31
August
2010
Dear Colleagues, Friends and Family,
I am writing to share the news that I have signed a 2-year contract
to work as a research and data management consultant with Haydom
Lutheran Hospital (www.haydom.no) in rural, northern Tanzania. Since
coming to Tanzania in 2006 as a Biology and Health Education volunteer
with the United States Peace Corps, I have worked as a Research
Project Manager for the Johns Hopkins University Department of
Ophthalmology at the Kongwa Trachoma Project, as an Operations
Research Consultant for Catholic Relief Services on a Mobile Health
(mHealth) project for OVC (Orphans and Vulnerable Children) in Arusha,
and as a Public Health Consultant for the United States Agency for
International Development (USAID) mapping the Health Systems
Strengthening budget for Global Round 9 alongside the work of other
bilateral development partners (e.g., Canadian, Danish, Norwegian,
Dutch, Swiss, Japanese, British, and American). Having lived and
worked throughout Tanzania in the southwest (Njombe), central zone
(Dodoma), and along the coast (Dar-es-Salaam), I am excited to work at
a new location in the north (Manyara).
Founded by Norwegian missionaries in 1955, Haydom Lutheran Hospital
(HLH) has grown to become a regional referral hospital with 450 beds,
580 staff, and the only facility of its kind in the region. Located
in the southwest part of the Manyara region in the Mbulu district, HLH
serves over 70,000 patients per year in more than 7 districts across 4
regions. HLH is also a research partner for a number of international
and local research projects including the Bill and Melinda Gates
Foundation funded MAL-ED project to study malnutrition and enteric
diseases (www.fnih.org/work/key-initiatives/mal-ed) and the Helping
Babies Breathe (www.helpingbabiesbreathe.org) neonatal resuscitation
research project. In my role here at HLH, I will be working to expand
the research capacities of the hospital and to attract new research
partners. With medical records dating back to the first patients in
1955, HLH is expanding its data collection activities. In addition to
improving data collection in each of the hospital’s wards, I will be
working to better utilize these data for the benefit of donors and
other stakeholders, and especially to improve the data feedback to the
wards themselves, to improve hospital practices.
Culturally, Haydom is located in a fascinating part of Tanzania. All
four of Africa’s major language groups are represented among the
people here: the majority Iraqw people (Cushitic language group), the
Isanzu and Iramba peoples (Bantu language group), the Datoga people
(Nilotic language group) and the hunter-gatherer Hadzabe people
(Khosian language group). HLH helped to establish the 4 Corners
Cultural Centre which brings these groups together in a unique
partnership for mutual collaboration, communication and celebration.
Where these groups historically were in conflict with one another,
they now have a forum for conflict resolution and mutual cultural
enrichment.
My wife Jessica and I are happy to announce our move to Haydom and
warmly welcome you to our new home. Whether for possible professional
collaboration or for a vacation to Tanzania, I hope that you do not
hesitate to contact me. I wish you all the best and Karibu Tanzania!
Joshua P. Levens, Ph.D.
Research and Data Management Consultant
Haydom Lutheran Hospital
Private Bag, P.O. Mbulu
Manyara, Tanzania
jlevens@haydom.co.tz
josh@joshualevens.com
Joshua 
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18
May
2010
My friend Wolfgang asked me some time back if he could distribute entries from this blog to his English class in Germany. Having planned a lesson on American volunteerism, he considered my Tanzania-inspired cultural vignettes as ample fodder for language practice. Naturally predisposed to literary exhibitionism as every blogger must be, I of course agreed. At this point, I had already finished my service with the Peace Corps in southwest Tanzania, was settling in to a research management job in central Tanzania, and was incessantly prone to waxing rhapsodically on the cultural conversation between the US and East Africa as it was. In addition, having taught Tanzanian high school students for two years, I was interested to get a sense of what their German counterparts were like.
Before filling the class in on my details, Wolfgang asked his students to extrapolate on my life and background before moving to Africa. They imagined my American life to be “busy and unhealthy,” filled with “lots of fast food,” living a “chaotic lifestyle” in a “little apartment” where I drove a “Ford Mustang” to my job as either an “office clerk or butcher.” Of course, nothing was said of my “wise-cracking next-door neighbor” who “carries a loaded handgun” and “watches Fox News,” but they were obviously still learning the finer points of American culture. Truthfully, however, the students’ questions and concerns about living in a place like Tanzania were no different than those of their American counterparts. They asked about living “without TV,” at a lower “technical standard,” and without the “luxuriousities” of the developed world. They wondered whether or not I planned on living in Africa forever and if it was difficult to live away from family and friends.
Looking back over a year later to the answers I gave then, I find that little has changed. While I am living in Dar-es-Salaam instead of small town or village, I am already making plans to move back to the bush. While I continue to miss family and friends, I don’t miss life in the United States. While I don’t plan on returning to life without running water and electricity (at least in its sporadically available form), I am happy to live a simpler life style, with a big garden in beautiful surroundings. At the time, there were a few students in Wolfgang’s class who expressed an interest in visiting Africa or even volunteering for a longer term. If any of them is still interested, they should feel free to contact me. That includes you too Wolfgang. Karibuni sana.
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15
January
2010
It is not recommended to look directly at a solar eclipse. Neither is it recommended to consume saturated fats, eat with your hands out of a communal bowl, or ride a bike through the streets of Dar-es-Salaam during rush hour. Initially, I was prepared for exclusively appropriate eclipse viewing. I placed a piece of white paper against a tree, cut a pin hole through a piece of aluminum foil and then held it between the paper and the moon, as the moon floated between the foil and the sun. Here in Dar, eclipse coverage reached 71.74% at 5:31:48.8 GMT/UT, or roughly 8:30 am, which the locals call half-past two in the morning (sensibly starting the clock when the sun comes up at 7:00 am). It is not recommended to look directly at a solar eclipse, though I don’t know how anyone can resist.
The clouds moved quickly this morning. When they hit just right, sometimes for nearly 30 seconds, there was just enough cloud cover to see the moon blocking out the sun without the clouds blocking them both out, and without the sun’s intensity painfully burning out your retina. Viewing the eclipse on paper was interesting, in a 6th grade science experiment kind of way. Viewing the eclipse directly was amazing, in an images from the Hubble telescope kind of way.
Simple bits of elegant celestial geometry, solar eclipses attract the more adventurous of the more polar residents towards the equator. The Central African Republic, China, India, Kenya, the Maldives, Myanmar, Somalia, Sri Lanka and Uganda got the best show this time around. Coming from the US, I had never seen a solar eclipse before. Here in Dar, they last saw one in 2005, but will have them again in 2013, 2016, 2020, 2027 and 2030, before getting the greatest show on earth, a total eclipse of the sun in 2031. I would like to be around for that one, provided I haven’t already burned out my retinas.
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27
August
2009
My first experience with death in Tanzania occurred about two months into my Peace Corps training in Morogoro. A woman who cooked lunches for our language training group at Kihonda Secondary had lost her young son to malaria. Our language teacher Petronella (Petti for short) moved ahead in the lesson plan and took us to the section in our book on funerals and their preparations. I learned then that visiting the home of the bereaved to express condolences, “Pole sana” (pronounced Poh-lay sah-nah) and offering a small donation (mchango) to help cover funeral expenses was the typical custom. We walked quietly together to the woman’s home. When we arrived, we entered one at a time, the women of our group wearing khangas that Petti brought for the occasion, each bearing a message about Death, God, or Heaven. We sat on a grass mat on the floor with the bereaved, all of them women, passing around pictures of the young boy. “Pole sana.” You would use the same words with someone over even a mild inconvenience. To a woman whose beloved child has been lost forever, the words are the same: Pole sana. Of course, we could do little more than sit with her while she cried in the arms of her family, pole sana, little more than look at the pictures of her precious, little boy, pole sana, and leave our modest contribution for the funeral costs before returning to the classroom.
The first funeral service I attended in country happened during my parents’ visit to Lupembe village in June of my first year in Tanzania. We had been planning to throw a party for all the students and teachers on the day of their arrival. However, the death of a prominent, local woman necessitated a change in plans. This woman had been the granddaughter of the tribal sub-chief and a non-voting representative to parliament. She had passed away as a young adult from “malaria,” as it was agreed in polite conversation. Several months before, she had given an inspirational talk to the students and her memory was still fresh in everyone’s minds. As we found out later, though she had long since moved away, her final request had been to be buried here, in the village where she was born. The funeral was something of a media event. Television cameras and photographers recorded the proceedings. My parents and I, and my friend Deb (she runs an NGO for orphans and vulnerable children, see www.theolivebranchforchildren.org to help support her work) were recognized by the officiant and we came forward to give our mchango, say a few words, and express our condolences to the family. We had not lingered. Not having really known the woman or her family and feeling awkward about the attention that our very presence commanded, we left after less than an hour.
Death is a common enough occurrence in Tanzanian village life. Funeral on Saturday, church on Sunday, week in and week out, it seems. Despite having been in Tanzania for almost three years, I have managed to avoid both on all but a few occasions. I went to church once with my host family in Morogoro, once when I arrived in Lupembe to introduce myself, and once when I left to say goodbye. As for funerals, I never had a desire to go for voyeuristic reasons and had never really needed to go as a close friend to the aggrieved, to support a family in mourning. Never, until a couple months ago.
The office manager at our field research station is the glue that holds the place together. She handles logistics, payroll, inventory, personnel and is always the person to look for when you have a question. She has been working here for over 20 years. She is the sort of person who is necessary at any successfully functioning organization, the sort of person who would need to be replaced by a minimum of 2-3 people and even then at a loss. When her young son, the second of three children, was first admitted to the hospital, her anxiety showed but she never skipped a beat at work. Everything got accomplished in the usual manner and on time. The initial diagnosis of malaria and the prescribed quinine drip was worrisome, nothing to take lightly, but nothing so uncommon either. Of the diseases that Tanzanian hospitals are experienced and well equipped to handle, malaria is right there at the top. The child was well over 5 years old, past the age when most malaria fatalities occur, as the body has had time to develop resistence to the parasite.
Things did not go as anticipated. He got worse, broke out in pus-filled sores and maintained an alarmingly high fever. He passed away after less than a week. Before I heard the news, I heard the wailing of grief. The celebratory drumming and dancing that had been almost nonstop since the harvest began was cut short. Loud angry cries conversed with piteous whimpers and hushed sobbing. First, the women came, one after another, khangas wrapped around their hips and covering their heads. They came to her home, filling its rooms and spilling out into the yard. They were the grief’s constant companions.
The next day, when the body was to be interred, Jessica and I went to pay our respects. She wore a khanga and I a suit and tie. I wasn’t expecting my outfit to draw so many comments. Western business dress is rather common among the professional classes, even in a small town like Kongwa. However, I was the most dressed-up person there. “Wazungu dress up for funerals,” the director of our research center explained to one of the curious staff members. Well, it’s just another thing to chalk up to cultural difference, I told myself after deciding not to change clothes. In intimate cultural matters, there seem to be wide allowances for foreigners, provided nothing comes across as disrespectful.
When Jessica and I arrived at the house, we hit another stark cultural difference. All the women were gathered out front; all the men were on the far side of the yard, where the funeral service was to be held. There was no gender mixing. Jess and I had not wanted to separate. We loitered on the outskirts looking even more out of place, if such a thing were possible, until a co-worker of mine came to lead us into the house. I say “us” even though it was Jessica who she took by the hand and brought inside. I followed, assuming I was to be included. I was less sure when we stepped indoors. All the furniture had been removed and women were sitting and standing on every square inch of floor space. Most were singing; the rest were crying. I followed Jess down the hall and stopped short of a backroom that held most of the immediate family. I felt like I wasn’t supposed to be there, didn’t know who I would leave my mchango with and turned to leave Jessica there with the rest of the women. I turned around to see my co-worker and friend, a mother mourning the wicked absurbity of her child’s death. All at once she was in my arms, asking me why. I held her and told her that we would take care of her. She was led by her family into the backroom and I wandered outside.
I walked to the backyard and sat with the men, inevitably getting drawn into unwanted conversations that seemed to center around how much I stood out. “Yes, I live here. . . Yes, I speak Swahili. . . Oh no, thank you very much. . . Yes, this is a beautiful country. . . No, I hope to be here for many years. . .” I didn’t want friendly banter. I wanted to cry, something all the women were doing and none of the men were. Jessica emerged from the house and was led to the benches, reserved for family members, under the tent, at the front of the service area. I excused myself and went to meet her, both of us straddling the gender line in the middle of the yard. We were sitting nearly alone, on benches reserved for the family. We were uncomfortable and kept making movements to leave, to stand up and blend back into the crowd only to be immediately attended to and motioned back into our seats. We were uncomfortable being singled out. They were uncomfortable not singling us out.
First the family came in and as they began to take seats on the benches, we were able to stand back into the crowd. I say the family came, but I mean the women and children. The young boy’s father and male relatives sat with the male guests in the backyard, dispersed among them. The women, the mother, her sisters, female friends, the grandmother walked in together, a huddled mass of shuddering and sobbing, with a rhythmic energy to their processional.
When the men brought in the boy’s body, carried in a simple but elegantly decorated casket, the grief reached a new pitch. I found it hard to stay composed. There were women who lay prostrate on grass mats, attended to by their loved ones. The women were expressive in tears and in songs. The men had a different role to play, one that required them to stay solemn and blank. The men in the family stayed by the casket, throughout the bible readings, sermon and songs. At the end, everyone was to walk by the body, to say goodbye. The men remained stoically together. When one of their number could no longer hold back the tears, he covered his face and faded into the background.
At the end, the men loaded the casket into a truck and the people crowded into several cars and trucks, packed in, hanging out the sides. We drove just down the road to a place where one patch of land was incongruously decorated with grave markers. A hole had already been dug. A mat was already prepared on the hard, dusty ground for the women, the immediate family. The men lowered the body inside and began to cover it with dirt, with hoes and with their hands. I again felt out of place in suit and tie. I watched as the men covered the body with handfuls of dirt and then as the women covered it with flowers.
Namkumbuka (I remember) Ezekiel. Pole sana.
Joshua Tanzanian Society & Culture 2 Comments »
14
June
2009
Here in Kongwa, it’s the time of the year when girls and boys are ushered into adulthood. Drums, whistles and songs can be heard at all hours as everyone practices and celebrates for the festivities to come. Despite how brown and dusty everything has gotten, everyone’s in a good mood. The rains have long finished, all the crops have been harvested and the locals have more time and money on their hands than at any other time of the year. Yesterday, led by the sounds of the music, I wandered down to the enclosure built for selling off surplus corn and found that several vendors were set up selling goat meat and alcohol made from every conceivable substrate: milk, bamboo juice and hibiscus to name a few. People were happy, friendly and pretty drunk for the mid-afternoon. I was welcomed to the community by a number of older men and women in typical fashion:
“We are your parents; this is your home.”
“Let me know when you get married so we can throw you a party.”
“You are a Tanzanian now.”
“Can I have 20 cents for some moonshine?”
For the new, youngest members of the adult community (ages 12+), this is the time of their lives when they learn about their tribal history and traditions and are physically marked out as being adults. Among the Wagogo (the dominant tribal group here) this often includes facial scarring, cirumcision for boys, and (all too often) genital mutilation for girls. I remember my first Swahili teacher, Jumapili, telling me about his own initiation ceremony and circumcision. After being cut, he and the other boys were led into lake Victoria where small fishes, drawn by the blood, came to feed on their fresh cuts. Any boys that tried to flee were driven back into the lake by the older men, armed with sticks. At least here in Kongwa town, it is typical for boys to be brought to the district hospital for circumcision. The level of hygiene in this practice obviously deteriorates as one travels further out into the villages. One of the reasons I was told this was an ideal time of the year for circumcision was that the weather has finally cooled down. However, it seems to me a slight consolation to feel a pleasant breeze as your foreskin is getting chopped off.
As for the girls, the practice of female genital mutiliation is illegal and therefore there exists a great deal of reluctance to talk about it. However, in all of Tanzania, it is most widely practiced from this area of Central Tanzania up to the north towards Arusha. Traditionally it was quite common among both the Wagogo and the Masai, still highly populated in those areas of Tanzania today. One NGO associated with battling this practice is the African Medical and Research Foundation (AMREF) in Tanzania. Although the organization’s programs in Kongwa are quite limited, they are the only group doing anything here on this front.
In our own project on the ancillary benefits of Azithromycin, we are looking at sexually transmitted infections (STIs), among other disease categories, and are therefore asking women about pain with urination. Given not only the existence of female genital mutilation but the taboos against its open discussion, this naturally poses a research challenge. Finding out more about the prevalence of this practice and its disease consequences would be both important and logistically-challenging medical research. It is a topic long overdue for study here and one that ought to be implemented in the context of a broad-based series of preventative, educational, women’s empowerment programs.
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13
March
2009
I met the nicest witchdoctor last week. I was spending the day in one of our study villages, supervising village health workers, biking around to points of interest and taking GPS coordinates. It started out as a joke when Steve Schachterle and I agreed to write a paper on “Distance to Witchdoctor” as part of our analysis of relevant variables correlated to different disease categories: Malaria, Acute Respiratory Infections, Diarrheal Disease and Sexually Transmitted Infections. The more I thought about it, however, the more I felt it was actually important to include witchdoctors among our identified local resources, since they justifiably serve as dispensers and repositories of traditional medical knowledge.
First, I suppose I should say something about the term “witchdoctor.” Although not the sort of thing that anyone would self-apply where I come from, Tanzanians often use the English word “witchdoctor” in a completely neutral sense. Like the word “half-caste” for people with mixed race heritage, it sounds much worse to the American ear than to the Tanzanian. As for the far more unfortunate tendency of Tanzanians to use the N-word as a label for black Americans, well, that’s painful to hear for many reasons – not the least of which being a lack of consciousness that anyone would find it offensive. In any case, for the sake of propriety, perhaps I should substitute “traditional healer” for “witchdoctor,” although I am not entirely sure whose sensibilities I would be protecting in this instance. Maybe they have decided to take back the word “witchdoctor.”
Despite the freedom available in English usage, I have found it more important to be careful with my terminology in Kiswahili. In looking around the village for traditional healers, I explicitly used the term Mganga wa Kinyeji (village doctor) or Mganga wa Asili (traditional doctor) in my search. While “witchdoctor” may be a neutral term, Mchawi (witch/wizard/sorcerer) is not. To make matters a bit complicated, Tanzanians generally consider the terms Mganga and Mchawi to be synonymous, the former a nicety disguising the underlying malevolent reality of the latter. “Is it possible to be Mganga without also being Mchawi?” I asked some Tanzanian colleagues. “If an Mganga only helps people,” I was told in the tone of voice suggesting the concession of an unlikelihood, “then he is not Mchawi.”
Medicinal elements of traditional beliefs and practices can be touchy subjects to broach, especially coming from a white American. Among the more harsh criticisms I have heard Tanzanians level at one another is the claim that some tribe/ethnic group (Kabila) is barbarous or unchristian, as evidenced by their traditional religious/magical/spiritual practices. I hear gossipy backbiting about who wears amulets, buries good luck charms, or talks to their dead ancestors along with the typical denunciation that such people are not real Christians. Of course, the longer I stay in Tanzania the more convinced I am that most people have not so much given up traditional beliefs as they have incorporated them into Christianity, Islam or modern science, as the case may be. “I don’t believe in witchcraft since as I Christian I believe all power comes from God,” a primary school teacher friend told me, “therefore God protects me from the witchcraft.” If this quote leaves you a bit confused, trust me, it’s better to just embrace the paradox.
Taking GPS coordinates at the homes of local healers, I made sure to sound a positive note about what I was doing. “I am using this computer to identify important locations in the village so we can make a map,” I explained to the kindly old man, the fourth and final of the villages’ Waganga. “We are marking the village government office, school, churches, water sources, dispensary, drug store, and the homes of the Waganga,” I continued as he looked at me somewhat worried, “places where people can get local medicine” I added in my best nonchalant tone. “We would also like to see some of your medicines,” one of the village health workers added, anticipating my interest.
The old man immediately struck a pleading if defensive note. “All of my medicines come from tree roots,” he insisted, “I am not Mchawi.” I emphasized that his work was important and that I was only interested in knowing where people could get medicine in the village. “People just pay me with food,” he continued, “I only work to help people, not to make money.” In addition to being known for their ability to get rich from their spells, Wachawi also use sinister ingredients in their medicines: blood, bones, hair, skin – often requiring a brutal collection. In my former village, a local man was found dead in the woods with much of his skin missing. Witchcraft was the universal suspect. Albinos are in particular danger on this account, as many Wachawi agree that their skin possesses magical properties. White, European skin, I was assured by everyone, has no magical benefits, though some regard European hair as potent. The old man said he used only tree roots to distance himself from such practices.
As the Mganga took me and the other village health workers to his shaded treatment area, he continued to plea his case. “If my medicine doesn’t work,” he continued, “I tell people to go to the dispensary. If that doesn’t work, then they need to go to the hospital in Kongwa or even Dodoma.” I was impressed. By the far the biggest problem with local healers is their potential opposition to western medicines. Especially given much of the widespread skepticism regarding AIDS and the western powers (“Americans put HIV into condoms,” I have heard from suspicious Tanzanians on more than one occasion), there are plenty of Waganga who implore their HIV+ patients to take traditional medicines in lieu of Antiretroviral medications. Obviously this Mganga was concerned with the health of his patients, not his medical market share.
“I only have one medicine right now to show you,” the old man apologized. I assured him I was happy to see whatever was on hand as I took the proffered gourd-bottle. “What does this medicine treat?” I asked. “It is a topical oil,” he explained, “for injuries, pain, malaria,” he gave as examples. I had to admit that I was hoping for a slightly less grandiose claim, given how circumspect he had been up until this point. Nevertheless, I understood him to be sincere and thanked him for his work. I am not inherently opposed to placebos, especially when accompanied by the appropriate referral for serious cases.
Undoubtedly much of the magical approach to illness stems from an inherent sense of powerlessness in the face of disease and uncertainty. When a patient comes to you clearly suffering, it feels like doing something, anything, has to be better than admitting defeat. There is little consolation in telling someone to just get bed rest and let nature run its course. I can relate to the witchdoctor’s woes, as I get asked for medical advice on a regular basis these days. I am not a medial doctor, nor do I have at my disposal any diagnostic tools other than a rapid malaria test kit, a thermometer, and the knowledge gained from countless, paranoid hours spent reading my Peace Corps issued copy of Where There is No Doctor, analyzing my mysterious skin inflammations and unpredictable digestive cycle.
During the course of our current study, our village health workers are dispensing Coartem and Quinine for malaria, Amoxacillin for acute respiratory, ear and some skin infections, oral rehydration salts for diarrhea, Azithromycin for chlamydia, Ciproflaxin for gonorrhea, Paracetamol for non-malaria fevers and cough syrup for coughs without rapid breathing. Naturally the villagers have come to expect us to have a medicine for every illness and have expressed feeling neglected or cheated if we cannot provide them with such. It is in fact the reason we are giving out limited amounts of cough syrup. Our initial treatment regimen called only for treating coughs accompanied by rapid breathing. Mothers were getting annoyed at reporting their child’s persistent coughs during the health workers’ twice weekly visits without getting anything for it.
As I continue to talk with villagers about their symptoms, I find it is often the case that the best treatments are simple, common and throroughly unexciting. In this arid environment with limited access to clean water, most people are not drinking enough. Even for those with better than average access to water, this still seems to be a common problem. I have had several people tell me about muscle soreness and headaches at the end of the day. These same people are reporting that they often drink less than a half liter of water per day. Additionally, the local diet is dominated by starches and other carbohydrates with limited fresh vegetables. Telling people to drink more water and get more vitamins in their diet feels a bit like a brush off – to me and to them. It would be nice if I had my own tree root oil to dispense.
The most common requests of Waganga/Wachawi in this area appear to be exorcising demons and producing rain. Being bothered by demons seems to be a common complaint and one for which the local solutions are viewed as rather reliable. The bad news for my work is that the first requirement for the demon-afflicted is cutting out all western medicines. Apparently they are contra-indicated for the local stuff. A trip out into the wilderness for up to a week commonly comes next. Finally, local medicines, prayers, drumming and dancing generally finishes things off. As for rainmaking, and I swear I’m not making this up, the local spiritual and meteorological practitioner climbs up onto the roof of a house with a mud-baked roof, takes off his clothes and moons the sky. I guess I shouldn’t knock it until I’ve tried it.
Further reading:
Newspaper article on witchcraft and the law in Tanzania
Insightful commentary on witchcraft in Tanzania by a public health worker
Joshua Kongwa Trachoma Project, Tanzanian Society & Culture 5 Comments »
14
February
2009
Although nearly ubiquitous throughout Tanzanian schools, corporal punishment is a demonstrable failure. Even if one were to discount its blows to student self-respect and human rights, corporal punishment quite simply fails even in the simple task of deterrence. Discipline problems are usually in direct proportion to the amount and quality of teacher supervision. Too often, teachers and administrators are absent, leaving students alone in classrooms for most of or all of the school day. Is it any wonder then that such students fail to arrive punctually, to stay put in the classroom all day, or to study quietly?
As a secondary school teacher at a rural Tanzanian school for two years, I often bitterly joked with my fellow teachers that if corporal punishment were so effective, it ought to be used right up the chain of command. Absent teachers ought to be flogged by the headmaster, absent headmasters to be flogged by the District Commissioner and so on, right up to the members of the National Examination Council of Tanzania (NECTA) whose examinations are filled with fractured English, poorly chosen questions and numerous outright mistakes.
To give one truly horrible example from these tests, students were asked to explain why Newton’s Law of Universal Gravitation does NOT apply near the surface of the Earth. So much for UNIVERSAL gravitation. Where is the oversight of NECTA? Why are students routinely punished for their poor performance on poor-quality tests?
Now it seems that reality also has a dark sense of humor. The BBC has reported the beating of primary school teachers in the Kagera region, ordered by the District Commissioner.
The teachers who were flogged reported that they were too ashamed to continue teaching. Yet students throughout Tanzania deal with such indignities daily and teachers still argue that beatings are necessary pedagogical tools. Even worse, there are those who argue that beatings are an inherent part of African culture and the only way to make African students behave. This is not African culture. This is the culture of slavery, colonialism and humiliation. Since independence, Tanzania has been governed by the Chama Cha Mapinduzi (CCM) “Party of the Revolution.” When will the revolution throw off the shackles of corporal punishment in the educational system? The problem is not unique Kagera’s District Commissioner Albert Mnali. It is a country-wide problem that needs to be addressed now.
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26
January
2009
Dear colleagues, friends and family,
It has been over two months since completing my service with the United States Peace Corps. To those of you I got to meet and reconnect with in Baltimore, Denver and Tampa during the month of December, it was truly a pleasure, though all too short. To those of you I did not get to see, I hope to be back in the states sometime in the Fall and again for all of December. Otherwise, Karibuni Tanzania!
Jessica and I are now back in Africa and busy transitioning from the cool, rainy southern highlands to the desert foothills of Central Tanzania. We are living in Kongwa, Dodoma and spending most of each day immersed in the work of the Kongwa Trachoma Project (KTP). A registered Tanzanian NGO in partnership with researchers from the Johns Hopkins School of Medicine and the Bloomberg School of Public Health, KTP is the principal Tanzanian partner involved in the international Partnership for the Rapid Elimination of Trachoma (PRET).
A bacterium in the Chlamydia genus, C. trachomatis is the leading infectious cause of blindness worldwide and affects hundreds of millions of people. In conjunction with the World Health Organization’s goal of fully controlling trachoma worldwide by the year 2020, KTP’s activities follow the SAFE guidelines to trachoma eradication: Surgery, Antibiotics, Facial cleanliness and Environmental improvement. There are currently projects underway which screen at-risk populations for trachoma and implement mass treatment with Azithromycin for villages with 10%+ infectious rates (following international and national standards of treatment). My current project builds off of this work.
Since Azithromycin is known to be effective against a host of pathogens, the ancillary benefits of this drug against malaria, sexually-transmitted infections (STIs), acute respiratory infections (ARIs) and diarrheal diseases are being studied. My own work has involved training village health workers and their supervisors, who are conducting health-surveillance of our study population and providing community-based treatment. Now that training has finished, I am continuing to monitor the course of the data collection process and implementation of treatment regimens, both in the study villages and in the KTP offices in Kongwa.
As a historian of science and medicine, it has been a fascinating experience to be involved in a research project and to observe the factors that contribute to experimental design and implementation: scientific, historical, ethical and practical. As a former secondary school biology teacher in Tanzania, it has also been interesting to be involved in the pedagogical aspects of this work, explaining physiology and pharmacology as well as research values and methods to the village health assistants (the family, friends, neighbors and even participants in our study population) as well as to their supervisors, the direct care providers in the village setting.
On my recent visit to the US, I remember many of you expressing surprise at mine and Jessica’s intentions to remain in Tanzania for the foreseeable future. Certainly that goal is contingent on the continuing availability of challenging and meaningful work such as this. We have reason to be optimistic at our prospects, yet we are, of course, prudently planning for the next year and beyond. We are continuing to search for organizations and individuals interested in discovering Tanzania and in collaborating with Tanzanians. It is the Peace Corps’ goal to establish mutually beneficial relationships between Americans and host-country nationals. As former volunteers, both Jessica and I are committed to that goal and believe that friendship, communication and collaboration are the best forms of foreign policy. It was truly gratifying to hear from a good many of you that you followed this blog with interest. If I can ever be of assistance in connecting you with some part of this country and its truly amazing people, please do not hesitate to contact me: josh@joshualevens.com
Peace.
Joshua Kongwa Trachoma Project 1 Comment »
13
November
2008
As I sit down to write my final blog entry at UL Secondary as an education volunteer with the United States Peace Corps in Tanzania, I still have tears in my eyes. I have never felt so proud. I am sitting in my school library which, thanks to the donations of many who are hopefully reading this, has a solar power set-up for using a laptop computer. My Form II students are continuing to take their national examinations today. My Form IV students already finished two weeks ago. The remaining Form I and Form III classes are busily preparing for my annual biology examination this Friday. Over the next seven days, I will be packing up my home, giving away many of my household possessions and saying goodbye to my friends and colleagues of the past two years. Foremost in my mind this morning, however, is the news that Barack Obama has been elected President of the United States. I have never felt so proud to be an American.
When I left my country in September 2006, the world seemed a very different place. Disenfranchisement of my fellow Floridians and the murder of my fellow human beings in the name of fear had left me disillusioned and angry. Listening to family, friends and loved ones, with their calculated and strategic language, justify the dropping of bombs on cities, on hospitals, on homes, on people unlucky enough to be born in the wrong part of the world, sapped me of all hope and energy. The only “smart” bomb, after all, is the one with the good sense not to explode. I remember so many people that talked about national security and national interests as if 100,000 dead Iraqi civilians were a reasonable opportunity cost. I felt out of touch with so many of my fellow Americans. Mostly, I felt helpless to do anything that could make a difference.
My reasons for coming to Tanzania were largely selfish, as I confessed to my Peace Corps recruiter in his Washington, D.C. office. I had no delusions that I would save the world. I knew that I would get far more out of the experience than I could possibly give. I would teach math and science, important work to be sure, but I would learn another language, another culture, another corner of our planet that most of my fellow Americans would never get to see, living in the place where humanity itself first emerged during (what must be called tongue-in-cheek) the Cainozoic era. What I never expected to receive, however, was grace.
Before I left the United States, I was consumed by the daily news, with my country’s sins of commission and omission, with events in the world over which I had no power and felt I could not change. In Tanzania, I have been given the grace to simply live in peace, to think only about spending time with my students, my friends, working in my garden, and enjoying life from one sunset to the next. I cannot begin to adequately express my gratitude to my country for supporting me in my Peace Corps service, to the Tanzanian Ministry of Education for its cooperation with Peace Corps/Tanzania, to my community for treating me both as an honored guest and as simply a friend and neighbor, and finally to my family and friends for both material support of my projects and emotional support for my service and life here.
It has been fascinating to observe this election year from the vantage of a rural village in the Tanzanian southern highlands, 80 km. away from paved roads, in a community with minimal infrastructure, health care, access to running water or electricity. During the primary season, crammed in the cab of a Tea truck for the three hour trek to town, I overheard Tanzanians discussing the Iowa caucus and New Hampshire primary as if I were riding a bus in Baltimore. It is my sincere hope that Americans recognize the extent to which people all over the world have been watching, awaiting, and now celebrating this historic time in our country’s history.
As a teacher at my school reminded me yesterday, however, what politicians say before elections and what they do in office are often incongruous. There are examples all around us to make Tanzanians skeptical about elections. Kenya and Zimbabwe remain fresh in everyone’s minds and I have spoken to Tanzanians who secretly fear for their own upcoming election cycle in 2010. Of course Tanzania is not Kenya and it is nowhere near Zimbabwe. The United States of today is also not the United States of even two years ago. And yet, I remain cautious in my optimism. Undoubtedly there will be times of disappointment in the Obama administration, in Afghanistan, in Iraq, in Palestine, in the health care system, in foreign aid, and in financial regulatory agencies, to name, I am sure, but a few. Today, however, I cannot care about these things. Today, I cannot wait to be disappointed in Obama. To alter my Dad’s phraseology concerning golf and work, a bad day with Obama is better than a good day with Bush.
At present, my future plans are still only short-term. I will finish my Peace Corps service on November 20. I will fly back to the states in December and hopefully return to Tanzania in another work capacity. In the meantime I hope to reconnect with family, friends, and colleagues, in other words, all of you. For keeping up with this website, for sending me emails, letters and packages for the past two years, I thank you. Once I return to the United States and have regular computer/internet time, I will update and revise this website for whatever function it will serve in the next stage of my life and career. Thanks again to Brian Hart for designing and maintaining this page. While I do plan on writing more over the next several weeks, this seems to be as good a time as any to say again: Asanteni, kwa herini, na tutaonana siku nyingine. Thank you, all the best, and we will see each other again someday.
Joshua Uncategorized 5 Comments »
13
November
2008
“Saving the world one garden at a time,” is how Peace Corps Tanzania’s permaculture guru Peter Jenson describes his environmental mission. For a busy education volunteer teaching 450 students during 28 periods per week, such a mantra can be comforting. Only one garden and I can help save the world?! After all, as a teacher, I can hardly spend all day farming, or even spend more than 10-15 minutes in the garden on most days. Between cooking, cleaning, dishes, laundry, exercise, teaching, reading, grading papers and whatever else passes for free time, the day often flies by with many of my morning’s aspirations neglected. Most evenings I end up rebuking myself for all those things left undone. I meant to go visit my friend in the village, practice yoga, play soccer, clean out the storage room, or cook something other than rice and beans. All that being said, spending time in the garden, playing in the dirt, has been one of the most relaxing and rewarding pasttimes I have taken up this past year.
My school’s garden project would never have gotten off the ground in the first place if not for the expertise and assistance of my former site mate, environmental volunteer Jason Maglaughlin, whose own 32 garden bed, model permaculture site inspired me every time I visited him. Together we planned a collaborative venture with a select group of students, many of them orphans, to teach permaculture, bio-intensive farming and composting, and to prepare a garden at the school to supplement the students’ regular nutritional intake. Although Jason had to leave Tanzania before the actual planting, his protege and good friend in the village came and helped with the teaching and the seed-bed preparation.
To emphasize why nutrition alone is a worthy venture here, let me remind you what my students are fed at school. The daily menu begins with uji (corn flour mixed to a watery consistency with sugar) for breakfast, ugali (corn flour mixed to a thick pasty consistency) with beans for lunch, and ugali with beans again for dinner. Sick students and those who pay extra will additionally get one serving of greens (overcooked with oil and salt). This is the regular menu, seven days of the week. On holidays, they may be served rice instead of ugali. For fruits and vegetables, the students are left to their own devices. Fortunately, fruit trees are quite common in the surrounding area. Nevertheless, most students do not usually get an appropriately balanced diet.
Quite selfishly, I too had grown weary of my carb-heavy diet and thought about the garden fresh salads I ate every time I visited Jason. Thus was the Lupembe Orphan’s Garden project born. After consulting with the students about a proper location for the garden, we eventually chose a site adjacent to my own backyard. This allowed us to dig a trench from the roofline to bring rainwater into the garden plot. We also dug a trench from a spot on the connecting footpath that regularly flooded. The key to any good garden, after all, is water.
Since we started this project in the dry season right before the students left for their winter (June-July) break, I often had to haul at least two buckets of water from the river each day, just to keep the seedlings from drying out, not to mention the water I still needed for washing, cooking, cleaning, and drinking. Needless to say, my neck muscles got a good workout and I’m pretty good at balancing a bucket on my head now, though I still need to use a hand for balance. It never ceases to amaze me how gracefully and seemingly effortlessly Tanzanian women balance unwieldy loads on their heads as they climb steep hills, curtsey and chat.
After about seven weeks, the results of all this hard work started to pay off. From late July until mid-September, I was harvesting about two buckets worth of various salad greens every week. I would make two large salads for the group once a week and have a small salad myself every day. Even though uncooked vegetables are anathema to Tanzanians on the first pass, I soon had students begging for salad and for seeds to plant in their gardens at home. As I write this, there are still greens to be harvested, though much less. All the broccoli, arugala and romaine has already gone to seed. However, the tomatoes are only now just ready to harvest and I have already begun planting for the next volunteer, who is due to take over my site at the end of this month.
A good friend of mine who runs a rose farm in Njombe once asked me how I could be motivated to plant seeds that I would not get to harvest. It seems to me that this is actually quite a good metaphor for the work of the education project with Peace Corps Tanzania: “Planting seeds that others will reap.” During training, we were warned against developing an “Ediface Complex” during our service, feeling as though we needed to build some structure to feel as though we had accomplished something. The work of a teacher may only be realized long after the fact. Hopefully the results will be more important and longer-lasting than so many other structures, built with good intentions, yet unused and long forgotten, strewn across this continent. In my final days here at site, I am continuing to spend time with those students who have meant so much to me over the last two years. I am also still playing in the dirt, planting seeds.
Joshua Uncategorized 1 Comment »
