Well, for me 2014 started out on the beautiful island of Madagascar in the small beach village of Morondova, across from Mozambique on the west coast of the island. Madagascar is the 4th largest island in the world and truly is large - the quickest way to get around is to fly. After arriving in Anatanarivo (everyone calls it Tana), the largest city and capital, my colleague, Cathleen and I were met by our guide, Hari. We spent the first night in a lovely hotel, and then started the next morning to drive over the next two days to Morondova, on the west coast of the island. Antanarivo is located in the center of the island and has a total of 12 hills in the city. Most of the streets are cobblestone. It reminded me a little of Venice without water, but with hills, some very steep. The people in Tana have a Malaysian appearance - and are very friendly. Since Madagascar was at one time a French colony, French is still a common language, along with Madagasy. There are baquettes everywhere and many restaurants with good French food and wine.
Our first stop was a small city about two hours south of Tana, Antsirabe, where we spent the night and toured some small "mom and pop" businesses. I found the Madagasy people very hospitable and industrious. These small businesses were making paper, recycling aluminum into cooking pots, making jewelry and other items from "zebu (cow/oxen) horns", and making candy.
Paper Making Factory
Zebu Horn Carving Factory
Aluminum Recycling Business
Candy Making Family Business
The following day, we spent the next 10 hours driving from Antsirabe to Morondova on the west coast. This was a great opportunity to see the countryside and notice the change in people and living from the center of the island to the west coast. The west coast has a strong African influence both in appearance of the people and in their houses.
Countryside
You could not visit Madagascar without seeing the Baobab Trees. - We were fortunate to visit at sunset and get some great photos.
The mode of transportation in many parts is still the cart with "zebu's" or a "rickshaw" type vehicle either pulled by human energy (foot power) or by a bicycle.
The ocean was beautiful, although too warm for my liking and the sunsets spectacular.
This was a wonderful opportunity to see a most amazing country. I am sure one I will most likely not be able to repeat.
Since returning to Mwanza after my nice break, I went back to full working mode with lecturing and clinical supervision. On some days I will have about 50+ students on the clinical wards, spread out over 7 areas. Some are on a ward for one week and some for two weeks. I try to get by to see each student to have them present their patient and the nursing care they are giving.
Slowly, I am working with the charge nurses on each ward to have them begin to pass on some of their "pearls" to the students. There are so many "needs" and it is difficult to identify which ones are the most important. Everyday and sometimes more than once a day, I need to "recalibrate" my thinking as to what is the highest priority as well as to why I am here. It is always a challenge, but if you look at the glass half full - you are not disappointed. There have been many articles written about working as either a doctor or nurse in a developing country - and the normal stages you go through - sort of like Kubler Ross's Stages and I have to say that I have experienced almost all of them. In order to make effective change you first have to be able to identify what you are feeling and why you are feeling that way.
For the most part, Tanzania is roughly about 30-40 years behind many developed countries, especially the US and Europe. For example, there is very little to almost nothing for those with disabilities. Palliative care for end stage disease is almost non-existent and pain management is suboptimal. This can be difficult to see. The future of nursing and subsequently change in the health care of Tanzania is in the students - and that is a motivation for me. I have to remind myself that it will come slowly (pole pole).
It is hard to believe that it is almost the end of January. I have to say the time is going quickly. I am slowly getting into the rhythm of living here and have learned when to "exhaust" myself with the sokoni (market) and when to just stay home. I have been very fortunate to have met some wonderful people and we often eat many of our meals together. My K-Swahili is coming along pole pole, a little too slowly for my liking. The students should all speak English - so it will do me or them little good to try to speak K-Swahili with them. It would be nice to know more, especially with the patient's in the hospital.
I miss you all and the Northwest - although I have to say, this time of year I don't miss the weather. Next month, I will meet Jonathan (my youngest son) in Zanzibar. He is visiting Kenya and Tanzania as a teacher with an alternative high school out of Bellingham; Explorations Academy. That will certainly be a treat.
Hope this finds you all well. Your e-mails are always welcomed.
Best regards, Dorothy
