Wilkes in Tanzania: Lifelong Journeys

May 19, 2015 by

groupAs I undertake my eighteenth trip to East Africa and my fourteenth year in northwestern Tanzania, I am once again excited to be embarking on another trip of discovery with undergraduate and professional health care students and faculty. This picture of me with Tanzanian and South Korean friends was taken in January 2015 in Tanzania during my time there studying KiSwahili with other Wazungu (non-Tanzanians) who work in East Africa.

Every year becomes a new chapter in an ever changing dialogue of people and culture. In 2002, I originally developed this study abroad program to introduce university students to community heath in a rural Africa setting in order to enhance their cross-cultural awareness and competencies. In addition, I wanted to teach students how to engage in international research in partnership with local African agencies and health care providers by involving them in my own research. Since that time, over 150 students and faculty colleagues have joined me in my summer trips to Karagwe Tanzania. It has been a starting point for a life of global engagement for many as they choose Africa for their first trip outside of the USA. My own perspectives have expanded exponentially throughout these years as I experience new perspectives about what it means to be a global citizen through the eyes of my fellow travelers and the family friends, and colleagues who welcome us in Tanzania. The partnerships that we have forged have led to research on HIV and AIDS demographics and program assessment, a series of children’s books in Swahili with community partners, and our current project since 2012 on maternal and infant health. All of these things have shaped “my story” as a person. For our first blogs this year, I asked everyone to “write their story” after listening to an excellent talk by African author Chimamanda Ngozi Adichie: http://on.ted.com/b0sY9. This year’s Wilkes community immersion global health study abroad trip includes four professional and pre-professional health care students: Sara Brozena, Erica Chambers, Kelsey Feinman, and Areil Velez. In addition, we are joined by Dr. Cynthia Mailloux, chairperson of Nursing and faculty member at Misericorida University. You will find their stories and pictures below.

I often say that my story feels like “oh, what a wonderful life!” I have been able to meet, and form relationships, with so many interesting people across the globe as my travels and teaching take me to country after country on five continents.
It is in rural Africa, in Karagwe, part of the northwestern Kagera region of Tanzania that I find a home place and a family of friends outside of the USA. For a time every summer, this place and the people that I engage with expand my cultural boundaries and inspire me with their compassion, dedication to family and community, enjoyment of life, and laughter. The study abroad and research trip that I have been leading to the Karagwe area since 2002 have been pivotal in developing my understanding of my life as a global citizen who comes from one of the wealthiest and most privileged country in the twenty-first century. These trips inspire me and my students and colleagues in an ongoing journey to find ways to partner and share. The hospitality and rich vibrant interconnected complex cultures of East Africa are like a novel in which every chapter has a new revelation. We learn as our study abroad group spends its days immersed in Nyakahanga Hospital and its community health programs or with other partners like the AIDS Orphan Project, MAVUNO, WOMEDA, Radio Karagwe, FADECO, local schools, etc. All of these organizations are grass roots initiatives and testimony to the success of African entrepreneurs. The leaders and workers in these organizations inspire us with their commitment and creativity as they work within their communities dealing with multiple challenges of underdeveloped infrastructure and lack of resources. (See http://www.mavunoproject.org/, https://www.facebook.com/pages/Womeda/285166848171570, https://www.youtube.com/watch?v=CWxUFUkEUb8, http://www.fadeco.info/).

dadAs I reflect on my story and my family, the people I have met have constantly shaped and expanded my world view. In the above picture, my father and I are walking on the beach in his home state of Oregon. Although we live on opposite sides of the USA, he has been my constant supporter and his life of travel, curiosity about world events, positive outlook, volunteer work, perseverance, and generosity to friends has been a marvelous example. He and my mother shared with me their enthusiasm for education, music, community, the value of family, and an appreciation of new experience and travel. I grew up in a family that moved often with homes in five different states scattered across the USA (West, Midwest, and East). My parents encouraged me to seek friends across cultural and language boundaries as they welcomed Native Americans, Mexican sharecroppers, recent immigrants and others to our home. No doubt that this encouraged my interest in cross-cultural immersion and communication.

v1I am also sharing a picture of my Tanzanian colleague and friend Venant Mugenyi. Venant has been the director of the Karagwe AIDS Control Project in Karagwe Tanzania since the 1990s. His dedication to others, practical wisdom, and sense of humor have shaped my understanding of the Karagwe community and the needs of orphaned children. Through our work together, we have had an ongoing project to support orphans in this area (see Wilkes Embrace a Child campaign: https://www.facebook.com/embraceachild). This has given me a window into many aspects of Tanzanian culture (family life, education, opportunities or lack thereof, and the power of hope). He has also given me and others a place to share what we have as donors by supporting a child in school. His commitment and ingenuity has touched the lives of thousands in his community. He is one of many people whose friendship has shaped my perspectives and my story.

Introducing the Wilkes in Tanzania 2015 Travelers

May 19, 2015 by

ericachambersHello, or as they say in Swahili, Hujambo! My name is Erica Chambers and I have just finished my first year of pharmacy school at Wilkes University. I have always been interested in global health and the pharmaceutical industry. I have always enjoyed traveling, therefore, I want to use this opportunity to gain a different perspective on health. As I embark on my first journey to Tanzania, I will take in many experiences and learn as much as possible. I am also excited to build relationships with the people in Tanzania. As I build these relationships, I want to use it as a platform to continue my service in Tanzania and even other parts of the world. Being able to have this opportunity will shape my career as a future pharmacist.

sarabrozenaMy name is Sarah Brozena, and next fall will be my fifth year at Wilkes University and my third year of pharmacy graduate school. This summer, I have decided to take a trip half way across the world to Tanzania to learn about global disease and antibiotic resistance. When I arrived at this decision, I surprised not only casual acquaintances, but close friends, family, and myself. Since I was a child, I made it my mission to explore as many different activities as I could. I joined soccer teams, fought in karate matches, learned to play an instrument, built model rockets, and read hundreds of books. As I got older, I became grounded in my studies but always strived to find new exciting challenges. I joined the Wilkes lacrosse team without knowing anything about the game. I pledged a fraternity and took a summer job knowing next to nothing about it. My trip to Tanzania will be the next exciting challenge. As I face the prospect of entering the professional world as a pharmacist, I want to find ways to expand on my desire to learn and experience new things. Through my current job at a retail pharmacy, I am in constant communication with the general public. This has made me realize that everyone has amazing stories and experiences just waiting to be told. And there are many threads that connect people in unexpected ways. The same antibiotic I give to the young boy dressed as superman I also give to the woman who is about to celebrate her ninety-second birthday. I call the same doctor asking about refills for the woman finally returning to work after brain surgery and the man who just bought his first car. As a pharmacy student, I get to help and talk to people of every age and background. On my trip during my immersion into activities of a regional rural hospital, I plan to investigate antimalarial and antibiotic resistance in Tanzania and its effect on community health. I chose this topic for a couple of reasons. Antimalarial and antibiotic resistance is an issue seen on a global scale and that requires global awareness and education to combat. Its effects have been seen around the world and the resulting treatment failures have forced policy change in almost every country. As an American and a global citizen, I work to be informed about national and global health issues. During my experience in Tanzania and my immersion in their health system, I hope to spread awareness of antimalarial and antibiotic resistance to the Tanzanian people. I also plan to learn from the various professionals I encounter and see how this issue has affected their health system. As I count down the days until I leave for Tanzania, I experience a mixture of excitement and trepidation. I hope to learn about people and medicine from across the globe, while discovering a little about myself in the process.

arielvelezMy name is Ariel Velez. I was born and raised in New York City which is a great place to grow up. I had many friends from all around the world who were first generation Americans just like myself. My parents came to the USA from the Dominican Republic. Being brought up around all this diversity sparked an interest in wanting to travel the world and experience many different cultures. I like to think of myself as a motivated, caring, and loving individual. I love helping others, it gives me a great sense of fulfillment. This is why I chose to pursue a career in nursing. In my upcoming trip to Tanzania I hope to feed both my interests by not only learning all I can about the people and culture but also by doing everything I can to help in the two weeks I am there.

guyana sonI am Dr. Cynthia Mailloux and seen here with colleagues from Guyana. I began my life as a middle class American and have had a good life sharing the American dream with my family. We lived in Wilkes Barre PA and summered at Indian Lake. It was there that I developed a deep sense and appreciation for nature and all of its grandeur. As I continued on my journey of life, I got married and moved to Detroit where I got to experience more than the Wyoming Valley. By this time, I graduated from college and was a practicing registered nurse. I thrived as I was able to care for patients during their times of need. Once I moved back to Wyoming Valley, I began teaching nursing which I found to be my true passion. I earned my Master’s degree at Misericordia University and my PhD at Penn State. I am presently the chairperson of the Department of Nursing at Misericordia University. It was here that I developed the passion to look at health care from a more global perspective. I have traveled across the globe before doing a project in Guyana and visiting Australia last year to explore study abroad options for our students. Visiting Tanzania and Uganda will provide me another opportunity to share with students the importance of understanding health care in developing countries.

FullSizeRender(1) My name is Kelsey Feinman and I recently graduated from Misericordia University after four years! I begin a graduate program in August to become a physician assistant and I would ultimately love to work in a neonatal intensive care unit. I have always wanted to travel and experience other cultures but haven’t had the opportunity until now and I am ecstatic that in the process I get to experience the health care differences. I am also eager to form relationships with individuals in Tanzania and understand how their daily routines differ from my own. I also hope to take from this trip a better understanding of the patient/healthcare provider relationship to mold the way I will interact with my future patients.

A final lesson on technology and appreciating what you have

July 23, 2012 by

It was bittersweet to leave Africa. I already miss the people and the environment there. The thought of leaving was especially difficult after spending time with Mama Muga, a nearby friend who welcomed us to her home. Her family said goodbye to us with a night of dinner and dancing, and the whole atmosphere was energetic and friendly. We went back to learn how to make chai and listen to different African music types. I felt like we were part of their family.

I spent my last day at the AIDS Control Project helping in any way I could. The people there have so eagerly helped me so much with my documentary, and I wanted to give back to them. I ended up giving the secretary there a whole computer lesson. She was having difficulties with opening PDF files and asked for help.

I sat with her for at least an hour teaching her different things. I taught her the options of right-clicking, how to click and drag, how to have multiple windows, how to delete files, how to save items onto the desktop, how to move things to and from My Documents, how to use Powerpoint and how to insert Excel charts into Word documents. She said I would save her a lot of time, especially with the Excel charts shortcut. Previously she would type data into Word, minimize the window to get to the computer calculator, do calculations and return to Word to type in answers.

I also taught her how to created folders. I noticed in her documents that she had never created a folder before, so her computer was filled with years worth of files, hundreds of files. I wondered how she was able to find anything in there. I explained how she could use the new folders to organize things. I hope I helped to make her work easier and more productive.

She explained her issue with PDFs, telling me how it was an ongoing problem. People would send emails with PDF attachments, and an error would appear. She would ask them to resend the file, and there would still be an error. It turns out she was trying to open them in Word. The solution was as simple as showing her how to open the files in Adobe Reader instead. I said, “it’s easy!” but she explained that it’s not so easy when you don’t know.

I really thought about this response. It made me realize how lucky we have it as Americans, growing up with this type of technology and being able to take computer classes. I tried to imagine how confusing it would be for someone who doesn’t have the resources for learning in front of them and is trying to tackle the complex realm of technology.

But, beyond that, I realized how lucky Americans are overall. This has become a defining concept for me, one I have taken back from this trip. Now that I’m back, my main goal is to appreciate what I have. I appreciate the opportunities I have in America more than ever. It has really hit me how those opportunities aren’t available everywhere. Things like education and employment are readily available for us if we look for them. If you’re born into a poor family, you can work toward a better life. There are so many potentials. This is much less likely in Africa. If your family is poor here, your potential is limited to working on the family farm, and you have pressing matters of survival to deal with. I feel like I’ve taken these opportunities and resources for granted because I never realized how valuable they are. In this way especially, Africa has really opened my eyes and my mind.

When I came to Tanzania, I had no intention of learning about myself or about America. I wanted to focus on learning about the culture here. But, while I learned so much about the community and activities here, I unexpectedly ended up reflecting and learning about America too. I feel like I will return a more compassionate and appreciative person, and in that way I will try to channel the wonderful people I’ve met here.

Now that I’m back, I’ll be working on finishing up my documentary, “It Takes a Village,” which will focus on the ACP project to send orphans to school. I hope it brings attention to the great work this organization is doing.

Money can buy a bed, but it can’t buy sleep

July 7, 2012 by

I’ve been thinking a lot lately about what Africa needs. The people here face many problems with things like lacking health care, education and social equality. I think the ideal solution is nothing like what I would’ve automatically thought before I came to Tanzania.

It occurred to me today as I was listening to Joseph Sekiku, founder of the Fadeco community radio station. He was answering some questions about the limitations of health care in rural areas of Tanzania. He said there are many more options in the capital, Dar es Salaam, such as more doctors, more specialists, more hospitals and more resources. These options don’t just apply to health care: there are also more schools and teachers for education, more sources of public transportation and more employment opportunities. These options don’t extend to rural areas. For a solution, Sekiku had a brilliantly simple response that I hadn’t considered, but it made perfect sense.

“Money can buy a bed, but it can’t buy sleep,” Sekiku told us. He elaborated, explaining that more tangible resources are not what rural Tanzania needs. He said it needs training.

I think Americans are too quick to turn to objects as solutions. We try to solve our problems with money or machinery. While this might help us, it doesn’t help Tanzanians in the long run. Sekiku talked about the negatives of foreign food aid. Programs like that, while compassionate in nature, require reliance on outside help. They don’t help Africans learn how to grow their own food. They don’t help Africans to be independent.

Training and education helps people to solve their problems independently and can have a preventative effect. This can be applied to rural hospitals. The Karagwe hospital Nyakahanga, for example, has machinery that very few people know how to use. The staff does not need more machines like this. Like Sekiku said, they need training. Training would enable them to make the most of the resources they already have and the ability to access more resources.

In many cases, this training could translate to survival in rural Tanzania. Sekiku said he would like to see a group of people trained out of the hospital to be paramedics. People could also be trained to not only grow their own food, but how to have nutritional diets.

I think a lot can be learned from this mentality. From this perspective, training and education are the most valuable resources for Africa.

Tea parties and multiparty systems

July 7, 2012 by

By Christine Shaneberger

Hujambo!

Lots of research over the last few days. I got the chance to chat with two men about my project over some Tanzanian Chai, which of course turned into a conversation about politics. Tanzania has an election coming up in 2015, so I have been eager to hear what people have to say about it. Although Tanzania isn’t officially a single party system, in effect it has acted as one in the past. Recently, an opposition party has begun to gain more attention. This has sparked an unusual amount of interest in the upcoming campaign for some Tanzanians. As the two men talked, I could see traces of countless conversations I had heard in America about politicians. Some highlights included: “They all lie!” and “They don’t care about the people!”

Maybe our politics aren’t so different after all.

Finally, the conversation turned to political culture, which I was excited about because I had been waiting to talk to someone about it since I arrived. Both men seemed to agree that the reason Tanzania has been so stable in a relatively unpredictable region can be traced back to their first president, Mwalimu Nyerere who advocated teaching the people about politics. They also emphasized the role of unity and national identity. When I asked about it they both said almost simultaneously “We all know Kiswahili!” The unification of over 20 tribes in the mid 1960’s was no small matter, and probably does have a lot to do with their stability.

Finally, I got the chance to ask about the consistent success of the Chama Cha Mapinduzi party. Although Tanzania seems to have a relatively healthy and free electoral process, one response shocked me; “People fear about the change. They think it will cause war, fighting, conflict. They see the ruling party and say that if you are going change, you are going to see problems. So they see no nee do change the party. They think they should allow the ruling party to continue to rule.”

When I asked him if he thought this feeling would change he replied, “I think the time will come. We can’t fear forever.”

Teaching Tanzanians how to fish with community radio

June 30, 2012 by

Radio has power in Tanzania. We learned this when we visited the community radio station, Fadeco. The station founder, Joseph Sekiku, told us all about the ability of his radio programs.

As a community station, Fadeco broadcasts informative programs to benefit listeners. The topics range from health, agriculture and environment to women empowerment. With all these programs, the goal is to educate and aid people. Sekiku related this to the phrase about teaching a person to fish rather than giving him the fish. “Give a man a fish and he will eat for a day. Teach a man to fish and he eats for a lifetime.” Information and education empowers people, and prevents problems from starting. Sekiku said he was using these programs to “teach people to fish.” Instead of trying to distribute AIDS medicine, he was distributing information on how to live with AIDS. Instead of handing out food to people, he was teaching them how to harvest their own food.

One of Fadeco’s goals is to give voice to those who don’t have a voice. He said he invites people on-air from all backgrounds, regardless of social status. They come on and talk about social issues from their perspectives. He helps them to get their message out and get support. As he said to us, “This is a loudspeaker. Come and use it.”

Sekiku said the station has a reach of 10 million listeners, and since the station began he’s seen a great increase in radios in the area. The impact the station has had was apparent from the success stories Sekiku told. He talked about how he brought light to the difficulties disabled people were facing in the community. He said a large amount of people are living with disabilities, such as a missing limb, and are rejected from their communities. He invited disabled people to talk about these problems from their viewpoints. Afterwards, listeners responded with the realization of the judgment they placed on these disabled community members. The disabled people gained respect from their community. And not only that, the government decided to assist disabled people. All because of the information broadcast by Fadeco.

Sekiku spoke passionately about this impact. It was inspiring how devoted he was to his work. With engineering background, he decided to purchase radio equipment and start Fadeco on his own. His friends didn’t believe it could be done, but he proved them wrong. Since then, he has used the power of information to improve the lives of his listeners. He truly understood the importance of media to a community.

Lessons about research

June 30, 2012 by

By Christine Shaneberger

Today we dove into our individual research. I began my day at the Aids Control Program where Venant was kind enough to show me stacks of records about their progress over the years.

I had heard many times that field research is often a process in which one discovers what is not possible and that I should expect to run into a multitude of problems throughout my project. Today was my first glimpse of this. As I was reviewing ACPs records I realized that collecting data for the scope of my research would be impossible given the records available.

Although this was a little frustrating, I think I learned a valuable lesson about field research . Luckily, I was able to refocus my project and will be researching a different aspect of ACP for the remainder of my research.

Today was really valuable and humbling for me. A relatively large setback in research made it clear to me that I need to embrace and internalize parts of Tanzanian culture I have learned about in the last few weeks while I’m gathering data.

Things move much more slowly here and people enjoy small moments rather than worry about the seemingly intangible “bigger picture”. Today was a reminder to relax and absorb as much of this experience as possible, rather than waste it worrying about data and how much work I can cram into the next few weeks.

A voice for women in Karagwe

June 30, 2012 by

By Chrisitne Shaneberger

Our NGO of the day was Womeda. I don’t think any trip to East Africa would be complete without focusing on women’s rights. It probably goes without saying that women’s rights have a long way to go in Tanzania, but Womeda is an absolutely incredible organization that has a huge impact on the community. They provide domestic and sexual abuse counseling, legal services, marriage counseling, child protection, and economic empowerment services to women in Karagwe District. I think I was most struck by the consultant employed by Womeda, Evelyn. She was hardly the typical rural Tanzanian woman we have encountered. She was overwhelmingly confident and adamant about changing women’s societal roles. Even more surprising was her clothing choice. She is the only woman in Karagwe that I have seen in pants.

The director of Womeda, Juma, was equally as amazing. Just like Evelyn, Juma was hardly a typical Tanzanian man. He talked about his wishes to see gender equality and his role in creating a world safer for his wife and daughters.

The value of education in Tanzania

June 26, 2012 by

By: Christine Shaneberger

Benitha, a recipient of educational aid from AIDS Control Program, stands with her family.

Another bittersweet day in Karagwe, Tanzania. We had the opportunity to visit AIDS orphans and families helped by the AIDS Control Program. Each evening Dr. Winkler leads a period of discussion and reflection on various topics. Last night’s question was “If you could raise money for any cause in Karagwe, what would it be?” Before today my answer would most certainly have been HIV and AIDS treatment. After today, I’m not entirely sure what my answer should be. It was obvious to me today that I had no idea how complex the problems are here, and furthermore how engrained these social problems are in the community and individual families. The AIDS orphaned children show so much promise, but are often shackled to their situations. As a child I grew up hearing “you can be whatever you want if you are willing to work for it”, but that is not always the case here. Some of the children we met are in school only because they receive educational aid from Mr. Venant and the Aids Control Program. Some of them are nearly at the top of their class because they have such a drive to succeed but their aspirations are limited by their family situations. Today, we witnessed a brief snapshot of the harsh reality of AIDS, not only for those that are infected, but by their children and grandchildren. One boy, Ananias in particular is very motivated academically but was unable to further his education because he was solely responsible for providing for his family, and had been since the age of 12.

This program has been nothing if not exposure to the realities of rural Africa. After meeting briefly with Ananias and his family we went to a private school where his grades and potential were discussed with the head master. It was decided that he would attend the private school to repeat forms 2 through 4 and then retake the national exam in the hopes of moving on with his education. Ananias had preformed very poorly in school because of his difficult family situation but both the school and Dr. Winkler are hoping for better performance if he is put in boarding school.

The most difficult part of the day was when we visited Benitha’s family. She is 13 years old, and thankfully attending a boarding school. Her mother is completely blind and raising her sister’s children who are both under 4. When we arrived we saw how malnourished the young boy was and had to explain to this small girl that her nephew was sick. Watching Benitha’s reaction was extremely difficult. While she was extremely composed, it looked as if her world was crashing around her. She is only a child, but she is dealing with an incredibly difficult situation. We urged her to assist her mother in getting this boy some more protein, but she will only be at the house for another 2 weeks before she leaves for school again. Benitha has a bright future ahead of her, but I couldn’t begin to imagine the responsibility and hardship that is hers alone.

The will to succeed is so strong here. It makes me evaluate how much has been handed to me in America. Too often, education is treated as an unwelcome obligation. Education is such a privilege and should be treated as such. I think the children here are wise beyond their years. They understand the importance of every opportunity they are afforded and are so grateful. I hope that I will have an answer for Dr. Winkler’s question by the end of my experience in Africa because I really hope to have a better understanding of the need in Karagwe.

It takes a village to raise a child

June 26, 2012 by

Anangelesi and Anagilenti talked to us about how much they love going to school.

I got the chance to talk to three shy, sweet and incredibly smart young orphans today. The first two were 12-year-old twin sisters Anangelesi and Anagilenti. The girls ranked 10th and 14th at the public school they attend. The orphan education program pays for school fees for both of them.

Their family met us with cold soda and warm greetings. Their older brother lived in a house nearby and was a major source of support for the children. It was immediately clear that they were a part of a large community. Neighbors surrounded the house and continued to emerge up until we left. They all gathered around to hear about the twins’ success.

Anangelesi and Anagilenti talked about how much they love school. They both dream of going on to become teachers. But, they struggle with a lot of household responsibilities that distract from their studies, like gathering water, cooking and cleaning. It is a difficult balance for them, but knowing they have the support of their sponsors behind them motivates them.

Then we visited Pius, a highly intelligent 17 year old. He read off his progress report to us: straight A’s. He is currently ranked 2nd in his class out of nearly 200 students. While this is a great feat under normal circumstances, Pius has the additional struggle of learning English. All of his class lectures and textbooks are in English, and when he started at the school he did not know the language at all. His grades show how he excelled in this transition.

Pius talked about how thankful he was to have support from the orphan education program. This funding enabled him to excel and pursue a rich future. He hopes to become a pilot.

Pius also has the support of a large community. His aunt took him in when his parents died, and other community members lent their support. Pius owes a lot of his success to this community, and he hopes to honor them with his academic success. Mr. Venant Mugenyi, who coordinates the orphan education program, said it best: “It takes a village to raise a child.”

Kirstin interviewing Mr. Venant Mugenyi about the orphan education program.


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