Swinging into the new school year....

Malaria, Mosquitoes, ...

I recently read a really good series of articles online about malaria. They are quite detailed, a bit long and not dumbed down, but very readable for the layperson.

The articles were apparently written by a doctor who has lived in Uganda (a neighboring country of Tanzania) for many years and wanted to clear up the confusion around a disease that everyone knows about but with a lot of misunderstanding and misconceptions.

The articles are written as seven parts. I give a brief description of each part and provide a link to it.

Part 1. What happens when malaria gets into your blood stream and multiplies.

Part 2. Developing (partial) immunity. How the parasite actually reproduces and gets spread between people.

Part 3. Diagnosis, misdiagnosis, symptoms, and prophylaxis.

Part 4. Rapid tests for malaria and what can go wrong with them.

Part 5. Effective treatment, treatment options, risks.

Part 6. Prevention options, besides drugs.

Part 7. Prophylaxis drugs. Some thoughts about prevention.

For Diane and me, one thing I got from reading this series is that we are actually pretty unlikely to get sick with malaria, for several reasons.

First, it is only a certain kind of mosquito that can carry the malaria parasites. I have been looking carefully at the ones in our home that bite us. They are not the malaria kind. Also, we are rarely outside when it is dark, which is when the malarial mosquitoes are mostly out and about. My guess is that in our day to day life here in Mtwara our exposure to potentially infectious bites is really very low.

On the other hand, if we should go travel somewhere on a wildlife safari the exposure could shoot way up. As long as we are in Tanzania we should not become complacent.

Second, the fact that we are both taking a prophylaxis called mefloquine provides a lot of protection against the parasite should it be introduced into our bodies. According to the author, he has not seen a single case of a patient taking mefloquine properly who has had malaria. Other types of prophylaxis are also extremely effective.

Third, the symptoms that indicate possible malaria can all be caused by other diseases, of which there is a plethora in sub-Saharan Africa. Missing those others can be serious.

If we do get sick and suspect malaria we should be careful about the diagnostic process. Malaria seems to be greatly overdiagnosed.

In any case, besides the risk of malaria I get a fair number of mosquito bites that are just plain very itchy and annoying. So we use a mosquito net on our bed, I often wear long pants at home even when it's hot, and I keep insect repellant handy if we do go out at night. -Earl

Sunshine, serenity and solitude by the sea...

A gently swaying hammock under the whispering pines. A lonely dhow anchored a hundred yards offshore. A vast sea-green sea that stretches to forever. Coconut palm fronds waving in the wind. A brisk salty sea breeze. Although we were surrounded by fragrant frangipani, flame trees, fiery red hibiscus & brilliant bougainvillea, there was not a soul around.

Sunshine, serenity & solitude by the sea! How delightful!

Taking advantage of our month long school break , Earl & I hopped on a tightly packed bus for a 9+ hour rough & tumble ride to Dar. After a couple of days at the less than luxurious & very cheap YMCA (shared bath, cold water & no towels), we boarded the Sea Bus ferry for a 2 hour sea voyage to the magical isle of Zanzibar aka Unguja Island.

Greeted by Father Damas at the hustling, bustling & extremely chaotic ferry terminal, we climbed into his old army jeep and circled around Zanzibar Town. On our way to the heart of the city, Stone Town, we caught glimpses of narrow streets & cobbled alleyways, women draped in black, overhanging verandas, colorful TingaTinga art, bustling bazaars, the Sultan's Palace, Beit El-Ajaib (House of Wonders), street-side vendors, and numerous Moslem minarets piercing the azure sky. The sun was sizzling hot & there was a spicy aroma in the air. Father Damas dropped us off at the Bishop's House, next door to St. Joseph's Cathedral. Also known as "Kanisa la Minara Miwili" (Church with Two Towers), the cathedral was built in 1898 by a French architect. At first glance, one might think one was in Paris!

Sister Laurent, our hostess, escorted us to our simply furnished room with bed & bath. Our window overlooked the narrow street below which was splashed with brightly colored paintings of everything African: dancers & drummers, zebras & giraffes, sun & seascapes, mud huts & mangroves. The highlight of our Stone Town stay was the House of Wonders, home to the Zanzibar National Museum of History & Culture. Besides viewing a life-sized mtepe, a traditional Swahili sailing vessel made without nails, the planks held together only with coconut fibers & wooden pegs, we learned about Princess Salame who secretly eloped with a German soldier & spent almost the rest of her life in Germany. A woman before her time, she was an advocate for healthcare & the education of women.

After our brief stay in the soul of Zanzibar Town, we bussed 60km to the northernmost tip of Zanzibar where we were perched on a small seaside outcrop with a spectacular view of the Indian Ocean. We stayed 3 days at the Mnarani Beach Cottages in Nungwi (private bath, hot water & BIG towels!), a real splurge for us - once every 16 years. The last splurge was on our honeymoon at the Keltic Lodge in Cape Breton, Nova Scotia. On Cape Breton we were 46+ degrees north of the equator and here we could practically touch it! Mnarani means "lighthouse" which was right next door. Built in 1888, the 70 foot tall lighthouse is still blinking!

Earl & I also ventured on a Spice Tour where we met other tourists from England, Holland, Liechtenstein, Canada & Tanzania. Nassor, our Zanzibari tour guide, led us on a leisurely stroll through the jungle-like plantation sprinkled with wild orchids. We nipped nutmeg from the tree, plucked lemon grass from the earth, scraped cinnamon bark off the tree, painted our faces with red Masai powder, whiffed vanilla beans on the vine, rolled peppercorns between our fingers, sniffed a bouquet of fresh cloves, and fingered smooth cones of cayenne peppers. We also sampled a medley of fresh picked fruit such as papaya, jackfruit, star fruit, mangoes, marmalade oranges, and pineapple. Our guides adorned us with woven jungle leaf jewelry - ties, necklaces, rings & bracelets. After a hot lunch of traditional foods such as coconut soup, pilau, & sauteed spinach (all seasoned with the spices we just sampled) in the shade of a thatched roof banda, we descended into the deep dark seaside Slave Cave. After Nassor shared a little Slave Cave history, we climbed out of the dark & into the light to take a refreshing dip in the Indian Ocean.

After an exceptionally crazy non-stop school year, we had a wonderfully relaxing holiday! Diane

Zanzibar Island Trip - Photos

In December we took the ferry from Dar es Salaam to Zanzibar, a beautiful two-hour ride on calm seas. While Diane slept, I went outside to enjoy the ocean and the warm winds. We stayed at guest quarters at the Catholic Cathedral in town and explored the streets a bit. It's a small historic city with a very Old World feel to it.



We did something very touristy -- we went on a "spice tour" to visit a farm where various kinds of spices are grown (along with fruits also). Zanzibar is known for this.





And we splurged on a stay at an idyllic beach cottage resort at Nungwi, which is at the very northern tip of the island. -Earl

Blessings of the Christ Child

Creche at our parish, Church of Jesus Christ the Redeemer








Merry Merry Christmas and Blessings of the Christ Child to one and all…

It’s really hard to believe it is Christmas here in East Africa. Off the beaten path it does not –feel– like Christmas. The sun is blazing hot and the humidity is off the chart. An occasional breeze blows by. We sit and swelter. I search for signs of Christmas. Christmas trees? Barren desert. Christmas lights? No electricity. A Christmas toast? Unpotable water. Christmas cards? Illiteracy. Candy canes? Bare cupboards. Christmas parties? Malaria & HIV/AIDS. Christmas presents? Abject poverty.

Living in a predominantly Muslim society in the poorest region of Tanzania, how does one ‘experience' the joy and wonder of Christmas?

On Christmas Eve Earl & I returned from our first vacation in Tanzania. Heading north, we rocked & rolled on a cramped dilapidated bus for more than 9 hours to Dar es Salaam. After taking a few days to take care of personal stuff, we boarded an overcrowded ferry and set sail across the Indian Ocean to the isle of Zanzibar. We spent 3 days in the charming historic city of Stone Town & then 3 days on the northernmost tip at a lovely picturesque beach in Nungwi. Returning to the YMCA in Dar, we spent a few more days in the hustle & bustle of the big sprawling seaport. It was there at the Y that we saw our first Christmas tree! But it was very short, scrawny, artificial and so pathetic and forlorn that it was depressing. Even a Charlie Brown Christmas tree has more charm. Why bother?

Moreover, we would not have known it was Advent except for the Scripture readings at Mass every morning. However, we do celebrate Christmas Eve in a big way at our church. But once you step outside, it’s just another sizzling hot dusty day. Bummer.

Soooooo I was really struck when our best friend, Moris, texted us the “Invitation” that Earl posted below. Yes, I have been invited to Jesus’ birthday party before, but this was the first invitation that suggested you “cleanse your heart beforehand.” In a country where the level of poverty is staggering at 33.6 percent; where the number of poor has increased by 1.3 million*; where most child deaths are due to malaria, pneumonia, diarrhea, malnutrition, low birth weight complications as well as HIV/AIDS; and where about 27.5 per cent of the population is illiterate**—Christmas is celebrated in the HEART. Not with glittery Christmas trees, twinkling Christmas lights & cheery Christmas toasts. Not with corny Christmas cards, red-striped candy canes, late night parties or extravagant presents. Strangers to the rampant consumerism & materialism around the world, Tanzanians know very well the meaning of Christmas. They know where to find the Christ Child on Christmas morn. They do not have to search far and wide. They simply look into the inn of their heart.

Well, it is nearly a year and a half since we landed here in East Africa in July, 2009! WOW!!!

We pray that everyone, especially our dear family and friends, will have a Blessed Christmas and a New Year abundant with God’s graces. May your lives be filled with much love, an abiding peace, an everlasting hope, and abundant joy. Please know that you are ever in our hearts and prayers — for you are greatly missed and deeply loved. ~ Diane

* Household Budget Survey 2007, United Nations Development Program
**Statistics cited from the United Nations Development Program: http://www.tz.undp.org/

Kadi ya Mwaliko (Invitation Card)

Message received on a Tanzanian mobile phone:

"Familia ya Yusufu na Mariam wa Bethlehem wanapenda kukualika kwenye sherehe ya kuzaliwa mtoto wao mpendwa Yesu itakayo fanyika tarehe 25 mwezi Desemba katika kila moyo wa mkristu ulimwenguni kote. Safisha moyo wako kabla. Merry Christmas and Happy New Year."

Translation: The family of Joseph and Mary of Bethlehem would like to invite you to the celebration of the birth of their dear child Jesus, to take place the 25th of December in the hearts of all Christians everywhere. Cleanse your heart beforehand. Merry Christmas and Happy New Year.

Sending everyone Christmas and new year's greetings from this hot part of the world. - Diane & Earl

Living (Un)routinely

"Since routine is simply a means of controlling time, Europeans are better at it, and therefore accomplish more in a day, a month, or a year. They pay in monotony. Africans control time less efficiently, but enjoy it more: they pay in stagnation." from The Mottled Lizard, by Elspeth Huxley

The notion of using routine in order to manage time reminds me of the Industrial Revolution, when the factory assembly line took efficient use of time to an extreme. Along with the incredible innovations in making goods we apparently learned to apply the characteristics of rigid order, repetition, and predictability to our own lives, both inside and outside of the workplace. In other words, we learned to make our lives more machine-like, more like a precisely defined, tightly-coupled sequence of steps.

At Old St. Mary's Cathedral in San Francisco the clock tower has a plaque with a verse from the Hebrew Scriptures: "Son, observe the time, and fly from evil. [Ecclesiasticus 4:23]". An ancient Jewish scribe recorded this admonition that time is short and must be spent wisely in pursuit of the good.

More than two thousand years separate these two writers but in my mind there is a kind of common view of time as a precious finite "resource". So this attitude has been around a bit and became intensified with all the material successes of the developed world in modern times.

But we are really talking about two different things here. One is the use of routine as a way to control and manage time. The other is the drive to make good use of it. Those are two different things.

In the past few decades in the U.S. corporate world the former has been relaxed quite a bit. That's partly due to technology such as computers, the Internet, and cell phones. I think it is also due to the accelerated pace of change in the marketplace and in the business world. Being agile, adaptable, and responsive to uncertainty is considered to be an essential advantage. Still, the ability to follow routine is part of our cultural DNA.

My experience so far is that Tanzanians are not terribly fond of creating and following routine. It is something that they learned from their former colonizers, the British, whom they try to emulate in some ways, but not something that they much take to.

Consequently, I have had to learn both to adjust to people not following routine very well Unin my opinion) as well as often tossing it out the window entirely. For instance, on more than one occasion the school has had visitors show up with no warning at all, much less an appointment. I was expected to drop whatever I was doing in order to talk with them or show them around.

Initially, I found this sort of thing annoying and frustrating. Gradually, I've come to develop my ability to respond immediately to whatever comes up and to recognize that in many situations the interruption to my routine simply does not matter. I can pick up where I left off at a later time.

-Earl

[ Note: in software development the term "routine" roughly means a set sequence of steps that is part of a larger computer program. How apt that is for the most complex and flexible of machines. ]