Mvua Inanyesha (Its Raining--sometimes)

David with hedgehog 3.0

It has been hard to get back into the rhythm of blogging after our 2 weeks in Iringa. One reason is because the week after we got back was pretty uneventful as we settled back into rhythms of life here in Arusha. The only thing worth mentioning probably is the weather.

In fact, I have not figured out the weather here. As you know, being south of the equator means that our hot season is December through March, and the colder season is in the summer. This was evident on our arrival when we joined a swimming club and could not believe anyone would want to swim in the near arctic water of the pool. In fact we never saw anyone join us in the morning for a swim.

But by December that had changed. It started to get warmer and through the winter more people have been coming. On our return from Iringa I would describe several nights here as pretty hot. Like Bujumbura weather. Not that you would need an airconditioner, but having a fan blowing across the bed at least.

The rainy season is even more confusing. Usually when it rains it feels very cold and clammy here, like a Seattle winter. We have 2 rainy seasons, one around December and another beginning in March. But it was a little hard to tell where one ended and the other began this year. When it rains it pours and floods! Rivers fill, there is plenty of water filling reservoirs and water tanks. The savannah turns a lush green, and looks less like a desert. But then it will stop, even just for a week and the water just seems to vanish--sucked up by the earth, and in days the vegetation is parched and brown again. The overall effect to date is that it is a pretty arrid climate.

The other odd thing about the rain, especially around Arusha is the 'rain shadow' cast by Mt. Meru. What this basically means is that areas that seem to be only minutes apart driving may have vastly different amounts of rain fall. Even today, after church, we were in a torrential downpour for a good part of the afternoon while we ate lunch in town. When it was finally dry enough to get to the car and drive home, about 15-20 minutes away, we found it bone dry. No rain had reached it. I think it will take several years to get used to the rhyhm of weather here, and I think it is appropriate to have a wardrobe comprable to what one would wear in the Pacific Northwest--light, warm, and waterproof.

Besides contemplating weather, Rebecca and I did quite a bit of catching up in the office. I was getting ready for a trip on the following Monday up to Ngorongoro to get an update on the work of our partner who has recently started a maternal and child health project up there. It is a multipronged intervention which requires the partner to set up caregroups of traditional midwives who in turn oversee neighborhood groups of pregnant and lactating women. There are about 75 neighborhood groups with 10-20 women each. The project also is procuring antenatal care vitamins, and providing nutritional incentives to encourage women to attend these visits. Finally, there is a component to provide nurse-midwives in the clinics in the area with a practicum to hone their delivery skills.

All of this to say, it is a complex project which only started in the last 4 months and I had some trepidation about going up and finding the partner completely overwhelmed with the amount of work they had to do.

I arrived by daladala to Karatu on Monday and stayed the night, then the director of the partnership, Laangakwa, a Maasai man with a degree in sociology, met me in his landrover and drove me up. It had rained that night and the roads into the Ngorongoro game park we extremely muddy and slippery. I was glad I was not driving. (It was actually somewhat amusing, because the driver was a maasai in full traditional dress. He looked like he just came in from herding cattle, but he was a very good driver as well.

NDI office, no electricity

It was also very cold, and I was not well prepared for the cold and wet since the last time I had visited it was quite hot. We drove to their office where I was able to see the way they were keeping data for the project. We are tracking the number of pregnant women in the program, # of antenatal care visits, and especially the number of facility assisted deliveries vs. home deliveries. The data for home deliveries is really valuable because it is not tracked at all in this ward. The facilities know the # of deliveries they do, but have no idea how many happen in homes. Since our program covers the entire ward, we are able to track the # of home deliveries monthly. I could see we had a long way to go as of some 200 pregnant women in the ward, there had been 25 home deliveries in one month and only 2 at a facility. Changing that ratio will be a major indicator of success of our program.

We are also collecting data on infant and maternal mortality as reported by the neighborhood groups each month. This is also important to know because it is rare that a child or woman who is dying or dies is taken to a facility, so most of these deaths go uncounted. They are simply buried by the family and are never reported to the medical system.

I found that the partner had a good system to help the traditional midwives track these indicators in their neighborhood groups. I was quite impressed.

Traditional midwives at training

I also had a chance to see a care group meeting where a group of 13 traditional midwives were being trained. It was a lesson on having a birth plan. (Something we encourage women to think about well in advance of delivery, as things like permission from husband and mother-in-law, as well as financing, and transport need to be planned for well in advance if she is going to get to a facility for birth. The training was done quite well but I did have a learning moment myself when I saw that the teaching aids--cards with pictures of people-- a mother, husband, etc. in front of a hut were shown. Most of the traditional midwives, who understood well the content of the lesson, were completely baffled by the simple illustrations, and many held them upside down. I realized that they had probably never seen books or even paper, and could not easily 'read' an illustration, because even a 2d representation on a paper has a syntax and is something we learn to 'read' at a very early age. I could see that for these women, the lines on the paper did not obviously look like a representation of anything, and they had to be coached to see the illustration for what it was representing.

They did, however, understand the importance of a birth plan and seemed ready to disseminate the information to their groups.

After the training I headed back to Karatu with Laangakwa and got a daladala back to Arusha. A daladala is a kind of minivan with a footprint that is not even as big as a honda minivan, but can they ever pack it with people. I road with about 25 other passengers in a vehicle made to seat about 12 baed on the number of seats. We are packed in like sardines and many are standing completely hunched over. You can't budge and just try to minimize the discomfort of motionlessness, and pray quietly that the dreiver does not get in an accident. On the upside, it only costs about $3 for the 200 kem trip!

Oren petting realistic looking elephant at Impala hotel

I got back on Tuesday evening and was happy to be with the family. Believe me, it is harder to be the one at home with the kids. Because school begins so early, the day starts just after 5am for Rebecca and I in order to get everything ready for the kids and us to have a 6:40 am departure. I think the uniforms are what really kill us. We have to have not only their school uniform but also an elaborate PE uniform that has a separate shirt, pants, long soccer socks, shoes and shin guards, and when there is swimming--towel, goggles and suit. This all has to be found and loaded into bags along with them in full uniform. Rebecca and I also have to pack for the day because we drop the kids off at the bus stop near our office then go for a swim before work. (We get there at 7am.)

MCC team meeting

I feel refreshed by 8:15 am when we are done with the swim and dressed to go to work, but the time between 5 and 8 can feel nearly unbearable by Thursday. (Note, one of the worst moments is having to jump in the icy pool just after 7!). Still I would not trade away the routine, because the morning swim is one of the really life-giving rituals that really prepares me for the day. (We pray right after the swim which is very helpful too.) We are doing a lenten fast during the day this month, so being hungry during the day might contribute to a feeling of exhaustion.

David as Frodo

So we have been back into the routine now that the kids are back in school and have about 2 more weeks of it before their next break. Other highlights of the week that I will not elaborate on were our weekly choir practice on Wednesday evening to prepare for our Easter service, the kids having a dress up day for book week at school (David was Frodo) a team meeting on Friday for MCC, which we do quarterly, and a fondue party we were invited to attend by a Swiss/British couple on Saturday. It was delicious and a fitting end to a socially engaging week.

Rebecca was just recovering from a spot of food poisoning she may have contracted at a World Council of Churches meeting she attended. She was well enough this morning to step in and lead music at our church when the person scheduled this week had a family emergency. We finished off Sunday with a relaxing (rainy) lunch then went home where I decided to make cream puffs for dessert tonight. We enjoyed them over a game of Carcisonne. Kids are now back in bed ready to repeat the routine again tomorrow morning.

Rebecca leading worship (Neil on mandolin)