May 2006

Dear Ones Who Care for Tanzania,

The first news is not the best news. The Elizabeth Glazer Foundation, which we'd hoped would help us build the Safe Birthing Center, has been assigned other areas of Tanzania in which to work. So, the funding for this desperately needed facility will have to come from other sources.

We went to Shinyanga and Isaka to "get the lay of the land" and see what's there, what's needed, and think about what it will cost. The roads were paved, for awhile. Then it was bumpity bump over unimproved roads. However, the South Africans have the contract and are building a nice new road. It may just be a few years before it's done.

Shinyanga is about 3 hours from Mwanza. The dispensary there is well-run but is undersized for the population it serves. The medical board has plans to improve and expand the facility, and wants to buy the kindergarten school that is next door and for sale. It would make excellent wards and the dispensary would be on its way to becoming a health center. We looked at the plans which meet government regulations, but we have some suggestions, they have some ideas, and Denny is now busy working on a master plan.

There is not enough water at the dispensary to keep up with the needs. The toilets don't work well and some do not work at all. There is a huge pipe being laid from Lake Victoria to Shinyanga, but we're not sure when that will happen. They need a bore hole and a holding tank. They also need to be able to harvest the roof water to use for toilets, etc.

There is a government hospital at Shinyanga but only 100 beds and one M.D. There are several AMOs (Assistant Medical Officers) but not enough to serve the needs of all the people. The dispensary needs to become a health center. The difference between a health center and a dispensary is the number of beds available to serve overnight patients as well as a few other things. Being able to do safe deliveries is the most important renovation needed but that means creating an operating room for C-Sections. At Shinyanga the old offices of the pastor and staff would work very well as a pre-op, surgery, and post-op area and an addition could be put on the rear of the building for sterilization and lab.

There is a nice AIDS counseling center and they have medications for treating opportunistic infections but no anti-retroviral medication is available as they do not have a CD-4 counter.

The staff was capable but overworked. The meds were carefully controlled, the bookkeeping was adequate but would be better if computerized.

Isaka is a "If you build it, they will come" type of place. It is far, far out in the bush on 125 acres of land owned by the church. It does not at this point attract all that many people because they have no Maternal and Child Health Center. They do not have an exam table with stirrups. The rooms are there, the equipment is not.

The biggest problem at Isaka is lack of water. They need a bore hole with a submersible pump and a water tower. There was a test bore drilled but we do not have the results yet as to whether there is an aquifer under the land and how far down it is.

Another problem at Isaka is that the corrugated iron roofing is on top of flat boards and this has attracted bees to make their hives in the open space. Then, when the dry season comes and the heat of the metal roof melts the wax it drips into the ceiling boards and is a mess. Soon the weight will pull them down. So, new roofs, expansion into a safe birthing center, and water.

The staff was adorable. They were "fupi" like Denny and me. Short. There are several tribes in the area, but far and away the Sukuma outnumber the others. They are tall and slender like the Massai.

The medications were well controlled and the bookkeeping accurate. Everything was clean which is astounding considering how water must be purchased and carried.

If we want to think big for these people, there is enough space for a landing strip for airlifting emergency cases. There are air ambulance services available in this area.

We're booking medical teams now into 2008, not that 2007 is already full. We've got medical students coming from Germany and guests coming to help from the U.S.

We welcome you to this place. We need all the help we can get.

Mary Ellen has made tremendous strides getting the e-learning nursing school ready to launch. She coordinates all the regulatory things that need to be done in Dar es Salaam for all of the projects. Denny is drawing, drawing, drawing plans to be gone over with the medical boards involved. Sele is working daily to get the dispensary at Isaka ready to open. Denny is shopping for lab equipment so the dispensary will be a good one. I'm telling you about it.....and a few other things.

Thank you and bless each of you for caring and for your help. Your devotion is what makes this happen.

We found a place to eat a quick lunch yesterday called the Hub Hub Fast Food Restaurant. Denny and I ordered kuku (chicken) and it was like rubber, and Mandasi, sort of a fried bread. Sele and Magola, however, were smarter and ordered samake (fish) and rice. Theirs was delicious (Magola gave me a bite). There was landscaping around the patio of the outdoor eating area and there was the most beautiful pink double hibiscus flower I'd ever seen. How few flowers are perfect. How few things in nature are what we'd call "perfect." People are that way, too, aren't they? We all have little flaws. God did make us and in God's eyes we are perfect. Perfection is not common at all, but we work towards excellence. Then, we accept the shortfall knowing we've done our best. God forgives us our deficits, as we forgive others....

Many blessings,

Paula and Denny