How is it Wednesday? How is it the 10th already? And where is that moon? These are the questions we ask as we rise giving thanks for another day.
Another early morning as this time we set out for Selian Hospital and their 7:30 a.m. chapel. This is where Dr. Jacobson started when he came to Tanzania over three decades ago. It was a dispensary then and just celebrated 25 years as a full hospital. (Fun fact: Dr. Nathan Gossai — Trinity member and son of our teammate Marie Rogger — worked at Selian for a few months between college and medical school.)
Our tour guide was the Head Nurse Felix. He’s been there nearly twenty years and is very well versed in both the history and the operations. Again, it’s like and not like our hospitals at home. This time it was even more clear that the Tanzanians are deeply concerned about their patients and aware of the realities of their home lives. (What one hospice nurse calls “Africa life.”) It could be because Selian serves the middle to low income folks.
We toured a pediatric unit that does a fair bit of malnutrition refeeding and a maternity ward that struggles with women brought in after traditional indigenous birth methods have failed. And patients’ families have a kitchen where they can cook for their hospitalized loved ones and laundry facilities if they end up staying a long time.
After the tour we were greeted by hospice director and RN Elisabeth, hospice RN Paulina and the hospice chaplain. They sat with us to explain how this particular hospice and palliative care team works. (They are connected to both Selian and ALMC.) They are passionate about their work and, like the other related medical ministries, in need of funds.
The men had returned to the lodge by this time for lunch and a sojourn to two history museums. It worked our well because our two hospice visits took us to very small homes.
Over 90% of their patients have HIV/AIDS and many of them are receiving palliative care rather than hospice. Others have cancer. There is no cancer screening here so most patients aren’t diagnosed until they are stage 4 and/or terminal. (Cervical cancer is a significant cause of death for women in Tanzania, which we found shocking. It’s a very survivable cancer found in the US on routine pap smear screening.)
Our first visit was to a 55 year old man with HIV/AIDS who just spent 6 months in a tuberculosis treatment center. The nurses made him meet us outside and made him sit down wind. While thoughtful, not particularly comforting. He was very kind and seemed not to mind us being there.
He was deemed to be doing okay and supplemented with a multivitamin.
Then we visited the home of a 30 year old mother of 5. She and her husband are both diagnosed with HIV/AIDS. The children came out to greet us and by Maasai tradition present their heads for a caress. They were sweet, gentle kids.
We were invited into their home where the nurses met only with the young mother. “Her man” was away. One of the nurses made a comment to us on the way in about how tightly spaced her children were and how they had spoken to her about the impact on her health. Then they found out she’s pregnant with number six. The nurses were very direct about birth control and the woman said her husband doesn’t want her to use it. Fortunately, there are proven and successful ways to prevent the baby from contracting the virus so she will need to be carefully monitored.
They escorted us to our cars and posed for pictures. Then the husband came home and was given something for a “little trouble in his chest.”
Saying goodbye to Elisabeth and Paulina was very hard. We completely fell in love with their compassionate and forthright natures. They would be amazing friends.
After an hour or so of downtime, the Jacobsons came over to our lodge for happy hour and to enjoy the unexpected drum/dance/acrobatic show poolside. It all feels a little surreal after Mwatasi home visits and Arusha hospice visits. We are humbly grateful to have this privilege. And it’s awkward.
Our drivers arrived at 7 to take us to a place Michele remembered from a past trip: Khan’s Barbeque. Situated down a side street by the central market, Khan’s shop repairs fuel injectors for diesel engines by day and serves mutton, beef, chicken, naan, salads, chips and hot pickles by night. The street is called Mosque Street because the are three mosques within about two blocks. (The Tanzanian population is about 40% Muslim, 40% Christian and the balance traditional religions.) The restaurant is completely outside, braziers in the street with tables under the awning across the way. As we sat down to eat, the call to prayer sounded over our heads. It was a moment of pure intercultural bliss. While we still couldn’t see the moon, you could almost feel it tip over.
La la salama,
Pastor Chris and your Tanzania Team
Photos: Pictures of the children’s ward at Selian. Michele in the Land Cruiser in the way to Khan’s and Khan’s Barbeque.