Diary - Monday, July 25, 2005 

Warm greetings to you all once again from Jambiani and we hope that if you are reading this update that all is wonder-full in your life in this moment.

Well, I guess our biggest bit of news is that we have finally signed a contract with the Ministry of Health!! We started this process about four years ago so we are, needless to say, pretty happy about this development. Having this piece of paper work finalized, opens the doors for the arrival of TWECS (Third World Eye Care Society) sometime next year. This Canadian based NGO will bring in specialists who will assess vision, prescribe glasses and perform minor surgical procedures for up to 15,000 patients!!! What a gift to the many people here who need some form of vision correction. In addition, we can now begin the process of establishing a medical treatment facility within our present clinic environment so that when we get patients arriving with nasty cuts, broken bones and dislocations, ulcers, sores, skin conditions and infections to name a few, we will have an appropriate space set up that will be more suited to dealing with problems like this. This will be a huge gift to the community. We are grateful.

As well, you may know that we and especially Pat would like to establish a small school here on our site in Jambiani. This would be primarily aimed at giving students an opportunity to acquire skills to enable them to gain employment in the tourism sector. Associated with this school would be a small fruit processing facility. We are a bit closer to realizing this dream as one of Pats contacts from Rotary is chiefly responsible for overseeing developments of this nature and he is very keen on the idea. We also have the interest of several Rotary Clubs in Germany, Holland and the UK who may be willing to assist with the funding side of this possibility so we are really optimistic that this will eventuate.

One of our biggest challenges is to ensure the sustainability of the work that we have started and this requires quite a reasonable sum of money each year. One benefit of a school here is that we would incorporate a small training restaurant as part of the overall plan and along with the juice outlet, this may generate enough income to sustain the entire project. A complete win win scenario. We'll keep you posted as things unfold and develop.

Duncan and Sheryl have only one day left in the clinic now after spending almost two months here. Their two boys arrive tomorrow and will stay with us until Friday at which point they will all leave for the north of Zanzibar for a well deserved holiday. They'll be back in Jambiani for a short stay after that and then they are off to the mainland for a safari. What a tremendous trip and especially for their two sons!

We've really enjoyed Duncan (Daudi) and Sheryl's (Sharifa) company and we and all the patients they were able to help thank them from the bottom of our hearts for their selfless contribution to making a difference in this world gone a tad mad. Asante sana Duncan and Sheryl. Keribu tena! Oh yes, that's Sheryl below showing the locals a dance move or two and Pat and I, Mama, Kate and Barry (right) at my birthday party on the 22nd. It was fun!!!

As promised, here are some thoughts from Duncan and Sheryl before they head off for further adventures.

HABS Clinic – Jambiani, Tanzania

We can't quite believe that our two months here at the HABS clinic in Jambiani is winding up. Much of our experience here as volunteers will likely echo that of earlier visitors. This has been an incredible opportunity for us both. Especially pleasurable has been the wonderful warmth and welcome we have received from the local residents of Jambiani and the many patients that came from all over the island to see us. Many invited us into their homes and included us in their daily life in a way that let us feel much more like members of the community than simply tourists. We were also tremendously impressed by the achievements of Alastair and Pat in establishing and building up the HABS facilities and services to a point where their names have become bywords (and indeed passwords to acceptance) throughout the region. Just mentioning "Ali Baba and Mama Pat" turned us instantly from regular tourists into welcome guests.

The best part of our visit here has been our time in the clinic. Our practice mostly combines applied kinesiology and psychotherapy, so we have been much more dependent upon verbal communication with patients than most prior practitioners. The translation assistance (and Kiswahili coaching) from Chai has been invaluable. We found that studying Kiswahili has been quite critical for our clinic work, and by the end of our 2 month period we have been able to communicate with some ease, at least on clinic topics. A shorter stay would have been much less satisfying for mind/body work. We find, however, that much of our clinic-Kiswahili is less useful for casual conversations – "how is the pain now?", and "how often are your bowel movements?" don't seem to have much use outside of the clinic!

We found that working from a combined psychological/physiological approach was helpful with extreme traumatic events such as patients who experienced a near drowning, or who were subjected to spells by the local wizards. However, usually horrendous accidents and illnesses were only gradually disclosed and as practitioners we needed to use much intuition to explore a lot of the mystery symptomatology that presented - especially the quite numerous conversion cases displaying non-anatomical pain patterns and constantly changing symptoms that wandered from location to location. We were also glad that we decided to pack microcurrent equipment with us, as we frequently used this modality to successfully manage chronic pain patterns. Given how seriously the local people take their football, we saw a lot of football injuries, old and new!

It was interesting that even when we were working at the physical level with primarily somatically based complaints it was difficult for many patients to provide clear feedback regarding the relative effectiveness of treatments. Mostly, we had to content ourselves with "afadhali kidogo" (i.e. "a little better" - but without any descriptors as to how it was better being forthcoming); or thankfully more often we heard "nzuri sana" (very good) or "hamna maumivu" (no pain). It seemed that one of the best outcome measures was patients returning to see us (which often means a commitment to a full day of travelling.) It was rewarding and heart wrenching at the same time to see how disappointed many patients were when we told them we were leaving.

Another significant feature of the experience in Jambiani has been the severity of the conditions that people presented with when they came for treatment. In the first couple of weeks alone we encountered several severe stroke cases, a muscular dystrophy case and a variety of children with birth trauma or early childhood fever-induced central nervous system deficits. Many of these cases would not typically be referred to us within the Canadian health care system. Happily, we discovered that we were able to significantly improve function in a number of these situations. This has some interesting implications for our practice once we return home.

Overall this has been a challenging but intensely rewarding experience that we would highly recommend to others. Today was our last day in the clinic, and we will be missing our HABS clinic days and our work with Chai our translator very much. We are very grateful for the hard work and support from Alastair and Pat which has made this possible, and their gifts of connecting health practitioners and the local people of Zanzibar. Asante sana!

Duncan and Sheryl (Daudi na Sharifa)

So it looks like next year will be action packed. We are booked out with volunteers, we hope to start construction of the school and also of another house for Pat and I. As much as we appreciate the company of others, it will be an ideal situation when the volunteers can have their own space and we ours, that way for those of us who like to wander around the house naked, we can, without worrying about scaring any of our guests. :-) Also next year we will be sponsoring TWECS as well as starting up with new and improved medical care services. Pat will be very busy preparing the curriculum for the school and seeking out prospective students and if the school is completed, actually starting the program. It's ambitious but it's all good and we can only see benefits all around for everyone involved.

We have about ten weeks left now before we head out. Our next volunteer is scheduled to arrive in September. Barb Hunter is a massage therapist from the interior of British Columbia. We met briefly at the fund raiser that was held in Vancouver last year so we are really looking forward to meeting Barb again and welcoming her to Jambiani.

We have several maintenance projects lined up for the next few weeks so that, along with my clinic responsibilities should keep us busy right up until our departure on September 30th.

We are still enjoying the winter season now with noticeably cooler evenings and mornings but nice warm days. It is pretty hard to beat.

Anyhow, I think that's about it for now. We are all well here and as all-ways we are excited, motivated and looking forward to the future of this project as we shift into second gear and bring the educational component of our HABS mandate online and to the people. This has become a real team effort so to all of you who are helping out in any way whatsoever, we thank you so much for making this dream come true.

Until the next time, much love to you all from all of us here at the Wellness Center in the "Jam".

Alastair and Pat