba team had
already made it back to Mwanza on the morning flight. Liz then phoned me
when she got back to the Ismailo Lodge and had met up with Tracey who seemed
to have had a good time. Tracey had had a similar experience, at the end the
clinic, in giving away some shoes to a child.
Liz had decided not
to go off to the local market and was working her way through the trip
evaluation form. They were then all going off to
Tunza Lodge on the
lake for a Thank You meal.
Friday 15 February 2013
they all went their separate ways:
- Some of
them (including Tracey) flew back to the UK and arrive tomorrow morning
- Some went
on a safari to the Serengeti, which B2A arrange as an optional bolt-on (at
Liz, Judy and Brian
have done the Serengeti trip before and so they have arranged (at own
expense) to go to Tarangire National Park, near to Lake Manyara. They fly
from Mwanza to Kilimanjaro Airport and, because the park gates shut at a
specific time, they are spending tonight at the
and will then enter the park early tomorrow for their safari. This will give
them almost two days of watching wildlife. With this in mind, Liz has taken
our 39x spotting telescope and tripod with her, as well as her binoculars.
Whilst in the park, they will be staying at the
Tarangire Safari Lodge.
Personally, I can't say I envy them; I would much prefer to spend the
weekend in Knebworth, washing the car ! The only downside is that Knebworth
doesn't have many of our favourite bird, the lilac-breasted roller (left),
which looks as if someone went berserk with a paint-pot and has to be one of
the prettiest birds in the world. The three of them (dentists, not birds)
will fly to Nairobi and catch an overnight flight back on Sunday, arriving
at 05.20 the next day.
No, the surgery
is not open on Monday !
Before she set off
Liz was keen that I stop the blog at this point as she is now on a private
holiday. Many thanks for reading the blog; I hope that it has given you an
idea of the work of Bridge2Aid and of life in rural Tanzania. If you live in
or near Knebworth then we hope to see you at the fund-raising quiz on 28