Mambo vipi!

Mambo from Tanzania!
I'm so sorry to leave all of you hanging for so many days, but it has been a very busy week! I arrived in Moshi over 24 hours after I left home and was utterly exhausted and overwhelmed. I won't lie that my first night was a bit rough, but twelve hours later I had met all of my contacts at KCMC and my lifesaver Dana which made all the difference.

Allow me to recap the last week here and throw in a few of the highlights:
This week is the national elections for president which has been quite interesting. There has been lots of shouting and music in the street, lots of music, and lots of paraphernalia supporting one candidate or another. Today is election day and the town seems very calm.

I am working in all of the different pediatric clinics at KCMC. Since KCMC is a referral hospital, it gets very sick children whose parents have waiting to bring them because the expense of health care is often more than the family budget can afford. I have seen many clinical cases that I would never see in the US including rabies, congenital hypothyroidism, and lots of rheumatic heart disease. The mentality in treating these children is very different because of their co-morbid conditions (HIV/AIDS, tuberculosis, malnutrition, unvaccinated) which changes the entire approach to their care. Sadly, it sometimes becomes more palliative care because there is nothing more to do for their situation. The medical language is English but the patients and their families all speak Swahili so I am trying to learn key phrases. It is a difficult language to learn, but I am slowly gettin' there. The Duke collaboration with KCMC is quite large and there are a lot of really great physicians here. The idea of a nurse practitioner does not really exist in Tanzania so I had a difficult time in my first couple of days explaining that I needed to follow the doctors and not the nurses.

I live with 2 British 3rd year medical students interested in internal medicine, a Danish 1st year medical student studying lipodystrophy associated with antiretroviral therapy in HIV pediatric patients, and an American PA student doing OB/GYN. Our house has the essentials and that's about it! We lose power almost every day which I fully expected.

Yesterday I went on a trek with my roommates and my friend Dana up to a village named Materuni to see their waterfall (pictures coming later!). The hike to the falls took us through banana and coffee plantations and on the paths of the small village. Children love to see mzungu (white people) so we had quite an entourage throughout our hike. The falls are about 80 meters high and beautiful! We continued hiking to the border of the Kilimanjaro National Forest and took a sharp turn up the mountain where we ended up at our guide's homestead for lunch. As part of our dessert he brought us some dried coffee beans which we shelled, sorted, roasted, ground, boiled, and pressed into the most delicious (and time intensive) cup of coffee I have ever had in my entire life! You know how much I love coffee so that is a hefty compliment, but there's really no comparison when you're sitting on top of a mountain in Africa sipping kahawa (coffee) with beautiful Swahili watoto (children) in a house with dirt floors. We also tried maize beer (gross) and banana beer (equally as gross). I can't wait to show you the pictures!

I plan on hanging out and resting for the rest of today and while the rest of the Americans celebrate Halloween I will be resting for a bright and early day in the HIV family clinic.

Thank you to everyone who has made comments and emailed me! They are nice gifts to get during the week! Keep them coming, although I will respond to everyone here since internet is so scarce. Love you all!

Safe & Sound

I arrived and have a place to stay. I start in clinic tomorrow. All is well. Keep those prayers coming though because this is a very different experience and I need all the help I can get. Love you all and will be in contact soon.

Thank you's

There are a lot of people to thank for helping to make this trip possible. From logistics, to supplies, to emotional support, I can hardly say thank you enough. To the people that had a very large hand in making sure I made it to Tanzania to work with little children like the cutie pictured above, thank you. You would not let me plan this trip alone, so I will carry you with me as I travel.

Thank you (in no particular order...except for Mom & Dad--you're the best!):

Mom & Dad- for letting me spread my wings

Aunt Janet & Uncle Bob- for providing me with tons of advice on Africa, health care, and encouraging me to stick with it!... not to mention the Skittles that will be my "birthday cake" in November

Duke School of Nursing professors, staff, Hase family, & NAPNAP- for organizing, arranging, and funding my time in Tanzania

Richard- for errand running, mentally preparing, and supporting me through all of the nerves. Our cultural immersion exercise: watching The Lion King while eating Cinnabons.

Emily & Audrey- for sending up prayers on repeat, sifting through the questions and planning with me, stocking me up with some great stuff that I'll need, and being great friends who understand the chaos of it all because you're living it too.

Sweet cousin Katherine- for awesome skirts, a one-a-day letter that will make me cry once-a-day while I'm there, and being my personal cheerleader.

Townie friends near and far- for wonderful emails, phone calls, and letters wishing me well and giving me some great advice on how to survive the culture shock. I have had notes and phone calls from Hawaii to Miami, Washington D.C. to Washington state, and everywhere in between. Thanks to all the townies that came out to The Station last night to say good-bye!

The road is calling, now I've got to go. ~Matt Costa

Packing List

My flight for Tanzania leaves in about 10 hours. I'm still running around doing last minute tasks-- among those is updating all of my wonderful family and friends.

I'll share a secret with you... I have no expectations. I do not know what is ahead of me in the coming weeks and that has definitely been a source of stress for me. I am someone that likes to know what lies on the horizon. Even if the plan is to sleep in a puddle of mud, I would like to know so that I can mentally prepare myself for soggy underpants, dirt in my ears, and grit in my teeth. That has certainly been a barrier in getting myself in the mindset to go.

I plan on taking the VERY LONG plane ride tomorrow (upwards of 24 hours travel time) to prepare my heart, learn Swahili, and educate myself on the WHO (World Health Organization) standards on international medicine... Honestly, I think preparing my heart is the hardest task of those.

It's hard to pack light when you're spending several months in Africa. I'm making it out with one suitcase, my backpack, and a purse. I plan on leaving a lot of things in Moshi so hopefully my load will be much lighter coming home. Here are some of the contents of my bag:
-2 pairs of scrubs and a lab coat
-bare essentials of medical supplies
-the OTC pharmacy
-2 giant bags of Skittles and beef jerky (in separate bags of course)
-4 pairs of shoes (I'm such an American woman)
-7 pairs of underwear (Sorry Katherine, I'm not being as hard core)
-bananagrams, pack of cards, ipod
-2 guide books, 1 pocket Swahili guide, 3 novels, Harriet Lane, 2 WHO journals
-stethoscope, otoscope, ophthalmascope
-1000 stickers, 8 packs of bubbles, 1 glitter ball
-Carolina t-shirts (gotta represent!), a Duke Children's t-shirt

Circle of Life

Tanzania will be easy... I mean, I've seen The Lion King like a thousand times.
...And I speak Swahili perfectly, "Naaaaaaaaaaaants ingonyama bagithi Baba"
They'll have no idea I'm a mzungu (white person).

A week in preview meets my To Do List

Days until I leave for Tanzania: 7
Days left at peds clinic in Raleigh: 2.5
Pages to write in my final grad school paper: 3
Number of fingers I will put up when I drive away from school on Friday while shouting "PEACE OUT": 2

Number of suitcases I plan to take: 2
Amount of packing I've done: 0
Hour of the day I depart RDU: 0600
Legs to my flight: 5
Hours in the air: 18

Books on Tanzania that I have: 3
Books on Tanzania that I have read: 0
Number of Swahili words I know: 3?

Carolina basketball: Fresh Start

Dear Roy,
I know your new season begins today and I'm really excited for you. It's been a tough year for us both, what with the unforeseen flop that was last season and my attending Dook, but I'm optimistic this year. I don't even mind that you sent Will Graves packin'. He probably deserved it. Fool Roy once and you're benched, but fool him twice and you're off the team.

I'd like to go ahead and put in my request for a baller season. I'd like to see less of this:
And this:
And a lot more of this:

I'd even settle for some of this:
I really appreciate the effort. And so does my friend Barack.
Stay classy.
Love, becky

Here's to General Johnson and his Carolina Girls!

This is one of the anthems of my childhood and obviously the theme song of my university years. General Johnson, age 67, has ended an era in Carolina beach music with his passing, but he will be long remembered. One last shag for The General tonight at the last Friday on the Front Porch!

Shakori Hills

I just wanted to make sure everyone in the Chapel Hill area knew about Shakori Hills.
This will be my sixth year going to Shakori and it's a wonderfully amazing place filled with lots and lots of music and dancing! Bluegrass, zydeco, raggae, cajun, drumming, and absolutely everything in between.

Here's the skinny:

Who: Shakori Hills Grassroots Festival

What: Good music, good food, good folks

When: THIS WEEKEND!! October 7-10

Where: Chatam County (near Pittsboro) about 20 minutes from CH. Click here for directions.

Cost: You can buy tickets for the whole weekend, per day, or volunteer for 3 hours/day and get a free ticket. Tickets become half price after 9 pm (just when it starts getting good!)

Hope to see you there!

Never forget the zebras

I am learning that primary care is a different world. Whereas I am used to the "exceptions to the rule" at work in the Peds Cardiac ICU at Duke where I take care of the sick-of-the-sick, it has been a very different experience to be in the community with so many healthy children. It has taken time to adjust to these vibrant and normal children while remembering that not every head ache is a brain tumor, not all children have a heart defect, and that irritable babies do not equate with meningitis.

My time in the clinic in Raleigh has shown me that although I'm running with a pack of horses, there are still zebras hidden within the group. It's my job to find them. Today brought an important lesson in that search, but thanks to my preceptor Gigi's high index of suspicion, we sent a zebra for an emergency surgery before any complications arose.

I've still got a lot to learn.

Baby Lile rhymes with smile

A little background: My cousin Katherine is pregnant with her first baby and they're keeping the gender a surprise. Without knowing whether it's a boy or girl it's hard to refer to "it" as anything but "it". So it seemed only fitting that when I showed the Liles how to swaddle their new baby using a stuffed animal Gonzo (from the muppets)... and the baby received its first nickname.

Katherine's boss & dear friend, Chantry, threw her a baby shower in Blacksburg, Va last weekend and I happily attended as the Carson representative. My Aunt Janet & Jesse's mom were also there-- complete with night time nuzzles, banana grams, and lots of food.

Up in the hills of Virginia, Katherine's closest friends and family gathered to impart wishes, wisdom, and wipes (baby wipes that is!) to the new mom and dad. I think my favorite part was the Prayer Tree that Chantry made. She wrote her prayers for Katherine on little cards and placed them on the tree so that each guest could take one and be praying for Katherine, Jesse, and baby Gonzo. I took two.

This baby will have 25% Carson genes-- hopefully the best ones! While our relationship is technically second-cousin-once-removed or something ridiculous like that, we decided that it would be more fitting to call me Aunt b.

I was so excited to get to see a very pregnant Katherine since we have grown up together and this is a very far stretch from the events of our past (read: Kitty cat nightgowns, thrifting, sun bathing in Barcelona). It seemed like she was sad to say good-bye and send me off to Africa but I reminded her, "I won't be gone that long. Think about it. You'll be pregnant when I leave and you'll still be pregnant when I get back."

Can't wait to meet baby Gonzo!