Traditional Birth Attendants

Have I mentioned how much I love Tanzania? We drove down the escarpment today into some fairly remote villages to find traditional birth attendants. We went to Chem chem and talked with 2 of the more active TBAs. They have not had any formal training, and MIHV would like them to attend the next training session we are having. MIHV is using the Home Based Life Saving Skills manual provided by the American College of Nurse Midwives - which I think is fabulous. More than 80% of women in Tanzania delivery with a TBA at home - often miles and miles from the nearest health facility - so it's critical that these TBAs receive some formal instruction for what to do with complicated cases.

I'm dying to attend a home birth. We have our own nurses working on contacting the TBAs in the area to see if they can make that happen for me!

My weekend was pretty quiet. I went to Bytes with Meredith on Friday. Meredith is from Ohio and just finished law school. This is her fourth or fifth trip to Tanzania, and she will be here for a year working for Dr. Frank and his wife, Susan, as the "volunteer coordinator" for FAME medical clinic. Meredith first came to Tanzania to work as a volunteer at an orphanage and was here for a year that time. Her stories of all these children that are at Rift Valley orphanage that were either abandoned (usually by an alcoholic teenage mother) or whose parents have died of AIDS have brought me to tears. She is planning on adopting at least one baby before she moves back to the states. I am totally inspired by her ability to change the world one person at a time.

My account of the local hospital was fairly horrible, but that doesn't mean the people of Karatu are without good medical care or compassion. FAME medical clinic was opened this year by Frank - an American anesthesiologist - turned internist/family practitioner. I have mentioned him before. His clinic is absolutely lovely and clean! You could probably eat off of the floor there. He has 2 other amazing Tanzanian doctors working with him, plus 2 fabulous nurses (one is a nurse-midwife). I spent some time there last week reviewing topics like cervical carcinoma (for which there is currently no screening program here - aka Pap smears) and antenatal care. I also consulted on a patient for them who came to the clinic on Sunday. I am totally inspired by what Dr. Frank and his staff are doing there. I was offered a full time position - and have strongly been considering it. I told him if he could find a way to pay off my student loans and pay my mortgage - I might just stay!

Kim arrives tomorrow night - and I can't wait!! I have been working with various safari agencies to get us a good deal. I think we will spend a few days in the Serengeti, and then go to the Ngorongoro crater. Next week, we'll fly to Zanzibar for a few days of complete relaxation. I can't believe my time here is almost up!!

I like sharing some of the very random things I am learning about this culture. It is apparently much worse to be a thief here in Tanzania than it is to be a rapist or murderer. I was told that if I was ever in trouble or someone was seriously bothering me, I should yell out "thief" - which apparently will get anyone nearby to start beating the crap out of the person (sometimes to death). But I wouldn't get the same reaction if I yelled out "murderer." Crazy, eh?

Asante!