Last day in TZ

We are on our final leg of the trip and arrived yesterday in Dar Es Salaam after a long bus ride in a Land-cruiser. We spent the first part of the day at the Woodcarvers market where we were harassed/ambushed for 15-20 minutes by whole families of merchants (mostly men). As Dr. Ken put it, it’s like Masai market on steroids (Masai market, in Iringa, is a flea market where local crafts/goods are bargained for).

Kulwa, our skillful, thoughtful, and irreplaceable driver, has guided us through the chaos on the streets of Dar Es Salaam (mainly Toyota automobiles of various kinds). He seems to know every local in the southern half of TZ.

For lunch we went to “Slipway”, a market along the coast with various shops, food, and art. I met up with an old friend, Adilly, who I had met on a previous visit to TZ and who is now in his final year of medical training in Dar Es Salaam. He has an incredible life story, is a pleasant person, and plans on returning to Ilula after completing his training. He is a close friend of Dr Benjamin Chota, a  physician at Ilula Lutheran Hospital I had the pleasure of working alongside but who is regrettably an Arsenal fan. His studies are being supported financially by Bega Kwa Bega.

For dinner we went to Sea-Cliff Hotel and Casino where there is a beautiful restaurant/bar that sits on a cliff overlooking the Indian Ocean. The food was amazing and now we are heading to the airport before departing shortly before midnight.

Earlier this trip we visited Tungamalenga, a small town on the way from Iringa to Ruaha National Park. One of our tasks was to provide bi-annual medications and medical supplies to the village’s Dispensary provided by one of the Lutheran Churches in the Twin Cities. In TZ a Dispensary provides very basic healthcare where vaginal deliveries are performed and uncomplicated outpatient maladies are treated. Those patients requiring over 12 hours of observation are transferred to the next level of care called a Health Care Center. Thereafter, if needing over 24 hours observation patients are transferred to a District Hospital (such as Ilula Lutheran Hospital), which can perform basic/common surgeries, C-sections, and administer more diverse medications/antiinfectives. Further elevation of care includes a Regional Hospital (for Ilula this would be in Iringa) and the most complicated healthcare involving various specialty services occurs mainly in Dar Es Salaam.

Tungamalenga was incredibly clean and organized; it also had evidence of great documentation and record keeping. This brings up complicated questions regarding lula Lutheran Hospital and whom (if anyone) takes ownership for the state of the hospital. At first glance Tungamalenga Dispensary appear to be doing more with less, however, it is a complicated picture and there are many variables involved. I may talk more about this at a different time.

We are arriving to airport with plenty of time to spare, approximately 5.0 hours early.