United State of Happy New Year!

Happy New Year townies! I'm off to Mac's New Year's Eve Carrburrito party before heading downtown to party like it's... well... 2010. I hope everyone has a safe and celebration and helps ring in 2011 with sequins and glitter!

You obviously know my love of music videos and my secret love of the top 40 (shout out to my fellow love Toewsy!). This is the culmination of 2010's best music in a mashup by DJ Earworm called "Don't Stop the Pop".



New Year's cheers to all those friends in different time zones who aren't celebrating on Eastern Standard Time: Costa Rica, Tanzania, Hawaii, and somewhere in middle America road trip.

Bring it on 2011!

Em & Aud's Excellent Adventure

Two of my classmates from Duke have just arrived in my old stomping grounds of Moshi, Tanzania. They took my place in the pediatric clinics, living on the compound, and exploring the greater Kilimanjaro area. Since I was the first student to go from our primary care program, I had a lot of kinks to work out and spent much time "trail blazing" to figure out how to survive in TZ and make the academic portion of our program a success. Their blog is www.emandaudintz.blogspot.com and you can follow their journey there. This was their post to say asante to all of my help in preparing them for this adventure... Hope ya'll have a great time! Safari njema!

Two brave PNP students, Becky and Kelly, embarked on this same experience previously on their own. These girls established relationships and set precedents for future nurse practitioner students to gain global health experiences at KCMC. A wise professor once said, “trailblazers experience the most bumps in the road!” Well, Becky and Kelly sure had their share of potholes to deal with, but handled them with poise thus paving the way for our time here in TZ. To you we are extremely grateful! Your advice, resources, packing lists, cell phones, and long Q & A sessions have helped us immensely. You are amazing… we will be saluting you from the top of Kili!

Becky the Superstar!

Merry Christmas from Local Townie!

In lieu of a traditional Christmas card (because my life has been anything but traditional this year) and in order to save the planet, I blogged my Christmas card.

This was my Christmas tree in Tanzania. The closest I got to a white Christmas in Africa was seeing the glistening snow on Kilimanjaro. It's good to be home for Christmas.

This is our family picture from Christmas morning. We were obviously in the spirit.

I was lucky enough to get down to Birmingham to celebrate Christmas with Richard and his family. In addition to celebrating the Christmas season, we celebrated finishing my Master's degree at Duke. It was a whirlwind to get everything finished in time, but I'm done and graduated! Definitely deserved a celebration!

Merry Christmas to everyone! I wish you a happy holiday and a wonderful 2011...

it's going to be a big year with babies, new jobs, fun destinations, and lots of friends and family. I can't wait see what it brings. Love.

By popular request: Tanzanian superlatives

Top 10 reasons why I am (or am not) returning to Tanzania:

Am-
1. Karibu is the first word you hear. Welcome.
2. Summer year round? Ndio, asante sana.

3. Why drink water with parasites when you can drink Cokes all day?!
4. I could get used to Africa time: 4 hours of work, a nap every day, in bed by 10 pm.
5. I want to carry my baby in a kanga.
6. Bartering is really fun, even if you still get mzungu prices.
7. A fruit salad to feed a small army costs about $2 and you can buy everything from the mamas right outside your house.
8. There's a lot of work that needs to be done.
9. Swahili is a beautiful language.
10. I am a millionaire in Tanzania! ($1=1500 Tsh)

Am not-
(above: some of my favorite nurses at my "going away" party at The Station in Carrboro)
1. It's really hard to get hugs across the Atlantic Ocean.
2. Being a nurse is a difficult battle in Africa, and being a nurse practitioner is unheard of.

3. I love all 4 seasons.
4. I prefer to sit... not squat.
5. I'm spoiled and appreciate electricity... especially when it's dark.
6. Dala dalas make Carolina's U bus on a rainy Monday in August seem like a limosine.
7. The amount of cereal I eat in a month would cost $24 (36,000 Tsh) and I like it better when it crunches because it's fresh... not because it has ants in it..

8. I like wearing dresses, skirts, and shorts that are quite scandalous... the stop above my knees.

9. It's annoying to have your skin color be associated with wealth and therefore be harassed because of it.
10. White girl of Irish descent in Tanzania = sunburn

Before & after: What I had in my suitcase upon arrival and departure:
Before- (See the previous post on how ridiculously unprepared I was.) In short, a few medical supplies, 7 shirts, 4 pants/skirts, 3 tubes of sunscreen, 1 towel, 3 pairs of shoes, 2 packs of Skittles, my laptop and ipod
After- 5 pounds of coffee, countless bags of tea, 6 kangas (the wrap skirts that the women wear), 4 pairs of shoes (please note I came home with more shoes than I left with despite having left my hiking boots in TZ), antibiotics/antiparasitics/antifungals from the duka la dawa, very few clothes

5 foods I dreamed about while I was gone:
1. All things Mexican
2. Cinnamon buns
3. Tar Heel pie
4. Thanksgiving stuffing
5. cereal

Ways I grew that I never expected:
- I cannot have much sympathy for people in Tanzania because I don't actually have any idea what they go through on a daily basis. My capacity for empathy grew exponentially as I saw their situations, listened to their stories, and helped them deal with the circumstances of their lives.
- My passion drove my career to work with children because they are so dependent and vulnerable to insults against their health. Imagine how I felt when you add economic disparity, a resource-limited health care setting, and a country that has twice the health risks.
- I know that I am enormously blessed to be an American. I had no idea how blessed I was to be an American woman, have value in my family, to befrom a middle class family, to have an education at the graduate level, and never worry where my next meal will come from. I do not take so much for granted anymore.

Embarrassing moments a la East Africa:
-Messing up the greetings (which are very important) on my first day and having a room full of Tanzanians literally laugh at me.
-Hosting a dinner party at my house in the doctor's compound and having our ever-leaking toilet water run into the living room. Classy.

-Getting caught with my thighs exposed.

Bert asked me to use 3 adjectives to describe my experience in Africa:
welcoming, slow, delicious

One A Day: 50 days of daily humor by Cousin Katherine

Katherine is my favorite girl cousin and she is one of the most special people in this world. I told you that she made me a One-a-day note for me while I was in Tanzania and it made my day to read her quips every day. She dated the front of the card and wrote a saying, a verse, a past time, or a joke on the back. The days were numbered in the corner so I could know exactly how long I'd been gone. It certainly got me through some of the more difficult times and seemed to be right on track with exactly what I was thinking! I wanted to share some of the best ones with you:

October 25: YAY! The grand-Becky-"I'm spending seven weeks in Tanzania with five pairs of panties"-adventure begins! I love you! (Oh yea... save some babies too!)
October 27: Two silkworms were in a race. The result: a tie. Two antennas met on a roof, fell in love, and got married. The wedding wasn't much, but the reception was excellent.
October 28: Think of all of us here-- family & friends-- who love you so much and wish you the best of times. Now, enjoy your day! You are loved! SIDE NOTE: This was taped to my mirror in my room for the next six weeks. I looked at it every day and smiled.
November 2: Psalm 24:1
November 6: Flying is learning how to throw yourself at the ground and miss. Fly high Becky!
November 7: You've been gone two weeks. Biggest adventure so far? (The answer is YES!)
November 13: Happy, happy, happy, happy birthday, dear sweet cousin Becky! I love you so much! Enjoy celebrating--this will most definitely be a birthday to remember, and a year to remember! For your birthday, you'll have to wait a few weeks but I decided to get you a nephew or neice. I thought you might like it--only it won't be ready until the end of December...
November 22: Some cosmic questions for you to ponder: If the elderly are called "old people" how come children aren't called "new people"? If it's true that we're here to help others, then what are the others here for? How come when asked what things they'd bring to a desert island, no one ever says "a boat"?
November 27: Ten things you can do with a coconut...
November 28: According to statistics, approximately 40,000 Americans are injured by toilets every year. My imagination runs wild...
December 7: Q: What's brown and on the ground and sticky? A: A stick. Eww. Where did your mind go? Clean yourself up. I mean really. SIDE NOTE: I laughed out loud and wrote what I had been thinking on the bottom of the card. You can tell where my mind was: "I was totally thinking it was a cinnamon bun that fell off the table. Guess I was wrong, but now I really want a cinnamon bun."
December 9: Hard work never killed anybody, but why take a chance? SIDE NOTE: You have no idea how true that statement is in Africa.
December 10: Psalm 23:1-3, I pray that your time in Africa has been a time of fullness, of rest, and of quiet restoration (on top of being an adventure).
December 13: Welcome home! Yay! Feel LOVED! SIDE NOTE: I do!

Homecoming!

I changed my facebook status yesterday to: "31 hours after leaving my Tanzanian house, I have arrived back at my North Carolina home."

As I left Tanzania, I was left with a mixture of emotions. I was remembering how scared I was when I arrived just 7 short weeks ago and realizing how comfortable I had become. The unknowns had become familiars and I was comfortable taking care of the things that used to scare me.

Saying goodbye to people was difficult. The Tanzanians all wanted to know when I was going to come back. The truth was I didn't know, but I just told them that I had to go home, back to Duke, and finish some work. Then I'd see where I ended up. To the same degree that Tanzanians are so welcoming, they hate to see you go. Stay and have another Tangawizi ginger ale, stay and work with the watoto in the hospital, stay and make Tanzania your home.

The cab ride back to the airport with Bwana Carol traced my steps back over the things that had been so foreign on the day I arrived. He had given me an ndizi that was tiny and yellow and delicious and I recalled that I knew one word in Swahili. Now I could carry on a broken Swahili conversation with him and my belly was full of mango and passionfruit. I looked out the window from the plane as we were taking off and I had a visceral feeling that I cannot explain... maybe it was knowing that I was going to miss Tanzania.

I flew into D.C. and could see the bare trees and snow-topped roofs over the Capital City. My bare toes were met with sideways glances from other bundled travelers as to why I was so inappropriately dressed for the frigid weather. Duh, I just left Africa. I checked my bags and immediately went to my connecting gate... after I ordered a grande Starbuck's coffee. Gosh I am such an American!

I landed at RDU and collected my bags. As I rounded the corner to exit the concourse I could see my Dad. I broke into a run and had one of those great airport moments where you say hello to a loved one in front of complete strangers. It felt good to be home. My Dad was no less than thrilled.

What was the first thing I did when I got back? The answer is obvious. I needed Mexican food. One Armadillo Grill chicken taco and cheese queso later, I went home and tackled my next big craving... a steaming hot shower where I did not have to hold the shower head. Then I turned on my cell phone and started making calls across the country to the people I missed most and was excited to talk to again... I started with Denver.

My room is now a complete mess covered in the regurgitation of my bags. Dad made enchiladas for dinner (by my request. I really missed Mexican food!) and I made it until about 7:45 pm before I crashed into my bed (no mosquito net required!). Today I am off to Duke to tie up some loose ends and I'm very excited to see my professors.

It feels good to be home.

Tutaonana baadaye Tanzania!

See you later Tanzania! I am spending my last day in Tanzania hanging with my TZ BFF, Dana. We have lived it up in town, chilled on the compound, and are headed out again after a splendid African afternoon nap. I am trying to pack my bag and feel like a bit of a stereotype of a female traveler as I sit on top of an overstuffed suitcase, trying helplesses (and hopelessly) to close the bulging zipper. Some rearranging will need to happen.

I leave tomorrow on the 5:15 pm flight out of Kilimanjaro headed for Ethiopia, followed by Rome and DC before arriving at RDU 28 hours later. Hamna shida.

I was told by a professor that after the initial culture shock, the next time I would feel sad would be when I left Tanzania. While I am very excited to go home, there is some truth to that statement and I will surely miss TZ. I have missed so much of the fall that I am unsure of what it will be like to get back to North Carolina-- perhaps another culture shock. I look forward to seeing all of you and I hope that my secret fans (read: school friends, family, friends' parents, etc.) will speak up and leave comments. I have loved all of your encouragement and support!

This will not be the last of local townie's TZ blogposts, but it will be the last from the ground in Africa. Kwaheri Tanzania, hello America!

Cravings

Traveling to Africa comes with a complimentary dose of culture shock that I experienced in my first couple of weeks here. I missed so much about America and had a difficult adjustment to the way things worked here in Tanzania. As I finish up my work and look back on my time here, the shock has subsided and I am realizing that there are aspects of life here that I will miss a lot.

Things I missed about America:
-a hot shower, where I could stand without holding the faucet head
-washing machines, and not having crunchy clothes when they come out of the dryer
-good cheese
-fresh brewed coffee
-reliable internet
-perfume

Things I did not miss about America:
-driving 45 minutes to clinic everyday
-12 hour nightshifts
-18 degree mornings and scraping off my windshield
-high priced everything

Things I will miss about Tanzania:
-the produce!
-the constantly blooming flowers
-greeting everyone in the street
-deep fried everything
-the babies wrapped up in kangas

Things I will not miss about Tanzania:
-dumping out the bucket of leaking toilet water three times a day
-dala dalas
-mosquito nets
-body odor
-power outages every day
-being called 'mzungu'

My new Swahili vernacular

When I got off the plane two months ago, the only Swahili I knew was "Jambo!" My TZ friends are quite impressed with how far it has come in such a short time and I have found that certain words and phrases and snuck their way into my speech. I figured I would give ya'll a quick dictionary lesson so that when I get home and I still have TZ on the brain, you can understand what I'm trying to say.

GREETINGS:
Jambo (Response: Jambo)- Hello!
Mambo (Response: Poa)- a casual hello!
Habari- How are you?
... za asubuhi- How is your morning? (Response: nzuri- good)
... za mchana- How is your afternoon? (Response: safi- literally means clean... you would understand the importance of being clean if you rode the dala dala or washed your feet after a day of tromping through mud/dust)
... za jioni- How is your evening? (Response: salama- peaceful)
Usiku mwema- Good night!
Lala salama- Sleep well! (literally "peaceful sleep")
Kwaheri- bye!
Shikamuu (Response: Marahaba) - literally "I lie at your feet" is said as a greeting to elders as a sign of respect.
Hamna shida- No problem (the equivalent of Kenya's "hakunah matata" which I'm sure you all know from The Lion King)

Other words:
dala dala- bus
asante- thank you
sana- very
pole- sorry
karibu- welcome
who- nani
what- nini
when- lini
where- wapi
why- kwahili
really- kweli
ndizi- bananas... mmmmm
embe- mango... mmmmm

That should enable you to understand my Southern Swahili when I get home.

Kwaheri!!!

Karibu

I love the way Swahili uses "karibu" as a welcoming word. It means both "welcome" and "you're welcome". Tanzanians do not wait for someone to say "thank you" before they pronounce "Karibu!", which makes it more of an offering to the guest rather than an obligation.
I walk around town or KCMC and hear, "Karibu mzungu!" to welcome me to Tanzania. I walk into a shop or someone's home and I hear another karibu to welcome me to buy something or to feel at home. As food is placed on the table, a karibu is offered to tell me to enjoy the delicious meal.
In the Carson house we say "Proud to serve." I think the word "karibu" sums up that mentality perfectly.

Gift Giving

In the spirit of Christmas (it doesn't much feel like Christmas here since it is 85 degrees... but my house does have a plastic Charlie Brown Christmas tree that we decorated with tinsel and tiny lights) and in Tanzanian culture, I am spending this week giving gifts to the important people in my life here in Tanzania. Adellaide is the international nursing student coordinator and is getting all things that a nurse should have in her pockets-- a UNC notepad, pens, highlighter, and calculator. Vera is the Duke liason at KCMC and is getting earrings. The clinic nurses are getting American pens (a highly coveted possession). And the doctors are getting bubbles and stickers to entertain the children in clinic. There have been some Tanzanian mamas who welcomed me into their homes and fed me (wayyyy too much), so I am giving them durable grocery bags to take to the market.
Hospitality and gratitude are very important parts of Tanzanian culture so it feels good to show my thanks and appreciation to everyone that has helped me thrive here.
I am getting excited to be back for Christmas. Dad told me that all he wanted for Christmas was me back on American soil, so I'm giving him his gift a little early and coming home next Monday.

The Circle of Life

I just got back from my safari and it was AMAZING! I'm pretty sure we sang the entire soundtrack to The Lion King from start to finish. I was surprised at how easy it is to find the animals and that they are totally used to the big "animals" that drive around and make a lot of noise.

We saw just about every animal and got into a few interesting situations...Don't worry nothing dangerous... There was a fresh wildebeast kill by the side of the road with a lion in a post-lunch coma and we watched two lionesses stalk a herd of wildebeast, hoping for a snack. Sadly, they spooked the herd and there was no kill.

The three parks are all incredibly beautiful in their own ways. Tarangire is full of foothills with winding roads and animals around every corner, while the Serengeti is vast and beautiful with unique architecture of trees and watering holes, and Ngorongoro is a giant crater that is beautiful from above and below and has the best of both worlds with its lush jungle and wide open plains. Camping was quite interesting since our last night had a few uninvited guests... hyenas and wild boards invaded our campground. I stayed put until they were long gone and got up to see the African sky at night. Sunrise was pretty impressive as well. I saw the sun rise over the Serengeti and Ngorongoro crater. I will post more pictures later, but I wanted you to get a taste of wild Africa.

Hash run

Yesterday I went on a hash run that was an unbelievable experience. For those that don't know what a hash is, usually a person (the "hare") leads the run and places flour for the people behind to follow. Hash runs in Moshi tend to take you through villages and around waterfalls, but yesterday was a bit different. We were hashing through a gorge and the river that runs through it. It was an amazing sight to be hopping over rocks (or falling on them in most cases) in the middle of a pristine river with vines hanging down over the trees and the canyon walls towering 50 feet over us. My legs are pretty beat up right now (nowhere near as bad as Dana's), and the bum of my shorts has been ripped to shreds, but it was maybe the coolest thing I've done in Tanzania. I'm sure the locals thought we were insane wazungu and I need to go find out what kind of drugs to buy to cover shisto (Uncle Bob, any ideas? Albendazole?) but it was so worth it!

Safari njema!

That means "Bon voyage!" or "have a good trip!" I leave on safari tomorrow morning. I am going with two other Australian girls from KCMC for four days in the Serengeti, Ngorogoro Crater, and Tarangire National Parks in Tanzania. We are camping and I am really looking forward to the endless stars in the African sky.

After I am saturated with giraffes, elephants, lions, cheetahs, flamingos, baboons, and the rest of the African plains I will come back for one more week at KCMC. It's hard to believe how quickly this experience has gone. I am very comfortable and enjoy straying from the mzungu path so that I get to do what the locals do.

Asante-giving in Africa

My Thanksgiving was unconventional, to say the least. I went with a group of American ex-pats to a Tanzanian barbeque restaurant where we had to forfeit our stuffing and cranberry sauce for ndizi (banana) and kuku (chicken). It was delicious but I am still miss some of my diet from back home. We went around the table and told everyone what we would be doing if we were back at home in the States right now. My story was about my Dad rocking out the kitchen as the chef-du-jour, watching re-runs of Saturday Night Live with my brother and Dad, putting some Tar Heel pie to the face (can't wait to have a piece at Christmas!), finally waddling to the couch post-dinner, and seeing whether my mom and I have enough bravery to tackle the black Friday crowds.

Our "Asante"giving ended up with a trip to a playground lit up by the African stars and moon. Swings, a merry-go round, see saw, jungle gym, and slide made that kuku sit a little funny in my stomach, but it was so worth it to have a few minutes of childlike play.

The Americans are also missing our usual diet... greasy Mexican food. So I think we're going to have another holiday this weekend and call it "Gracias"giving as an excuse to put cheese on everything and smother it in local avacado. Mmmmm

Saving babies

Everything is exaggerated in Africa. Time moves slower, the mountains are bigger, and the kids are sicker. For those of you who know my background, you know that I am an ICU nurse whose heavy heart pushed her into primary care in search of healthy kids. But now the kids in primary care are just as sick are breaking my heart every day. Yesterday and today were particularly difficult.

We started off clinic with a very sick little boy with HIV and CP in respiratory distress. We ended up admitting him to the ward with a severe pneumonia.

The next patient was a 16 year old boy that we disclosed his HIV status to and he had NO IDEA. (In Tanzania, the children are simply given medicine and they have no idea why they take it. "Disclosure", or telling a child about their HIV status, happens around 12 or 13.) All he knew was that he took medicine every day because his father told him to and that his mother died when he was little. It remains unclear to me whether he was totally in the dark, or perhaps suspected that he had HIV, but we told him all about his disease. It was one of the more difficult conversations I have ever had with a patient. To him it was a death sentence and meant that he would be ostracized from his friends. We emphasized that he would live a normal life-- he just had to remember his medicine every day. He could even follow his dream of being a pilot if he studied very hard in school. After about an hour of tear-filled counseling, he said, "I would just like to go home if it is possible."

We re-admitted a kid that came back for a check-up after being discharged with a severe infection. He had cancer about a year ago and it had metastasized to the liver. No one told him that he had to go through another two rounds of chemo.

And the cherry on top of my Debbie week was that a beautiful little girl was abandoned in the pediatric ward today. Her mother left and the nurses brought her into the clinic. She looks about 6 months old and has the most wonderful personality. It has been outlawed for single women to adopt Tanzanian children.

Ugh. Rough. I'm headed back to my house now for lunch, a handful of Skittles (thanks Aunt Janet & Uncle Bob!), and a nap.

Tomorrow will be better.

Quarter Century Update

Closeup of Becky at age 25!


Enjoying a Fanta in front of my house in my birthday dress... until the dress broke and I ended up in jeans. It was pretty balmy for November 13, but I never complain about getting to wear dresses.


This is in front of Ndoro falls. Every once in a while I would say to myself, "It's my 25th birthday and I am hiking through a Tanzanian mountain village in search of waterfalls... What?!" The hike down to the base of the falls was a Kili-like excursion and we were soaking wet from all the mist. We luckily found our way out, with no help from our "rafiki" (friend), and back to town.


This is Shanette and me in front of the sign to the falls. Our dala dala trip was quite interesting (complete with a birthday phone call!) but we finally made it up to the park.


Kinukamori falls. The legend is that there was a woman (the statue at the top) who found out that she was pregnant outside of wedlock (which is very bad in Chagga culture) and was going to commit suicide by jumping over the falls. She decided against it and on her way back to the village she came across a leopard. She ran away from the leopard and forgot the the falls were behind her and fell over the edge. The statue stands to commemorate her story.


Me, Shanette, and Dana in Marangu.

For those of you that missed out on the celebration of my birthday and are craving more pictures, here are a few pictures from my 25th birthday. Thank you for all the notes, calls, and fb messages!

Reading List

If you're looking for a good read then I have a few suggestions.

Mountains Beyond Mountains by Tracy Kidder is about the work of Dr. Paul Farmer and his efforts to cure TB in Haiti and across the world. It is a great book for both the medical and non-medical reader. If you trade Haiti for Tanzania and Creole for Swahili then you've got my life here in another resource-limited nation.

Three Cups of Tea by Greg Mortenson is not exactly about my life here in Tanzania, but he is from Moshi and his parents started KCMC back in the 1970's.

Rains in Africa

The short rainy season has begun. The dusty streets are now soggy with a mud that cakes to the bottoms of your shoes. The potholes in the road are filled with an orange water that splashes me when cars drive by. Thankfully it mostly rains at night, but it can continue into the morning hours which makes walking to work a tricky task... like today.



Someone lifted my bag in clinic today. It's not a big deal, but the principle of stealing from a volunteer stinks. It was a bag that I had sewn several years ago, but inside my bag was an umbrella and my raincoat. I was super bummed. But my spirits lifted when I realized I had brought an umbrella to give as a gift that I will keep instead. Then I was super bummed again when I realized it had a Dook symbol on it and I will have to carry it around for the next month.

Wonderful TANZANIAN birthday!

Thank you for all the birthday love! I had an awesome day yesterday with my friends Dana and Shanette. We went up to a small mountain town and went hiking around looking for waterfalls. A couple of times I had to gut check myself and say: "Today is my 25th birthday, a quarter century, and I am hiking through a small African village while waterfall hopping. Whoa."

We came back and made our breakfast for dinner while pumping up the jams in the kitchen. I think I'm getting old though because as soon as November 14th came around at midnight, I was ready for bed.

Meg is one of my very best friends. Meg has a blog. Meg made me a birthday blogpost and it made me so happy. ThAnk you Meg. Please check it out:
http://partiallycommitted.tumblr.com/post/1561889501/this-is-becky

I will post pics of my birthday later in the week.

Eating with the locals

In an attempt to forget the really sick kids I've seen this week, I have been having fun at night with friends, Moshi townies, and total strangers who become family while bonding over our love of food.

My first Tanzanian cooking experience was with Mama Rose and Baba Norbert. They invited Dana and me over to cook and we made a dish from scratch. Mama Rose even made us wear kangas as we cooked outside over charcoal. The dish was called pilau... mmmm
Over a charcoal grill:
- Heat oil, add red onions and garlic
- add soup and heat up
- add g'nombe (cow) and let simmer
- add veggies (carrots, peppers, potatoes)
- add more soup
- add soaked rice
- let simmer until all the water is cooked out
Pile it high on your plate and cover with a cucumber/tomato vinaigrette. Clean your plate (because it's rude not to) and allow Mama Rose to pile it up again because "This is Africa, not America. You eat in Africa!" Finish your Fanta, avacado/mango juice, and Sprite. Try to waddle home.

I have eaten at some great restaurants (there is a large Indian population in Tanzania so Indian food/curry is quite common):
-El Rancho (I know, I thought Mexican and was a little disappointed when I couldn't get a cheesy enchilada, but it was delicious anyway)
-Kindoroko Hotel
-Coffee Shop (inventive name I know, but it was the first place I ate when I got to TZ)
-Indo Italiano (Indian meets Italian food)
-The Watering Hole (a mzungu hangout, but it's a cool atmosphere)
-Kilimanjaro Coffee Lounge (not to be confused with Coffee Shop, it's another mzungu hangout but you can get yummy food, pretty good cake, and wireless internet)
-Samosas are a delicious little pastry where veggies meet flaky breading and you can get them anywhere
-Taj Mahal (I told you Indian food was popular!)

Tonight Dana and I are cooking with another Tanzanian friend. I am on my way to pick up the chicken. We shop with the same girl every week in the market, Aisha, and she has started giving us better prices since we have become her rafiki (friends). It is sure to be amazing.

I have invented a dessert called Tanzanian Shimo (Hole) Cake. I am having it for my birthday along with a breakfast for dinner party: Eggs, ketchup, pancakes, ndizi (bananas), nutella, fanta.

I will tell you all about my big weekend next week after I have sufficiently indulged and partied like it's Africa. My dress is pressed and ready for a night on the town! I am a little bit sad that I will not be celebrating with a lot of people that I love, but I have had at least 5 birthday celebrations already this year and I am planning on a few more when I get back. By that time I'll be about 175 years old. It sounds like everyone will still be celebrating since there are lots of travel plans and fun days on the schedule for tomorrow.

Love!

Pictures I know you're dying for!

This is Kilimanjaro on our way up the mountain to Materuni waterfalls. She stays hidden behind the clouds most of the time, but when she comes out, Kili is beautiful! The waterfall is near the village at Materuni. Dana is in the first picture. She's a 3rd year med student at Duke and studying HIV/TB in children. We're headed to some more waterfalls this weekend. Gosh, I'm such a good townie.

T.I.A.-- This is Africa

Habari rafiki! I thought I'd keep you all updated on my time here. It's hard to believe I have already been here two weeks! Time has flown despite the slower speed of life here. We call it Africa time. And when frustrations of life here drive you crazy, all you say is, "TIA-- This is Africa," and you keep going. I have been met with some frustrations this week but they have not stopped me and my experience at KCMC has been filled with amazing stories, revelations, and triumphs.

I have been getting lots of questions from family and friends in the U.S. who are wondering what life is like here. I thought I would answer some of those questions here:

What are you eating?
The answer is quite simple: anything and everything. The produce is the freshest and most amazing that I have ever seen. Fresh from the farms are delicious, maparachichi (avacados), membe (mangos), pineapple (I forget how to say that one), passion fruit, and anything else you can imagine. Dana and I made an amazing peanut sauce last week and bought fresh chickens from the market. Eating out is quite a spectacle though... you have to factor in Africa time and realize that it will take you about 2 hours (minimum) to eat.

What are you wearing?
It is hot. Not quite as hot as NC in the summertime because it isn't as humid, but wearing tons of clothes can make it pretty sweaty. In the hospital I have to wear a lab coat, which I am not fond of since it tends to make children quite intimidated and I am scary enough as a white person! I was told to compare the Tanzanian social norm of women covering their legs to the American social norm of women covering their breasts. You can show as much calf as you'd like, but keep those thighs covered!
To those who know my love of thrifting-- Dana and I went to Memorial Market yesterday where tons of American clothes get sold second hand. We even found a pair of Carolina basketball shorts! We were the only wazungu (white people) there and we spent 3 hours going through rows and rows of clothing and bartering with the shopkeepers. I came away with a whole new wardrobe-- including a birthday dress for next weekend!

How do you get around?
The dalla dalla (bus) is the primary means of transportation to the main part of town. It is essentially a minibus that is PACKED to overflowing with Tanzanians. The cost of getting to town is 250 Tsh (Tanzanian shillings)... the equivalent of about 10 cents. Whether an armpit in your face or someone's mango basket in your lap, it is guaranteed to be an interesting ride. It is not safe to be a mzungu (white person) out after dark so we take taxis to restaurants or to hang out with friends.

Can you speak Swahili?
I've got the greetings down and I can certainly barter with the Tanzanians at the market (and win!), but I have yet to understand how a sentence is formed. I can get by with a few phrases in clinic that I say to parents and children. I have come a long way since getting laughed at on my first day, but there is still a lot to learn. I will give a Swahili lesson here in another post.


How about Kilimanjaro?
I can see Kili from my back porch, but she stays hidden behind the clouds most of the time. Sometimes I have a good view in the morning with a beautiful Carolina blue sky on my walk to KCMC. To those of you who are asking whether I will climb... please talk to the people that know me best and know how much I HATE being cold... much less sleeping in the cold. I am opting out of the climb and am instead planning a few trips which I will keep you updated on.

Have to go, let me hear from you!
Love rebecca (my Swahili name since Becky is too difficult to say with their accent)

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!

Entitled to Happiness

The topic of our entitled American culture (and my generation in particular) has been the subject of conversation a couple of times in the past week, which I now feel compelled to comment on. It's true, we as Americans believe that happiness, convenience, and service are owed to us. When you graduate from school you think an employer will come barging down your door to have you come work for them (with an impressive benefits package). When the wireless on your ipod doesn't work you get annoyed at the inconvenience because you need to check your email for the 50th time today. And the U-scan at Harris Teeter should never have a line because you are entirely too busy to wait (never mind that you have the money to shop at Harris Teeter).

Whatever happened to talking to people in line at the grocery store? Or giving the courtesy wave when someone lets you into the traffic lane? Or simply being impressed that the town of Carrboro has free wireless?

An article we talked about in clinic this week comments on the "high self esteem" of today's young generation that is selfish, self-centered, and entitled. Chores are a thing of the past (most parents admit to me that the only "chore" their child has is to "tidy their room". What happened to folding towels, sweeping floors, emptying the dishwasher, or helping at the grocery store?). This high self esteem supposedly makes us less likely to think of others, less likely to serve others, and more prone to episodes of severe despression. While service to others is extremely important to me as both a Carson and a Carolina graduate, I see a lot of truth in this statement. Take those self-important Tweeters or facebook status updaters... "Baking cookies with my kitty Fluffy!!!!.... Eating cookies and watching at movie with Fluffy, best cat EVER!!!... Emptying the lint out of the dryer!!!!" However mundane, these S.I. posters will think that they are the cat's meow instead of thinking of how they can contribute to society. Take a look at the article-- it's an interesting read.

Time to let steam our of children's self-esteem.

If you're not convinced that we don't appreciate all of the joys of our very privelidged life, look at Louis C.K. commenting on our disregard for all things technology. This video puts it all in perspective a little bit. I am sure you will laugh because it's completely true.


So as I prepare to head to a third world nation and take with me a few luxuries of the modern world (read: peanut butter, bug spray, and toothpaste with mini breath strips), I am reminded to be humble. I am reminded to be thankful and to see joy in the places that I'd least expect it.
I am going to help a generation of children that has never known DVR, laptops, or cell phones... but they are just as happy.

Countdown to Tanzania! 1 month!

I received my visa today so it's official... I'm going to Tanzania!!! I will be in Moshi, a bustling town right outside of the Mt Kilimanjaro park and very close to the Kenyan border. For those of you who will be keeping up with my travels in Africa via Local Townie, I will post periodically before I leave on October 25 and will post as much as possible while I'm in Tanzania (although I make no promises with the internet access!).

The countdown is on! 1 month!

I will be staying in a compound for volunteers that are working at KCMC (Kilimanjaro Christian Medical Center) in Moshi, Tanzania with other international medical students, physicians, and volunteers. Duke has a relationship with the hospital and I will be attending rounds in the pediatric wards. A student went from the acute/chronic program last year, but no one has gone from the primary care program before so I will be the first, which should be interesting since I'll also be working in a children's clinic in town.

I'm starting to pack and starting with my small arsenal of a pharmacy which will include: advil, malaria prophylaxis, diamox (for high altitudes), cipro (for those GI bugs), pedilyte (for rehydration after the GI bugs), probiotics (to return to normal after the GI bugs), bug spray.

I am up to date on all my vaccines after next week with yellow fever, HepA, flu, and typhoid.

The reality of my trip has only partially set in but what's more unreal is that when I finish this trip, I will be finished with graduate school. Just one short month of Raleigh clinic work and two months abroad stand in the way of me being a PNP and that's pretty hard to believe!

My family and friends have done well to support me in organizing this trip while battling "Africa time" and encouraging me to take this opportunity. It will undoubtedly be the greatest adventure I have ever embarked on.