Writing As I See The World

A Little Rolling Stones Wisdom: If You Try Some Time....

My project has so many different facets, and as I have moved along through this process there is so much need it can be a tad overwhelming to navigate.  Virtually nothing is as straightforward as it seemed back in San Francisco.

I am also reminded how much I love working with small and rural hospitals, because there is often so much that can be done.  The theme for my work with the hospital in Bagamoyo, Tanzania reminds me of the Rolling Stones tune:  "You can't always get what you want... but if you try some time you find, you get what you need."  So much of the time I spend in Bagamoyo looks a lot like coaching and encouraging people to think about what they want and putting that need into clear words.  It took a while to sink in that people are not often asked what they want, more often having things sent their way, whether they actually need them or not. Unfortunately, aid has a habit of working that way, as does being a small fish hoping for some scraps from above.  The matching of local priorities with some prioritization "out there" is often a mismatch.

There is also a related aspect of working in Tanzania which seems really paradoxical.  Living in Dar es Salaam and being a white guy invites a steady stream of requests for money.  One of my colleagues says it is because I carry myself in a "distinguished" manner, giving the aura of wealth, which makes me giggle in a decidedly undistinguished manner.  So there is an element here of being very direct about asking for what one wants.  This carries into the price negotiations that are a daily aspect of life here. The paradox in this context is finding that when I ask people I am working with what they want from a collaborative relationship, I get a blank face.  People are not used to being asked that question.

It is also cultural.  As a rule, Tanzanians are unfailingly polite in interactions.  The way people ask for things uses a different language than in neighboring Kenya, where the norm is to be very direct in your requests.  Here, that directness is considered incredibly rude.

I have come to love working in Bagamoyo.  It is about more than the project, it is about encouraging people to think a little differently.  To ask for what they want, respecting their polite nature while also being very clear.  And I am thrilled to say that they have caught on!  It took awhile to sink in (for everyone concerned!). And suddenly I'm finding a new energy that was not there when I first started, a sense of empowerment. I suspect people saw me, cautiously, as yet another in a line of people promising a lot and in the end delivering little.  I took a page from the Rolling Stones.  If you know what you want and you can clearly communicate what your priorities really are, you might actually get what you need. If you wait for someone else to decide what you want, the odds of getting what you want are pretty slim.

It seems to be working.  The operating theater at Bagamoyo Hospital is getting attention.  We stepped back from the amorphic statement that "we need a new theater and the kitchen sink too" (a term they found humorous after I laughed at myself and explained this weird comment that blurted out from my mouth)" and instead looked at it in stages. What can be done to make the current theater better - what would most improve the quality of care delivered and meet community need.  It became a much more straightforward project.  This was followed with asking what training they would like to improve their skills.  This is the thrust of the idea of collaboration with the university - they get something in return, notably educational, but also a new forum for facility and equipment improvements.  We set up a similar conversation with nursing, and I asked a staff member at the hospital to lead the meeting, encouraging him to guide his colleagues through the process of being clear about what they want.

I'm heading up to Bagamoyo this week with a Professor of Surgery from the university who clearly understands the district hospital context.  ...If you try some time you find you get what you need.  We are not yet to any specifics, but they are getting much-needed attention.  Experiencing their clear requests getting a positive response puts a huge smile on my face. They can make it happen.

The Somewhat Tenuous Internet Tether

Yesterday afternoon at The Slipway, sitting outside under an acacia tree, and then quickly moving under an open sided canopy when the sky opened up with a drenching rain, the internet connection was great. The time difference meant it was 9:00 Sunday morning in Michigan, so I had a chance to talk on Skype with my dad and then my sister Jan.  It was a blessedly great connection.  During the conversation with Jan, who also studied in Germany back in the 1980s, she mentioned how amazing it is to (sometimes) have instant communication over such incredibly long distances.  The internet has made it feasible and really inexpensive or even free.  We contrasted this with our experience in Germany so many years ago (yikes...) when we would call home on special occasion days at a pay phone, inserting our big 5 Mark coins and then talking really fast while we watched the seconds tick down on the telephone.  Times have changed so much.  

Today, we expect instant communication (well, speaking for myself and probably many in the 'developed' world.. a funny term from this perspective).  Yet, despite the fact that I am in Tanzania and am writing this, the internet and its use it still not a widespread phenomenon.  The internet connection here at Muhimbili University creaks along, sometimes fast enough for Skype to work, more often not, sometimes it doesn't work at all. And sometimes there is no internet for days. It doesn't particularly seem to bother Tanzanians much.  It is what it is when it is....Trying to chat on Skype with Brad and his parents (visiting San Francisco from Georgia) this morning was ultimately aborted. Very few students have computers, there is a small computer lab in the library (shades of the 1980s in my education), and truly, little real business is done on the internet.  If I want to get someone a document through e-mail, it helps to call and let them know it is there. Otherwise it is often more productive to print it out and run it over to them.  Trying to reach companies through their (often bare bones) websites is generally a fruitless activity.  Buying a plane ticket, for example, is much better done by going to the airline office downtown after a stop at an ATM because almost all transactions here are in cash.  In person, it is relatively easy.  The cash transaction issue also highlights our dependence on credit cards, which aren't used here (and at the few places that do accept them, like sometimes at hotels - plus a 5% service fee, but don't count on it - the machines often do not work).

Ahh... my internet meditation... waiting for the wheels to turn... breath in, breath out...

At the same time, things are changing fast.  I look at the aspirations of the One Laptop Per Child project to get every primary school child in East Africa a laptop, a rather audacious goal.  Part of me wonders how much time people at One Laptop have actually spent in places in East Africa that barely have working electricity (or none).  However, that audacious goal, even if partly implemented, would be a huge stride. Electronics are ludicrously expensive here and way out of reach of the vast majority of people.  I've gone through sticker shock in electronics stores.  And given the number of kids in most public primary school classrooms in Tanzania (the norm is 65) having a local area network in the classroom might help with the education process in an environment where paper copies of materials often don't exist (it's a challenge at the university!).  It could mean a lot to the learning process.

I suspect the online life of Tanzanians is on the cusp of enormous change.

Walking Through the Neighborhood

I live on Bagamoyo Road, the main route to the northern suburbs of Dar es Salaam.  By default, it isn't exactly the most pedestrian-friendly part of a city that doesn't get big accolades for pedestrian friendliness.  Bagamoyo Road is three lanes, with the middle lane alternating between north and southbound traffic, and is often at a standstill in both directions.  The alternating lane doesn't really have rules, per se.  During the morning rush, it is pretty much a southbound lane, and in the evening rush northbound.  Or, it may be both simultaneously.  Or, a combination of cars, daladalas or bijajis may use the dirt shoulder. It makes walking up the road to the internet cafe an exercise in ... ... awareness.

What this also means is that if we aren't taking daladalas, we are usually taking taxis.  I had never walked more than 10 minutes up the road.  So today, Sunday afternoon, I decided to explore.  I had a feeling that the road branching off from Bagamoyo just north of us went all the way through about a mile to Shoppers Plaza, a small mall that I had never been to, but was reputed to have a great bookstore and coffee shop. And, in the back of my mind, I thought, if that goes well, I may go all the way to The Slipway, an ex-pat outdoor shopping plaza on Msasani Bay, and use the wireless there.  

Unusually for a side road, the first half mile was asphalt.  And then it became, as so many roads in Dar do, something more like an ad-hoc road through an urban wilderness.  Kind of like a road you might see in some wilderness area, that is sort of there, sort of not, rutted, potholed, full of large lakes in the rainy season, and muddy.  When walking in Dar, I often think of cartoons where you see footprints of where someone has walked, with zig-zags and curlicues, as that is often what it feels like, navigating less-muddy footpaths on the road, going around the muddiest areas whenever possible, circumnavigating bodies of water that I have seen swallow cars, while cars, daladalas and piki pikis (motorcycles) are doing the same thing, while simultaneously being aware of the waves of rust-colored muddy water they leave in their wake.  Gentle Tanzanians become crazy people behind the wheel, but I must they say they are pretty polite when it comes to avoiding splashing pedestrians.

Back to my walk, once again imagining the confusing GPS version of my path down what on a map might appear to be a straight road.  Watching a woman give up, take off her sandals and just wade while balancing her groceries atop her head (something that always puts me in awe - I have no idea how one does that - even 5 gallon plastic pails of stuff balanced on the head - another African mystery.  I tried it with a five-gallon plastic jug of filtered water once on the way home - it hurts).  

My muddy path takes me past small found-wood stalls with tin roofs selling beautiful dresses, men sitting out front of another shop, offering me a warm "habari" or "karibu," a fruit vendor, a small stand with a charcoal brazier grilling meat on sticks while someone else cooks chips in a deep vat of oil.  It is life in the neighborhood.  I would love to take photos of everyday life like this, but I would be offending the spirit of being there... that real sense of karibu/welcome.

Looming ahead is the 3-story Shoppers Plaza, a mall that includes a large grocery store, bookstore, coffee shop, dress shops, etc., a place at which virtually nobody in the immediate neighborhood could afford to shop.  After buying coffee for one of my roommates, I continue on toward Msasani Bay.  The next part is through a slum.  The tin-roofed buildings get much closer together, some of them also made of mud and sticks, the streets a bit more of a maze and even muddier (as if that were possible), surprised looks along with the offers of "habari" or "jambo" (surprise that there is a crazy mzungu walking through the neighborhood), and yet much the same feel.  Fruit stalls, roasting skewers of meat, smiles, kids playing, a hardware store, a tailor working at an ancient-looking sewing machine with beautiful clothing hanging on the wood walls behind him, stalls selling clothing that looks like US or European cast-offs (the t-shirts are a dead giveaway), and what always impresses me when in seriously economically disadvantaged areas here with mud everywhere - clean well-dressed people going about their business.

I exit the slum even more abruptly than I entered.  The slum gives way to huge houses with manicured lawns behind walls with electric wires atop and forbidding gates.  Some of them are embassies.  The heavily-secured US Embassy is just down the road.  It's quite the economic shift.  I walk past the Irish Pub, another hangout on Msasani Bay that has a wonderful quiet deck on the water where you can enjoy a beer in the cool(er) evening with friends.  At the end of this I am at The Slipway, a very prim and proper mall built mostly for ex-patriates, with a huge children's playground and outdoor cafes on the shore of Msasani Bay and the Indian Ocean.  

I write while sitting in the courtyard at The Slipway, looking out at the water, under the shade of an acacia tree.  I was just startled (and then started laughing) after two small gray lizards with bright yellow heads (a variety of gecko?) plop down from above on my keyboard.  They might have been as startled as me, sitting on my keyboard staring at me.  They didn't type anything.