Jambo Tanzania - Part Two: Arusha!

Six a.m. on New Year’s Day 2010 found us at the deserted Kisutu branch of the Kilimanjaro Express (“KLM Express”) bus company. However, the bus was already there waiting for passengers, and that always is good news. At 6:15 a.m. sharp, we bid adieu to Uncle Zaffar and boarded the bus for a short hop over to the Ubungo Bus Terminal, where we were scheduled to pick up the majority of customers.

The fun at Ubungo only began after the fully-loaded bus embarked on the long road journey to Arusha. Since the exit to the front of our coach appeared congested, the driver decided to reverse his vehicle to the central road cutting across the terminal. The next 30 minutes was an agonizing journey through parking lot hell, with the assortment of coaches, city buses and dala dalas (minibuses) attempting to make a mad dash towards the singular exit out of Ubungo, only to realize that they had to cut into the sluggish queue of buses whose drivers were not willing to make any concessions. It was akin to a really viscous liquid trying to squeeze through a funnel with a narrow stem. A cacophony of honking sounds and irate muttering bus drivers, and near misses ensued. It turned out that a dilapidated dala dala had decided to quit on the other artery, leading to this mess. Eventually, we exited onto Morogoro Road, picked up a couple of additional passengers on the outskirts of Dar-es-Salaam, and were on our way to the northern Tanzanian town of Arusha.

The journey was quite uneventful, with the scenery outside changing from palm-tree lined fields to centuries-old baobab trees firmly entrenched in the red mud to steep escarpments rising out of the sisal plantations. The multi-storied concrete buildings gave way to the mud- and clay-enclosures topped with tin and thatched roofs. We passed through villages where residents were taking their noon-time siestas under the shade of the largest baobab tree in town. The increase in elevation was also noticeable, with the heat and humidity melting away to just heat alternating with cool breezes through our non-airconditioned bus. Adnaan and I were willing to forgo this luxury to save a few bucks. Along the way, there were several references to Barack Obama, including a painting on the back of the bus proclaiming “Barack Obama, 44th President of the United States”, with the White House in the background. About halfway through the journey, we stopped at the new bus terminal at Korogwe, a huge improvement over the previous terminal I had passed through 5 years earlier. The cafeterias and bus parking areas were more organized, and there were even regular announcements warning passengers when their buses were about to depart. I was impressed. After 20 minutes, our journey recommenced. Around 3:30 p.m., we reached Moshi, the departure point of the majority of the Mt. Kilimanjaro-bound trekkers. I had hoped to catch a glimpse of Mt. Kilimanjaro, but it was enshrouded by a thick layer of clouds. Fifteen minutes later we were on the move again, reaching central Arusha at about 5:30 p.m.

Djamil Chacha and our cousin Faisal picked us up and took us to the Sheriff compound on Goliondoi Street, close to Tourist Central (i.e. the restaurants, cafes, and curio stores and markets frequented by non-Tanzanian visitors). After freshening up, we headed to the mosque to say our evening prayers and to meet with other members of our extended family. That night we enjoyed a sumptuous meal prepared by Farha Chachi. Even Insiyya, who we hadn’t seen in 7 years, was there. We talked about what had transpired in the last 5 years since we last were here, and I tried my broken Gujrati. Needless to say, it needs improvement. We then turned in for the night. I was pleasantly surprised that I needed a blanket to keep myself warm at night, a situation opposite to the one experienced in Dar-es-Salaam, where I had to strip down to my shorts to make sleep bearable.

The next day was an educational one. We had arranged to get a personal tour of the Shia Ithnaasheri Dispensary and Hospital so we could get a feel for how the greater Tanzanian community was served in the public health sector. I received a crash course in the Tanzanian public health system. At the top were government-run hospitals, such as the Mt. Meru Hospital in Arusha. Next were private, charitable hospitals which provided inpatient services. Next on down were the dispensaries, who provided primarily outpatient and pharmacy services. At the bottom tier were the local clinics which provided basic healthcare and medication.

At the Shia Ithnaasheri Dispensary, the director, Dr. Mohammed Alwani, met us and gave us a brief overview of the daily operations of the Dispensary. He told us that most of the equipment and medication was either purchased out of pocket, despite the dispensary being a charitable organization, or donated by European or American benefactors. He then paired us with Head Nurse Rose, and she took us on a tour of the facilities. We got to see the medical records department, filled with tons of files and folders, and Rose told us about their innovative organizational system. We were then taken to the dispensary, where patients picked up their medication, and then the pharmacy, where we met Simba (“Lion”), nicknamed because of his tall muscular frame and his fondness for working with orphaned wild animals. He showed us a video he had made where he was feeding and training a wild leopard. He hoped to get a contract with Discovery Channel and set up his own nature preserve in Kenya. We then saw the injection room (for insulin shots), the physical therapy room (where a patient was receiving treatment for scoliosis), the ENT room (where a doctor was consulting a mother on her child’s ear pain), and the lab, where the technicians were centrifuging some blood samples and observing them under a microscope. I explained to them how I also work with blood but in a totally different way, and they understood.

We then went upstairs to see the remaining facilities. At the base of the stairs was an incinerator to burn medical waste and behind the back wall of the dispensary was a cemetery, where several of my relatives are buried. How convenient! We met my uncle, Dr. Mohammed, who’s an ultrasound specialist. He described to us how difficult to procure updated machines, necessitating the need to learn how to fix them himself and keep them going beyond their effective life span. We also visited the accountant for the dispensary, who told us about the dearth of speech pathologists, and that he had to look for therapy for his daughter abroad, but didn’t quite see improvements in her speech. We thanked Rose and Dr. Alwani for their time and opening our eyes to a microcosm of health care in Tanzania.

Djamil Chacha then took us to the Shia Ithnaasheri Hosspital. We met Sadiq Chagani, the director of the hospital, who briefly described the operations of the hospital, including the fact that several specialists visit once a week from KCMC, in Moshi, to perform surgical procedures on the hospital’s patient. He then asked the chief anesthesiologist to give us a tour of the surgical facilities. He pointed out that some of the imaging equipment was donated, most recently the CT machine, by a German couple. The anesthesiologist, whose name escapes me, asked us to remove our shoes and wear rubber slippers placed inside the surgical prep facility, which was a narrow room with a small shower stall and a large metal sink with several bars of antibacterial soap. Then we went inside the surgical theater, filled with several pieces of equipment surrounding a foot-pedal operated bed. I observed that the anesthetic-dispensing machine, ventilator, heart-lung machine, and blood transfusion equipment was a far cry from the equipment we take for granted in American hospitals. I don’t even think I saw a crash cart or an automated external defibrillator. Sadiq then took us around the various wings of the hospital and the lab, where I had a chat with the technician about how he prepared his samples. On our way out, we passed the mammography unit, which was also broken. Sadiq explained that the processing board had fried and he was still waiting for the replacement part to arrive. It was extremely disheartening to see old and failing equipment, especially for a Westerner like me, but at the same time, the patients generally seemed more upbeat and appreciative about the fact they were receiving any care at all. A poignant example was when an elderly man shook Sadiq’s hand and thanked him for orthopedic consultation services rendered by the hospital even though he had waited in a long line to see the specialist.

Outside, Adnaan turned to me and said, “Do you notice what’s wrong?” It took me a while to figure out that the ambulance was hemmed in by other cars, so if there was a call to the hospital, the ambulance driver would have to find the other drivers to move their cars, wasting valuable time. Adnaan then went inside the ambulance and pointed out that the simple stretcher and oxygen unit inside was a far cry from the fancy gadgets he used as a member of the Stony Brook Volunteer Ambulance Corps. This concluded our tour and we thanked Sadiq and were on our way. The visit to the Dispensary and Hospital was eye-opening, and the doctors, nurses, and staff were doing more with less and quite resourceful. And, most importantly, the patients showed their gratitude for receiving care when the alternative would be pain and possibly premature death. I think we could all learn from this.

In the afternoon, we went to Mountain Lodge at Lake Duluti with Djamil Chacha to take in the peace and serenity, and of course enjoy the delicious buffet. When I was 7 (and Adnaan 3), my parents and us kids had come here to stay a couple nights. It was also the first and last time I had ridden on a horse. From all this traveling back and forth on the main highway into Arusha, I noticed the distinct difference in the slogans on the back of the buses. No longer were the proclamations hopeful or seeking divine intervention, like in Dar-es-Salaam. Instead, they were full of confidence, optimism, and a bit of brashness. For example, one of the minibuses had “Ruff Ryders” written on the back.

For dinner, we went to Mohammed Chacha and Azra Chachi’s house on the other side of town. The neighborhood was suffering a power outage at the time, but when we arrived the lights came back on, and we were henceforth dubbed the Noor (“Light”) Brothers by our cousins Jehangir and Mubashir. We even got to meet 4-year old Sajida, precocious and assertive, as we got to experience when all of us had to suffer through half an hour of nursery rhymes. Poor Mohammed Chacha.

The following day, we went for an afternoon hill climb with Uncle Muslim and Faisal. However, as we were about set out, a torrential downpour ensued. Stranded under the “Sheriff” sign outside the Sheriff Dewji & Sons offices, we waited out the storm. A concerned Djamil Chacha asked us to reconsider our trek, but the eternally optimistic Uncle Muslim reasoned with him and convinced him we were in good hands and the weather would improve. After eating a few “pipis” (hard candy) and watching the sheets of rain trickle to a drizzle, we set up Goliondoi Road and through the Eastern part of town towards Kijenge. On the main road out of town, we were accosted by hawkers trying to sell headphones and bracelets, to which I responded “hapana, hapana" (“no, no”). On our way, we passed a Stop and Shop convenience store which made me laugh, as the one I am used to is a large supermarket chain in Long Island. We crossed over a rickety wooden bridge with intermittent railing and a few planks missing. Getting a grip was difficult as our sneakers were already caked with mud. We slogged through the muddy alleys of Kijenge, trying to avoid the trash floating in the rivulets and streams passing underfoot. As the tin roofs of the town disappeared below us and the canopy of lush green, rain-streaked leaves rose above us, we though the worst was behind us. Not so fast! We got lost several times trying to search for the main trail up the hill. After backtracking quite a bit, we found a wide muddy path that clambered up the slippery slope. Our travails were momentarily forgotten as we saw Arusha spread out below us, and the clouds parted briefly so we could see Mt. Kilimanjaro’s sister peak, Mt. Meru. It was quite a sight. What was most surprising was that the final hundred yards to the clearing we sought was paved with bricks and a gazebo stood just below the top. The bitter irony was that the whole climb we were seeking respite from the relentless rain, but the rain had stopped when we reached the gazebo. We rested a bit, taking pictures, drinking sherbet, and eating crisps. Then we headed down, slipping, sliding, and falling all over the place. If I had a glimmer of hope of preserving the mudlessness of my clothes, it all vanished during the last fall, as my jacket, shirt and pants were all streaked with wide swaths of mud. Eventually, we reached the main road back to town, where a very worried Djamil Chacha spotted us and gave us a ride back home. And he had every right to be worried, as the road is frequented by bandits who prey on unsuspecting tourists at night. Later, we were rewarded with succulent barbeque, including Adnaan’s favorite, nundu (fat from the back of the cow and a heart attack waiting to happen). All the while, we were making fun of this fat kid a couple tables away who had a peculiar eating style and sat cross-legged on his chair.

The next day was a relatively easy day, as we paid a visit to the curio market nearby and bought a few souvenirs. We roamed the offices and met our uncles and cousins we had missed the previous few days. I also got a few bags of ground coffee beans for myself, even though I don’t regularly drink coffee, just because they smell so good! Adnaan and I visited Phui Fatma, one of our grand-aunts, who emphasized the changing face of Arusha from a sleepy northern town to a bustling, noisy, and dusty hub of tourists, farmers, Maasai, and opportunists.

“Before, I could sleep peacefully at night, even though our apartment is next to the main road. Now, you can hear all the ao-jao (coming and goings) and people laughing and talking. It’s really annoying, but what can you do.”

We met with Uncle Akil at his optometry clinic and ate pizza and burgers at McMoody’s. In the afternoon, we went with Uncle Gulamabbas to visit some lodges. On the way there, we passed by some factories and warehouses operated by Sheriff Dewji & Sons, but half of which were now rented out to others, as the younger individuals in the family move away and take up jobs in the health care and engineering sectors. At Karama Lodge, we observed some of the wildlife at the base of the cabins, placed on stilts above the sloping hill, including a naughty vervet monkey and its children. I was happy to finally get a good view of Mt. Meru and in the distance, Mt. Kilimanjaro. We then went to Coffee Lodge, passing an “Obama Bar”. Uncle Gulamabbas remarked that references to Obama were a common sight since his election, and several establishments had renamed themselves as a result of his win. While at Coffee Lodge, we had some freshly brewed coffee. Although I’m not a coffee drinker, those few cups of coffee are the some of the best I’ve ever had. We drove back to Mohammed Chacha’s place for dinner. Unfortunately, our Noor Brothers magic had rubbed off, and we ate dinner by lantern-light. The lights briefly flickered back on just prior to our departure, and then went off, announcing that it was time to go.

Later that night, we went with Uncle Hameed to the pediatric burns and malnutrition units at Mt. Meru Hospital. While some of the inuries were horrific and the children were definitely in pain, the smile that Uncle Hameed brought to their faces by giving them composition books and pencils was just otherworldly. One of the children was quite the artist too! One of the images seared into my mind from that night was a severely malnourished and orphaned (or abandoned) Maasai boy who had been found on the border between Tanzania and Kenya. His regularly shaped head rested on a neck half the size of my wrist. His body was tiny and his abdomen misshapen. The lady who took care of him showed us the scars on his belly from where a witch doctor had squirted traditional medicine to drive his demons away. But the most poignant memories for me come from the premature ward, where babies are lined up by 3 and 4 and placed in several cribs in a room with wall-mounted heaters. The babies for the most part are normal except for the fact they are tiny. One of the babies was isolated from the rest and placed under a UV light and face covered because she had jaundice. My dreams that night were vivid, but I woke up with a smile on my face because I knew there were honorable individuals like Uncle Hameed taking care of these kids.

Early the next morning, we went for prayers at the mosque, and then departed for the 6 a.m. bus to Dar-es-Salaam. The return journey was great for the first half. It was thrilling to be sitting behind the driver and flinching every time we passed another vehicle or approached oncoming traffic, moving deftly back into our lane with just inches to spare. The fact that the curtains were flapping in the wind made it all the more wild. Just before our bus turned south on the road between Himo and Chalinze, we passed through a weighing station and market that gave us stunning views of Mt. Kilimanjaro, the tallest peak in Africa. I still can’t believe I stood on its summit 7 years ago. As we went further south, the elevation decreased, and the heat and humidity came rushing back. Then we reached Chalinze, and chaos broke out. Only one of the two weighing stations was operational, and traffic moving in all four directions made a beeline for the station. Seizing the opportunity, the bus driver reversed onto the scales, only to be chased out and told to get back in the line. While we were waiting, local vendors plied us with their woodwork, assortment of nuts, and lots and lots of pineapples, since ananasi season was in full bloom. After we departed the weighing station, we were on the final 90 minute leg, and the most exhausting part of the trip. On top of the permeating heat and humidity, my knees were killing me, as I couldn’t move my legs, due to the metal barrier in front of our seats. Never again am I sitting in the front of the bus. Of course, Adnaan slept through it all. Even the bus attendant was sleeping in the space behind the driver, only waking up about 20 minutes from Dar-es-Salaam.

Finally we pulled into the Ubungo bus terminal and disembarked. We were back!

Up Next: Part 3 - Zanzibar

Click here for pictures from my trip: http://travel.webshots.com/album/576647760xxpRyj