First week of school is finished! Wow what a week. So many things happened I don’t even know where to begin. Things I never dreamed I would ever see or experience in my life. In one week.

Where do I start to process?

There were the school beatings. That was hard to deal with and I don’t think it will ever be easy. Children here are caned for misbehaving in school. For any minor thing, for arriving late, for getting bad grades, for not bringing water to school to water the plants (yet half the country has no water to use/drink in their home including me), etc.) Boys can be caned on the back and girls can be caned on the arms. This rule is not always followed. The rule is 3 times, that is not always followed. If the parents give permission then they can get more canes. The students have to be on their hands and knees while they receive the beating and sometimes they don’t even flinch they are so used to it. It kills me. The beatings are done in front of the entire school to teach everyone a lesson about discipline. The sounds of the whips are the worse. I always turn my head or walk away. I can’t stand to watch. In the staff meeting this week the head mistress asked me in front of the ENTIRE faculty if I would beat the students when I was teacher on duty, I said No. She laughed, and said then what will you do when the kids arrive late and their uniforms are not tidy? I said I will talk with the students and the entire faculty laughed. It made me so angry but I didn’t say anything. Emily told me when she was on her way to school this week with her headmaster, they passed one of her students biking to school and the headmaster says, “ah look one of our students, he will be late to school, how lazy of him.” Emily and I were saying that night how crazy it is that he would label that child as lazy. He is biking to school, which is 8 km away from home. Probably woke up before the sun came up to cook breakfast on the jiko for his brothers and sisters and to do cleaning for his parents. The child is the farthest thing from lazy and is doing the best he can. In my staff meeting (which was conducted in English so I could know what was being said, thank God, I was very appreciative they accommodated me.) the head mistress pushed that the children need to be beat for speaking in Swahili at school. That this is an English only school and she really needs the cooperation with the teachers on this (with the discipline) that the discipline master cannot do all the discipline, teachers can help too. This was crazy to me, because none of the teachers at this school teach in English. They are supposed to, but their English is so poor they teach in Swahili. This is a disadvantage for the students because the NECTA exam is all in English so how can these students succeed if they are constantly taught in Swahili? Anyways, my blood was boiling at this point in the meeting because I’m thinking you are going to beat these kids for speaking there native tongue yet you do in every class?? That is so HYPOCRYTICAL. So I told them that. I raised my hand and said I was confused at this policy they wanted to enforce with the students, because as teachers we are supposed to set good examples and if we are going to beat students for speaking Swahili then why is it okay to use this language as the language of instruction in the classroom? They all were very silent and the headmistress said she was very embarrassed. She sees my point and maybe the English thing is only something they will have to work on over time. I was thinking, yeah.

I am teaching Form 3 Biology. So I have 7 classes a week. I realized a lot very quickly about my students. First of all my school has little to no resources. I couldn’t even get a syllabus/curriculum to see the material I needed to cover this term. I finally realize it is shared between 3-4 other biology teachers. I tried to go make photocopies for myself but the electricity is so sporadic that when I went into town there was no electricity so that was a fail. They only covered THREE topics last term. That is literally nothing, and on top of that they cannot recall any of it. I gave them a review quiz the second day because the first day the headmistress makes them clean the environment aka clean the school grounds, sweep the dirt, etc. On the review quiz I picked out questions from the three topics they covered in their notes and in the book. It was 18 questions. I bought flip chart paper so it is the size of poster board. I wrote the questions on the flip chart so I could tape it on the chalkboard. I made true/false questions, multiple choice, and fill in the blank questions. My kids had trouble answering a true/false question and a multiple-choice question. I had to walk them through it and they are form 3, which in America this would be equivalent to juniors in high school. I had torn white printer paper in half and passed it out to my students for them to do the quiz on. I soon realized after class that grading assignments would be quite tedious with 60+ kids. The class average on the quiz was 7.8/18 so 43%. In Africa, I realized this was a C not F. 20% is passing. Crazy I know. But I am holding my class to a higher standard and they need to do better. Only 1 person made a 15/18 so I rewarded the top 3 grades with stickers and lollipops. I decided from the quiz outcomes that there is no point in starting new material if we don’t know any of the previous material. I came up with an idea that I would divide my class into groups and assign them different topics within the first chapter. They will use the flip chart paper to display their information and will teach the class about their topic. This is how they will review the material from last term. I will give them a grade on their project and on their presentation. This is a great way to get them up and moving and get the students thinking outside of the box and using their creativity. You should have seen some of the things they came up with the last two days (I have two different streams, so it is neat to compare my two classes). They were drawing the human body, the brain, diagrams; I was so impressed!! We will see how they finish up and present next week! I will try and take a video for y’all!

The teachers at my school are mostly men, with a couple women. I love the women teachers. They are so kind and warm. We talk each day and they are so welcoming. Some of them are Muslim so they fast during the day. We other teachers aren’t much different we just get to have water and they don’t. There is no lunch break or tea break because my school cannot afford to provide that. Sometimes there is tea but we have to pay. I do enjoy the fact that when I am done teaching you can leave school, you technically don’t have to stay the whole day. So if I teach morning classes then I can leave early, my headmistress is pretty lenient about that. There are also a lot of student teachers at my school from universities around Tanzania. There universities send them to different schools to gain teaching experience before they can get their teaching certificate. I’m so glad World Teach does not allow a student teacher to work with me, because as for the rest of the teachers they are basically without a job for 4-6 weeks. The student teacher just teaches there class for that time and the teacher sits in the teachers lounge and has to stay at school and do nothing, the teachers say that it creates a lack of motivation for their job. I would definitely feel the same way.

I get to school by a piki each day. My driver’s name is Martin and he is the best! He speaks no English though so we do struggle, but he takes me to wherever I need to go after school whether it’s town or the stationary store. The school wanted me to bike each day but it is about 10 km (about 7 miles) from my house to the school, so that would be 14 miles a day and we barely eat as it is so I opted out of that one! I know they bike hours each day but I honestly don’t have the energy to bike 14 miles a day I would have to work my way up to that not just tomorrow be able to bike 14 miles no problem!

On Tuesday I walked to the hospital in town. I wanted to see if I could volunteer after school. Bariadi has 1.5 million people but only 3 hospitals. The Somanda hospital is so close to my house. I can walk there in about 10 minutes. After clearing it with the District Education Officer and the Hospital Administration I was cleared to volunteer. The Somanda hospital has 150 beds and 5 wards. Labor/Maternity, Pediatrics, Women Surgical, Male Surgical, and Infectious. There is very little electricity with frequent power outages, no A/C only open windows and lots of patients sharing beds because of little space. In one area there are probably 9 beds, then you move to the next area and there are 9 more, so no one has there own private area or room. The hospital does not provide food or water for their patients, family or friends have to bring that for them. Mostly there are patients with malaria, sepsis, cholera, AIDS, tuberculosis, lots of motorcycle (piki piki) accidents so tons of broken femurs, lots of burn victims from burning the trash or cooking and the wind causes a bad fire, lots of babies dead in utero or complications/sepsis due to C-sections. I have learned so much this week it is unreal. To be a doctor here you have to go to school for 5 years. Meaning four years of university plus one more. Crazy I know.

I went to the hospital after school on Wednesday to start volunteering. I was mainly in the labor/maternity ward for the afternoon. I saw a lady who was having contractions and was prepped for delivery. They do not give any pain meds here to the mothers only oxytocin to induce contractions. I was working with Dr. Mponya and we had just finished with another patient. He looks over the patient; she was barely dilated which I thought was a bit off. He thought maybe we would need to do a C-section due to her previous caesarean scar. He examined the abdomen and just as casual as could be stood up and was like well her baby is dead. I was like what?! And he said yep there is no fetal heart rate, her baby is dead we will need to send her to surgery to get it removed. He started to speak in another language. I was like does she know that her baby is dead? Have you told her? And he said yes I just told her. She didn’t show any emotion, she just remained expressionless, and just laid there as the two women beside her gave birth. The doctor walked out. I just stood there.

They have no hospital blankets or sheets for the beds here, just kangas, which is basically just a patterned piece of fabric. The mothers use it as a sheet and the nurses use it to swaddle the babies. They have one light to warm the babies under in the entire hospital and I haven’t seen them ever bathe the babies once they are born.

In the male ward there are tons of fractures. I was so amazed at how they repaired fractures for femurs. They stick two hollow needles in their calf. They are very large and hollow this has medicine going into it on both ends. Also it is connected to string, the string is wrapped around the foot, then it is connected to a giant bag a soil which hangs off the end of the bed. This keeps the leg completely straight and unable to move. They stay like this for 8 weeks. This allows the bone to heal but causes bed sores underneath the leg because the leg is unable to move due to the heavy weight of the soil keeping the leg in that tight position.

I saw a man with previous abdominal obstruction. He had had surgery to repair then came in with complications, they did a second surgery to repair then on the 15^th of this month he came in again complaining of lower abdominal pain. Dr. Mponya once again thinks it is due to complications. He says adhesions have occurred in the intestines and if progression doesn’t occur in a day or two a third surgery will have to be done. At this point the patient is screaming in pain. Dr. Mponya prescribes him some Panadol. Panadol is equivalent to acetaminophen or Tylenol. That is all he gave him as he is screaming in pain. They have no morphine or no strong pain medicine. It amazed me how freely he chose to operate that many times on a patient, if there were so many complications occurring.

Thursday when I came in after school I went to the pediatrics ward. There were so many children with malaria. A little girl probably 4 or 5 was shivering under her kanga and was burning up with a fever!!! Her entire body was on fire she was so hot. I called over one of the male nurses and was showing him how hot she was and how much she was shaking. I asked if we could give her some Panadol and he said No. her fever wasn’t high enough he said. At this point I was so angry. I wanted to walk around the hospital and pass out Advil that I had at my house that I had brought from home. Why are they letting these people suffer? Help them!! I wanted to say. I look over and this little boy is convulsing on his bed. His eyes are rolling back in his head and he is foaming at the mouth. What would be the first thing that would pop in your head if you saw this? It was a seizure for me. I got the nurse and said, this little boy is having a seizure! And he says no he has pneumonia. PNEUMONIA????!!! WHAT?! I’m like? Are you serious? No way, this is not pneumonia. He picks up the little boy and takes him over to the oxygen machine and gives him oxygen. He is not conscious at this point still convulsing and foaming at the mouth. Lets plug up another airway and make it harder to breathe!! I was so upset. This is not pneumonia!!!! This little boy is going to die I thought, how is this pneumonia. I held his hand and just prayed for what felt like forever. God please don’t let him die. Take care of him, lay your hands on him and heal him Lord. Give him the strength to make it through the night.

I walked to maternity/labor and watched a young mother give birth to her first child. I was encouraging her and telling her everything was going to be all right. She was all alone and very scared. When the baby was born the nurse asked if she wanted to hold her and she said no. That literally broke my heart. I didn’t understand how you could just have had a child and not want to hold it. She turned her head and didn’t even look at it. She was emotionless. The nurse just let the baby lay on the table for the longest time why she tended to the mother. No one paid attention to it but me. That took me a while to process. Emily told me later that night when I went home that the child survival rate is so low here due to so many diseases. People here in Africa don’t name their baby until the age of 1 because so many children die before then. So if they survive the first year then they will get a name. Mothers don’t want to get attached to their babies because of the high mortality rate. Or she suggested it could have been a pregnancy due to rape. I will never know the answer but to see a mother respond that way to her child was heart breaking.

On Friday school gets out at noon so I had lots of time at the hospital. I worked with the orthopedic doctor for a while looking at lots of fractures, then I went back to the maternity/labor ward. If you guys aren’t noticing yet I tend to like that ward a lot. When I walked in the back room, a mother was on the table looked very pregnant and was complaining of feeling super full. They took a nasogastric tube and started shoving up her nose so the tube could eventually reach her stomach. They did this procedure with no numbing spray or anything. Normally there would be a bag connected to the end of the tube to collect everything coming up from the stomach but the mother immediately started vomiting all over herself. It didn’t look like food or anything you knew it was from the inside of her body, directly from her stomach orange and black. It was all over her I felt so bad. They didn’t have towels or anything to clean it up only little pieces of gauze. So we got gloves on and started to clean her up. She was so helpless and had no energy left to move. We moved her to a clean bed and she just laid there lifeless. When she was doing okay I left to go check on the little boy Emmanuel, he was the 3 year old who supposedly had “pneumonia” last night. Today he had a feeding tube up his nose and looked a lot better thank God. I said hello to his mom and held his hand for a long time. I thanked God for keeping him safe throughout the night. I asked the nurse why he had a feeding tube today and she got his chart and said he has been rediagnosed with Meningitis and has started treatment; you treat Meningitis with 1g of Ceftriaxone. They also had previously given him treatment for Malaria, Lord knows what they gave him for his supposed Pneumonia I think they gave him two different antibiotics. This little boy was so sick. Meningitis is just not common here so I just was confused at how they came to this conclusion. They said due to his eyes still rolling back in his head and the convulsing last night is a sign of meningitis. His neck is stiff which is also a sign. His little arms were stiff too last night. He was doing better today though since his treatment started. I hadn’t seen one Doctor look at him though since last night or since I had been there today, which didn’t give me much comfort. His mom would look at me with her eyes full of questions and I couldn’t answer her in the local language of Sakuma. I went and got Dr. Ntelemko. I wanted to make sure this was the right treatment plan for Emmanuel. I told him I wanted him to come look at the 3 year old who had meningitis, he says, “no one has meningitis in this hospital.” I said, well your nurses sure are diagnosing someone with meningitis. He came with me to see him. I was hoping he would say they were wrong but he agreed that he thought Emmanuel had bacterial Meningitis. He took me to the infectious ward after seeing Emmanuel and showed me a girl who was about 15 who suffered from Meningitis. Her parents had waited too long to bring her in to the hospital to get treatment and the meningitis began to attack her brain. She now cannot speak. She can move her eyes so she knew we were there with her but she cannot make any words.

The Doctors were very excited today because they got their first ultrasound machine in the hospital. They had an extremely old one but it broke a long time ago and they never could use it. Little did I know after an hour or two of playing around with the machine they let practice on patients! It was so neat! We got to look at a pregnant woman and measure the birth weight and the femur size, and all kinds of stuff! After the overload of ultrasound fun I went back to the maternity/labor ward to check on the nasogastric patient. The nurse, Jen, said she was sent to surgery to see what was going on with her abdomen. I said “What about her baby?” She said, “Oh she lost her baby.” I’m like “what?” and she says, “yes she lost her baby already on the 16^th, the baby was transverse in the abdomen, so they went to do a C-section and the baby was dead in utero. She delayed too long to come to the hospital. Sepsis occurred after C-section.” Another death. They didn’t know whether the sepsis in the abdomen now was due to the C-section or due to the length of the dead baby in her abdomen that caused the sepsis. Jen went to retrieve her from surgery a little bit later, and due to the over crowding in the hospital she was put directly in the middle of all the new mothers who had just delivered. All I could think was how difficult that must be. Her baby died yet everywhere she looked she was surrounded by crying babies and breast-feeding mothers. I hold a lot of the babies to give the moms a break. You never see any men in the ward. So it is only the mom and the baby.

I was sitting down and one of the male nurses came over to me from pediatrics. He said Madame your patient, your patient. I said what? What patient? He said the boy.  What about the boy I said? He is bad condition he said. I said what do you mean bad condition? He is good he said. I said is he bad or is he good? Nothing he was saying was making sense. There was definitely a language barrier. I said I am coming I will come to check on him.

I enter the ward and I immediately see a green curtain put up around his bed. I walk around the curtain, and a blanket is over him. I don’t think anything of this because when children or babies are cold here they cover them all the way up here even their head. I uncover him. I grab his hand and it is freezing cold. My heart starts to race. I check for a pulse but I don’t feel anything. I look into his eyes but they just aren’t with me. I look for the nurse, and he’s a few feet away. I say, “I don’t feel a pulse, I think he’s dead. Is he dead.” Tears filling my eyes. He says so nonchalantly yes Madame he’s been dead. Look, and starts pulling back his eyes and I just cant look. I try to find his mom and I finally see her. I just grab her hand and hug her. ‘Pole sana” I say. It means I’m so sorry in Swahili. She just has her head down. I start to cry, which no one does here. I walk away and one of the nurses sees me, she says, “Pole sana, it is always so hard.” I walk outside and just walk past the hospital and lose it. He was just fine? He was just fine! How can life be taken away so fast. He was 3 years old. It isn’t fair. It made me uneasy how comfortable everyone was with death here like it was no big deal. They are so accustomed to it. That made me so sad. I was so sad. Jen walks up to me she was trying to find me. “Why are you standing out here alone” she said. Then she saw I had been crying. “Why are you sad?” “Im okay” I said. But she kept asking me, so I told her, “the little boy died.” She said, “Ahh Im sorry, do you have a pen?” Death is just another part of the day here. But to me I will always be affected by it. I will always remember the look on Emmanuel’s face. I will always remember that he deserved a chance to live. I walked in to the maternity ward and held a baby that was just born tears streaming down my face I looked at that beautiful child and wondered if they would be lucky enough to live past age 3.

The next day Sam picked me up to take me to his village in Ikoloko. Sam works with an NGO called Well Share, which deals with public health. He works with the 3^rd hospital that was just built. He wanted me to come to teach the head of the hospital how to use an ultrasound machine that was donated to their facility. It was a 2 hour drive out to the village. He is 14 miles from the Serengeti. I could see the mountains in the distance! The hospital is smaller than Somanda but nice. I taught Helen, the head of the hospital how to use the ultrasound machine. It was portable and pretty easy to use. We practiced on Sam, Emily and one lady who was complaining of abdominal pain. We practiced looking at different organs and arteries and veins. We drove back in the dark and had some car trouble so we had to stop at his friend’s house to borrow his car so we could make the rest of the trip home. Long but fun and rewarding day! I would love to volunteer there more but the trip out there is so far!

This week has been one week that will be ingrained in my mind forever and it was the first week. Now onto the second.