Patience and Patients

Swahili Word of the Week: Haraka Haraka Haina Baraka- Hurry, Hurry has no blessings

Weather: Mild, Breezy with the occasional shower.

Special Shout Out: Danny and Lynn- I am so excited!

Patience and Patients

As you grow older you begin to realize your traits and how hard they are to change. My thirties have been a time where I have learned to love myself for all my faults, pet peeves and idiosyncrasies. That being said, I know I am not a patient person. I turn into the evil lady who hates children when they kick my seat on the airplane. I will become mkali (fiery) at the taxi driver that does not take the jam free way home and don’t get me started in waiting in non-moving queues.

It is amazing that I have chosen to spend the following year in a country where every phrase seems to relate to the fact that going slowly or taking time is rewarded where haste and speed is considered reckless. I am looking at it as life test, at times it pushes me to the edge of sanity as I try to use logic to resolve issues. There is a different type of logic here but in its own way, it’s a beautiful and endearing quality of tanzanians. Their patience appears to be endless. I try and focus on this rather than the annoyed and impatient voice in my head that starts an inner dialogue on how this could be run so much more efficiently. Tanzanians appear not to get angry or frustrated. I have not seen road rage, middle fingers or swear words even though the traffic is some of the worst I have experienced (though they do like their horns). They wait in hot, disorganized lines without complaining and will chat away as my frustration builds and builds. I obviously have much to still learn.

This weekend I was lucky enough to get to ZIFF- Zanzibar International Film Festival. There were some great films, lots of live music and a great atmosphere. On Saturday afternoon I headed north to Kendwa in search of white sand and turquoise waters; I was not disappointed. We took up a Chai Maharage (translates literally to “tea and beans” because you sit on benches in the back of a pickup truck facing each other, similar to when you sit across from the ladies who sell you tea and beans for breakfast!) which when I asked the conductor how long it would take, was nicely surprised when he answered 50 minutes- 1 hour tops. Two hours later I kicked myself for believing him, when I asked my friend why the man had said an hour was told “it was to keep you warm” ie he gave me an answer I wanted to hear. The journey was only about 50km on a relatively good road. “Why?” you ask, did it take so long to go that far. Well quite simply in the fact that the driver stopped about every 100ft to pick up or drop off a passenger. This was infuriating to me. We would pick up a passenger and then get going only to stop within easy walking distance to drop off someone else (and of course each person getting on/off would have bananas, children, sewing machine, spare tire etc.). Meanwhile there were nicely placed blue signs in appropriate areas of the road saying “Bus Stop”; No one stood at those. After about 20km of stops and starts I had started to lose my cool and asked why people didn’t gather at the bus stops or at least in a couple central locations in each village. The reply I got was “This is Zanzibar”, I guess that is an answer I can’t really argue with.

After a fabulous weekend away, I returned to my new house newly furnished. On average my furniture arrived about 2 weeks late per piece. I would call everyday to see progress after the deadline for completion had passed. Each day I was told “Kesho Dada”- Tomorrow Sister, again it was so I stayed “warm”.

I am happy to say after a good 6 months I am now officially a TZ nurse and will be volunteering at the national hospital. I have missed my clinical practice and am so looking forward to working with patients, especially here. Patients here have a completely different outlook on medical care. It is a privilege, one that they will wait for hours and days to experience. The national hospital here has patients on the ground, outside on gurneys for hours and dead bodies often in the halls for hours til they are finally transported to the morgue by overworked and understaffed employees. When going in to get my ID card, I passed through a medical ward. I stepped over a patient who was breathing about 32 times a minute. For the non nurses out there, respiration rates are generally between 14-14 times a minutes. In the US this person would be sitting up, oxygen applied and most likely having breathing treatments. This lovely girl was instead of the floor, flat on her back looking very uncomfortable, but not complaining and waiting patiently until the nurse could attend to her. The nurse was frantically looking after another patient that was worse off than this one.

Work has been amazingly hectic, but with that it means we are moving forward nicely. How exciting! My place has spare room so if anyone needs a vacation, Karibu.

Are you happy to be back?

Swahili Word of the Week: Nitarudi- I have returned

Weather: Glorious, light breeze, sunshine, low humidity and a cool 28 C. Perfect Beach weather, definitely where I am headed this weekend.

Special Shout Out: Oh so many this week…
Ellen- you are a legend in packing, how I couldn’t have done without you.
Dad- Flying up to SF meant so much and who would have thought we would get our mountain of a to do list done and still get to Swans!
Heather- Thanks for flying all the way from NY to see me, loved our Epic Trip and yes there will always be the Tiburon
Kate- Hostess with the mostest
Nons and Si- Awesome dinner party
Mum-Love the London Time, Oliver!, camera and the skirt!
Chloe- my birthday card from you is officially the best I have ever gotten, thanks for the laughs
And everyone else was amazing too, thanks for making home such a great place to come home too.



Are you happy to be back?

I have to say it was with some trepidation that I returned back to SF to finalize the move to Dar. Moving out of Hoffman seemed like cutting the last tie and I was worried upon return, that I would realize I had made a decision that was not right for me. Although it was great to see everyone and everything, the trip home confirmed that at least for the next year, the decision to stay here is a good one.

I was able to visit both my old hospital floors in SF, and although I miss bedside nursing tremendously and miss my patient interactions, I came to realize that it will always be there. I have a chance to affect change on a large scale here in Tanzania and I am going to remain focused and motivated on that thought.

Making it back to SF, SB and London was such a treat. If you ever need an ego boost moving out of the country is a good way to get one. I got a lot of ‘is it good to be back?’, ‘are you having culture shock?’ etc. And yes it was good to be back and no I didn’t really have culture shock. I have had it before; going into Whole Foods on the first day I got back probably wasn’t the wisest choice but it wasn’t as bad as I have had it in the past. Maybe because I am getting used to the to and fro or maybe I have become jaded (hopefully not). Similarly, when I got back to Dar I was greeted with a Hero’s welcome. Not just because I was bearing gifts, but a true welcome ‘home’.

Many of the nurses were happy to have me back and gave me a little pump up for the slog ahead. I wanted to share the following email, not because he sings my praises, but because I really believe people here are doing such great work with limited resources. We need to remember that sometimes recognition can be reward enough.



Hi Alice!

I am very happy that you are now back to Tanzania.
I thank God that your trip was wonderfully and you traveled all the
way safely.
Thank you very much for appreciating what we are doing here at Kiomboi,
you have impressed my heart,for me is enough just knowing that there is somebody somewhere
who real recognize our work.For sure i tell you Alice,we do a lot of important things
here but few people do recognize.
I have got an information also that you have brought some books,thank you so much.
This library is real helping us and our students too, although Hospital staff members are not
yet motivated to use our library but I believe one day it will be of great important to them too.
Thanks also for the fund and every thing.
Your welcome once again here at Kiomboi and see the progress.

With Humbleness


I am not normally a promotor, but I discovered a great organization for those that want to support African and Global Nurses http://www.grettafoundation.org/

Asante Sana

Uuguzi huleta afya...Nurses bring health!

Swahili Word of the Week: Uuguzi huleta afya...Nurses bring health!

Weather: It is perfect. Blue skies, Upepo season has arrived and it is lovely. Breezes, sun and clear air. I love it!

Special Shout Out: Thank for all the birthday wishes and cards. Made my birthday season!

Nurses in Tanzania

So as I prepare for my trip home (YIPPEEE) I contemplate my time here so far. Last week was a very nice summation of what amazing experiences I have had so far. I had a superb birthday and then traveled upcountry to do site visits on our libraries that we have place in VERY rural areas. This gave me an opportunity to see some of the work that we are accomplishing.

A wise woman once told me (thank you kate campell) about the lollypop theory. Bedside nursing, although very hard work ,generally gives you a little lollypop at the end of each shift. When you walk out of an exhausting 12 hour shift, there is generally at least one thing that you did well and had a positive affect on a patient. The work I do now does not have this immediate gratification, but hopefully in time there will be a huge lollypop that will make up for all the little lollypops I am missing being away from bedside nursing.

Last week I got to have a quick lick of this larger lollypop. After traveling for 2 full days up to Singida I arrived at a nursing school in very remote Tanzania. Although, very minimalist compared to developed nation standards, they are churning out good nurses. What was amazing was the dedication of these nursing students. There were 265 enrolled nursing students, most of them were 18 years old. Very shy, polite and dressed in pink pinafores. The school had a total of 4 nurse tutors for all 265 students. No skills lab and a very, very outdated library. The capacity of the school was 120 students. This meant that all students shared a twin bed. Dorms were set up with two bunk beds so in a 12 x 8 room there were 8 nursing students. Yet when I arrived, they greeted me with shy smile and told me how much they enjoyed and appreciated their new Mobile Library; As did their exhausted and overworked tutors.

We continued on through to 4 more nursing schools and met an amazing third generation Norwegian MD TZ resident whose grandfather was a Dr in TZ in the 1950’s, as was his father and now he is the medical director. They were running an amazing hospital in the middle of nowhere. People travelled from miles around. The tribes around the area are very primitive, I saw my first tribe members with facial scarring. Beautiful. The nursing students here were also amazing. I met with the 3rd year leadership students. As part of leadership they are assigned different school tasks. Some were assigned to the kitchen and as part of the leadership class had just slaughtered a cow (only in Africa moment). These nursing students are entering jobs where they generally have 30 patients, they are underpaid, not respected and very overworked. They share beds, books and uniforms in order to get through nursing school. It makes me proud to be a nurse because nurses are a dedicated and amazing breed.

The trip was grueling on awful roads. I was physically sore from being jostled around for 8 hours a day in the back of the car. My life flashed before my eyes at least three times. Once when a daladala stopped short in the middle of the road. The driver had me in stitches when he stated that “DalaDala drivers are all born from the same father.” This is so true. Every country you go to DalaDala drivers all drive too fast, play their music too loud, stop in inconvenient places and have no regard to anyone else on the road. My second life flash moment happened as we were traveling down from Arusha. We came upon a quite spectacular crash where 4 Lorries had collided. Two being petrol tankers. One exploded, the other lay on its side with about 200 people crowded around it with Jerry cans. I asked the driver why and he said the driver of the Lorry would charge the people to fill up the Jerry can to empty the truck. I guess the nearest petrol station was a few 100 km away so it was door to door service for most of these people. It does make you wonder if the money ever makes it back to the petrol company though, and the safety of emptying fuel in the bush out of a crashed tanker with an exploded tanker a few hundred meters away, hmmmmmm.

Food for thought
Tanzanian nurses comprise over 60% of thehealthcare workforce
By 2020 they will only have 50% of the nurses they need (at the rate their producing nurses)
The average age of a nurse tutor in TZ is 55.

the affair

Weather- The rain is here, seriously. It has not stopped in three days, there are floods everywhere and the city is a sodden mess.

Swahili Word of the Week: Nakupenda- I love you

Special Shout Out: Happy Birthday DAD! You are hands down the best dad in the world and I love you so…

The Affair

No, for all you expecting juicy details about a lover, alas the affair is with TZ not with a man.

I was lucky enough to be invited to a lovely birthday party last week where we chartered a 120 foot, 100 year old schooner. She was a true beauty, many G & T’s at sunset, delicious dinner and then dancing under the star all in the Indian Ocean. LOVELY. While on the boat I met a lovely soul, she and I philosophized about life in TZ. She had read a book called the four stages of culture shock. She thought moving to a foreign country (especially a developing one) was like a relationship. The first three months were the honeymoon period, everything is exotic, new and exciting. The second three months you are settling in, you become comfortable and enjoy it. The third stage you hate everything. The traffic, the noise, the fumes, how slow everything moves and that takes you to the fourth stage. This is where you are truly comfortable. You see the good, bad and the ugly but you take it all in and live your life happily. For those of you that don’t know I have decided to stay for a year. It seems only fair that I make it to stage 4 so I am going to give it a try, though seriously, the project I am working on needs a person on the ground, I am learning a lot and I am liking this shake up of my life a bit. I am so far following the plan and have moved nicely into stage 2, not looking forward to stage three.

I have become to analyze Tanzania in this affair I am having with her. The rain has come this week and it seems to have washed away all the masks and bandages Tanzania wears; she is now showing herself with all her wounds and vulnerabilities. The rain has been incessant and with it has come chaos. Tanzania is stuck between desperately trying to become a modern nation while having little of the infrastructure, governmental support and planning to get it there. I will use traffic as an example because it rules your life here. Tanzania (at least Dar) has a middle class that can afford to buy cars. The roads were built when Dar was a city of 1-2 million, we are now close to 6 million. Roads have not been improved, the public transportation is not really public, it is uncomfortable and not consistent. Finally the ministers don’t have to deal with the traffic. You see them block huge amounts of roads so that they can drive their black Mercedes through the traffic while the rest of us pay dearly for the roads being cleared. Traffic is AWFUL but the rain has taken it to a whole new level. Dar roads functions barely in the sun, with the rain and the floods it stops, literally. Yesterday it took me 3 hours to go 25km. Huge surges of people marched along the roads with water up to their knees, there is no drainage, the dirt roads now have 3-5 foot puddles, taxi’s, dala dalas and pedestrians try desperately to get around. The lack of traffic laws that are always in place (quote from my taxi driver “I don’t worry about traffic lights, no one is going to stop me anyway) seem to become anarchy in the rain. Gridlocks like I have never seen were in every junction. I have to say that I was a little smug when I biked to my local Indian store, talked on the phone for an hour, shopped, ate some dhal and then returned and the same cars were in the intersection. Go Bikes. But it is sad that Tanzania is stuck and I hate to say it but I do not see a solution happening anytime soon. It has made me appreciate urban planning. That being said, they say true love is loving something for its faults, wounds and vulnerabilities. Even after my long traffic days, a quick bike around my neighborhood let me witness my community building stepping stones through newly formed lakes. My local chip seller took my hand so I could balance on them as I marched across. This made me smile and fall in love all over again.

Job is going very well. Started on some new activities, working with many nurse leaders on curriculum development, working on a national standardized HIV course for all tutors and looking into placing skills labs in the nursing schools (right now nurse students practice their first skills on their patients, YOUCH!)

Life, Friends and Cheese

Swahili Word of the Week: Safari Njema- safe travels

Weather: Cooler and the rains have arrived. Torrential downpours that last 20-30 minutes, flooding streets, and making for the walk home in flip flops a laundry nightmare. All my clothes have mud specks flipped up the back.

Special Shout Out: Mum and Ronnie. Thanks for the mail. Such a treat to get good old snail mail. I loved it!


Life, Friends and Cheese

Coming up to my 3-month anniversary in Dar and Tanzanian (April 23rd) I have had a little flashback to my early days and also a flash forward to life that is. On first arrival I was taken in by TZ’s kindness, change of pace and exoticness. Now three months down the line I have become more blasé and lost a bit of perspective of how life is different here. I have got into a somewhat routine. I have made friends, I can fill my time quite easily. I understand my job, I feel that I am doing a good job and work well with all my colleagues.
This week we had a mobile library training for our librarian managers and librarian assistants. My perspective on time, as I mentioned before, has been taking a beating. Things move so slowly here! A training that should be one day is 5 (though I got it shortened to two). I am keeping my fingers crossed that librarians will be up and running when I do site visits in 1 month (both are around a 16 hour bus ride away, lord help me!)

In essence, I have become very comfortable here and ultimately happy. I have become used to power outages, that generally 9 out of the 10 channels on TV are in Swahili, that crossing the road is a Russian roulette every time, that I am constantly damp with sweat, that buying produce is either from the guy on the bicycle with baskets on the back piled high with veggies and fruits OR men on the sidewalk with small piles of tomatoes, chilis, peppers, eggplant or lychees. I am used to no cheese.

Nothing like a little trip to change some perspectives. Last weekend I went up to Nairobi and then Nanyuki for a visit with my African Family. For those that haven’t heard the stories of how my parents met the de Boers and the Campbell/Duckworth clans, ask me sometime. It is a bookworthy story. I am blessed to have them out here and they showed me a weekend to remember. It was so nice to be among people who knew me well, to be able to relax, let my hair down and be. In previous visits to Nairobi I had seen at as an African city, with its busyness, street stalls and traffic. After living in Dar it was suddenly a Mecca. They had coffee shops! With real coffee! Nakumatt grocery that sold everything under the sun! Thump bought me blender, my cooking life in Dar will forever be changed. And Fi took me shopping for all sorts of excitement including a fitted sheet so I won’t wake up twisted in a flat sheet with my face pasted to my polyester mattress. It was a haven of excitement. I was lucky to be able to go birding with expert, hike up parts of Mt Kenya with gorgeous views, clean air and great conversations (and see a cool chameleon), play tennis and have some lovely conversations and laughs with friends. Coming back to Dar from Nairobi took another adjustment. But coming back was nice, when I walked in the door it was good to be “home”. Not only that, I imported a shocking amount of cheese from Nairobi, this paired with the box of wine that I constantly have chilled in my fridge gave me great excitement this week after coming home for work. Can you overdose on cheese? I don’t know, but if you don’t hear from me in awhile you’ll know why!

Happy Birthday Heather!

Masai at Kigamboni South Beach-My fave Dar beach

Frangapani- so delicious smelling

Looking hot and bothered with my bike sale, the bike on the left black should be mine tomorrow I hope.