April 2009

April Update from IHP

Dear Ones who care about International Health Partners, US & TZ,

What a month it has been! We have had students coming and going (their letters follow), and patients coming to the clinic needing care, buildings being designed (Denny is working on the details of the Administration building area), and marvelous volunteers.

Where is God in all of this? I think God IS in all of this. I think this IS the work of God, each of us with our own little assignment to choose, or not to choose, to take on. Sometimes it’s a burden, frankly. Sometimes you have to think, “Why did we start this?” But the answer is always the same. The work needs to be done and we were chosen to do it and we’ve chosen to say “yes” to doing it. Period. Then God sends the help we need. Sounds so simple, doesn’t it?

It is the generous donations that each of you have given that keep us going and make this work possible. If you didn’t send the funding, there wouldn’t be cement to finish the birthing center or start the eye center or buy the plumbing for the Patricia Ward or the steel frames for the shelving or the wood or the nails or the gas for the welders. There wouldn’t be enough reagents in the lab to give good diagnosis so we would be “guessing and hoping” when we prescribe a medication for symptoms rather than knowing exactly what we’re treating and how to do it. YOU are making the difference!

We all ‘show up for work’ in different ways. Each of us has a job to do. You show up for your job. We show up for ours. Together we are working to make the world, at least this tiny corner of it, a better place. Together, we are peacemakers.

Please be aware of how much we are depending on you. Each of you. We do not have big grants stuffing our coffers. We don’t have any, actually at this point though we’re setting up to apply for some. It is each dollar, Euro that comes in that means we can go shopping for the supplies we need.

You know, when we started this, Denny and I decided to buy some lottery tickets. We said, “Well, if there really is divine justice, then God will just pick our numbers and we’ll build a hospital! Easy! Hmmmmm. After throwing away quite a few lottery tickets we decided, “No, God wants as many people as possible involved in this.” Oh. So, it is YOUR involvement that is making this happen. It is YOUR involvement that is making it possible for the 60-100 patients a day that come to our clinic to be seen. No, it is not free for them (unless they have no resources whatsoever), but it is very affordable. We charge 2000 Tshillings ($1.60) for a consultation. A chicken (to kill and eat) is 8,000 Tsh ($6.40)right now in Mwanza. A can of tuna is 3700 Tsh. ($2.96). Eggs are 2400 Tsh ($1.92) per dozen. With the income from what the patients pay, we’re able to pay our staff, buy cleaning supplies and some lab supplies. IHP pitches in with about half the lab supplies so that we can offer good laboratory medicine that people can afford.

If you want to help (and we certainly NEED your help), please send donations to:

International Health Partners, US & Tz

Joyce Zemel, Treasurer

1811 So. 39^th St. #36

Mesa, AZ 85206

Or, go to our website, www.ihptz.org and hit “Just Give.”

Note from webmaster: You're already on the web site just go to the home page to find : Just Give", Thanks!

There has been a change for the visa status of people coming to volunteer for IHP. Please, when you arrive at the airport, ask for a CTA visa. We will send you an invitation to come which is called a letter of support which is necessary to receive a CTA visa. CTA means Carrying on Temporary Assignment. The visa is $100.00 just like the tourist visa and it is good for 2 months. You will NOT need a tourist visa.

This is the visa you will need if you’re a student, if you’re coming to volunteer medical services or if you’re coming for construction or helping IHP in any way at all.

Additionally, there is NO PLACE in Mwanza where you can cash traveler’s checks. Please make arrangements with your bank to use an ATM card and let them know you’re coming to Tanzania. Or, carry cash safely underneath your clothing.

As promised, the students and volunteers have written their impressions below. Bless them. No one told how I burnt the bread the other day or served fried fish for breakfast. Okay, I experiment a little but they do seem to survive okay. Each morning everyone has breakfast with Denny and me. We talk about what’s coming up that day, what I need to do/buy in town. Who’s going to town with me to do what, etc. They make suggestions for how to make the clinic run more smoothly and we listen! We are all learning from each other out here.

The students:

Sunil Arora

IV year med student, University of Toledo College Medicine

International medicine has always been an interest o f mine because I want to learn how medicine is practiced in other parts of the world. Being educated in a western medical system, I had a very narrow perspective on medicine and I wanted to expand my knowledge and understanding of healthcare as a whole. I initially planned on doing a rotation in India but had trouble finding a hospital that was comfortable with American medical students. IHP-TZ had the ideal setup of a rural clinic run by people who have practiced medicine in America. My experience so far has been very pleasurable due to the wonderful staff and amazing hospitality of Paula and Denny. The patients are very receptive to us and have taught us more than we can hope to provide them in return. Treating diseases such as Malaria, Typhoid and other parasitic infections has added to my knowledge base in ways that would be difficult in America. Also having the opportunity to perform minor procedures and learn to use an ultrasound machine will be very valuable for my upcoming intern year.

Andrew Assenmacher

4th year medical student, University of Toledo College Medicine

Going into medical school, I thought it was very important to gain experience with medical care in other countries and in underserved areas. IHP-TZ had the combination that I was looking for. I have been able to deal with a variety of tropical medicines and a better understanding of health care in the third world. The experience here is unlike any other rotations and the students have had opportunities to be very active in patient care and are given their own autonomy. There is a permanent facility with the Nyakato Clinic that ensures continuity of care for your patients after you leave. Although the clinics established, they are expanding into a full hospital so that you are also a part of the process of bringing new facilities to the community. Mwanza has a landscape like nothing I’ve seen and the people have been very welcoming.

Asher Shafton

4th year medical student, University of Toledo College of Medicine

After almost four years of medical school in the United States, I felt that I was beginning to have a grasp on western medicine but also understood that other parts of the world are not the same. I wanted to learn how to practice medicine in a different setting. The Nyakato Health Clinic with Paula and Denny provided me this chance. I have learned how to recognize and treat diseases that I will probably never see in the United States, such as malaria, typhoid fever, and schistosomiasis. I have also come across many common ailments that I have already seen in the US, but have learned to treat them in a different manner due to the limited resources. All of the people I have met, from Paula and Denny to the doctors and staff of the clinic, have helped make this experience a great one. I look forward to my last week here and hopefully returning in the future during residency or as a practicing physician.

Shamik Trivedi

4th year medical student, University of Toledo College of Medicine

After traveling to India and Tanzania/Kenya during medical school and seeing the need for medical professionals in those countries, I decided I wanted to work in an international setting during my fourth year. I have always been interested in international medicine and learning about medical issues that affect the eastern part of the world, ones I normally do not see in the states. Through discussions with other medical students at UT, I soon found that other students were interested in the same venture. I believed that practicing medicine in a rural setting with different hardships than ones I am used in the states would help me become a better doctor. So far my belief has held true in working at IHP-TZ in Mwanza, Tanzania. My interactions with the nurses, doctors, and patients have shaped my view on tropical medicine and the way to treat diseases that are prevalent in the area. Since IHP-TZ has worked with medical students before, the setup is perfect to learn a lot of information as well as embrace the international medical experience. The doctors provide us with clinical clues/pearls to diagnose Malaria, Typhoid fever, Amoebiasis, as well as other tropical diseases I would have never included in my differential diagnosis. As we become more comfortable with the diseases, the doctors have given us more autonomy and trusted us in performing procedures. So far the experience has surpassed my expectations and Paula and Denny have been great hosts as well as educators. I know that this month will impact my future career as a medical doctor and I hope to be able to provide care in an international health setting like IHP-TZ in the future.

Loyal Coshway

4th year medical student, University of Toledo College of Medicine

The IHP-TZ clinic in Mwanza offers an amazing opportunity to practice international medicine in an established health care setting. It is a unique experience to partner with bilingual full time doctors who have continuity of care with the patients. Drs. Bon, Msenge, and Lofstrom have been very generous in expanding our knowledge of tropical medicine. As we are growing more comfortable with treating malaria, typhoid, etc, the doctors ask for our input and full participation regarding history, laboratory investigations, and treatment. I am interested in infectious disease, so another bonus is the opportunity to work in the laboratory, stain slides, and observe malaria, amoebas, and other pathogens under the microscope. We students are also able to dispense medications in the pharmacy. By working with the patient, lab, and pharmacy we learn the full clinical picture from pathogen to patient. Finally one of the best parts of coming to Tanzania is meeting new people and being inspired by their stories. It is great to work with Paula and Denny and see their plans for building a hospital come closer to fruition. I have also enjoyed interacting with medical students of different nationalities and learning about their health care systems. Lastly meeting the people of Tanzania and learning about their culture has been truly enriching, and an experience I will never forget.

Tom Massey and Andrea Waldecker

Final-year medical students, University of Oxford, UK

We arrived in Mwanza from the UK for part of our medical Elective just a few days ago. Despite only being here a short while, we have already experienced a wide variety of medicine, culture, and people. We spend our days in Nyakato health center assisting the (very patient) doctors with their work, as well as learning how to do laboratory tests and pharmacy work. The range of pathology is large, and skewed towards infectious diseases that we are not used to seeing. Thankfully the health center has good supplies of antibiotics so we are able to treat a good number of patients effectively. The patients themselves show particular forbearance, whether waiting around for tests or having painful procedures such a dental extractions with only minimal anaesthetic. The people we have met in Mwanza have all been extremely welcoming, from Paula and Denny who run the medical center to the waiters at the local bar, despite our total lack of talent in learning Swahili! Hopefully over the next few weeks we can pick up a bit more so that we are able to converse more fruitfully with patients and locals alike.

A letter from Emma Bellerby:

I think I decided to come to Tanzania because for the first time in a forever I had some unexpected free time, and what better way to use it up than to come to the Clinic. On a more personal level, I think what I wanted to get out of it was some clarification. I wanted to know that what I was doing with my life was either the right decision or the wrong decision, and I thought coming to Africa where the problems are so much more real would give me some perspective.

What I’ve learnt in my stay is that problems don’t just sort themselves out and you can’t abandon your life and expect it to be back to normal when you return. Clarification is not gained through running away. I have met so many people here who have overcome the problems that life has thrown at them to an extraordinary level.

When I get back home I promise to always face the music, and tackle the problems instead of letting them mould over in the dark cupboard that is the back of my head. I will not look for magic, easy solutions to obstacles that only mask the issues instead of correcting them.

On another, lighter note, I promise to be more affectionate and welcoming to new people. In Tanzania there is no element of the British culture of being standoffish with people you have just met. It is completely normal to hold hands with a new friend to show fondness and loyalty, and it is also ordinary to invite new faces to dinner on the same day as meeting. I was completely overwhelmed with the generosity of the people I have met here; almost everywhere I went I was welcomed with a smile.

Lastly, I promise to come back! I don’t think Africa is through with Emma Bellerby just yet. Apart from the weather and the wildlife, there is something about Tanzania that really intrigues me. The people here are incredible and the way they live is truly inspiring. I don’t think I have spent enough time here to appreciate just what an unbelievable country this is, and I know that at some point I will be back to see more.

Paula writing again…

Attached are pictures of the Austrian medical students and Denise Webb, M.D., delivering a baby in an emergency situation, outside! The mother could not make it to the hospital. The other picture is of Roger Booth taking a pictures of a line of siafu or army ants. They’re fine if you don’t disturb them. And a picture of Emma Bellerby and Dr. Msengi. Lastly is a picture of Katarina Hirschmann, a German medical student with a small patient.

Blessings to each of you,

And thanks,

Paula and Denny

Austrian medical students and Denise Webb, M.D., delivering a baby.