Day 11: I'm Pickin' Up Dehydration...

Day 11: April 14, 2014

I wasn't the least bit prepared for what my body had been trying to tell me the night before.  I woke a little bit after midnight feeling MISERABLE.  I had fever, obviously, but couldn't check it as I had no thermometer.  I also had the beginnings of what would wind up over the next 36 hours as being the WORST chills of my life.  My skin felt like it was burning up. 

I spent a fair portion of the night in and out of the bathroom, and after a back and forth struggle, something along the lines of ETEC made its return with a vengeance.  What bothered me most thru the night were the fever and chills, however.  I fell asleep, but whenever I'd wake up to try to use the bathroom or just because I couldn't sleep, I would be uncontrollably shivering all over.  Worse yet, it was the middle of the night, and I had no Tylenol or Motrin, so it was up to my body to get a hold on whatever was causing the fever.

I decided at around the 5 am bathroom trip that I was NOT going to work the following day.  At about 7:30 I got out of bed simply to ask someone for Motrin, and Carmelle fortunately had some.  I spent the remainder of the day cycling between lying in bed, waking up to take Motrin, and in the bathroom.  When my fever was under control, I felt okay-ish.  However, whenever it returned, I felt HORRIBLE.  Even worse still, it appeared that the Motrin was only lasting a couple hours as the shaking chills would return in about that amount of time.  My day was essentially this: sleep unless A) taking motrin or B) in bathroom...and mostly it was just sleep.

As the afternoon went on, I realized very quickly I was not taking in nearly enough fluids to keep up with what I was losing thru fever, bathroom trips, etc.  I texted Carmelle to pick up some sprite, fanta, etc to help encourage my intake, and she agreed to on the way back from clinic at the end of the day.  Water just didn't sound good, nothing really sounded good.  I didn't want to eat or drink, but that sprite and fanta sure sounded good.

Finally about 6 PM or so, Carmelle arrived at the house and with her the fluids.  I was continuing to make frequent bathroom trips, and so was eager to get some fluids in.  The sprite actually tasted pretty good, and I downed about half the bottle in no time.  Then it was time for another trip to the restroom, AGAIN.  This time, and fair warning this is TMI, as I sat in the restroom, I began to feel nauseated.  Eventually it became appparent to me that throwing up was inevitable.  I finished as fast as I possibly could and stood up just in time to throw up into the sink.

I was broken.  I moaned and cried out as I threw up.  I hadn't felt this bad in a long time, and to do it so far away from home and the security blanket of family and the American medical system was even worse.  Finally, after a few rounds saying hello to Ralph and Barfolomew, I felt a little bit better.  As I walked out toward the living room to be where someone could see me, the stomach rumbled again and I went for the front bathroom.  After finishing up what seemed like my 10th toilet trip of the day, I just wanted to sit somewhere and just be still.  I stood up, and obviously too quickly, because as soon as I did by head became incredible light, I felt really woozy, and I realized that I was either going to be taking myself to the floor voluntarily or involuntarily.  So, it was kind of a mix.  I sat and then quickly lied down on the threshold of the bathroom door.  After a few seconds I called out that I needed to talke to someone, and when my housemates saw my pitiful self on the floor, we all decided it was time for backup. 

In a few seconds, I was having a phone conversation with Jason while lying on the floor.  He and Liane decided they'd come over and bring some IV fluids and Zofran to try to tank me up...a little concierge medicine in the middle of Tanzania.  After hanging up, I slowly sat up and then, with help, stood up and walked to the couch.  I felt better after the whole ordeal, but still obviously was behind on my fluids.

In the 45 minutes or so that it took Jason and Liane to run to the pharmacy for supplies, I started to feel a bit less terrible.  Once they arrived, we talked about what had been going on, and they opened up a large kit of supplies (like a medical Batman utility belt). Soon I was a veritable pharmacy.  I had cipro, 4 and 8 mg Zofran, acetaminophen, azithromycin, some oral rehydration solution packets, etc.  Then it was time for the IV, for which I was so very thankful.

 The good Dr. Jason helping fix me up.

No pain no gain 

It took three different attempts, and let me tell you, I underestimated the pain of placing an IV...I mean, it's not terrible, but it's not like a vaccine or anything.  On the third attempt, Jason had his line (and some good blood return as well that poured down my arm and onto the pillow, as I now proudly show as a souvenir on my pillowcase), and my fluids were hanging from a nearby light fixture on the wall. 

 Success!

It's fewer attempts than it would have taken me, to be sure!

Overall, I took what I now realize was 16 mg of zofran (yes, my heart never went into V-fib from an excessively long QT interval) and got 2 liters of LR over the next 2 hours. Also, my rapid malaria test was negative...ha! When they finished, my color was back (per my housemates), and I felt loads better.  Armed with a some meds, a rehydrated mind, and enough fluids running through me to last at least till AM, I felt fine when Jason and Liane left.  It had been a little medical party, and as the fluids went in everyone sat around and drank tea, chatting about this and that.  I pretty much just sat.

As the day ended, I sipped on fluids (no chugging and vomiting for this guy, thanks) and rested on the couch.  Deciding I would rather be as visible as possible, I started the night out sleeping on the couch. 

Day 10: The Pope, Scotch & Chocolate, and Half a Pot of Coffee

Day 10: April 13, 2014


So I woke up this morning a bit later than I had anticipated.  I got up at the last possible moment (ie a couple minutes after my last snooze went off and one minute before I fell back asleep and committed myself to a later (and potentially even longer, I'm told) Mass time).  I walked out the door right at 6:30 and walked as fast as I could comfortably without breaking into a profuse sweat.

As I went, I tried to pray part of my daily Rosary, but was concentrated almost more on making it on time.  I knew I'd be okay when I passed a couple nuns walking in the same direction, so I chilled out a bit.

Suffice it to say, this Sunday was a VAST improvement over last Sunday.

First, I had my bearings...where is the altar, the choir, the holy water, Jesus in the tabernacle, etc.  So I found myself a seat amid the rather still empty Church after arriving at about 6:42.  Then I looked around and realized that the columns separating the nave from the aisle were blocking my view of Jesus (the tabernacle was off on a side altar...DON'T GET ME STARTED...).  So I readjusted my approach and took a seat where I could see Him and the altar at the same time.  Bam.

Second, this Sunday I came prepared. I had downloaded the readings onto my phone before arriving and so was going to be able to follow along like clockwork, even if the Mass was all in Swahili.  Also, when the time came for everyone to stand up, walk to the front of the Church, and put their offering into the slit-topped wooden box, I was not empty-handed...though as it turns out the seat I had chosen was the dividing point in the Church where they put a second box, so literally all I had to do was stand up, take a step forward, and sit back down...HA!

Third, I knew what to expect.  LOADS of singing, a very public offertory, announcements that I'm certain I must be getting purgatory credit for.  It didn't bother me too much...I brought religious reading material and wasn't going to be afraid to use it.

As the Cathedral filled, I started to notice the choir dressed in bright red shirts and red/white patterned dresses this Sunday.  The lectors wore full length red robes.  And as it would follow, the altar boys (yes all boys/young men!) wore red garments as well.  Certainly they were going all out for Palm/Passion Sunday.

After the Church filled up and as Mass was starting, I realized I had left my umbrella in the little nook at the front of each pew.  I hoped it would be there at the end of Mass, but I wouldn't be suprised or upset if it wasn't, I told myself.  I let the thought of it go, and it was time for the greatest show on (heaven and) earth!

The singing dominated the Mass again, of course, as the choir not only sang beautifully, but this Sunday had found their dancing shoes...now, not dancing in the aisles or even spinning, etc in their pews...moreso just a smooth movement in place almost like you might expect to see somewhere in the Caribbean maybe.  I dunno, I am terrible at both dancing and describing dance, so there.  They were dancing.

The Choir

However, the priest decided to join the club this week to...and there was CHANTING...now this guy was speaking my language.  The intonations were familiar and almost made it seem like a language I truly knew, and helped me follow along even better.  All throughout the Mass I felt like I had a better understanding of what was being said, felt more a part of what was going on, etc.

Then, just before the Gospel was proclaimed (like JUST before, as in, the priest had already kissed the book, said which Gospel it was from, was about to read the first word of the first verse), the priest stopped, said something in his normal, non-reading-the-Gospel voice, and two men stood up and escorted another man out of the Church!  I had no idea what was going on.  The man had said nothing, as far as I knew had not done anything, but it was very quickly accepted that he had to go, and so he went.  Then the priest made a very calm remark in Swahili that of course I couldn't understand, and proceeded as if nothing had happened.

As the Gospel proceeded, I realized about when the priest said "Hosannah" that he wasn't reading the Passion as I had expected.  I then realized (though I half noticed and knew something wasn't quite right earlier) that the entrance into Jerusalem Gospel wasn't read at the beginning of Mass as per usual Palm Sunday.  Strange, I thought...then I realized that my hand was empty...we had no palms!  I assumed there were good reasons for both, but even still, I felt like I missed a little piece of what I was anticipating, even if it was going to be in a language I didn't understand.

Now just a few more quick points all in a row because this is getting too long.
1) The homily was long, but even in the way that the priest was speaking, I could tell he would have been more my kind of homilist (informed but also humorous and not too serious).
2) The incense was ABOUNDING.  I mean, when they incensed, they did it right.  As in, incense so thick you actually sometimes couldn't see the details on the priest's face. You could see the actual smoke! This made an impact on me in the sense that in a country where there is relatively so little, so much is given and used to reverence God and clearly emphasize his importance and the fact that He is GOD.
3) Once again, the Eucharistic prayer was just what I needed.  As soon as everyone's knees hit the kneeler in front of them, it was as if I was in any other Church in America, Ireland, Cambodia, Australia, Peru, and on and on and on...we are one holy catholic and apostolic.
4) The Mass was, in a way, a mix of old and (relatively) new.  In that I mean, there was so much reverence and homage to what I imagine pre-Vatican 2 (or even pre-2000) liturgy, and it was refreshing and absolutely desirable.  At the same time, this was the 2000 year old Church that has in relative recent history been more and more expansive into Africa, and the customs certainly contrast with what I considered to be "Church etiquette".  It made me feel a bit odd.  However, at the same time, though contrasting, in this setting, they are complimentary.  I think what bothers me back home is that when there is a strong emphasis on one aspect of the Mass, other components fall away.  Not always, but for example, it seems to me that the Masses with "get up and get moving" choirs and "feel good" priests are also the ones without incense, without stress on doctrine and dogma, without many of the things that traditional Catholics hold dear (and with extra components added in that are either semi-liturgical or blatantly NOT liturgical)....might I recommend The Spirit of the Liturgy??

The Cathedral after Mass...look! Nuns!

After Holy Communion, there were the customary ten minute announcements (see non-liturgical), and a miniature 2 minute second homily, then we were out in only...1 hour and 50 minutes!  Oy..but this time, I was more comfortable, more focused, and it didn't seem nearly as long. I took a few pictures after saying a couple prayers and then headed home.

As I got home, the three sibling hosts and Carmelle were headed out to church as well, so I had the morning to myself essentially.  I finished my Rosary and Morning Prayer, then noticed the power in the house (and in the neighborhood) was out when I found my bread still in the toaster as...bread.  So, I had bread with nutella and peanut butter, took it out to the veranda (by way of jumping the railing as the key of the door leading to was nowhere to be found), and enjoyed the morning with some good friends...the Pope Emeritus (in his book), Nickel Creek (on my phone), and Yuppy (one of the two dogs of the household). The last slept while I read...and somehow I was able to read and listen to the music at the same time...that never happens.

Besties...me, the Pope, Yuppy, Nickel Creek,  "Scotch & Chocolate"

An aside for Nickel Creek fans...maybe you got this before, and maybe you didn't...but I think I figured out why the instrumental song "Scotch & Chocolate" is so named. I never can figure the names out (though maybe that's the case for a fair number of the lyrics to their other songs), but this morning it made sense, at least to me.  The song's first half is rather slow and easy, low pitched, smooth...then about halfway through it picks up, becomes more vibrant, and ends up being incredibly fast.  Sooooo...how would you consume scotch...slow and easy, smooth. And chocolate?  As fast as possible. Hence, Scotch & Chocolate.

About 11, my housemates returned home, and we all decided to make Utengule, a coffee lodge and plantation about a 30 minute drive from the house.  We decided against a trip the Lake Malawi as it appeared there were some DARK storm clouds in that general direction...perhaps another day.

The ride out was a perfect length, with a mishmash of countryside scenery interspersed with shops and groups of small homes and shops with which the general weekend hubub was associated.  Small side streets off the main road were also packed with people trucks, produce, and random goods somehow for sale.  Over a few hills, under a bridge, and through increasingly prevalent countryside, we finally made a turn towards the mountain and proceeded into more forested area.  Another few minutes and we turned off paved road, up a hill maybe a kilometer long, and arrived at Utengule.

 Somehow I didn't even realize consciously that I was finishing the circle

The view, the food, and the kitchen

It was rather posh, if I can say so, at least by the standards in which I had been living for the previous 10 days.  The views were incredible, with the Mbeya mountain to the left, a valley in front in the distance (far far away, a large storm was proceeding from what I took to be south to north (left to right) and drenching, I imagined, everything in its path.  We stood and enjoyed the scenery for a while, then sat down to eat some lunch.  The prices certainly reflected the environment, though again relatively.  The food was certainly affordable and fairly priced...just more considering what you could scrape by on in Mbeya.  Further, the TZS 10,000 entrance fee actually doubled as a voucher for the equivalent amount of food or drink, so that made things even better.

The four of us (Amelia, Carmelle, Josh, and myself) enjoyed lunch, and I went with the more popular option of pizza!  Yes, the second time in two days, but I can almost never turn down pizza (unless whataburger is next to it).  We waited a few minutes as the cook working in a nearby outdoor kitchen prepared our pizzas, and then enjoyed our food.  The pizza was fine...nothing to write home about (though maybe in a sense I just did), but also certainly not bad by any means.  It could have used a bit more sauce, cheese, and crunch/bake time.  I downed it along with my bitter lemon soda in no time...though I opted out of putting additional "tomato sauce" (aka KETCHUP) on mine as our Namibian hosts did.

After eating, I realized that I was totally beat.  So, being at a coffee plantation, I ordered some French press coffee.  As the largest pot was only $3, I saw no reason to order a small or medium.  However, Josh was the only one who joined me in consuming the coffee, so, three and a half cups later, I had something to say about EVERYTHING.  My energy was back with a vengeance. I felt great.

I drank half....this last pic is for Reid-o

See, I felt GREAT!

After we finished up our little java experience, we paid our check and looked around the lodge a bit.  I bought a tin of coffee with my Visa, which due to poor reception at the lodge took about 4 swipes to go thru successfully (quite a scare given how hard it was to actually get my PIN for it and the fact that it was my only means of withdrawing cash for the next two weeks).  Then it was time to head off.

As Josh and I sat in the cab of the truck on the ride over, it was our turn to deal with the elements...which were becoming a bit hairier as time went on...clouds were gathering around us.  Nonetheless, I wanted to see the coffee plantation, so rather than take a 30 minute hike there, we drove about 5 minutes (standing in the bed holding onto the horizontal bar in proper style) on the road down from the hill along a river to our left and turned off right into the fields.

We jumped out, took a few minutes to take some pictures as time would allow, including some jumping pics.  Also, I ate a raw coffee bean...don't, they don't taste good.  Quickly we then headed for home hoping to avoid the weather.

 Doing silly things in the coffee fields

Doing a stupid thing in a coffee field...YUCK

As we raced back, the rain began, and though not too heavy, Josh and I definitely got the worse half of the trip.  I cycled between squatting/sitting and standing, wanting to grab a shot here and there of certain things along the road.  Eventually I figured I could turn on my camera, start recording, place in in my holster, and get a good video of the road with both hands clenched onto the bar still. I was most proud.  Josh and I continued to get pelted by cold rain, but the view of the mountains, countryside, and towns with clouds moving all about were worth the small price the elements demanded. Indeed, a truck bed is the way to see this place.

 Did I say it wasn't bad?

We stopped for a few minutes to feed Amelia's horses on the way home, and finally just as the rain was getting really strong, we made it home.  I was only so we as to need to take off my fleece, which rendered me pretty dry.

After getting settled, Carmelle, Amelia, and I decided to play a rainy day game of Scrabble.  It was more fun than I remember it being.  I started out pretty slow, and was handicapped by a multitude of vowels for about the middle third of the game (literally I played MAUI as it was my only play), but then used a few combination plays that generated multiple words to catch up.  The only contention came as one of the players attempted to play the word "SIZER".  I wasn't too sure that this word existed, and neither was our very slow internet connection. However, the player who played it eventually found a Webster's online dictionary entry for something called a "SIZER die"...I don't even remember what it is.

In any case, we won't discuss who won, as it is not proper to brag, and I promised that I wouldn't.

 About the only thing you could make out of these letters...alphabet soup

 Two non-winners and a winner

The finished product...I still think "Sizer Die" sounds like a German curse word

After the game, it was just about dinner time, so I volunteered to go and pick up food to go from Mbeya Hotel.  I knew there was a soccer match on, so I figured I would just hang out and watch it while I waited.  I walked the short five minutes down, placed the to-go order, and the woman nodded and said, very clearly, "Twenty minutes."

Now, we had NEVER been given a time before.  This was unprecedented.  On top of that, the restaurant was more full than I had ever seen before.  I doubted the estimate as we hadn't ever seen food in less than 30 minutes.  Whatever, I nodded and told the woman I would be in the bar area watching the game.

 The always picturesque walk down to Mbeya Hotel.

Yes, this was full.  The capacity is about 10 people, then it's standing room only

The area was rather full, and I had to motion to the bartender and holler out to get a drink as the seats were all taken...SRO for Chelsea vs Swanson.  All in all, I was there for the entire second half (yes 45 minutes), had the locals do what I think was making fun of me for making ooh and ahh and grunting noises at near misses and goals (eg when I said "Gah!" a local turned to me and sad "No Gah, Ba!" (Ba was the name of the player who missed the goal shot), and didn't really even mind the wait.  I gathered the food once it was finally ready and headed back up hill.

As we all sat down for dinner, I realized I was EXHAUSTED.  The coffee certainly had worn off, but still.  Also, I had very little appetite.  No worries I thought, that just meant leftovers of my Paneer masala.  We talked a bit, I actually found an ability to finish the cocoa my hosts had made, and then decided it was bedtime.  I was so tired I didn't even shower, and clearly didn't pay much attention to the fact that I felt a bit warm.

Proof that I was tired but still feeling okay when I went to bed.

It was an exhausting day...so I thought.

Day 9: Seven Miles in Heaven

Day 9 - April 12, 2014

I slept like a rock.  When I awoke the first time, it was dark outside.  I wondered what time it must have been and lay there for just a few minutes before my alarm went off, letting me know that I had slept the entire night through.  I felt rather rested, and stayed in bed lazily praying my daily Rosary before turning to my phone and checking quickly on what had been new in America while I slept.  Finally I got to getting up and around.  By the time I did, the sun had started to shed some light onto the mountain and it was light enough to navigate out of the room without fear of tripping.  

 

I made myself just a bit of toast with Nutella this morning, because I had plans to go for my first run since getting here (and my first run in Africa I'm pretty sure, since I didn't run in Bots, unless you wanna count running to catch a taxi or to get to the airport on time on the last day of my previous African adventure).  While sitting on the veranda as the sun over the mountain just to our southeast, I read morning prayer while eating my breakfast, perused the GPS map of the surrounding area to somewhat familiarize myself with the area's roads, and was ready to head out.  I put on my bright green running socks that Ali bought for me just before leaving (super comfy), created a Nickel Creek playlist on my phone, and set it up to play while my phone kept track of my run.  

 

It started out pleasantly enough, briefly jogging down the road the house was on and up another that previously I had only looked upon while walking to work.  After that, I kind of just turned here and there where the path took, staying closer to the mountain and completely off the main road.  

 

I wish my words could do it justice, but the scenery was beautiful.  I was glad that I was running and couldn't easily stop to take pictures, as I enjoyed just taking it all in uninterruptedly.  As Nickel Creek provided a largely instrumental and (even when lyrics accomanied their guitar, fiddle, and mandolin) delicate and perfectly fitting musical score, I ran up the imperfectly paved roads, with colors scattered and cascading about every which direction.  Beautiful shades of brown and green from the pine, flat-leaved, and banana trees that arose on either side, with branches draped here and there.  On the trees were flowers of bright red, coral, crimson, pink, yellow, fuschia, purple (and yes, three different shades of red, I wasn't being redundant).  Lower to the ground the houses that flanked the road stood, many simple concrete or white clay with silver and rust-colored rooves, needlessly standing guard over the crops being tended in the deep brown soil in each of their yards...nothing could or would possibly disturb this scene, would it? (The exception of a white uzungu running by).  Many of the houses, even if simple, had their own simple yet spacious patios on which one could safely sit and regard the land nearby or the valley below as the storm clouds would inevitably roll in, saturate the earth, and roll out.  On the road ahead, older olive green pollen covered much of the uneven gray street, coral flowers from the overhanging trees above were strewn in a way that was almost intentionally welcoming , surely blown down, though gently enough, by the previous rain shower.  It was a scene that was so breathtaking that I almost didn't realize that the uphill climb was literally taking my breath away...I was not in shape for an uphill, high-elevation run.

 

Soon the road turned away from the mountain and the obviously more expensive houses toward the top of the path, and provided me a break from the more challenging part of the path.  However, the scenery was just as fascinating, as the rainbow of colors continued to scatter and dance around.  My brief downhill break on the west-heading portion of Lupa Road complete, I turned back up the road we took toward the clinic, the majority of the climb behind me this time.  Rather than cutting through on the unpaved road closer to the main road we usually took, I continued on the paved path that remained a bit higher up.  On my right were two houses  painted bleached white and covered with the typical metal roofings.  However, these roofings had been painted a pastel green and purple, and somehow the combination of the contrasting white walls and the underlying shiny tin roof created a pastel that was soft yet brighter than any such shade I had quite seen before.  I continued on my run, marveling at this amazing treat that I was getting to enjoy all on my own...well, with Nickel Creek accompanying of course.

 

Then, I turned down Hospital Road and ran down towards the Cathedral.  I had passed a few locals already on my path, but here crowds of people were standing or walking about.  I cautiously dodged back and forth avoiding the different groups walking up or down the hill, but I certainly could not avoid their obvious stares of interest, disbelief, or humor at the sight of this uzungu running by nonchalantly. I was just glad I wasn't running uphill at the time, or they really would have laughed at me as I huffed and puffed.  I finally managed to make it past Kissa pharmacy, the hospital, and the Cathedral, and took just a quick turn onto the main road.  Wanting to avoid as much hustle and bustle as possible, I turned back up toward the mountain as soon as the opportunity presented itself, made my way back up to the road I had been on before turning down the hill, and retraced my steps back toward the house, with the path the same but brand new as the new perspective of going back toward the house provided views of the homes and land that I hadn't seen on my way out.  

 

Returning to the front of the house, I looked down at my watch and saw that my trip had taken me about 20 minutes...it seemed like there was no way such beauty could be packed into such a short amount of time.  I decided to take another lap or two, and ran just to the end of our road before starting back up again.  At the end of this road, which one couldn't see from in front of our house as vegetation blocked it's view from those who hadn't ventured down to the corner, stood two new houses of bleached white color and pastel roofings similar to those I had seen minutes earlier.  These were perched just up the hill a bit, overlooking the valley below, and on the bleached white fence surrounding the property were some moderately elaborate designs to provide further regality.  I stood for a moment admiring them, and then turned back and began my second lap.

 

As I did, I passed a couple of women and a boy, probably about age 9 or so.  Maybe a minute after I passed them, suddenly the boy was at my side running right along with me.  We ran together for a bit, and when I turned uphill, he kept right along with me!  I wondered if he was supposed to be doing such a thing, as did he, I think, since after a minute or two he turned back to check on his mother a ways back.  This young kiddo, running in tattered and dirty khakis, long-sleeves, uphill, in orange flip-flops, was not only keeping, but setting, the pace for me.  He took it in pretty easy stride as I tried not to look winded.  Another glance back down the hill, and a turn to the east on my part, and he reached the limit of what he was comfortable doing without fear of being in trouble.  I continued on my own, happy to have had his company for a moment.  I took in the scenery from before on my second go-round, and this time just turned around when I reached Hospital Road rather than going through the throngs of people and running at all on the main road.  Maybe ten minutes later, on my path back, I passed my running mate again, and he yelled and waved excitedly.  "Smoothie Song" by Nickel Creek provided the perfect background for this portion of the run.

 

When I reached the point on my path near Hillview Hotel (just a bit north and uphill from our road, I turned up a cross street away from the mountain.  As "What's Going On" hit it's musical peak, I reached the peak of the road, which quickly descended toward town at the perfect time, revealing the city and valley below with dark yet sunlight-highlighted clouds hanging above in the distance.  In a moment, I was flying down the hill, reached about 10 meters from the main road, and turned around, waving to a couple of nuns I saw on the side of the road.  My choice to have Nickel Creek as my musical accompaniment was PERFECT, as it seemed the best parts of each song hit at the top of each subsequent hill, with fiddle and mandolin intertwining and complimenting each other as perfectly as the music did the scenery around.  

 

Reaching the house again, I modified my last trip out to make it a bit shorter, as lap 2 had taken a bit longer than the first.  I decided to go back up that hill I had just seen one last time and break my vow to not take any pictures...since my run would be about over anyway once I got to the view of the valley, I figured it would be okay to stop and try to capture some of this beauty to share (especially with Ali).  

 

As I reached that point again, I stopped and paused my run, took my phone out of it's protective covering (a small plastic ziptop bag) and took a few pictures of the amazing surroundings.  A couple pics in, I heard a man yelling a ways off.  A few more pictures, and suddenly he was standing just on the other side of the road beyond the fence to the south.  He was talking to me, and though I couldn't quite understand what he was saying.  I heard the word "picture" and he didn't look exquisitely happy, so I figured he perhaps didn't want me taking pictures for some reason.  I obliged with a "Sorry, pole-pole (sorry-sorry)" and brought my camera down.  I snuck a few more pictures discreetly as he walked away and then a few not so discreetly once he was out of sight.  

 

On my way home, I stopped briefly along the way to take a few more pictures of all the different flowers I could find, then no so briefly once I reached our gate.  I walked down our road to take a couple shots of the white/pastel homes at the corner, and a panoramic of them and the valley below.  Then I walked home, into the gate, and decided to get a few pics of some of the flowers and plants in the garden and yard around the house.  I walked in, 7 miles done, and sat on the breezy veranda to cool off. God had given me an amazing gift this morning.

 

Then, it was time for a hot shower, and it was a welcome, wonderful one at that.

 

Now that that long diatribe about running and flowers and such is over, let's discuss showering without a shower curtain.  You see, in our house, beautiful as it is, for some reason the bathtub/shower has no shower curtain.  Consider then, how difficult it must be to take a shower in such a manner without making a huge mess.  One can employ such strategies as:

1) Only turning enough pressure on to create a soft stream to reach the occupier of the shower

2) Aiming the showerhead just off to the side where the wall adjoining the tub is, preventing a huge mess

3) Keeping the elbow that is on the outside-facing side of the shower firmly and straightly at one's side, as an elbow that reaches toward the shoulder, head, or neck becomes a conduit for a steady stream out of the shower and certain failure

Now, even taking these strategies, one must consider the following.  Take, if you will, the example of a one philosopher Alton Brown, who discusses most ingeniously in his work, "I'm Just Here for the Food" how to properly season food.  Salt, he states, will cover a much wider surface area and will distribute more evenly if sprinkled from farther from the food than just inches away.  This concept is rather useful in cooking, but also demonstrates, by analogy, how someone who is SIX FEET FOUR INCHES TALL would find it nearly impossible to not "sprinkle" water outside the small surface area of the bathtub/shower.

 

I just wanted you to appreciate the fact that I've gotten pretty good at taking showers here without turning our bathroom into Lake Malawi...and hopefully now you do, so we can proceed....Good!

 

After the shower I set to documenting my run for the day before I forgot all of its wonder and wonderful details.  And now I sit here, having watched the clouds roll by moving from there perch on the mountains this morning down over the city.  The rain is off and on here, and it's a lazy day...even reports of the government tearing down illegaly constructed businesses downtown and using tear gas against demonstrators can't really bother me from here...I'll just stay north of the main road for the foreseeable future, it's prettier up here anyway.  I just finished up some "fried bread" or "fat cakes" (much like pancakes, but thicker and not quite as sweet) with honey and nutella, accompanied by some nice strong Tanzania coffee...it's beatiful here, the windows and doors are open, the rain is falling gently but steadily and certainly not lightly, and the breezy, cool air is all around...what the rest of the day and weekend hold remains to be seen, but I'm happy having had my seven miles in heaven...the most beautiful run of my life.

 

The afternoon proceeded as one would expect on a day where clouds dominated the sky and rain fell constantly, with the only variant in its presence being its intensity: slowly and lazily.  We all sat around the house doing nothing or next to it.  Personally, I journaled until I was caught up, transferred some pictures over to the laptop to make room for more on my phone's camera, and then made some lunch at 2 PM.  Peanut butter and nutella on toast makes for quite the rainy day afternoon snack.  This was essentially like a peanut butter cup toast.  Yum.  

 

After I downed my food, there wasn't much left for me to even conjure up on my agenda for the day, so I finally was able to crack back into Jesus of Nazareth and made just a bit of progress.  While I was reading, Liane and Jason called us and asked Carmelle and I if we wanted to come over for a visiting scholar dinner of pizza and a movie...YES!  When asked if I had a pizza preference, I responded "Yes, I prefer it!"

 

Evening plans settled, I continued to read.  Just a few minutes later Amelia came in and asked if we wanted to go with her to feed her horses....and like that we were doing a whole two things in the same day!  How accomplished!  The three of us scrunched into the truck and headed down past the part of town we knew and into the valley.  Turning here and there and everywhich way, I knew I couldn't retrace my steps if I were required to later.  In any case, soon we were at the land where the horses were kept, an old Baptist Church turned into a home owned by an Australian living in Tanzania.  

 

We meandered down a small grassy hill to an open area in which the horses were kept.  Soon I saw four beautiful animals strolling through toward their owner, whom they recognized and were excitedly expecting a yummy treat.  Three brown horses and one grey, Amelia told about how she and her brother Josh spent 3.5 months riding them across Namibia and and Zambia and into Tanzania a few years back when they had moved.  It was pretty exciting to hear about some fo the stories that came along with a nearly transcontinental trip through desert and bush with four horses and two humans at the reins.  She also told us about how her grey horse used to be an endurance racer but had his career ended by minor injury.  He suddenly reminded me of Suz's buddy Blue! I knew he had looked familiar.

 

As the rain continued to fall, and we stepped over wet grass and mud, I was rather thankful to have worn my waterproof shoes, or "gum boots" as Amelia called her similar but taller footwear.  The horses cobbled up their oats, some faster than others.  The quicker of the four had to be shushed away by Amelia when they went looking to steal seconds from their friends.  Once they had finished up, Amelia cleaned out their hooves, fetched some water for them from up the hill, and they were set for the day.  It was a quick trip out there, but I was happy to have seen the horses, and given the rain, wasn't too heartbroken about the brevity.

 

We returned to the house about 5, and were due at Jason and Liane's at about 6:30.  While the others planned to lay low for the time being, I couldn't help but thinking that I kept hearing vuvuzelas in the distance down below.  I was certain there was a soccer match going on at the stadium across the main road.  Drumbeats nearly confirmed my suspicion.  

 

Either way, I was looking for an excuse to go out and do something if only for a bit, so I told everyone I was going to go down to Mbeya hotel to see if the expats were watching any soccer matches.  I walked back down the hill in my "gum shoes" to see what I could discover about these soccer matches (see what I did there??? eh? gumshoe? discover???).  I walked onto the patio at the hotel and found almost none were there.  The rain covered patio was rather dull looking.  

 

From the patio, I heard even louder noises coming from the stadium and so ventured my way across the main road, took a quick left turn, and was suddenly in a different world.  Such a contrast between the areas north and south of the main roads.  Once again i was in an area with dirt, now mud, roads, little run-down looking shops, and a market for vegetables.  Across from them was the crude construction of Sokoine Stadium surrounded by little shops as well.  Intermittently the yelling and cheers got louder, which I assume meant a goal or a stellar play.  I couldn't see much into the stadium even though the road I was on was a higher elevation.  I followed the road as it curved, passing another large group of men huddled around a TV watching soccer, and reaching the lone ticket booth.  Though it was closed, the chalkboard sign had written in sloppy letters the matches for the weekend.  One today, and one tomorrow.  After being approached by a woman from the stadium asking if I wanted a ticket, I told her tomorrow, asked what time the match was, and headed back up towards Mbeya hotel, noting now that the crowd of men huddled around the TV now huddled under their umbrellas as rain began to fall again.

 

On my way back, I decided to go into the bar at Mbeya and watch whatever soccer was on with whoever happened to be there.  I sat down on a stool, ordered a Serengeti, and watched the Sunderland-Everton match for the remainder of its first half.  Soon after I arrived, one of the quiter expats with a shaved head and and older face joined me and the four Mbeyans watching.  I had no dog in the fight, so when I noticed the American goalie playing for Sunderland, I quietly decided to pull for them.  Though I spoke no Swahili, the language of sports is universal, where oohs, ahs, ohs, frustrated grunts, and ecstatic screams all mean the same thing to everyone.  In this language, I soon discovered I was pulling for the "wrong team" and joined the group in their allegiance for the last few minutes.  As the half ended tied at nil, I finished my drink and headed up to the house, as it was just about 6.

 

After a quick pit stop at the house, it was time to make the trek to Jason and Liane's place, which was up the hill a ways along our path to clinic.  About 3 minutes into the walk, Jason approached in his car going back up the hill after picking up the pizza for dinner from Metro, a place just across from the stadium whose exterior I just explored.  He offered a ride, which was gratefully accepted.  Soon we were at their house, driving through the gate opened by a guard and parking next to their beautiful garden of maize, flowers, carrots, spinach, etc.  It was a really pretty place.  

 

Liane greeted us and in a few minutes we were sitting down enjoying a dinner of pizza, spinach cheese dip, and beer.  It was most genrous, most delicious, and most awesome of them to extend such an invitation.  We sat and talked about the clinic, some of their travels, potential plans for the rest of the weekend and travel, and the like.  Once dinner was over, we perused their collection of many, many downloaded movies and decided to watch "The Secret Life of Walter Mitty."  I had low expectations, as for some reason I remembered hearing that it was slow and boring, but I loved it!  Ben Stiller could never be boring even if the role required it, and the movie made me laugh out loud at least a few times.  It was a great opportunity to relax and enjoy a bit of suspended reality.  

 

Once the movie was over, it was time to head out, and Jason graciously made a trip back down the hill to the house to prevent another walk in the rain.  On arriving home, things were pretty low-key and quite.  We chatted just a bit, and I sent a couple messages back home as I hadn't had the chance to video chat.  Then it was time for a shower, journaling and a little evening prayer to bookend the day properly.

Day 8: And I didn't shower before bed!

Day 8: April 11, 2014

Due to limited internet data usage over the weekend, no pictures right now...sorry!! Come back Monday for the fully illustrated version!
 

I woke up early on Friday morning, hoping that I'd be able to make it to 6:45 AM Mass at the Cathedral...and hoping that daily Mass wouldn't be 2 hours long as well.  However, I didn't get the chance to ask any of our hosts about a key to unlock the gate that early in the morning, so I was just hoping that my waking up and rustling around the house might wake someone up and then I could ask them to let me out.  

 

Unfortunately, at 6:15 in Tanzania this time of year, it's still pretty dark outside, and I didn't much feel like waking anyone just to let me out like a dog.  So despite my opening of doors, turning on water, etc (none of which was intentionally louder than I'd otherwise be), noone awoke.  My backup plan was just to fit some morning prayer and the daily readings for the Office before the now usual routine of toast and Nutella.  As I finished up and got ready to make breakfast, I could hear the Cathedral bells rining in the distance out to the southwest.  Oh well, next week.

 

This morning I made myself THREE thick pieces of toast with Nutella, as I was planning ahead for what I anticipated would be a energy-requiring day of rounds in the Malnutrition Ward.  I scarfed the food down happily (I think I could eat Nutella on toast every day...I mean, c'mon, it's chocolate toast!) and did a bit more reading before we headed out to clinic...I was READY for the day, fueled by the power of hazelnuts (this blog brought to you by (and hopefully soon sponsored fully by) Nutella...can we say free Nutella for life???)

 

On the walk to work, I kind of got obsessed with the Cross on the side of the mountain.  It was light well by the rising sun, but the surroundig mountain was wreated in clouds as well, so it was really pretty.  I must have stopped seven or eight times to take pictures from different angles, and the 20 minute walk to work easily became 30.  I arrived a bit later than usual, but as Friday is a relaxed clinic day (and we were working in the Wards, which didn't really start until 9:30 or so anyway, the 8:15 arrival didn't matter much.  

 

I used the extra time to catch up on some journaling and post them while able to use the clinic Wifi. It's SOOO much easier to do that on a full functioning computer (unlike my almost useless, spyware ridden, beyond-it's-best-days laptop that was brand-spanking new and perfect for Botswana)...I added some pictures, captions, etc, in no time and had a day's worth posted before it was time to round.

 

This time on rounds, we were joined by one of the local Mbeyans who is also one of the clinic doctors.  We made our way over to MRH and under the covered sidewalk walkways to our now familiar Wadi.  As we chatted with our new team member and waited for rounds to begin, the intern Dr. Rajeb was busily working on a patient near the window in the second cubicle of beds.  It became very apparent that something was not right with this patient, as he was attempting to draw blood from her right arm and she did not move an muscle.  This girl was 9 or so years old, and she lay there motionless while he worked.  We walked over to see the patient and hear about what was going on.

 

Something was not right.  I immediately thought about how if this patient had presented to an ER in the US, she would have been in the ICU without a second thought.  She was unresponsive, staring blankly at the ceiling, with some fine involuntary twitching of her neck, increased upper extremity tone, and a somewhat stiff neck. Reading through her chart revealed that she was a sickle cell patient who came in after a day of leg swelling and then became decreasingly responsive, to the point at which we were seeing her today.  Per mom, she had been totally fine the day prior.  As we thought about all of the things that could be going wrong with her (sepsis/meningitis due to encapsulated bacteria secondary to an essentially useless spleen that develops in these kids beyond early childhood, a severe exacerbation of anemia leading to decreased oxygen delivery to the brain, stroke caused by sickled cells getting essentially caught in the smaller vessels of the brain), I noticed how Dr. Rajeb performed femoral stick to draw the blood that he couldn't obtain earlier from her arm.  The patient didn't so much as moan.

 

Almost more shocking than her presentation was the little that we could do.  We sent for a blood count, but couldn't send for a culture.  We started her on one antibiotic, but not double or triple coverage seen in super sick kiddos in the states.  We gave her some IV fluids (which came from a partially used bottle), but without knowing the results of the blood count couldn't know if she: needed a ton of fluid to prevent hypotension and septic shock; or whether doing so would potentially overload her heart, flood her lungs, and kill her if she had a severe anemia exacerbation instead.  No full monitors, no fancy lines, no intense nursing coverage.  The blood count would take 1-2 hours to come back (hopefully) per Dr. Jason, about 10-20 times longer than it might take for labs in the US, and that was because we had "ticke it 'urgent'".  So we did what we could, and proceeded to start rounding, keeping as close an eye on the patient as we could...though I wasn't sure what difference that might make as our options had been pretty much exercised for the time being.

 

The remainder of the wards were actually doing quite well.  The kids were progressing, some of them had been discharged, and the ward wasn't quite as full.  Winfrida, though still swollen incredibly, was improved as well, and we got a glimpse or two of her eyes, though they were still surrounded by those puffy cheeks and lids.  Everyone seemed to be making progress and heading in pretty much the right direction.  We were also moving faster thru the wards than the previous day.

 

About halfway through, we stopped to check on the unresponsive patient, and she seemed the same as before.  Now here IV fluids were running, but instead of using a pump to give exactly how much we wanted, we counted drops of water as they fell from the bag into the IV system.  This was the best approximation we could get, and after Jason metioned that 15-20 drops is roughly one milliliter, we did some crude math, adjusted the crude setup, and had our "desired rate"...so long as nobody touched the thing and the patient didn't move...unfortunately we knew that the latter was not a real concern.  Further, we noted that the patient's mama was trying diligently to have the girl take some milk to get her some enteral fluid as well.  Literally, she poured a small amount into the patient's open mouth ( due to her involuntarily dropped jaw), and again, no recognition or response of or to anything. Some of the milk eventually just dribbled out the sides of her mouth, and I'm certain the rested dripped down the back of her throat, perhaps into her gut but perhaps into her lungs.  I was sure she was aspirating.  Jason asked for an nasogastric tube to be placed, much to my relief.  He also mentioned to us as we finished up with her and walked out of earshot of the mother (who spoke no English, so it mattered little) that of 10 patients who come in looking like her, perhaps 1 or 2 end up being discharged.  Rather hopeless...though fortunately not completely.

 

The one other saddening aspect though was the discussion of "palliative care" for some of the kids with cererbal palsy and malnutrition.  In the States, a patient with CP who can't eat on their own well enough or safe enough uses a tube of one sort or the other to get their food and keep them alive and growing.  This plan takes supplies, pricey formula, dedicated parents and a home care team, and clean living conditions...of all those, few if any exist for the kiddos here.  So, when we came to our two kiddos with CP who were improving, though needing tube feedings to eat enough, we actually had to think about discussing with the mother (or bibi/grandmother, usually) how much they actually wanted us to do for them and how much we could do for them long-term.  I was glad that we only noted that that discussion would eventually need to take place, not that it actually took place today.  It was enough to make one feel a bit more hopeless.

 

We finished up with one final patient who had been admitted the day before with some low oxygen and likely pneumonia.  He was initially pretty sick, but this morning looked fantastic.  He was laughing and joking, and was a perfect counterpoint to our sick kiddo one wadi down.  I was glad he was our last patient, as he instilled some of the diminishing hope and reminded us why you always try, even and especially when hope seems lost.  Kids are AMAZINGLY resilient...and today my back was as well actually...it barely even hurt!  (3 hours of rounding instead of 5 will help with that I guess)

 

After rounds, we headed down the road to Deluxe and I had the usual...but this time I asked for "Pilau with NO NYAMA." It was Friday after all.  We finished up rather quickly, or I did at least.  Carmelle, who had food left, asked for "A BOX TO TAKE AWAY."  After repeating a few times and motioning with her hands, I thought the waitress understood...but when she piled my plate onto the leftovers on her plate, we were both confused.  A few minutes later the waitress returned with a take away box indeed, but also with a bill that had added one more meal.  Carmelle ended up with her second serving of wali nyama (white rice with meat) in a to-go box...we clearly needed to learn some more Swahili.

 

Back at the clinic, all of the patients had been seen for the day.  It was time for a lecture on Kaposi Sarcoma (the most common malignancy associated with HIV and amazingly prevalent in sub-Saharan Africa and especially Tanzania, where the infection rates of the virus that predispose to the cancer are INCREDIBLY high). In most kiddos, the virus causes some mafua (runny nose, flu-like symptoms), but in kids with HIV, it can cause some soft tissue tumors that can be pretty disfiguring.  The lecture was timely, as Friday in the clinic was KS day, where patients came in for chemotherapy for their cancer.  

 

A few amazing things about KS in Mbeya.  

1) The clinic is the only one to do outpatient chemotherapy without an oncologist, and the BIPAI docs at the clinic, Liane in particular, are able to give chemotherapy to these kiddos even though they aren't technically oncologists.  It's done out of need, and they do AMAZING work.

2) The tumors are rather disfiguring, so the work done here saves lives as well as changing quality of life and removing stigma.

3) The regimen of chemotherapy is simple, CHEAP, and BEYOND AMAZINGLY INCREDIBLE AND DRAMATIC.  We were shown picture of a girl who had KS on her mouth and tongue.  Her tongue, if you could call it that, was so enlarged from the grown that it filled her mouth, spilled out, and made it so that you could not see any portion of her chin.  It was difficult to look at, much less live with. She could barely sip small amounts of water and could not eat.  She was nutritionally wasted and likely rejected by her peers and maybe her community.  After 1 round of chemo treatment, the tumor was impressively lessened...after 3 or 4, negligible...after her standard 10 rounds of chemotherapy, IT WAS GONE.  You could see nothing remaining...she had gained weight and was smiling with the most priceless smile you could ever imagine.  The chemo must cost thousands and thousands right?  WRONG.  Each cycle, dependent on severity of illness, costs between 50 and 80 dollars....so that little girl's tongue tumor melted away for $800.  

Stick that on a poster and tell me who won't donate to that cause!

 

After that, even more uplifting events (isn't it amazing how God will allow you to see the worst of the world and then bring you right back and fill you with motivation and hope again?), as I got to call home.  Ali and the boys looked happy, as did Mary-Teresa.  John-Paul wasn't mad anymore thankfully, and asked "Hey dad, what's going on in Africa???"  I talked with them all, showed them some of the vegetation outside the clinic, and was excited to hear that our house is going up on the market THIS WEEKEND!

 

Ali, if our house is sold before I get back,and you move out without telling me where you're taking the kids and yourself, I'll understand for 23 days, but then I'll be mad:-P.

 

After hanging up, I finished up my journaling for the day before and used the internet to post as much as I could before leaving the free wifi of the clinic for the weekend.

 

I insisted that on the way home I would NOT stop to take pictures like I did the day before.  Well, I made it to store next door to the Cathedral and bought a bit more airtime, walked up the hill, but then broke my promise to myself.  Down the hill in the valley was the beginning of a rainbow.  It was WAY far off in the distance, it was incredibly WIDE, very short, and very faint.  It was what I imagine a rainbow being born would look like. As we continued the walk home, the rainbow became a bit more defined, a bit more vivid, and a bit taller.  It was like it was growing up before my eyes!

 

Time for a deep thought moment.  The rainbow as beginning to form in the valley below Mbeya where part of the city lay.  I couldn't help but think about how the mythical pot of gold at the end of a rainbow, and how in a sense the city was becoming that pot of gold...more and more appealing and more of a gift as the days went by.  Okay, it was kinda stupid, but you're the one taking time to read it, so there.

 

I arrived back at the house, remarking how it was now one week in the books!  It was a bit rough, with hills and valleys much like the city itself, but I felt like things were getting better each day.  To demonstrate, I added my airtime to my phone, navigated thru the secret menu Josh had shown be earlier in the week in SWAHILI, and added a true bundle, inclusive of SMS and minutes!  Now, granted, I had Cherise confirm that I was interpreting the Swahili correctly before making each choice and wasting my money again, but I think that just further demonstrates how much I've adapted!

 

I realize now that it made for 4 nights in a row, but dinner again was at Mbeya Hotel. I had a hankering for some of the delicious food I had seen my dinner mates enjoy the night before, and knew that there were many Catholic-Friday-in-Lent compatible options.  Learning from my mistakes earlier in the week, I walked up and asked to order straight away, chose our food, and then got a drink to sit out on the patio to enjoy while waiting the incredibly long amount of time.  I decided to pass the time while enjoying a Safari lager, watching the expats throw darts, play pool, curse in German and English, and talk about football matches coming up on Saturday.  I made it an opportunity to enjoy the wait rather than be frustrated by it.  It took forty-five minutes, but I didn't really mind...maybe I was adapting to the Tanzanian way of dining.

 

After the food was ready, we ate, and I gobbled up all of my butter paneer (Indian cheese), naan, and rice.  It was SO good...I actually felt kinda like I shouldn't have enjoyed it that much, as I didn't mind the meat being absent at all...it was a wonderful Friday meal.

 

I walked home, stuffed beyond belief but comfotable.  My stomach was happy, my mind was happy, and it was a great end to the first week.  I made it a quiet night at home, checking some things online on my phone, doing a crossword or part thereof, and calling it a day earlier than in the US.  I felt so content, and so tired and ready to rest, that I was a rebel, and I didn't take a shower before bed.  Don't tell Ali!

Day 7: How Crispy Got His Groove Back

Day 7: April 10, 2014

I woke up Thursday morning feeling better all around.  Granted, my stomach wasn't perfect...far far improved, nothing like the day before.  But there was still a little "Rumbly in my tumbly", the Pooh-Bear kind, so to speak...although the irony in that statement is delicious....no, BEAR POO IS NOT DELICIOUS!

So I got dressed and headed to the kitchen to enjoy the spoils of my supermarket spree the day before.  Toast with nutella FAR surpassed that of the previous days with store-bought bread and pineapple jam (which I came to find was made in Pakistan...who knew?...does cipro cover anthrax?) My stomach was pleased, and after finishing up eating while reading morning prayer we were off to work.

The only difference in the walk this morning was that puddles were everywhere!  It had rained all day and a good bit of the night, so navigating without stepping into puddles wasn't as mindless as prior days.  The creek we crossed on the day before with a miniature waterfall was roaring rather loudly, and mud replaced the previously dry dirt roads on which we trekked.

For some reason, on arriving to work and setting my things down, I felt TIRED.  I needed coffee, even though I had been given some by our hosts at the house to go with my bread and nutella.  I walked downstairs from our office to the break room ,where the clinic workers filled the room as they all took in the daily provided breakfast...this morning chapati and sausage!  Still not wanting to take food away from the workers, I stayed focused and found the instant coffee jar, picked up a clean mug, and filled it with water, powder, and sugar.  It actually tasted quite alright, and I navigated out of the feeding frenzy into the hallway and to my room to start seeing patients.

However, this morning was abbreviated, as after 1 or 2 patients Dr. Michelle found us for a lecture on treatment failure.  I welcomed the break, as I was still feeling tired even after my instant coffee. Further, any refreshers like the one the day before were karibu-sana as far as I was concerned.

After that, I struggled to find a translator consistently.  Maggie was working in the triage room, and it seemed like the person I would eventually find to translate for me for one patient was disappearing just as soon as we finished.  This lasted until about noon or so, when Maggie appeared as if from nowhere (yes, she was in triage before, but now she was at the front desk) and helped me out exclusively for the remainder of "the morning".  We got through a few patients together before breaking for lunch. My favorite, I guess, was a kiddo who had VERY viral symptoms for about a week, but mother was concerned about him and kept obsessing over minor symptoms that really appeared not concerning.  In the States, this kid would go home with supportive care.  However, as I checked the patient out to Dr. Jason, he made a good point: if mama was concerned about this kiddo enough, and we gave her nothing, she would be even more likely to go out seeking traditional or other medicines in the street.  As we had both seen a child in the hospital on Tuesday who had come in non-responsive and scary sick because of an ingestion of some street medicine, I caved.  I justified it by saying that I couldn't see the kids eardrums (which I couldn't), and wrote my first ever script for antibiotics in a kid that I knew didn't have a bacterial infection...honestly though, a little high-dose amoxicillin was really not likely to hurt him or anyone.  So yes, I saved his life...
Rule #5: Doctors should never prescribe antibiotics for a viral illness

At about 1:30, Maggie asked if we could break for lunch, and eager to not wait until the proper Tanzanian lunch at 2:30 or 3, I happily agreed.  Carmelle's interpreter had gone on lunch break, too, so we trekked into town for lunch.  Along the way, she wanted to try to change her flight at Precision Air to give herself a day for a mini-vacation on her trip home.  As the office was just a few doors down from Deluxe, we set out in that direction.

We took Simon's route into town, down a dirt (now mud) road and through a couple of fields. We pased a handful of chickens along the way, pecking through the numerous gardens scattered along the way, filled with corn and carrots.  We crossed over the shady bridge from two days before and past a car wash before we reached the area we were more familiar with.

At Precision, it seemed as if the flight change would take no time at all, and I was pleasantly surprised...however as we waited and waited, it became apparent the workers were having issues, and after about 15 minutes I decided to go pick up lunch for us while Carmelle stayed and worked with the airline.
While I waited for the food at the restaurant, I sipped on my Diet Pepsi and learned some new Swahili by googling words from the menu:
Ndizi = Banana
Nyama = meat or flesh
Maini = Liver
Ugali = stiff porridge, pap (remember that wonderful stuff Vincent had almost literally force-fed me in Gabs?)
Mshikaki = "holder", at least, this was my most literal translation...it likely meant skewers

In no time I had our food, but when I returned they all sat just the same as before in the Precision Air office, as if no time at all had passed.  Finally the airline decided to just contact her if they could make things work, and we walked back to clinic

At clinic I downed my food in the work area.  Then it was time to restart clinic...by this time it was about 3, so after I finished my patient the day was done...amazingly, as the numbers on the charts showed that we had seen 100 patients that day (altogether of course)

 Pilau Nyama from Deluxe Diner...that green stuff is nasty!

View out the office window from my blogging computer

After this it was, of course, time to call home.  Everyone looked great, and Mary-Teresa was a brand new child!  It was like she hadn't ever been sick. Jude and Ali were all dressed and ready for the day as well, but John-Paul was deciding to be a sour-puss and would only tell me "I'm mad." I broke his stern-looking face by telling him "John-Paul, that's not funny....haha-haha-hahahahahaha!"  If you've ever seen me do that with him before, you get it.  He broke a little smile and hid his face under Ali's arm, so I knew he was actually alright.

I spent the remainder of the afternoon at Baylor journaling and catching up on emails.  It wasn't until one of the workers at the clinic came by to tell me that we were closing that I realized that it was 6 PM and the lights were being turned off.  I quickly thanked him for not locking me in, packed up my things, and headed down the dim hallways and out the door.

 Turn out the lights, the party's over...

BIPAI Mbeya, Tanzania

St. Anthony Cathedral just down the road from clinic & across from Mbeya Referral Hospital

Earlier that afternoon, Jason and Liane had mentioned that some volunteer workers for the annual camp were in town for a couple days for planning and that they were meeting them at Mbeya hotel for dinner.  They had invited me to join, so I headed in that direction.  Along the way, I noticed my first rainbow since arriving in Tanzania...which is rather surprising considering it's rainy season.  It was rather well-defined, and a more faint cousin was just off to the south of it.... A DOUBLE RAINBOW!!!  I stopped more than a few times to take some pictures, both for myself and for my co-resident here in Mbeya who had mentioned on multiple occasions how she still hadn't seen a rainbow (and was rather frustrated by it).

Clear across the sky!!! (Well, not really...)

Finally I reached the road that ran up the hill to the house, with Mbeya Hotel on one side and the National Bank on the other.  I finally, FINALLY, was able to use my ATM to withdraw cash...and boy did I.  The 200,000 TZS came out in 5000 bills....so I soon had a wad of cash that I couldn't even fold up properly in my wallet! I didn't care, though, as I finally had my own financial means in Tanzania...one week in.

Ka-ching!  But now my wallet made me lopsided and wouldn't fold

I crossed the street to Mbeya Hotel with a bit more spring in my step, feeling much better than 48 hours and even 24 hours previous.  I had taken hold of things with cipro, my own ATM card, and was ready to celebrate.

Mbeya hotel

I joined Jason and Liane along with the volunteers, Allie and Julie.  We ordered our food and then took drinks (a Kilinmanjaro, personally) out to the patio while we waited...and boy did we.  We talked about our international experiences, the camp's goals and different sites, and other random things.  The rain came, the rain stopped, the sun went down, and one hour later our food was finally ready.  I scarfed down my appetizer meal of samosas as I had gone from mildly to moderately hungry in the time it took for our food to be ready.  We had a nice meal together inside the restaurant talking while an American movie (that I couldn't identify) with Swahili dubbing and French subtitles played on the TV in the corner. Eventually we finished up and about 8:15 I walked home.

Arriving home, I put down my things, relaxed on the couch, and did a crossword on my phone whilst the others did their own things.  After I finished, Amelia and I played the two longest games of Bananagrams I have ever experienced (it is SOOOO long when you only have two people...I had run out of room on the table as my letters were starting to fall off of the edge) while Josh watched and laughed at us as we scoffed at drawing Q's and Z's.  I won the first game, but was done in by my last three letters being H, J, and R at the very end.  We let the series stand at a draw for the night, and it was time for bed.

I straightened some things in the room, then took my shower (with no curtain...with no curtain, so keep that outside-facing arm straight down at your side and aim the showerhead at an angle toward the wall!) and settled in realizing it had been all day with only one trip to the ETEC room.  I didn't even have to stare at the sign on the stall in the bathroom at the clinic, which I assume translated roughly to:

"NO GANGSTERS STANDING ON THE TOILET ALLOWED!"

I felt great, optimistic that I had gotten into the swing of things.