Words from Tanzania

In this and other developing countries, electricity is not a right, and to have it in your facility or home means you are fortunate. That is, until the electricity damages your TV, computer or an expensive piece of medical equipment. The leaders of the ELCT Health Care (HCTS) Technical Services and Global Health Ministries (GHM) used their wits and came up with a joint plan to install appropriate power protection in all of the 20 ELCT hospitals before any new equipment is shipped or installed. History and experience have proven that expensive equipment does not stand a chance against very low, high or damaging voltages.

Loyal and generous supporters from the ELCA SEIA Synod immediately took action last year when hearing of this plan, and raised the funds for the protective equipment needed for Gonja Lutheran Hospital in the South Pare Mountains. The manager/director/technician of HCTS, Henry Sommerfeld and I (Todd) made a few trips to Gonja Hospital together to engineer a power protection solution. The equipment chosen (Sollatek SVS) is installed in line at the electrical distribution area and monitors and stabilizes the incoming voltage from the utility, and a lighting protection device snuffs out huge strikes.

Gonja Hospital is the first ELCT hospital to take part in the implementation of this program, and we are very pleased that the folks in Iowa supported it. Henry and I installed the protection equipment just before Easter. Gonja, with some very good and expensive equipment suffers many power dips, surges, brownouts and cuts weekly. We figure the strain (load) on the old lines, transformers and distribution equipment produce the poor power quality, and being 1350 meters up on a mountain, far away from the electrical source adds to this issue.

For now, we feel relatively secure in knowing the critical equipment such as two portable x-ray machines, an ultrasound machine, oxygen concentrators, suction machines, operating light, sterilizers, hematology and chemistry analyzers, CD4 counters and other equipment are protected. Thanks be to God for God’s people responding!

We just concluded the last of three palliative care seminars in March here in Tanzania as part of a Twinning Center project (PEPFAR) with the ELCT Pare Diocese and the SEIA Synod.

The participants were health care workers in the districts of Mwanga and Same, and the facilitators were varied, 3 different teams from Iowa and Dr. Amini Mshighwa, the diocese medical secretary and Rev. Joas Mpinda, the lead HIV/AIDS counselor for the diocese.

The curriculum used was from the African Palliative Care Association. Our facilitator teams from Iowa included doctors, social workers, pastors, health care administrators, nurses and laboratory technicians. They ably studied the materials and presented the powerpoint presentations extremely well, and used other presentation aids and methods such as good ole flip charts, role playing and small group discussions.

I (Todd) helped in the logistics and coordination areas, making sure everyone was happy, that they were supplied with plenty of food and drink, pens, paper and accommodation and transport funds. We were able to construct our own flip chart stand and large projector screen, and the facilitators supplied the laptop and LCD projector.

Palliative care is somewhat of a new thing in this country, but we are finding that it is quickly accepted and understood. In the past, persons with long term illnesses such as cancer and HIV/AIDs were left in their homes to suffer all the pain, isolation and dehumanizing effects of having a debilitating disease. The plans are to continue into a second year with palliative care in the Pare Diocese, expanding the knowledge and base of trained personnel into the community through 10 new support and care centers. We see this as a challenge, but one that is worthwhile.

In early February, we attended the Mbaga Parish Jubilee, located high in the South Pare Mountains. The occasion was to celebrate 100 years of being a mission and parish, and there just happened to be a few special guests—The descendants of the founding German missionary Jakob Janssen Dannholz, the ELCT head Bishop Alex Malasusa, Pare Diocese Bishop S.A. Msangi, and our very own ELCA Southeastern Iowa Synod Bishop P. Hougen. The SEIA Synod was well represented by a delegation of first time Tanzania travelers as part of a sponsored trip with Bishop Hougen acting as host. Many others from Germany, the US, and from around the country of Tanzania were also in attendance.

As is typical, the guests started arriving days before the celebration. For us and the day-travelers, it was only a one hour journey up the rough and tumble mountain roads leading out of Same town. By midmorning, all arrived at the Mbaga Parish and were greeted by parishioners, music and the traditional chai and food.

The service started with a procession led by the dignitaries and all others fell in line as they walked from the parish house to the special monument marking the 1908-2008 Jubilee. The monument was blessed, trees were planted, hymns sung and many speeches were given. The service lasted almost four hours. The special guests were honored with food prepared by what must have been an army of parish workers, then the parties dispersed.

There was another Jubilee in the year 2000, that one at Shigatini (North Pare Mtns) which marked the first German mission in the Pare settlement area. This Mbaga Jubilee celebrated the first German settlement in the South Pare Mountains

In Tanzania, primary school (our equiv of grade school) is compulsory and free, but only around 30-40% of those who finish primary school get a chance to move on to secondary school. The main factor- money. Although the government has made strong moves to lower the costs (around $140 per year) of a secondary school tuition at their schools, the private ones are maintaining a $400- $500 per year tuition (full boarding) fee. And, the private schools are having a tough time right now as they are losing their teachers to the increasing number of government secondary schools where the teachers’ salaries have been raised.

This beautiful day in January, we had the pleasure of transporting two wonderful young women to secondary school accompanied by their mothers. Agape Mmwiri (14) is the daughter of our good friends and neighbors, Assistant Bishop Rev. Eliraha Mmwiri and his wife Esther-Salome, along with their other children, one of whom is the adorable Heavenlightness (9) shown above with her big sister Agape. Mary Juma (16) is the daughter of Paulina Mndeme, a widowed diocese worker and good friend (see Mary in her beautiful green gown). Mruma Secondary School is one of 5 ELCT Pare Diocese secondary schools, located in the North Pare Mountains, just 14 kilometers from the urban town of Mwanga. The parents of Agape and Mary chose this ELCT private school because they know it is good, safe, and will provide a quality education, and they are willing to sacrifice and spend the money for those things.

Many preparations occurred before this day of course. The girls took many final examinations in primary school, and the results were reviewed by the government. Letters were written to the Mruma Secondary School, a church sponsorship was obtained, and then the long list of items was gathered for their daily school and personal needs. Here’s a short list of items we transported for each girl—a mattress, sheets, blanket, pillow, pillow cases, lockbox & lock, pens, exercise books, a ream of copy paper, blouses, black shoes, sweater, skirts, a bucket, a broom, a weed & grass slashing/cutting tool, a farm hoe and other personal items. So, in addition to the $450 tuition fee, each student must come up with many other requirements adding to about $100.

We are proud of these two young women and will continue to walk with and love their families as our own. Both are the first child in their families to attend secondary school, so some pressure might be on them to lead the way for their siblings. For now, we feel we’ve done our part as friends to support them in this big step.

Our neighbors and friends are just super! They agreed to have a combined Christmas dinner for 2-3 families with me and a few guests included. I don’t know exactly what their home celebrations or dinners would have been like, but this one, food served around 3:30pm, was grand! Although without Lori, we did have a nice time, and everyone knows when she returns there will be a couple more rounds of dinners to celebrate her return.

The meal consisted of 6 fried chickens, regular and spiced (pilau) rice, cooked cabbage, cooked mixed vegetables in sauce, sliced cucumbers, a fish for Todd, bananas, soda, water and one cookie per person for dessert. The women provided the work, I provided some dishes, glasses, soda, water, chicken, tables and chairs and the front porch.

Most of us attended a worship service earlier in the morning and the food preparation was done by the women (outdoor cooking) from 11am – 3pm. One family could not be in attendance as father was in a truck accident returning from Arusha the day before and lay in the hospital on Christmas Day.