Jambo from Tanzania!

27 06 2011

By Katya Papatla and Neha Bakhai

Habari! We have been in the village for about a week now. The past week has mostly been spent orienting ourselves to the village, as well as the Mwika Uuwo Dispensary. We have been working in the clinic almost every day for the last week. We spent the first few days shadowing the clinicians and learning more about the system they use to treat patients. We also took this as an opportunity to find something that we could do to help the clinic.

In general, the clinic is much slower moving than those that we are used to. The people who run the clinic have not been formally trained in medicine, and thus, are “clinicians” rather than doctors. Every two weeks, a doctor from the Kilimanjaro Christian Medical Center (KCMC) comes to the clinic as part of an outreach program. We were fortunate enough to be in the clinic this week when one of the doctors from this program came to work.

The local clinicians claim that the biggest problem is malaria. However,the doctor from KCMC told us that rural clinics tend to diagnose everything as malaria and this is actually not a problem in this area. Instead, we saw a lot of cases of hypertension and diabetes – it seems that cardiovascular disease is a growing issue among the older population.

Although this clinic is one of the best in the entire rural Kilimanjaro region, it is still severely lacking in supplies. For example, its lab consists of two microscopes and a small centrifuge machine. They are not able to run sputum tests for TB, and often times run out of latex gloves. A man who came in with a mango fly (a type of skin lesion with a bug) had to sit while the doctor cut into his back without local anesthesia. Also, as a dispensary, the clinic is legally only allowed to observe patients and make referrals to hospitals such as KCMC. Thus, a woman who came in with focal epilepsy and diabetes could not be given insulin, even though the clinic had some in the pharmacy. They also did not have the drugs to treat her epilepsy. Furthermore, the clinic also does not have official forms for prescriptions or referrals – the doctors write all of their diagnoses and recommendations on plain printer paper. This is one of the projects that we are hoping to take on for the clinic – to design official prescription, lab and referral forms for the doctors to use, thus making the process more efficient.

Today, we also visited the school where we will be doing our main project. The enrollment rate in secondary schools in Tanzania is very low, and we want to better understand what causes students to drop out of school. We will be interviewing secondary school students regarding what factors contributed to their decision to continue with their education, with the hopes that we can use this information to influence the primary school students. We will also be interviewing the 5th and 6th standards at the primary school to find out their attitudes towards continuing education. Our host mom says the biggest problem here is that those who can afford to pay for secondary education often do not realize the importance of going to school, while many people who do want to send their children to school cannot afford to. Thus, only a small handful of people who can BOTH afford to AND want to send their children to school actually do so. Furthermore, the students must past a test before going to secondary school – they only have one chance, and if they fail, they are forced to find work or go to some sort of vocational school.

We are hoping to set up a mentoring program between the older and younger students after we know more from the interviews and surveys. Our hope is that the older students can positively influence the younger ones, and help them make the decision to go to secondary school. We will most likely be asking the secondary students to write letters to the primary students and their families about their experiences, as well as to help us run a small homework help room and after-school activities session (we brought some games, art supplies and soccer supplies).

We will probably know more after a few days!

Tutaonana (until later),
Katya and Neha

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