"Nimerudi!" (I have returned!)

Well I’ve been home for over a month now, so I guess it’s about time to wrap things up. I arrived at the Albany airport at approximately 6:30pm on December 16^th, and was welcomed home by my mom, my sisters (who had made a beautiful poster for my homecoming), and a sick boyfriend. My journey home consisted of unsuccessful attempts to sleep and reflection on my African adventure. I suffered from home-sickness quite a lot at the beginning of my trip, but by the end I didn’t want to leave just yet (although I did want to be home).

Something I haven’t talked about in this blog is my thesis, which was a big part of the reason I chose to travel to Tanzania in the first place. I’m pretty sure nothing goes according to plan in Tanzania, and so it was with my thesis. In the beginning I had hoped that I would be able to get my hands on some clinical data under the impression that, compared to the US, Tanzanian privacy laws would be pretty lax. Unfortunately (or fortunately, depending on how you look at it) hospitals and clinics were more protective of their HIV patients than I expected, so I took a different approach.

Luckily for me I am writing a paper for the human biology department, which spans a lot more than just the physical human body. After running into several road blocks, I decided to research the interactions between culture, nutrition, and HIV through personal interviews with various local health professionals. At this point I had already conducted some baseline research using online WHO data that supported my original hypothesis that malnutrition is increasing HIV mortality rates in Tanzania. My next question was: Why? I formed my next hypothesis after a few weeks of observing the culture and casually discussing the issue with local Tanzanians. From here I decided to delve deeper into three main factors contributing to malnutrition in the Arusha region: cultural tradition, lack of knowledge, and gender inequality.
 

I conducted five interviews in which I asked questions about these topics. I spoke with an HIV/Nutrition educator, a retired physician who now works as a home-based care provider for people living with HIV/AIDS, a nutritionist, a nurse in the HIV unit of a local hospital, and the director of a women’s outreach program. All of these individuals focused on different factors that they felt were most influential to Tanzanian diets. Here are some of my conclusions:

Cultural Tradition: As I’ve mentioned, much of the Arusha region consists of Maasai and Maasai descendants. Maasai are traditionally pastoralists, raising mainly goat and cattle, and therefore have a diet rich in meat and milk. Green vegetables are rarely eaten and are actually referred to collectively as “grasses”, causing widespread vitamin/mineral deficiencies. The exclusive reservation of fruits for the young and the sick further contributes to these deficiencies. Because a large majority of Tanzanians who have HIV have never been tested, they continue to neglect these vital food groups causing the immune system to deteriorate quickly as the virus attacks the weakened immune system.

Lack of Knowledge: National studies have been conducted testing knowledge of both nutrition and HIV. The results show that knowledge levels are not up to par, hence GSC’s continued trainings. At a more local level, pre- and post-tests are administered to every adult group participating in the HIV/nutrition training. Although these trainings are successful in raising awareness of HIV and nutrition, it is alarming to see how little so many people know about these important topics before GSC intervenes. Nutrition education particularly is something we don’t often think about in America since the food pyramid and eating healthy is stressed at such a young age in our education systems. Knowing a balanced diet is the first step to good nutrition, and I was happy to hear that nutrition is one of the first topics of conversation after an HIV diagnosis. However, I have learned that even with this knowledge a desire to eat healthy and access to each food group are separate obstacles that make solving the problem of knowledge look easy. Here we come back to culture which has a huge impact on the desire to eat healthy. How can a man eat less meat and more fruit if it’s going to take away from his manhood? The mention of culture change scares these people, and many claim they would rather die than change. Unfortunately that is a very real possibility.

Gender Inequality: I know I’ve talked about gender inequality on here before, well surprise, surprise! It affects HIV and nutrition. Women are naturally put at a higher risk for HIV than man due to the “larger surface area of the vagina and cervix compared to the areas of the penis where transmission can happen (foreskin, urethra and small tears on the head),” (http://www.catie.ca/fact-sheets/epidemiology/women-and-biology-hiv-transmission). Additionally, social conditions give women (especially in rural villages) little control over their sexuality, including condom-use. People living with HIV/AIDS are put at risk for malnutrition since they require increased dietary intake and as the disease progresses they may become too physically exhausted to work (thereby losing income to buy adequate amounts of food). Many of those interviewed stated that women were also put at risk for malnutrition because men are more highly valued in society and therefore their dietary needs are prioritized by the family. Interestingly enough, the only interviewee who said that diets between men and women are not generally different was a man. I’ll have to do more background information to get a better idea of what’s really going on.

 

And that's the exciting conclusion to my Afrian Adventure!! KWAHERI!

"Safari Mbili" (Safari II)

I went on a safari to Lake Manyara and Ngorongoro Crater this weekend! Both areas were much different from Tirengire, the other safari I went on.

Lake Manyara is much denser with trees and vegetation. Although this made it difficult to spot a large variety of animals, it was the perfect environment for BABOONS!! We saw sooo many baboons. They were cool. It’s scary how human-like they are though…

 

Ngorongoro Crater had all kinds of land! – Grass-land, swamp-land, dry-land, wet-land, forest-land, and lakes. So needless to say the crater is home to a lot of different animals. I saw zebras, wildebeest (aka gnus), buffalo, hyenas, jackals, warthogs, flamingos, lions, hippos, rhinos, elephants, gazelles, and hartebeest!

 

One of the coolest things I saw was a couple of lions feasting on a zebra. Don’t get me wrong, zebras are my favorite animal, but I got to see the “circle of life” in action!! During the lions’ meal, their audience of both tourists and other animals grew and grew. Their animal viewers consisted of the nasty scavengers: hyenas, jackals, and vultures. The lions had to constantly scare these animals off so they could enjoy their zebra alone. Once the lions lost interest in the zebra, they started to let their guard down and the scavengers went in for the leftovers. We saw one hyena that snatched a zebra leg and ran away with it while the lions’ backs were turned, and by the time the lions spotted the thief he was long gone. The whole crew of hyenas laughed hysterically!! So bizarre… it’s like they really do have a sense of humor.

 

There were Maasai men herding their cows inside the crater!! But don’t worry, they rub a special solution on their skin to fool the lions into thinking they are animals (even if this does work I don’t really see how it protects them since lions do in fact eat animals).

 

It’s kind of hard to get a grasp on this country when you see so much beauty in it but know that it’s plagued with social, economic, political, and public health issues. The solutions aren’t any less complex.

"Nyumbani" (Home)

Per Mom’s request, this blog is about my home (when I’m not in the village) – Arusha.



The clocktower downtown

Arusha is a fairly modern city compared to the rest of Tanzania. The main roads are paved, a lot of houses have electricity and running water, and the population is (sort of) diverse. There are spots downtown that are sketchy, but there are also a lot of nice places to hang out! Walking down Sokoine Street, the main road through the downtown area, is the best way to get to know the city because it’s complete with everything from modern grocery stores to local markets where farmers sell their produce.

 

Sokoine Street

 

 

 

 

 

 

 

 

I live in Sakina, about a 30 minute walk from downtown. Sakina has a lot of small restaurants, bars, and specialty shops and contains several different neighborhoods. I frequently visit Sakina Supermarket which is a convenient 10 minute walk from my house. This supermarket is known for its bread, but I’m not sure why… it tastes just like all the other processed white bread loaves in the city! The neighborhood I live in is called Kibanda Maziwa which means “milk stand”. Apparently it used to be where people got their milk, but the milk stand no longer exists. There are a few shops in my neighborhood, a salon and barber shop, the Chemchem “grocery store” and a few convenience stores. It’s a beautiful neighborhood with lots of greenery; the roads aren’t too good for driving on though. My house is right next to a mosque and a church so when I’m not hearing the Muslim call to prayer I’m listening to the church choir. It’s nice background music, especially on Sundays when I’m stuck outside doing my laundry for the week!

 



The stream where some of the locals get water

 

The front of my beautiful home

 

 

"Ukimwi" (AIDS)

For the past couple of weeks I have been in two different villages teaching rural Maasai about HIV and nutrition, and it’s been totally different from conducting agricultural training. Talking about sex can be awkward anyway, but when you’re talking to Maasai women who spit in disgust at the words used to describe our reproductive organs, the awkwardness gets taken up a few notches.

Sex is very taboo in Maasai culture. The advice sex-ed teachers give in America that “you aren’t ready for sex if you can’t talk with your partner about it” doesn’t fly here, because kids can’t even talk to their own parents about it. The problem is sex is so taboo that it’s silently killing millions of people each year in the form of AIDS. And it’s not just silent because people won’t talk about the dangers of unprotected sex, it’s also silent because people are afraid to know their HIV status (ignorance is bliss) and they’re afraid to ask their partners to use a condom… the embarrassment would be far worse than contracting HIV, right?

Unfortunately embarrassment isn’t the only thing keeping people from using condoms. This week our female trainees laughed when we mentioned condoms as a form of HIV prevention because their husbands would surely beat them if they requested to use one. The other two prevention methods we teach are abstinence and being faithful, but these suggestions were shot down too – they said they couldn’t deny their husbands sex and there’s no way their husbands are going to be faithful. The common denominator of all these responses is gender inequality, which has an impact in Africa that rivals even HIV.

We got a lot of weird questions from trainees these past couple of weeks. After Allie (my fellow volunteer) gave a lecture on gender equality this week as part of the HIV training, a male trainee asked her how she feels about a man “booking” his wife during her mother’s pregnancy, i.e. before she is even born. Apparently this happens sometimes in Maasai culture. We also got questions from the primary school children we taught like, “What is a vagina?” and “What if someone never goes through puberty?” Another child asked how many stomachs women have!

I think the most shocking thing I heard from the trainees during my time as an HIV trainer so far happened when I was talking to a class about the importance of getting tested for HIV. I always explain that knowing you are HIV+ is better than not knowing because then you can take precaution not to spread it to your loved ones and you can start treatment which will allow you to live a longer, healthier life. This week that statement was followed by lots of chitchat among the trainees, so I asked what they were saying. I was told they were all disagreeing with me, because they would rather die than live with HIV. Knowing the trainees felt this way made me think our training up to that point had been completely ignored, since our purpose is to not only lower HIV rates but to decrease the stigma that so often accompanies HIV. Although HIV is a terrible disease which will inevitably progress to AIDS, it is not a death sentence as is commonly believed here. Someone living with HIV who doesn’t take care of themselves may only live for two years after contracting the disease, but someone who takes ARVs and maintains a healthy lifestyle can live for 20+ years before developing AIDS. It’s incredible to me that this fact doesn’t make a difference to these people. Despite the knowledge we supplied them with they are still terrified of HIV because of the stigma and discrimination surrounding it.

Although my HIV trainings have been frustrating, they have not been without benefit. The other volunteers and I are all more determined than ever to find solutions to these problems. This coming week will be my last week camping in the village and then I will be in Arusha for the last three weeks of my program to complete my capstone project, which happens to concern the effectiveness of our HIV trainings.

 

Our classroom in Gilailumbwa

 

Maasai

 

The villages I’ve been in over the past few weeks are predominately Maasai. Maasai is a tribe with a large presence in and around the Arusha area of Tanzania. Out of all the tribes here, I find Maasai the most interesting, partly because their culture is so different from mine.

Their livelihood revolves around their cows. They value their cows very highly not because they worship them but because of the milk, manure, and meat that they produce. Wealth is measured in cows: the more cows one has, the more prestige that person holds in the community. Even brides wealth is paid in cows!


Coming of age is a very important part in a Maasai man’s life and involves several steps. As explained to me by our Maasai intern Hagael, first the boy (who may be between the ages of approx. 14-18) must ask his father for permission to be circumcised. If permission is granted, he must then prove his strength by catching a bull and tying its legs together. After this, the boy must go to his grandfather for his blessing, and then he can be circumcised. The circumcision is done using no anesthetics, but if the boy cries or shows signs of weakness during the ceremony he brings great shame upon himself and his family. I cringe every time I see a Maasai boy all in black, because his clothing indicates that he has recently been circumcised and is still healing.


Although I have yet to experience it (since our trainees are generally hard-working), I have heard that Maasai men are very lazy and that their only daily task is to take the cows in at night. Women do the cooking, cleaning, child-rearing; they fetch the water, gather firewood, and of course cater to their husband’s every need. It’s not uncommon for the lucky man to have several wives to do this work for him, although I’m told that polygamy is becoming less prevalent in Maasai culture.


Due to their value of cows, a meal of milk and beef is often considered a good Maasai dinner. Unfortunately there is a belief in Maasai culture that fruits are for children and the weak/ill, so they are not consumed as commonly as they should be, contributing to malnutrition. Also, in general Maasai just don’t like vegetables (the Maasai word for green veggies like lettuce and spinach actually translates to “grasses”) so they are lacking in that food group as well.

The Maasai wardrobe is very interesting. The men wear “Maasai blankets” which are rectangular pieces of red, blue, or purple plaid cloth. They generally wrap one around the waist and one around the chest, and sometimes wear a third one like a cape. The women may also have a Maasai blanket handy to carry their babies on their backs. Most women wear a khanga wrap and lots of elaborate bead jewelry. Both men and women have stretched earlobes with large holes through them… I must admit it was hard not to stare during the first week I worked with them (even though I get stared at whenever I’m in public).

 

 

 

As for my vacation week, it was absolutely fantastic. Actually it couldn’t have been better. I got to hang out with my Dad last weekend! It was soooo nice to get to show him around my temporary home. We took a long tour of downtown Arusha on foot looking for soccer balls. My Dad made it a mission to buy soccer balls for a school down the road because he had seen the kids playing soccer with a bundle of rags during recess. The mission was accomplished! We also went on a safari, which even Dad appreciated despite his dislike of animals!

 

I don’t think I have to even tell you that Zanzibar was amazing. I’m not even ashamed to say that I spent all my time by the pool and on the beach (and not doing any kind of work whatsoever) because you would’ve done the same!! The scenery was breathtaking and the weather was perfect all week. It was really hard to come back home!

 

This week I’ll be in Arusha finishing up my last week of sustainable agriculture training, then I’ll be starting HIV/AIDS trainings!

"Vijijini" (In the Villages)

Hamjambo!! Hello everyone! Over the past two weeks I visited two rural Tanzanian villages with GSC: Maroroni and Tingatinga.

During my first week of field work, we camped out in Maroroni village (about an hour’s drive from Arusha). We brought buckets of our own clean drinking water, we heated up water for our bucket-baths using a good old-fashioned fire, and there was a pit latrine located conveniently in the center of our campsite. Breakfast, lunch, and dinner were made for us by a local, Leonardi, but they were made on a Tanzanian time schedule (one day dinner for 7pm was ready at 9pm). There’s not much to Maroroni. It’s extremely dry, there are chickens and donkeys roaming around everywhere, no electricity, and lots of school children who are fascinated by wazungu but too afraid to talk to us. The village people were mostly very welcoming, especially our trainees. Each day, me and the other trainers taught groups of villagers about bio-intensive agriculture (kilimo hai in Swahili). Kilimo hai is “a method of organic farming rooted in maintaining soil fertility and living soil.” We teach in English and everything we say is translated for the villagers by our Tanzanian interns into Swahili. The first couple days we just lecture, but the rest of the week we demonstrate kilimo hai through practicals. Our first group was extremely attentive, and it was really cool working side-by-side with the locals!

 

We were in Tingatinga, a Maasai village, for my second week of field work. This was my home during my stay: 

 

The scenery was much nicer than in Maroroni (which was like barren savannah). Tingatinga actually has green plants, and you can see Kilimanjaro from almost anywhere in the village!

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

A lot of the little kids here were excited to see wazungu and not too shy to talk to us, but I did run into one little girl who cried when she saw us because she was scared of wazungu. However we did make some friends in Tingatinga. We became quite close with two little kids, Everest and Kesia (right).

 

On another note, unfortunately we didn’t have any trainees this week. We had almost 50 people registered for our trainings but only a couple showed up. We were told that this happened because the villagers don’t want to come unless they get paid for it (some organizations do offer money for people to come to their trainings, but not GSC). But I don’t even want to teach people who just come for money! In order for what we teach to actually make a difference, we need people who are actually interested in learning about kilimo hai so that they will use it when we leave. Anyway, we had to cancel the trainings and we made some keyhole gardens and grain storage tanks for a few villagers instead.

 

This Friday was both Sarah’s and Ayo’s birthday, so of course we went out to celebrate!! -->

After a fun night at the Babylon Club, Saturday we went on a hike up Mt. Meru to the waterfalls with Luke’s host-brother, Hans, as our guide. The whole climb was absolutely gorgeous, and I finally got to see the tropical side of Africa!

Lots of exciting things to come!! This week I’ll be teaching kilimo hai in a new village, I get to hang out with my dad next weekend, and then I’m off to Zanzibar! NBD.
 

Comparisons

Over the past few weeks I have been reading World without End by Ken Follett. It is a historical fiction that takes place in medieval times, and as I have read it I have come across several similarities between medieval England and present-day Tanzania:

·    Male domination. In 14^th century England, the man’s role was to provide income and to make all family decisions. The woman’s role was to raise children, cook, clean, and obey her husband (e.g. the women got the short end of the stick). Today, Tanzania is no different. It is rare to find an independent woman here and even rarer to find a man who will cook or clean. It is frowned upon by all members of society for a man to do domestic chores because it takes away from his masculinity. Men have control over all money matters, even if his wife produces her own income by selling crops. If she needs money to buy groceries, she must ask her husband to give it to her. There are also no female doctors here, which is interesting because one of the main characters in World without End is a female who aspires to be a doctor, but can’t because society won’t allow it.

·    Medical care provided by churches. Medieval churches served as hospitals for the sick and injured, and the “doctors” were priests and priors who, despite their training, had no understanding of the human body. For example, blood-letting and purging were used for decades before people realized these “treatments” only worsened conditions. Of course Tanzanian doctors don’t do these kinds of things, but most hospitals here are sponsored by churches. However, it is not uncommon for a Tanzanian doctor to refuse to tell a patient their diagnosis if it is a bad one. For example, here is a story I actually heard from an HIV+ woman: she went to the clinic to get tested for HIV because she had suspicions that she had contracted the disease. The first doctor she went to refused to test her because he didn’t want to break the bad news to her if she tested positive. She convinced the next doctor she saw to test her, but he only agreed because she claimed she would not ask him for the results. She returned to his office the day after her test and asked him for the results, and he refused to tell her her status. Although he would not tell her, she said, “I already know I have HIV,” and he said, “How do you know?” She replied, “I can see it in your eyes.” She was right. However, that was years ago and today this woman, Mama Betty, is living healthy and positively despite her HIV.

·    Modes of disease transmittance. Just like people believed the European black plague was transmitted through looking at someone who was infected, this is a myth about HIV transmittance in Tanzania as well. It is one of several in fact. Another myth is that it is spread through witchcraft, another common belief between Tanzania and medieval England. Witchcraft is believed to be at the root of many problems here, and I have even met Tanzanians with college educations who believe that witchcraft is real. I have also been informed that (just like in medieval times) “witches/wizards” may be hunted down and killed so they will stop casting spells (like the HIV spell?).

·    Illegal homosexuality. Not surprisingly, homosexuality was illegal in medieval England (although it was common among monks and nuns, according to Follett) and is illegal in Tanzania. The reason this does not surprise me is because, unfortunately, 50% of the population (women) still don’t have the rights they deserve, so it seems highly unlikely that a much smaller population of people who may be viewed as “unnatural” would have the rights they deserve. People here LOVE Obama. I have to wonder, do they love him because he’s black? or because of his support of gay marriage?

These are simply observations. I am not making any implications, although it does seem that some of these cultural ideals may serve as barriers for development.

 

Next week, I’m off to teach bio-intensive agriculture in the villages! (Bet you didn’t know I know how to farm! It’s amazing what you can learn in a few weeks…)