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Letters from Tanzania: July 13, 2013

Mambo poa, from the base of Kilimanjaro!

I’ve been to Kilimanjaro before – just last year, in fact. Yet every time I see it, it takes my breath away. Like Mt. Hood in Oregon, it’s volcanic, and it appears to magically float above Moshi. Kilimanjaro is often in the clouds, so when there’s a clear day (like yesterday), it’s difficult to not just drop everything and sit and stare. I’ve never been a good meditator. However, when I stand and stare at Kilimanjaro, my mind clears, and I can truly zone out.

We’re in Moshi. Getting here wasn’t as easy as it was supposed to be… but when does anything ever go as planned in Africa? We took off from Tanga at 6 a.m., with the expectation of a 6-hour drive, and arriving in Moshi by noon. About 30-40 minutes outside of Tanga, we hit our first accident. A semi-type truck had flipped on its side and was completely blocking the two lane highway. Our little caravan was about 40 cars back from the accident, parked behind busloads of people, other semis and lorries, and dala dalas (which are Toyota minivans that are literally packed to the rooftops with people). The only vehicles getting by were the piki pikis (the motorcycles who could ride through the deep ditches). Nevertheless, we could see the accident clearly, especially when using the student’s monoculars (a binoculars with only one lens). There were a couple of dozen Tanzanians milling about the truck looking very concerned. I said to Maria and Corey, I guess we may be doing our lesson along the side of the road because it could be a couple of hours. They agreed. All along the road, people evacuated their vehicles and began to chat.

The students, who have become more and more flexible as the trip has gone on, pulled out things to entertain themselves. Some of them attempted to start roadside yoga, while others decided that snacking might be a good idea. About 5 minutes later, a bulldozer appeared like a mirage on the horizon, and pushed the semi off the side of the road. Maria, Corey, and I gaped at each other. Where in the world did a bulldozer come from, and how did it get there so quickly? TIA.

It seemed that no one else was surprised by the bulldozer in the middle of nowhere. Our drivers accepted it for what it was. We reloaded the trucks and moved on.

Not a mile beyond the first accident, one of the dala dalas attempted to make up time lost and went speeding by us on the wrong side of the road. About a mile later, we came across that dala dala, flipped over on the wrong side of the road, and attempting to unload people. Fortunately, it looked like the people were packed in so tightly that no one bounced around much and no one was hurt.

We got to Koronge, we stopped for breakfast at a little restaurant that Sonja, Ose, Maria, and I had eaten at the year before. Although it was set up for buses to stop, this place wasn’t ready for our group. The students devoured every donoti (donut), chapatti, and egg chop (a hardboiled egg rolled in ground meat – don’t ask what kind of meat because you’ll never know) in sight. And the restaurant ran out of food. So the students drank coffee (instant), and tea. When I received the bill, it was for over 100,000 shillings. We’d been charged for 24 cups off coffee (there are 18 of us, and half don’t drink coffee). We’d been charged for six people eating off the buffet at twice the normal price of the buffet. We’d been charged for omelets and eggs – and things that they weren’t even serving. When I argued with the waiter, he pretended he didn’t understand English, which he spoke near fluently 10 minutes earlier. I paid him the money and went to find reinforcements.

Enter, our drivers. Julius started to argue with the waiter. The waiter brought over two other restaurant staff. George and Sky then joined Julius. The six of them debated the bill. No one shouts or throws punches. There’s just very intense, rapid, staccato Swahili back and forth, with lots of head shaking (No, you’re wrong, No, you’re wrong.) Throughout the negotiation, Julius would hand me 10,000 shillings from the waiter, and 10,000 more. By the end of the discussion, we’d paid around 67,000 shillings – much more acceptable.

Then the road construction started. When a two-lane road is being repaired in Tanzania, a makeshift dirt road is built to one side. These roads attract a lot of traffic, as this is the major route between Dar Es Salaam and Moshi/Arusha. But the roads are incredibly dusty – so dusty that you can’t see the cars in front of you or behind you. Just like the Eskimos are said to have 13 words for snow, the Tanzanians have 13 words for dust. I’m certain at this point that I have witnessed all of the types of dust, and most of them have taken up residence in my lungs.

By the time we reached Moshi, it was after 3 p.m. Our six hour trip had taken more than nine hours. Then we had to locate the house where the students were going to stay. You’d think this would be an easy task. Just look it up on a map, right? Well, that may work if there were things like house numbers. Heck, most of the streets aren’t even named. Instead, you find a piki piki driver who knows where the house is, and you pay him to take you there. Alternatively, you call someone at the house to come meet you in a well-known location, and this person comes to get you and guide you to your destination. In this case, our destination was a house owned by a local foundation called “Making a Difference.”

Unfortunately, when we arrived, we discovered that there was another volunteer staying there – one with an unpleasant disposition. Not only did this mean that we were a room short for our group, the woman made the space seem half the size. She was combative, domineering, and defensive. Our idyllic paradise to house the students for the next four days was compromised. Furthermore, Mark had decided that the typical Africans mattress (a material covered foam pad) was not doing anything for his back. So we went hotel hunting. Four hotels later, we found a place for Mark. And we found a funky little hotel for the students too. The difference? Mark’s hotel has air conditioning, hot water, and a flat screen TV for $100/night. The students hotel has windows, running water, and really clean cement, and is $20/ night.

I’m staying at the student’s hotel with them (Mark is at the fancy hotel, and Maria and Corey are staying with one of Maria’s friends.) I’ve become much closer to the students on this leg of the journey – primarily because the door to my room doesn’t close. So the students have near constant access to me. I’m actually happy for this. In the past two cities, I’ve felt a little isolated from them. I prefer to be present to help them process their experiences.

One of the highlights of this part of our journey was the meeting with the National Research Laboratory in Arusha. The National Laboratory has several sites, and the one that does plant research is at the gate to Arusha National Park. It’s a natural medicine person’s dream. It’s in the foothills of Kilimanjaro, with mountain views in many directions. Plus, the national park has elephants, giraffes, impala, monkeys, etc. Apparently the only animals that they don’t have are lions. In fact, while we were meeting, a herd of elephants moved through the laboratory grounds. This is also a prime place for students to come do research, as they have hostels on site with kitchen, bathrooms, and bedroom. Can you imagine doing a summer research project on Kilimanjaro – waking up to giraffes out your window?

The meeting was quite a prestigious event, and only five of the students were able to attend. In Tanzania, research is overseen by the Minister of Research, and his three directors. One of the directors attended our meeting and led the discussion. The researchers at the laboratory were very excited to find American researchers interested in botanical medicine. Their passion is studying combination herbs, and they’ve created several medicinal products. We agreed to write 3 grants together – 1 for herbal products for Parkinsons (they have a 3 herb combination that they’ve been using successfully,) 1 for diabetes/insulin resistance, and 1 for immunomodulation of cancer. The possibilities are truly exciting. Travis, who wants to have a supplement company, is thrilled to have this connection. And Greg is thinking this lab may be a place for him to do a post-doctoral fellowship when he finishes at NCNM. Inggrid was also excited because she’s hoping to set up a similar facility in Indonesia.

Venesh tried to be excited about the lab, but he was too sick. He hadn’t been feeling well, but he didn’t want to miss the meeting because it was so important. As we sat through the meeting, Venesh shivered, then sweated, then shook, then looked pale – which is a challenge for him. As we left the lab, it was clear he was fighting some fierce little pathogen – the question was which one. Over the next several hours, his fever oscillated between 101 and 103. He had diarrhea, vomiting, and muscle aches. You don’t mess with a high fever in this neck of the world, so we tested him for malaria. Negative. Was it typhoid? Maria thought it might be. I was voting for a viral gastroenteritis. Have I mentioned that this is a terrific place to learn infectious disease?

In the meantime, Crane went downhill too. One minute he’s fine, and the next minute, he has the same symptoms as Venesh. We fully expected that some of the students would get sick while we were here, but we didn’t know who, when, and with what. So far, the boys have been handling it well. Yesterday, we left both of them wrapped in warm blankets at the lodge, and had Salim (our trip coordinator) check on them regularly. Today both guys are feeling better – and they credit Salim’s therapeutic goat soup with their recovery. Yes, goat soup. Who knew it was such a cure-all?

What do they have? We still don’t know. Here are the symptoms – you see if you can figure it out. Constipation, followed by diarrhea – and they are incredibly grateful for our hotel that has western toilets. The last hotel only had squat toilets. They’ve had fever that seems lower in the morning and spikes in the afternoon (that’s very typhoid). The fever broke today. Vomiting. Muscle pain, but no pain in the upper right quadrant of the abdomen (which is characteristic of typhoid.) The symptoms were bad for about three days, and now they’re doing better. I’m still voting for gastroenteritis…

So, if you’re going to force students to learn things while they’re in Africa, you need to be creative. Maria had a brilliant (though somewhat morbid) plan – to teach the water-borne infectious diseases at the hot springs outside of Moshi. So we piled into our vehicles and headed down yet another dirt road. Again, we followed a piki piki who knew where we were trying to go. This time, the road led us away from Kilimanjaro. And it kept going, and going, and going. I was certain we were headed toward Morogoro. We navigated through a stretch of road that was too rough for one of the vehicles to make it, and had to leave it behind After an hour of driving through desert and dust, we came upon an oasis – a beautiful spring hidden by palm trees and scrub brush. It came complete with a rope swing! Awesome spot. Unfortunately, once the students hit the water, there was no possibility of discussing water-borne illness. Too much fun was occurring. Guess we’ll have to do that on another long drive.

I’ll sign off for now, and write more later.

Sending love from Moshi!
Heather