Guest Post by Nurse Katie – Limited Resources

Since coming here, I’ve had to adjust to living in a place where
everything isn’t available all the time. I’ve also had to adjust to a
work environment that has limited supplies and capabilities. So many
things I’m accustomed to at home are limited or non-existent here:
water, electricity, transportation, medical supplies.

Water: In the village I live in, most people have a tap outside that provides running water. My room has a flush toilet and water tap, but…The water only runs in the pipes for about 2 hours a day. Sometimes. Some days it doesn’t run at all. Sometimes it runs in the morning. Sometimes in the afternoon. If I hear the water running in the pipes, I stop whatever I’m doing and fill up all my buckets, basins etc. If the water doesn’t run in a few days, there are other ways to get water. But that involves a long walk carrying heavy buckets. The hospital has huge rain barrels around the buildings, a lot of people get there water from there. But it is a lot of work to do that. I’ve also learned to position a bucket to catch water that runs off my roof. I usually leave that water for when I can’t fill up my basins with tap water. I have one really large basin I keep in my room for bath water and filling the toilet tank when the water isn’t running-which is most of the time. I also have a couple more I keep filled in my bathroom for hand washing and doing laundry. I didn’t realize how much water one person needs until I have had to physically carry all my water and manually fill my toilet and do laundry by hand.
Drinking water is a whole other issue. Some people here boil their tap/rain water. Others just drink it as is. I will drink it boiled-it doesn’t taste very great, or from bottles. If my stove worked- I think I used it 3 times and it broke- I would probably boil some drinking
water. I just buy a couple of 1.5 L bottles and they last me a while. I usually drink so much tea during the day that I don’t go through a lot of water.

Electricity: Most houses in the village are hooked up to electricity (umeme in Swahili). Once you get outside my village, few people have it in the “bush”. But the electricity is pretty unreliable. There is usually some kind of blackout once a day. Most of the time it isn’t too long, maybe a few hours at most. But sometimes we will go without power for over 24 hours. When the sun is out it isn’t too much of a problem, but it’s very inconvenient at night. We have to light kerosene lanterns or rely on flashlights. Most of the people I spend
time with have televisions, so we watch that at night for entertainment. It’s pretty dull when the power is out. Televisions are the biggest appliances most people have. Almost no one has a fridge or stove, definitely no washers/dryers.


At the health center, we have a freezer for vaccines and a fridge in the lab, so when the power is out for an extended period it  becomes an issue. Also not having power when working the night shift is very difficult.

Transportation: Only a handful of people have cars here, and those are used to drive people to Tukuyu. A lot of men have bicycles and I’ve seen a few women riders. A decent amount of men have motorcycles. If someone has to go to a nearby village, or if someone from a nearby village needs to get to the health center, they can pretty easily hire a motorcycle to take them. I would never go on one unless it was an emergency, but that’s me. The motorcycles are able to get to places the cars can’t go. There are no paved roads until you get to Tukuyu.

There are a few main roads that connect some of the villages, but smaller paths are more common. These are used by people on foot, bicycle and motorcycle. There are trucks that bring in Coke and Pepsi, and the trucks that pick up the tea on harvesting days. If you need to go to Tukuyu or beyond, most likely you will get in a car around 6:30
in the morning with a bunch of other people also going there. Until the car is absolutely packed with people/things/animals, it will stop
and pick up people on the way. When I say “car” I mean super beat up white safari type vehicle. A bench seat in front and two long benches in the back. One time I counted 18 people in the car along with 1 chicken. The driver is usually the owner and he will usually have a boy working for him that hangs onto the outside of the car. The boy helps people in, secures luggage/random stuff to the top and collects the fares. It’s only a couple dollars per person. Getting to Tukuyu is not too hard, you just have to get up super early. Getting back is trickier, because once the 3 or so cars that drive back to the village are gone, you either get a taxi-which no local person could afford, or you walk and hope you can hitch a ride on a motorcycle or truck or anything. Most of the cars come back to the village by early afternoon.

Medical supplies: We face a lot of shortages at the health center. There are too few workers. I think there are about 15 staff right now, they are supposed to have close to 30. There is a lack of equipment and supplies. They have nothing modern/electronic like in American hospitals. When I first got here, the nurses would cut gauze with a razor blade. I brought some extra scissors so I gave them a pair to use. There are only 2-3 blood pressure cuffs. They use the old mercury thermometers. They ration the gauze and tape pretty strictly. For cleaning wounds and sterilizing they only have iodine and another
antiseptic. No alcohol, no peroxide. The doctor told me they are supposed to have that but they can’t afford it and don’t have it supplied by the district. They have a few surgical instruments that everyone shares and clean by hand.
A few weeks ago we ran out of a lot of medications and supplies like little pill bags used to fill prescriptions. The nurses fold scrap paper into little packets to put prescriptions in. Dr. F went to Tukuyu to try to get some from the district office but he was unable to get a lot. The next day he had to go to another local dispensary (a smaller, satellite health center) to try and get some drugs we needed like aspirin. Can you imagine running out of aspirin in
America?

We also are out of treatment cards for the HIV program. The doctor made photocopies a couple weeks ago so we hand those out instead of the official blue ones. As far as I can tell, the health center fills out a request form for supplies and sends it to the district office or the Medical Supplies Department (MSD) in Dar es Salaam. If either of those agencies have the supplies, they send them. If not, we don’t get it. Or they sendcondoms. On a television show the other night, there was a skit about a hospital ordering supplies and when they went to do inventory all they had received was condoms. Boxes and boxes of condoms. Dr F. explained that if Dar es Salaam doesn’t have what a health center requests they will just send condoms instead. A lot of our drugs have stamps that they are “Gifts from the American People” or “A Gift from Japan.” I think these are first sent to Dar then they are distributed throughout the country. I think most of the TB and HIV drugs come from foreign aid as well.

Rant Alert!

So when I hear that things like the Global Fun are cutting future funding, it makes me mad because these are the people who will suffer. They don’t use the latest drugs for high blood pressure or diabetes or erectile dysfunction. They rely on drugs like aspirin and penicillin and amoxicillin. My pharmacy gives those antibiotics out for free! It’s hard for me to see such a disparity between “first” and “third” world medicine. Just a little bit of money goes so far here, I hate to see governments and NGOs cutting it back even more. The people here deserve to be healthy just like anyone else. Fun fact: Tanzania spends about $29 per person per year on healthcare. That’s what I pay for one office visit co-pay…

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