Days three & four in Tanzania

Hello again from Tanzania –
We are sorry we didn’t write to you yesterday…the electricity went off, and then the wifi failed at the guest house. It’s still not working so we are writing to you from a cafe with wifi.
So let’s catch you up.
On day three, we had a long meeting at the guest house of the Diocese of Meru with members of the diocese, the Evangelical Lutheran Church in Tanzania’s Palliative Care Program, the hospital and the palliative care program for more discussion about their plans for the future.
Interestingly, they served us tea and a snack – popcorn and peanuts!  We also had lunch together – pumpkin soup, spaghetti, and chicken.
In talking, Bishop Paulo Akyoo told us what our support means to Nkoaranga – “it means the lives of people who were dispairing are now getting encouraged. There is a life they can live as long as God desires to prolong it.”  He added about the patients suffering with HIV – “we don’t want to isolate them as victims of HIV but to integrate them into society with people without HIV.”
Dr. Paul Mmbando, the ELCT Palliative Care Manager mentioned “the work of the palliative care program is training people in country in palliative care. Before, people died like animals without pain control. The family suffers, they witness excruciating pain. Emotional and psychological care is critical.”
The General Secretary for the Diocese of Meru stated “Palliative Care means quality of life. It’s not the number of years one has, it is the quality of the years.”
We learned that there is a shortage of health care professionals in Tanzania – only 40% of their need for health care professionals is met.
After a long day, we came back to the guest house, then decided to be brave and walk to the ATM and “supermarket.”  It was fun!
Today was very moving. We learned how the support of Gilchrist Hospice Care has helped.
Patient named GiftWe went to the hospital and visited a young man named “Gift.”  He looks like he is 14 years old, but he is actually 20. He is HIV positive, has Tuberculosis, PCP (a type of pneumonia) and is on antiretroviral medication. When he came in to the hospital, his pulse was very slow. Today, it was in the 90’s. He’s doing much better due to the care of the PC team. Their goal is to discharge him to a family in the community, since his own family is not taking care of him. He often goes without food and is left alone. Our financial support helped pay for his hospitalization, and provided a goat and chicken to produce milk and eggs to eat.
Next we visited Frida Copriano Ayo. She is 52 years old and had a tumor in her neck. She lives in a mud and tin roof hut. Her family pulled money together and took her to India for surgery, which was a failure. She came home with a tracheostomy, and left sided paralysis due to a blockage. How has Gilchrist helped? Our funds have provided stipends for volunteers. One of the village volunteers discovered that she was living in a dark room in her hut, and alerted the Palliative Care team. They are successfully managing her pain and are visiting regularly for care.
Then we visited Rhoda. She is in her 50’s and is suffering from esophageal cancer. She initially was admitted to the hospital for IV fluids because she couldn’t eat. She was discharged to a small, dark room in her son’s home under the care of the Palliative Care team. Dr. Bakari provided education to the family about her diagnosis and that she was dying. Her pain is controlled by morphine. Rhoda is refusing to eat, and her family is struggling with the idea of not feeding her. The team explained that she is very near the end of her life, and that she should not be forced to eat. It’s interesting how so many of the issues are the same as what we experience with our patients. We will have a video to show you of the team singing a hymn to her and praying, as she lay across her daughter’s lap while her daughter stroked her hair.
We ate lunch at a roadside restaurant and had goat and ugali (which is like a sticky rice or polenta and is eaten communally with your hands pulling pieces off.
Cathy and baby and orphanage
Cathy Hamel, Gilchrist Executive Director, meeting one of the babies at the orphanage.

And today we did go to the Nkoaranga orphanage to see the babies and toddlers.

For our last dinner here we are going to the home of Dr. Samuel Kiwesa, the Medical Director for Nkoaraga Hospital.
We hope all is well with you.  See you soon.

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