Diary - Thursday, February 19, 2004

It is a very sultry morning here in Jambiani today, very little breeze and a sure sign that we are now entering the inter monsoonal period where the winds shift from the northeast back to the southeast. This period is also the precursor to the rains that we expect to arrive sometime within the next 6 weeks or so. I think I have mentioned before that Jambiani is in a relative dry zone so we really don't get the extensive and prolonged rains that they have on the mainland. This is probably a good thing. :)

I recently had a visit from three officials from the Ministry of Health. They were following up on our proposal to provide some limited medical services at the Center and were just coming to introduce themselves, see the premises and get a bit of information about our intentions. They were expecting to have a meeting yesterday so I hope to hear from them soon with respect to the administrative procedures involved with this new aspect of the project. Everything is looking good in this respect though, and we are very optimistic that this new service will be available in the not too distant future. :)

We had some very positive news yesterday regarding one of our friends and former employees here in Jambiani. Mustafa is 29 years old and was diagnosed about a year ago with atrial and ventricular septal defects. In our culture, these "holes" in the heart are usually diagnosed and treated quite early. Mustafa's condition is serious and although he is being stabilized by medication he must have corrective surgery or he will die, probably within the next year. Getting help for this type of problem is not easy here, as patients must travel overseas, usually to India, to get the required surgery. Of course this is a very expensive proposition and for most people it is simply not possible to get that kind of money. Fortunately the Government here on Zanzibar, reviews all such cases and in many instances they will cover the costs associated with getting the necessary treatment. In Mustafa's case this will be about $8000.00 US. For the past several weeks we have been trying to get information as to whether or not the Government would be supporting Mustafa or not. Yesterday we heard that there was an extremely good chance that he would be getting this lifesaving opportunity. Mustafa is a good friend, we have known him for many years now, and so we are very grateful that things are looking so optimistic for his future and his life. This does once again help us to realize just how fortunate we are to have the quality of health care that we have in our culture and it certainly makes one think twice before criticizing the system that we have in place back home.

The time seems to be flying by these days and soon Alva and Jabeen will be leaving us. I think they have a little over two weeks left in their stay. It has been delightful having them with us and they have done some wonderful work up at the Center. After they go, Pat and I will be on our own until the end of April as our two volunteers who were scheduled to arrive after Alva and Jabeen's departure had to cancel just recently. At the end of April we expect to welcome Dr. Grant Parker and a month later his partner Barbara. Grant is a Chiropractor and Barbara is a massage therapist, both from our hometown of Victoria. So we are looking forward to welcoming them, as they will bring years of experience with them and we are certain they will add lots of positive energy to the clinic and community in general. I'll give you more details on Grant and Barbara, as their arrival dates get a bit closer.

At this point I would like to include a small update from Janie Preece, the wonderful wife of Dr Pat Preece. Janie is very interested in becoming involved in some way or another with the educational system here when they return again later this year. Here's what she had to say about her experiences:

Blue Lagoon, Jambiani, Zanzibar
10/01/04 - 26/01/04

I wanted to use my time in Jambiani to identify what role there might be for wives, partners or other volunteers in the village community, particularly in academic education. Initially I had anticipated that this might consist of some supplementary teaching of English (my own subject) in Jambiani School, and I had meetings with the Headmaster, Mr Maabad and the Deputy Head, Mr Abdullah Mussa and a number of other staff. I attended some lessons (English, Maths and 'Civics') as an observer and had a bit of shock when I was asked to give an impromptu lecture in Civics to a class of 16/17 year olds, with no preparation whatsoever — rather nerve-wracking to say the least! I also made a film of the daily routine of school life, which gives a fair idea of the environment, curriculum, facilities etc.

Relatively speaking, Jambiani is a good school with mostly dedicated teachers (not all highly qualified however), a small library and a cheerful atmosphere. There is a new Science laboratory, built with outside donations, but completely empty of any equipment and therefore useless. There are no textbooks for any subject to speak of — certainly not enough to be used in a class at any one time — all the teaching is therefore by 'rote' or from the blackboard. The school has one computer, but no IT skills to speak of, and no photo copier (an extremely desirable piece of equipment, I felt). Despite these disadvantages, some students do rise to the top and do well, going onto college elsewhere and even to University in Stone Town, but I would guess that these are very much the exceptions. I did not observe a 'streaming' of bright pupils, though the Headmaster suggested that one role for me might be to take extra-curricular classes for the more academically able and ambitious pupils.

I felt that it would be inappropriate during such a short visit to start teaching in the school, but I did set up a short course of 'Everyday English', which was attended regularly and with great enthusiasm by a small group of young men aged 19-24 at Blue Lagoon. As it turned out, these classes were as useful to me as I hope they were, in some small measure, to them; for they made me painfully aware of far broader educational needs in the village. What struck me forcibly was their almost non-existent knowledge or awareness of life outside the narrow confines of their community. History, for example (apart from the history of Tanzania since the Revolution in 1964) is not taught at all; Geography, Science, Literature, Economics, Politics etc. are only touched upon at the most rudimentary levels in the school syllabus.

However, my small sample of pupils were, to a man (note, no women — their female counterparts being already deeply entrenched in the their manual and domestic roles) eager, enthusiastic and desperately thirsty for any knowledge of other nations, cultures, societies and traditions. They told me they regarded education as the "key" (I quote) to a better life for them and their families, but they are in a 'Catch 22' situation. Courses set up by the Government on tourism — for training in the service and leisure industry, e.g. cooking, waiting, receptionist jobs etc. — would cost a student $300 for a 9 month course in Stone Town (with bed and board extra). At the end of the course an official Diploma is issued and they told me that without this a young person is unlikely to be considered for a 'proper' job in the leisure industry — yet this level of fees is way, way beyond anything they could possibly hope to save from their subsistence wages as under-chef, under-waiter etc. in Jambiani. 'Official' qualifications, on the other hand, seem to be mandatory for all sorts of mundane and un-challenging occupations, such as sweeping up seaweed in front of the beach hotels.

During our lessons at Blue Lagoon, I became increasingly aware of the lack of what one might call the infrastructure to the Jambiani education. The spoken English of a reasonably educated adult is quite good (though rather comically sprinkled with long, and somewhat archaic words and phrases), and they often expressed surprisingly sophisticated concepts and personal philosophies; however, it began to dawn on me that this disguised any breadth of knowledge of the world outside Jambiani. As I taught them new words and expressions, we began to stray onto all sorts of topics which clearly fascinated them and about which they were very eager to learn more. I wished I had brought out an atlas, photographs, simple reference and reading books. I found that I was teaching them at a very simple level about all sorts of things — it seemed better not to set limits, but to let the lessons take their own shape, whilst trying to consolidate new knowledge in each session. They wrote simple compositions which focused on different topics — and I was amazed at the imagination and skill with which they were determined to bring newly acquired vocabulary into their essays.

Our lessons were fun, and — I hope — useful but they made me ponder somewhat. Despite the fact that there are now at least 40 TV sets in the village, and many folk have mobile phones, the modern world is very, very far away. Their thirst for education is enormous, and they have ambitions, albeit modest, to improve their lifestyle; but do we do them a service by helping them to qualify themselves for jobs, which are still extremely scarce? True, there is massive unemployment in the village, particularly among the young men, but can education really improve this situation, or would the result simply be to fuel discontent and frustration among the unemployed?

Part of the answer might be to teach them practical as well as academic skills. There is no industry to speak of in Jambiani, yet there is a market for handmade articles, such as sandals, soap, handbags, kikois, jewellery etc. which could be sold in the hotels and exported to Stone Town. Lessons in handcraft and cookery would be popular and useful; jam and juice making from the wonderful range of exotic local fruit might provide other employment. A degree more sophistication in packaging and labeling of the local products might make them more suitable for export — in other words, there are raw materials available, but an almost total lack of expertise in transforming these into marketable goods.

My conclusions, such as they were on such short acquaintance, are as follows: There is a great need for broader education in all academic subjects, backed up by simple reference books, atlases, dictionaries and so on. Manual and technical skills need to be taught; and markets sought for simple products. The supply of a number of up-to-date textbooks, enough to be shared between two pupils at a time (say, 30 for a class) would greatly aid the task of the teachers in the school. A robust photocopier would be a huge help. Equipment for the Science Laboratory is very important — at the moment the building is going to waste. Practical education in handicrafts — sewing — embroidery — cookery would be of great benefit, not only to impart skills, but also to help the economy of the village as a whole.

It is not necessary to be highly qualified in a narrow subject to teach in Jambiani. Almost anything we know, and take for granted, will be of interest and of use if it can be taught to the young people. A little help will go a very long way!

Despite their extreme poverty (most of the village live at subsistence level), they are proud of their friendly, generous community atmosphere. Everyone looks out for everyone else — and we were made universally welcome. Teaching under these circumstances would, I think, be a pleasure and privilege. I certainly hope to be back!

Janie Preece

And now some thoughts from Alva: :)

Lately I have been avoiding writing in my journal. I haven't wanted to acknowledge that there is a reason to record my time in Zanzibar, as soon it will be coming to an end. I have come to love this place and the people who live here and, as glad as I will be to see friends and family when I return to Canada, I am going to miss my friends and family here. As I write this I am listening to the surf breaking on the shore in front of Pat and Alastair's home and to the sound of children laughing and singing as they walk home from school. Alastair is preparing dinner in the kitchen while Pat is teaching her bi-weekly English class at the clinic and Jabeen is sitting on the steps reading a book. A flash of colour catches my eye; a woman wrapped in a vibrant kanga passes by. If I were to step outside the warm breeze might bring the scent of frangipani that is growing in the garden and, if it were evening, it might be the night-scented jasmine that would capture my attention. There is such a richness and vitality to life here yet the most basic rudimentary services and commodities, the ones that we in the west can still take for granted, do not exist.

In spite of the valiant efforts of many of the health care professionals in Zanzibar, the health care system is skeletal. It can barely provide the most basic care and, although the services that we provide here at the clinic are invaluable, it has become clear that the addition of a medical clinic is also needed. While Jambiani does have a small medical clinic already, and the nurse practitioner operating it does his best, it is too small and under funded to meet the needs of the community. Increasingly we, at the Wellness Center, find ourselves seeing people who come in for wound care, as well as medical advice on issues ranging from hiatus hernias to constipation, pneumonia, chest pain, fever, pregnancy complications, and physiotherapy for a child with cerebral palsy. Although people in Zanzibar are not as poor as in some parts of Africa, they have very little money, especially people in the villages. A good income in Jambiani is thirty dollars a month and very few people earn that much. The road to the community is long and unpaved and to pay for transportation to town to visit the hospital or to buy medicine is prohibitive for many and, to go to Dar Es Salaam where more sophisticated health care is available, is virtually impossible.

In the two months that "Daktari Jabeen" and I have been here we have had the opportunity to see many peoples health improve dramatically as a result of their visits to this clinic. People that could barely walk are now able to not only walk, but to go back to work to help feed their families. For people here physical injuries do not only mean pain and discomfort but also the inability to work and earn money for food and survival. There is no such institution as social assistance in Zanzibar, only what you can provide for yourself and family, and the generosity of friends and neighbors. When viewed from that perspective, chiropractic care and bodywork are critical. We have also seen people with serious wounds such as the woman who stepped on some broken glass while carrying a heavy sack of seaweed on her head. The glass went through her whole foot and, without appropriate care, would have become badly infected, possibly resulting in permanent damage and even a systemic infection. It has been very gratifying to see her heal, as well as so many others.

Volunteering here has been a wonderful experience and, although we are in the clinic during the week, there has been plenty of time on the weekends to explore the beaches, forests, music, and architecture of Zanzibar, and to meet it's people. One of the highlights was attending a music festival in Stonetown a couple of weekends ago with some friends. As our time here nears completion, I realize how much I am going to miss Zanzibar, the place itself, the people, the food, Alastair and Pat, Pandu, Bi Mwahida and Afua, Mrisho, Simi, and Maulidi, and so many others. I am definitely planning to come back, as well as to support what Pat and Alastair are doing here as much as I can while I am in Canada. Until then I have many wonderful memories.

Kwaherini,
Alva

And now for some final parting thoughts from Dr Jabeen:

Jambo… Habari gani?

It's Tuesday afternoon as I am sitting here looking out at the Indian Ocean with Alva and Mrisho. Sadness is starting to settle in as I realize that our time here is slowly coming to an end. Only 10 more days to go then Alva and I will be taking our journey over to the Mainland to start our Safari.

Yesterday evening I was sitting on the steps outside the house just listening to the waves crash along the house wall and staring out into the Indian Ocean, thinking how much I will miss Jambiani. I hope I get the opportunity to come back to this peaceful place one day.

I have started telling patients that next week is my last week here and it's very touching to see their responses. I am very glad that I volunteered for about 8 weeks because we have had the opportunity to see many positive changes in the patients we have treated. It's quite rewarding to notice that patients are feeling better, walking better and are much healthier through both the Breema and Chiropractic treatments. Last week we treated a 6-month-old girl who had presented with a chest cold and fever for 3-days duration. I adjusted her and we all administered some fever control treatment and told them to return in the afternoon. By 5pm, the little girl did not look any better so Pat and Alastair gave some money to the family so they could go to town and get treated at the hospital. Very generous. It will be great when we get some medical expertise in the clinic so we can all collaborate. Unfortunately, some of the locals are unfamiliar with the basics of fever control.

I know I will be taking away many many fond memories of this place. I really do feel that I have touched the hearts and health of many patients. I strongly believe that the future health of Jambiani has and will continue to increase thanks to the Jambiani Wellness Center. I will miss the patients, Pat, Alastair, Alva and all the wonderful people I have met here. I will miss my long walks down the beach as the villagers laugh at me because my rapid walking speed does not resonate with the lifestyle of Hakuna Matata.

Kwaherini. :)
Jabeen