Diary - Monday, May 10, 2004 

Good afternoon everyone. It is just after 2pm here in Jambiani, I have just finished with my "play" (can't seem to call what I do here work anymore :-)) up at the clinic, Pat is washing clothes (bless her heart :-)) and it is an absolutely beautiful day on Zanzibar. We hope you are all well and enjoying your selves completely. Pat and I are now down to our last three weeks before we depart on our journey back to Canada. We seem to always leave here with mixed feelings. There is no question that we appreciate seeing our friends and family again after such a long interval and, somewhat like breaking a fast, it is quite a treat to have access to all of the goods and services we have available in Canada (like the soft ice cream at Beacon Hill Park :-)) however, we do miss the simplicity of life here and the very "down to earth nature" of the Zanzibari people. Village life tends to grow on you and eventually your whole being resonates with the local tune so to speak. It can be quite a shock when one immerses oneself back into the western culture and as usual, we expect to be quite busy when we return to BC. However, we certainly are not complaining and we are grateful for the opportunity that we have to be doing what we are doing.

I'd like to take a moment to summarize for you what we have done since we arrived here in October, 2003, what is developing now and what our plans and hopes are for the future. Needless to say, it has been a busy time for us over the past 7 and one half months. By the time we leave, we will have welcomed 6 new volunteers to Jambiani. That makes a total of 11 practitioners who have come to help at the Center since we opened in January last year! We have an additional 9 volunteers confirmed for the next several months and at least another dozen who have expressed significant interest in the project and who are now working out the logistics of their availability. Of course, we are very grateful for the response we have received so far but I can assure you not nearly as grateful as the people of this community who are getting some fabulous attention from some very remarkable individuals. We have every reason to believe that this trend will continue.

One of the major up and coming projects is the work of Dr Pat Preece and his wife Janie. If you recall from previous updates, Pat is a retired but not tired MD from the UK who is willing to recruit volunteer medical doctors and perhaps some specialists to volunteer their services at our clinic in Jambiani and also to possibly teach and do some surgery at the local hospital in Stonetown. This would be a tremendous addition to our present level of service and would benefit many thousands of patients. We have been in communication with Dr Preece and it sounds like his initial planning is coming along nicely. We do have some administrative details to take care of, but barring any complications there, it is quite feasible that we could be offering medical services sometime in the first half of 2005.

At the moment, Pat has actually become, what we refer to as the "Mama Kidonda." We get frequent "drop in" patients who have cuts, punctures, ulcers and other skin abrasions. Pat has developed quite a following now and she can be seen wandering through the village with her bag of "wound care" materials as well as attending to patients on our front porch on a daily basis now. It would be ideal if we had a proper medical facility to take care of these folks. If we proceed with this, we will need to do some renovations in the clinic in order to create another room that can be used solely for medical procedures. Fortunately, we have the space for this purpose and we do not have to build an entirely new facility.

In the last couple of updates, I mentioned a larger project that we were working on but we were not able to reveal any details of this at the time. As Pat would say, I'm not the best at keeping secrets and I always insist that that's not the case, however I would like to give you a bit of information regarding this now. :-)

Our dear friend Kristi Falconer, after much persuasion and discussion has received preliminary approval by an organization that specializes in eye care services to come to Zanzibar sometime next year. Hopefully we will be able to give you their name in the near future. She and Pat have been in regular communication regarding this and it seems all has finally come together. This group can potentially test and provide corrective lenses for up to 10,000 patients!! As well they can do some minor surgery. We are, to say the least, ecstatic about this possibility and although we still have some hurdles to cross before this is 100% confirmed, things are looking very promising for this to eventualize. There are a lot of people on Zanzibar who would benefit greatly from this type of care, so this will be quite an event when it happens, hopefully sometime in the first half of 2005. We will keep you posted as things develop.

A couple of weeks ago we were introduced to a local businessman by two recently acquired friends of ours who have come here from Qualicum Beach on Vancouver Island. Actually Sudra is originally from Zanzibar and his partner Joanne is Canadian. Remarkably, this most generous individual proceeded to explain that he would be willing to cover the costs of shipping up to five containers of donated materials to Zanzibar from anywhere in the world as long as some of these donations went to our neighboring island of Pemba situated to the north of Zanzibar! I think Pat and I were somewhat astonished that someone would be willing to offer this level of assistance to complete strangers. This represents several thousand dollars worth of services so if you are aware of anyone or of any organization that is capable of filling a container full of goods such as medical supplies, clothing, strapping materials etc. please let us know so that we can start to organize some shipments.

We continue to host classes for the deaf and hard of hearing up at the clinic. This has turned into a huge success and even Pat is learning how to "zungumza kwa mikono" to speak with her hands. Now she can tell me where to go without raising her voice. :-)

Pat has just finished up her also very successful English classes. I'm sure she'll start them up again when we return in October.

We continue to see plenty of patients in the clinic and in addition, we do provide acute injury care from time to time to mainly soccer players who have the nasty habit of dislocating joints and breaking limbs as they give it all out on the field. In the early days of our work here, these types of injuries did seem a bit dramatic for us however now, it is all part and parcel of the whole package that we have embraced here and we have developed substantial confidence in our management of cases such as these. This is good!

On the building and maintenance side of the equation, we completely resurfaced the seawall at the front of the property and I'm happy to report that I have completed the painting of the accommodation and clinic. It was a very large job but we now don't have to worry about the paint washing away every time it rains. This also has to be good. :-)

We also added a pressure pump to our water delivery system, which we recently had to replace as a result of poor electrical connections. We need you Daniel Weisgerber. :-) This has been a welcome addition as we now have good water pressure for washing and taking care of the garden. Little comforts in life that can make a big difference.

On the financial side of things, we are, I can say, plugging away. We need about $32,000.00 Canadian per year to maintain our present level of operation. Recently, we have had some tremendous support from friends of Pat's family, Ocke and Norma Schuttevaer. Ocke has recently retired and he and Norma have taken an interest in the project here in Jambiani, so much so that they came from their home in Germany to visit us for one week last October. You may remember me mentioning them in a previous update. On their return, Ocke proceeded to send out letters to I think about 200 of their immediate friends, describing the project and asking for donations. They also asked for the addresses of other people who might be interested in helping out. Ocke has informed me that he has raised in excess of $7000US so far!!! What a wonderful thing to do and what a tremendous help this extra income will be. Of course this is well short of our yearly requirement but it takes some of the pressure off for the time being while we attempt to raise additional support for the work here. Thank you Ocke and Norma from Pat and I and all the people of Jambiani. We love you and all of those kind friends of yours who have contributed.

I did send a wish list to Ocke with an itemized inventory of projects that we would undertake immediately if we had the extra funds. I'll enclose that list here. I suppose there's no harm in putting it out there and who knows, there may be someone with a relative who has some spare change stashed in a box under his or her bed that needs a worthy cause to put it towards. :-)

The Hands Across Borders Society is now in a financial position where we must only focus on sustainability. We have absolutely no extra funds at this time to carry out any of a number of much needed capital expenditures. We have listed below, in order of priority, those projects and materials that would significantly enhance our effectiveness and quality of service here in our target village of Jambiani. All prices quoted are in US Dollars.

1. Wireless Internet Connection

• Fast, effective and reliable communication would be possible in Jambiani, however at this time, we rely solely on the services of Internet cafes in Stonetown for all of our communication needs. As Stonetown is one and one half hours by car from Jambiani, it is really only practical for us to make this journey once per week. This project has become very successful and it is not unusual for us to receive well over 200 e-mails per week. Reviewing and replying to many of these e-mails can take up to three hours of our time as the systems in town are very slow and on many occasions not working properly. As well, many of these e-mails are from prospective volunteers and are time sensitive in terms of requiring a swift response. In addition, we frequently use the Internet for research purposes and to acquire up to date information on the handling of difficult cases that we see in our clinic. We also communicate with other health care practitioners to gain their advice as to how we might best manage certain conditions. Sometimes delays in getting this information leads to the deterioration of a patients prognosis.
• We have investigated the costs associated with installing a wireless (satellite) system here at the clinic. This would provide instant, 24-hour access to the Internet. The system we are most impressed with is guaranteed to be 99.9% reliable and virtually trouble free. The addition of this capability would make a remarkable contribution to our work here on Zanzibar.
• Satconet is a Dar Es Salaam based company with a mean time between failures (MTBF) of 10 years. We have received an initial price quote as follows:
• Equipment $2,300
• Installation $590.00
• Total $2,890.00. I feel we could probably get this price discounted a bit as we are a non-profit organization and this was a quote given to a local family operated hotel.

2. Finishing work in the Clinic

• At present, we have been unable to finish all of the required work at the clinic. The windows do not have screens as yet. This allows easy access for insects and birds and we constantly have to clean the floors because of bird and insect droppings. Of course malaria is endemic here so the presence of mosquitoes in the center is a potential hazard.
• The floors have not been tiled and we are presently operating on bare concrete floors, which creates a less than optimal appearance and is less hygienic than we would like. We also are in the process of arranging to bring in medical services to the clinic. This will require some renovation work. We will need to partition part of our waiting room as well as bring in some plumbing so that the doctors have access to hot and cold water. The estimated costs for this work are as follows. I say estimated because I am basing the costs on previous work that we have had done in our accommodation for volunteers and am taking into account the inflation that has occurred here in the last year and one half.
• Window Screens for the Clinic - 25 wooden frames with mosquito net at 40,000 Tsh per frame is about $949.00
• Tiles for Clinic Floors Materials and labor about $1500.00
• Renovations for Medical Partition wall, Ceiling, Door, Wash Basin and associated plumbing connections, hot water tank and labour about $2000.00
• Total for this work $4449.00
• Underground Water Catchments: Although at present there seems to be abundant availability of fresh water, we would like to conserve this precious commodity as much as possible. Zanzibar gets significant amounts of rainfall each year however at this time very little effort is made to collect this water such as is done in Australia for example. We have established extensive gardens here at our Clinic, much of which is dedicated to the production of fresh fruit and vegetables. This produce is used to feed our volunteers and of course in this hot tropical climate, we need to use a lot of water to maintain it. We would like to build an underground concrete cistern so that we can collect rainwater. This would allow us to conserve very large quantities of fresh water that we are now using from Jambiani's main supply. We would be looking at a 25,000-gallon tank with associated pump and distribution pipes. We estimate the cost to construct such a system would be in the $8000.00 range.

4. Misc. Projects and Required Materials

• We have two temporary front gates that need to be replaced with proper ones. The estimated cost per gate is $800.
• Our main computer was a used model donated by KLM airlines. The monitor no longer works and the entire system is antiquated. We are now relying on an older model laptop for all our administrative work such as letter writing, accounting and correspondence. A new computer system with associated printer and scanner would certainly make our work that much easier and efficient. The costs for this equipment vary widely depending on quality and performance. I believe an adequate system can be obtained for about $1500-$1800.
• The stove in the accommodation was purchased in Dubai. It is too small for our requirements and is also now in need of repair. A larger replacement stove costs about $1000 here on Zanzibar.
• Of course we are always in need of clinic materials such as strapping bandages, braces and supports, analgesic creams etc. Donations of these materials are always gratefully accepted.
• We have not purchased a vehicle as yet. At the moment, we spend about $1500 per year on transportation costs. Of course in the long term it would be cost effective to purchase a second hand vehicle here or in Dubai. Excellent quality reconditioned vehicles are available for less than $7000. This would give us much greater mobility and would cut down on our expenses as we could use this vehicle to carry goods and supplies for future work projects as well as for passenger transport.

In reality, there is a never-ending need for upgrades and improvements in this environment. If we were to realize just one of the above items on this "wish list" we would be very grateful.

The total price tag for all of the above is about $27,439. In the big funding picture, this is a small amount indeed when you consider that many of the aid organizations here on Zanzibar such as the WHO have several up-market vehicles such as Pajero's and Toyota Landcruisers in their fleet. Just one of these vehicles retail for at least double the amount of the above figure.

Anyhow, that's enough begging for one day. Thanks for putting up with these requests, I'm sure you would all love to have a few extras in your life too.

Dr Parker will now be in the UK or Holland and we are eagerly anticipating his arrival next Sunday morning. The time is certainly whizzing by and before too long we will be on our way as well.

I will send one more update off to our man Kent at eMotionMediaGroup.com before we leave and then we will expect to hear from Grant and Barbara about their experiences here periodically. In addition, we'll be keeping you all informed as to our activities whilst enroute to Canada and after we get back as we expect to do some media and fund raising activities while we are in Victoria.

We continue to be motivated and excited about the evolution of HABS. It is a wonderful project with great potential to do good things on a planet that needs a lot of TLC. Once again thanks so much for your interest, your support in whatever form that may take and most of all for your constant love and affection that finds its way here in many forms. We are truly grateful... tunashukuru sana!!

Until the next time, much love from Ali Baba and Patima.

PS: Visit the photo gallery for larger versions of the photo's on this page and lots more!