Bir Family, Kolm Continents, Kumi Months

the view

2009-06-19T14:26:00.000-07:00

We are soon done and I marvel at-

all the people we have seen, smiling, friendly, oblivious, dumbfounded( the tandem gets the most looks) thousands of people of all ages

all the gardens we have seen- the universality of growing food and trying to make your 'home', property as beautiful as is possible. I do look forward to rejoining that fraternity/sorority and suspect I will garden with a slightly different additude

all the skies we have seen and their ever changing pattern of clouds and colours
when one cycles one has a better vantage point to see the weather ( especially when it is flatter than hilly) and a greater interest in the weather as it certainly can affect the day's experience

all the dogs we have seen( sorry cat lovers but the felines are less obvious and less interested in us so we are are similarly less interested in them)
dogs bark and chase
fortunately the barking is painless and in most situations they chase until their leash stops them of the fence limits them.
those left free are usually old or older, bark once feebly or not at all,stand up out of curiosity or not.

we have been chased only a few times -the first day, within the first 2-3 kms. for me knocking me down as I was just getting used to a fully loaded bike.

As we have cycled further north the dogs have gotten smaller and yelpy ( sorry Ernie) .
easy to ignore because althought persistent they can't reach our ankles

the usual pattern is that the first rider by rouses the dog(s), the second gets the full treatment and the third ( usually me-amb) rides by a tired or resigned dog(s)

Riding allows a View

Thank you

2009-06-19T14:09:00.000-07:00

we are nearing the end
I have not entered as much on our blog as I might have liked but we have been busy traveling

I did comment on beer
and food
and the sights of our ever changing scenery

we have been in 14 non English speaking countries ( not including Dubai which we visited twice for hours and never left the airport ( it is now however on my 'life list')

This has created a few problems
the first obviously is communication.

The second more embarassingly is, with my advancing years, my ability to remember a few key and/or polite essential words has almost disappeared.

We have succeeded with sign language, and the variable abilty of our hosts to speak English
Leah and my, French has come in occasionally handy although German would have been much more useful.

Remembering the history ( recent and nor so recent) it is impressive how many languages the locals know and /or understand and how different many of these languages are , plus in the case of Greek, Bulgarian and Serbian they use different alphabets

So we haven't understood conversations, TV or the newspaper so much of what we have appreciated is by inference and observation and much may be wrong.

When we found English speaking 'friends' we pumped them for their opinion on a number of subjects- but never enough

We had Lonely Planet Phrase books that were virtually useless- but great for pressing flowers.

for example here is the translation of 'Thank You" in the languages of the countries we visited in order ( including Estonian where we will be in 2 days)

Swahili: Asante sana

Turkish: teşekkür ederim

Greek: σε ευχαριστώ

Bulgarian: благодаря

Romanian: mulţumesc

Serbian: хвала ти

Croatian: hvala ti

Hungarian: köszönöm

Solvak: ďakujem ti

Czech: děkuji ti

Polish: dziękuję

Lithuanian: ačiū

Latvian: paldies

Estonian: tänan

How can I remeber those

A Look At Our Route

2009-06-11T13:15:00.001-07:00

day 1 hayrabolu turkey the day of surviving adversity actually -1.1kms( minus although leah will debate this)
day2 havsa turkey 53 kms amazing first day
day 3 edirne turkey 40 kms a bit too much highway
day 4 svelingrad bulgaria 77kms through greece sunny no food in turkey
day 5 rest day in svelingrad sunny
day 6 topolovgrad 66kms cool overcast multiple hill climbs aprox 20-25 kms uphill WITH HEADWINDS
day 7 Nova Zagora overcast , less cold, not windy (until last 5 kms why is that) 69 kms
day 8 Tvarditsa ( can't do accents
no hotel initially but we were directed to a 'guest house that was so perfect we took a rest day for
day 9 rest day a fair bit of rakia ( home made brandy drunk by ambrose- Leah had a gall bladder attack scare
day 10 a climb and an amazing downhill to Veliko Tarnovo a pass route we had not predicted when we did our (leah's )map studying but we garner info as we travel
day 11we take a rest day in VT
day 12 stay in TV and celebrate catholic easter ( eastern orthodox palm sunday) by doing a local cycle without panniers to a historically important monastery (Dryanovski0 with accompanying caves
day 13 Pavlikeni via celebrated churches and monasteries at Arbanassi ( wonderous)
day 14 -our first hotel headache when our planned destination Pordim did not have a hotel so another 20 kms. to Pleven
day 15 rest day
day 16 griff's 14th BDay and our second hotel stress when the hotel in Nikopol existed but WAS CLOSED ( see blog) so we went on to
Belene 100 KMS !!!
day 17 svistov 50 kms from plevan ( read back)
day 18 ferry to romania to Turnu Magurele easter saturday and midnight eatser celebrations
day 19 ( today) our 3rd hotel stressful experience ( easter sunday) hotel in draganesti-olt existed but was closed and again we have to ride on for a total of 98.5 kms to slatina
day 20 to craiova by train (we had lost days and got to far north east because of the hotel stress)
day 21 rest day in Craiova
day 22 train to bailestie and cycled to Vidin, bulgaria via Calafat
Day 23 into serbia and into negotin
day 24 over the carpathians to Donji Milanovac
Day 25 rest day short ride (50km) pannierless to narrowest part of danube
day 26 along danube gorge big tailwind and lots of tunnels sleep in golubac
day 27 croos danube meet nice german cyclists another tailwindy day sleep in bela cryka
day 28 80km day to pancevo great tail wind we were flying
day 29 rest day in belgrade (walked at least 20k
day30 north to ecka (thought to be 75km turned in to 107km after more hotel stres spen night in 4 star!!!
day 31 May Day tired legs and hypoglycemic ambrose into novi sad. hotel finiding a daily adventure. takes and hour of our time
Day 32 rest day in novi sad category 1 (little walking done)
day 33 Odzaci tried to go fishing
day 34 Osijek Croatia
day 35 & 36 in Zagreb ( by train) and back to osijek
day 37 Vinogradi
day 38 Mohacs ( Hungary)
day 39 Baja
day 40 a rest day
day 41 kalosca
day 42 hajos
day 43 kiskunmajsa
day 44 a crazy night in a pencion in that we found on the web but couldn't find in reality for over an hour near tiszakecske
day 45 budapest by train from Cegled (send fedex package)
day 46 rest day, hop on hop off bus tour of Budapest
day 47 meet paul and ed at airport
day 48 ed and pauls turn to do the hop on hop off
day 49 by train to Pilisvorosvar and cycle to Esztergom
day 50 Hurbanovo ( very hot)
day 51 ( today) simon sick ( gastro)so we stop early Surany
day 52 nitra Slovakia
day 53 Nove Mesko
day 54 Uhersky Brod Czech Rep.
day 55 rest day Category 1
day 56 prerov
day 57 Olomouc
day 58 Sumprek our first heavy rain
day 59 Kraliky our second heavy rain
day 60 Klodzko Poland
day 61 Wroclaw
day 62 rest day category 3
day 63 Brzeg
day 64 Klucsbork
day 65 Krakow after a ride and a train from czestochowa
day 66 auschwitz from krakow
day 67 rest day in krakow
day 68 krakow...bye ed.... hi barb
day 69 krakow
day 70 10 hour train =644 kms- tosuwalki
day 71 druskininkai lithuania 100 kms
day 72 alytus .. another heavy rain stopped on the way at Stalin World or Gruto parkas google it fascinating

2.5 weeks to go
………

My Prose is Bit Lacking

2009-05-01T13:13:00.000-07:00

This blog entry has been floating in my head for a few days,but it wasn't until Maria -my MOA (medical office assistant) of 20 years,office manager, 'older sister', dear friend,plus a large variety of other important roles- commented in a recent e-mail directed to Griffin...

"his prose is a bit lacking,though I certainly get the emotion"

this is the same woman who commented after seeing me jogging( running) and described it as 'plodding' or some similiar term.(and she still works with me-'for me' would be a total misnomer)

Now my lazy Gonzo 'style' of writing has some detractors I am sure.I felt it was necessary to reveal to others that there are high school prose skills still hiding in my grey matter....

We have been cycling for 46 days
We have had maybe 2 hours of rain!! great for us terrible for farmers

We were initially planning a one year vacation and would have cycled June -August.
But with our change to a ten month adventure the cycle portion changed to April -July
and inadvertently we have ended up in a most wonderous time of the year. Spring.

Certainly at home we all love spring and as spring is returning back home all of our friend's and family's e-mails comment on it happily. ( except maybe my family in Calgary and their 'freak= annual' April snow storms.

I suspect there is similar relief, excitement and joy when the weather warms and the snow melts here in the Balkans and Eastern Europe too.

There are two facets of this 'spring thaw' that we have witnessed so clearly from the seats of our bicycles as we we have ridden through rural Turkey, Greece( 1 day),Bulgaria,Romania ,Serbia,Croatia and now Hungary

First, the natural progression of spring.
Leah loves maps and reading them and has poured over our collection for hours before the trip and still daily to create a spectacular rural ride.This maximizes the cycling pleasure and minimizes risk of accident.

As an aside Leah and Griffin met a young French couple who are cycling around the world. They met them in Istanbul in front of the Blue Mosque. The thought of riding bikes through that megalopolis- 10-12 million people, terrible roads and worse drivers- is inconceivable.

Starting in Thrace on the second of April and throughout the early days we had radiantly sunny and warming weather and the plants were just starting to show signs of life.Generally bare ,on closer examination you could see the buds on trees, fruit trees, and vines, all considering the possibility of bursting.
Day by day we could see this botanical process unfold until by the time we were in Central Bulgaria there was a daily progression and procession of flowering trees unfolding before us.
Even our ignorance of which tree was which couldn't dampen the visual enjoyment.

When you are riding a bicycle the view is so important,it makes the ride interesting,it makes the ride pass,it makes you forget any aches or pains or leg fatigue.

Another aside-We were often asked before we left what the boys would do for school.I can go on and on about Geography,history,zoology, cutural studies... but here was Botany before their very eyes.Home schooling ,fitness and adventure every day.

While the tress were flowering and the leaves unfolding the lower plants also began to turn the shoulders of the road into weeds and wildflowers.Yes predominantly green but yellows, whites, blues and purples caught my eyes and I in fact starting to collect them and press them for my journal. Unidentified but colourful. Between flowers and picture taking and age I was always trailing our parade of bicycles.
To balance my flower collection Simon has started a thorn collection.It is surprising how many styles and shapes thorns come in.It is not surprising how difficult it is to transport thorns. But we will.
Beside wild flowers the daffodils and tulips couldn,t help but remind us of home

Then over Easter ( eastern Orhordox Easter was celebrated the week after Roman Catholic Easter this year)the lilacs, mainly violet, some white ,were all of a sudden everywhere.
It felt almost choreographed, as the lilacs seem to lose just a hint of vitality the bearded irises along the road were in bloom,purple my favourite are most common,yellow and white also in the mix and by the time we got to Croatia and Hungary a whole mix of colours and hybrids.

So it is May 15th and the roses and peonies are yelling

The second part of Spring and the botanical awakening is the cultural evidence.
This area is agrarian and besides the large communal farms still in Roamania there is farming on a large scale,market farming and home gardening that is the livelihood of everyone in these small towns.
Sadly ( my judgement) or naturally, these towns are changing. Populations leaving for bigger cities or in the case of EU members to other countries. Those who are making the move are predominantly the young,yet those left behind must still maintain these farms and gardens for income and subsistance.This activity is intense and meticulous. The garden plots, the lawns , the areas between house and road are all cultivated and nutured. In some towns this roadside area has vines trelessed high over the sidewalk. Grapes for homemade wine and rakia(eau de vie) a essential for every household.Great pride is taken in the growing and fermenting.

The large fields are full of winter grain still growing and the beginnings ,just in the last few days, of corn and potato.
Through Serbia and Croatia and now hungary the market farms ars are the latest area of family nad community activity. Medium size fields of beans, peas, carrots, radishes and in Hungary peppers ( for paprika-for goulash) , onions ,garlic and everything else that will make the summer and fall markets ( which we will sadly miss).
It was quite a change when this activity began, because instead of tractors now it was hands and bent backs doing the work.

So winter grains, spring grain planting and slowly germanating, fruit tress and vines flowering, market gardens, farm gardens planted, wild flowers and perennials flowering.
The markets full of early potatoes, last years cellar produce and annuals and tomato plants ready for this year.
We have followed the process and raced the plant's growth as we have headed north
Because of the spectacular weather we have had we are losing the race and now small cherries and minute bunchs of grapes can be seen and the wheat and barley is mature and green swaying with the wind ,which has also been favourable ( at our back).

This area is enormous and flat. we haven't climbed hills for 3 weeks and yet the size is still a fraction of our Canadian prairies.

Spring and maybe this one more than others has been a wonderous, delicious and entertaining time to cycle in this part of the world

our trip (so far)

2009-05-01T13:11:00.000-07:00

3 emails now on the blog

not to replace e-mail and blog
but if you want to follow
our route
day 1 hayrabolu turkey the day of surviving adversity actually -1.1kms( minus although leah will debate this)
day2 havsa turkey 53 kms amazing first day
day 3 edirne turkey 40 kms a bit too much highway
day 4 svelingrad bulgaria 77kms through greece sunny no food in turkey
day 5 rest day in svelingrad sunny
day 6 topolovgrad 66kms cool overcast multiple hill climbs aprox 20-25 kms uphill WITH HEADWINDS
day 7 Nova Zagora overcast , less cold, not windy (until last 5 kms why is that) 69 kms

mileage debate between gps and cycle computer
leah found a bulgarian map leas detailed scale but the towns are written in bulgarian alphabet -VERY HELPFUL and more details of mileage between towns

route has been perfect -lightly travelled ( although vehicles are limited in this country) rural ride
roads vary from excellent to rutted and amazing potholes ( but these are tolerable
accomodation working out very well and inexpensive
lots of wondeful birds ( mainly LBJ little brown jobs-sy says BBB boring brown birds) all with wonderful songs
food fine
restaurant ordering a humerous endevour
tomorrow 40kms with a significant climb
then rest day
then another larger climb day
fitness and butts improving
us

2nd email

last e-mail re our route went to day 7 Nova Zagora
day 8 Tvardica ( can't do accents
no hotel initially but we were directed to a 'guest house that was so perfect we took a rest day for
day 9 rest day a fair bit of rakia ( home made brandy drunk by ambrose- Leah had a gall bladder attack scare
day 10 a climb and an amazing downhill to Veliko Tarnovo a pass route we had not predicted when we did our (leah's )map studying but we garner info as we travel
day 11we take a rest day in VT
day 12 stay in TVand celebrate catholic easter ( eastern orthodox palm sunday) by doing a local cycle without panniers to a historically important monastery (Dryanovski0 with accompanying caves
day 13 Pavlikeni via celebrated churches and monasteries at Arbanassi ( wonderous)
day 14 -our first hotel headache when our planned destination Pordim did not have a hotel so another 20 kms. to Pleven
day 15 rest day
day 16 griff's 14th BDay and our second hotel stress when the hotel in Nikopol existed but WAS CLOSED ( see blog) so we went on to
Belene 100 KMS !!!
day 17 svistov 50 kms from plevan ( read back)
day 18 ferry to romania to Turnu Magurele easter saturday and midnight eatser celebrations
day 19 ( today) our 3rd hotel stressful experience ( easter sunday) hotel in draganesti-olt existed but was closed and again we have to ride on for a total of 98.5 kms to slatina

tomorrow train to craiova we have headed furhter east and north than planned and will use train to get better positioned, save some energy and time, avoid big roads and experience romanian trains

next few days from romania to Vidin and on to serbia

there you go

hotel stress stressful but there are great positive stories on those days too and the boys are heroes with these challenges

3rd email

day 20 to craiova by train (we had lost days and got to far north east because of the hotel stress)
day 21 rest day in Craiova
day 22 trin to bailste and cycled to Vidin, bulgaria via Calafat
Day 23 into serbia and into negotin
day 24 over the carpathians to Donji Milanovac
Day 25 rest day short ride (50km) paniierless to narrowest part of danube
day 26 along danube gorge big tailwind and lots of tunnels sleep in golubac
day 27 croos danube meet nice german cyclists another tailwindy day sleep in bela cryka
day 28 80km day to pancevo great tail wind we were flying
day 29 rest day in belgrade (walked at least 20k
day30 north to ecka (thought to be 75km turned in to 107km after more hotel stres spen night in 4 star!!!
day 31 May Day tired legs and hypoglycemic ambrose into novi sad. hotel finiding a daily adventure. takes and hour of our time
rest day tommorow. croatia in 2 days. ed and paul in 16
a

Bulgarian Birthday Surprise

2009-04-17T09:10:00.000-07:00

This was meant to be a leaving Bulgaria blog
But it was coincidental with Griffin’s 14th Birthday so that seemed a bit more important subject.
But what it really has become is another chapter in this part of our adventure-
Cycling in Eastern Europe- How it can be (and has been ) exciting and unpredictable constantly.

April 16 2009 Griffin’s 14th and a ride to Nikopol ( on the Danube, on the Romanian border)_A planned 57 km ride.
Stunningly sunny-blue cloudless sky a bit cool but promising to be warm. (Warmest April on record)
Birthday hugs, greetings and special breakfast of croissant (not filled with raisins, cheese or any other filling), jam, fruit with coffee and hot chocolates to follow.

Griffin navigates us out of Pleven ( a busy city) without much of a hitch.
The ride is luscious , rural and varied with hills and flat stretches. Small towns, large farms.
Our first surprise of the day was in Varbica when we find ourselves directed to a dirt road through a farmer’s field ( griffin has an early tumble without injuring himself or sullying his new birthday jersey).This tractor path connects us as promised to the highway we were seeking.
We laughed as we carried on.
Lunch in Milkovica sitting in the town square,young students (more like sy’s age) milling around with ice creams on their lunch break. Introductory English, giggles and pictures taken.
Now just 20 kms. to Nikopol and soon we see the Danube ,wide and slow.The Bulgarian side showing evidence of the communist age with decrepit, rusting factories .I share my understanding of communist history to an interested Simon as we ride the tandem.
We have a late climb before riding into Nikopol , We pass the new ferry terminal (supported by the EU) to Romania.
1430 hours, 66 kms- time to relax. We eventually find the hotel -it wasn’t full, it was CLOSED.
We had been assured that there was a hotel but nobody confirmed that it was open.
So we thought we would head off to Romania only to find that although there was a new ferry terminal. THERE WAS NO FERRY and there wouldn’t be for months.
So we had to find an option, no accommodation and the nearest ‘confirmed’ hotel 35 kms away.
Without any complaining from the boys we headed of to Belene.The sun stayed bright and warm, the ride went easily ( after the 6 km. climb out of Nikopol) and as the GPS and Sy’s bicycle computer both ticked over 100 Kms.we arrived in Belene.
The boys have been surprisingly impressive both physically and mentally in dealing with daily( almost daily) rides. We had planned a 50km/day average but are really closer to 70Km.
We found a hotel.72 Lev/PER PERSON (in contrast with 50-100Lev total- we have been paying up until now)
Fortunately there was a second smaller hotel that has cost us 72 Lev total.
We are here .We had beers, then a delicious Birthday dinner and think we have confirmed that the border crossing 30 kms east is open ( tomorrow’s destination)
So we have done 100 Kms. that hurdle has been cleared.
But we have headed East rather than West so we will have to push a bit in Romania. When we get there.

Our time in Romania has been just fine. Perfect weather ( no rain ) ,lovely route, friendly and helpful people. A small sense of its history and its challenges. Better than expected mileage, accommodation a daily question mark. Our bikes and bodies have been behaving.
The people have been helpful and friendly. Language always a challenge but English is creeping in and on occasions an English speaker gets called to help us out .Our French has come in handy ,German would be better as it is more widely the second, third or fourth language.
We get waves, honks ,curious stares and in smaller villages a look of absolute dumbfoundedness as 3 bikes (one a TANDEM) fly through
Food has been more than adequate, prices reasonable, bread a bit boring. Red wine has improved compared to Turkey and we expect that to continue.
After a few days in Romania we will actually return for a day or two in Bulgaria before Serbia.
100 Kms !!! The Danube!!!- Every day a story that has been unpredicted as the day began. The wonder and appeal of traveling.

Early in the Cycle

2009-04-05T10:26:00.001-07:00

We have left Turkey as of yesterday and begun the cycle 4 days ago! Departure from Istanbul was a bit scattered as we cleaned up final details of sending stuff to Canada (thanks once again Graham and his FedEx discount !!) How could we leave Turkey without succumbing to the carpet salesmen ?? Actually we did not buy a carpet….but a bit of stuff you will have to wait to see, and mostly we had to condense ourselves down to 8 panniers. The weather has warmed for our departure which has helped us to feel confident that we have enough warm clothes and wet weather gear.

Here here Amb’s journal entry for Day 1 of the cycle :

“ I am not sure if you call that a start or a story “

“Our first day of the 3 month last stage. Boys sleep like logs and hard to wake up. Leah and I sleep poorly and awaken early to a spectacular and dramatic call to prayer at the Blue Mosque (just outside our hotel window). Missed breakfast, no cab even though pre-booked, miss our bus (pre-bought tickets). How frustrating that was. The next bus is 30 minutes later and actually leaves an hour later. Sunny to drizzly/windy Thrace. Hyrabolu before noon and we set to work excited with spectators curiously congregating. No parts are missing. A torn plastic bag had not lost anything important but had been worn about by the chain of the tandem. This had been a worry. The first 2 single bikes came together easily, but as we put the tandem together we realize a chain wheel had been badly bent, cogs and ring. We were all devastated. Return to Istanbul may be our only choice, Amb may have to head back for replacement part. BUT the local spectators come to our aid. After tea-ing us (x3) and feeding us and offering cigarettes to Leah and I (really!): 1. They arranged the teeth to be straightened 2. Simon and I are driven to 3 separate places until we find a machinist who was able to straighten the ‘wow’ with an industrial metal press !! And this all without and English !! When Ambrose gets back excited, Leah is distraught about poor pannier fits. We realize we have never placed full panniers on the bikes prior to our crazed departure to fully test the configuration. We solve pannier and rack issues, remount the chain wheel, and Leah and Sy have a small tour with no noise, no skips, no derailing. Hooray !! We sit for another tea and consider our luck (both good and bad).

New pump also had never been used and needed some significant figuring out. At this point we realized we were not going to be cycling today after all and finished up the last few details when an English speaking (fair to good) teacher/internet café owner who helps us find a local hotel/restaurant/teachers residence. He also told us our planned route had a closed boarder crossing, so we plan to change our route……”

Anyways the chain wheel is holding and we are now in Svilengrad (pop’n 20,000 -- get out your maps!) in South-east Bulgaria taking a well earned and needed rest day (Day 5) Mileage has been unexpectedly large (53 km, 42 km, and yesterday’s 77 !! ) to bring us here. We realize daily mileage will be dictated largely by the location of accommodation. The remainder of our cycle in Turkey (the part they call Thrace) was characterized by further unbelievable hospitality and curiosity on the part of the Turkish. At one point an elderly couple stopped us in our tracks and insisted on us waiting while they ran inside and got us apples and oranges for the journey. Lots of hair ruffling and cheek pinching of the boys and apparent absolute delight and amazement in what we are doing, and the participation of the children. Via broken language we list the countries of our journey, and the reaction is incredulity!! People have been incredibly friendly and full of waves and hoots. One challenge early on was dogs on the edges of villages, coming out and chasing us. The first of these were really fierce and I heard Sy on the back of the tandem mumble in tears “I want to go home now”…and I didn’t blame him. However, gratefully the dogs that have followed have been much less scary and convincing and we are learning to ignore and just ride on.

Yesterday we crossed 2 boarders from Turkey to Greece then Greece to Turkey. We cycled though beautifully remote un-traveled feeling NE Greece limping from village to village over 2 unexpected steep long-ish climbs hoping for a Greek lunch along the way. However, the towns were sleepy tiny places with no restaurants so we plugged on with the food we had brought until we finally entered Bulgaria to a completely different feel again. Bulgaria seeming both more western and more poor (which translates into welcome lower costs for accommodation and food). We are staying in a Soviet era monstrosity hotel with commanding huge lobby and hundreds of unfilled rooms. No
Wi-fi internet in our hotel room, however, and so far the towns people much less interested in our tourist identity and lack of language. Virtually no English spoken with one shining exception of a woman named Deanna who has just returned home to Svilengrad after 14 years away studying in England and Switzerland. She has helped us to translate the menu and was a welcoming soul for our first night in Bulgaria.

Language will certainly by a challenge, and the alphabet is of course different (which we have not had to deal with in Tanzania or Turkey). It is amazing how when I think back that each stage of this odyssey has helped to prepare us for the next. First, our time in Africa helped the kids to adjust to being away from home, and to create a sense of home away from home (and daily they comment on what they are missing from Muheza, Sy especially) and to generally get used to the notion of other cultures and languages and how different it all can be. Turkey then prepared us for being nomads and creating ‘home’ with daily rituals and reading aloud and bonding as a family. Turkey introduced the idea of yet another culture, completely different again, and the sense of unbelievable history and complexity of the world. And now we are pursuing for sure the most challenging of all our time away, what with the added layer of intense physicality as well as regularly changing culture, language, alphabets, foods, religions and topography. Really a completely different thing, than spending 6 months stationary in Africa. In Tanzania, I felt that many before us has done what we were doing, but honestly, cycling through Thrace and receiving the hospitality and curiosity we did, made me feel that we were cycling on tiny rough roads where hardly a traveler had been (let alone a family of cyclists). This is both wonderful and a bit anxiety provoking !! (Amb, however, would never admit that… )

The boys are doing amazing on the bikes, Griff burning up the miles on his own bike, fully loaded panniers an all. Riding already 2 days more k’s than he has ever gone in his little life. Simon and I have been on the tandem together, mostly having a great time, him chattering and whistling (!) (are you peddling back there ??) and he seems to feel the wonder and accomplishment of it all almost as much as I am. Not that there wasn’t the odd muttering from the back of “this sucks” on the unexpected long hills yesterday, but I must admit I was thinking the same. It will take us some time to build up fitness and strength as we look ahead to the Balkan Mtns and the bigger Tartars of Slovakia….

Our sad news is that Sally and Rose will not be able to join us as expected in early May due to complications at Rose’s work not allowing her to go. We are all massively disappointed, especially the boys of course, but we are looking forward to cycling with Paul and maybe Ed beginning in mid May.

That’s all for now. Lots more but I have rambled enough. We are missing everyone and starting to get homesick in earnest. Trying to balance that with being fully in the moment here…

Xo Leah

We have Left Turkey

2009-04-05T05:14:00.001-07:00

We have left turkey
Goodbye land of pistachios, baklavah ,feta

2009-04-02T10:43:00.000-07:00

Cycling DAY 2

day one is longer story
let's say we went -1.1 kms( much longer story to follow)
today 53 kms ending with 2 seperate 1km slow gradual climbs ( net +51.9 KMS)
tired muscles ,hungry
maybe Greece tomorrow( might have to stay in Turkey because of accommodation)

BUNS of HALVAH

Istanbul

2009-03-31T11:12:00.002-07:00

Last day in Istanbul and rather than tourist times I did a bunch of traveling around by public transit to do errands ( bus ticket, fed ex) which gave me a different view of things.

my vision of Istanbul is a blend of Paris and Cairo ( as I remember them and assume they are now)
big busy, cosmopolitan,chique,too big. Striving to cope with their size . Enormous wealth while a large portion of poor,old, underemployed and undereducated struggle to survive as life changes faster than they can keep up

Istanbu

2009-03-31T11:12:00.001-07:00

Venturing into Kurdish Anatolia

2009-03-21T11:02:00.000-07:00

As I write on the laptop, we are on a bus driving east between Gaziantep and Sanliurfa in Eastern Anatolia of Turkey. This is the southeast and Amb’s long time dream to come here. We are close to the Syrian boarder, but it sounds like visa’s are a major hassle on site so we will not try to go just for the sake of going to Syria. We have nicely stepped off the tourist track which is great ! no more carpet sellers ! Our hotel last night was clearly oriented to Turkish travelers especially businessmen.

Turkey has been amazing. A complete change in everyway, in how we spend our days, the sites, the weather. It was difficult to leave Muheza and make the transition onto something so completely different. I am missing people in Muheza and the team at Bombo. Seems so weird that we can just pick up and go. But as the days slip past I feel more and more clear about the work we will pursue upon our return to Canada fundraising for further development of palliative care….

We have used just about every scrap of clothing we brought as its been much colder than we anticipated (0-8 or so) including some snow in Capadoccia. Istanbul an amazing place of course; we spent a fair bit of time visiting the obligatory museums, palaces, mosques and art galleries. We were a bit disjointed those first few days, learning to be nomads, and with each other 24/7. The family unit even closer now as we sort through all the emotions and challenges of travel (the specifics being totally different than Africa). I look at my family in wonder and know I will look back at this time as an incredible gift, a rich and complex experience for us all, not the least of which is simply to have all this time together so intimately. All of us finding it hard to muster the energy to learn a few words of Turkish (more difficult than Swahili by a longshot) and continue instead to exchange Swahili words between ourselves for comfort. “Pole sana” will be with us forever I think….The Turkish ‘Merhaba’ (hello) helprully close to the Swahili ‘marahaba’ (response to ‘shikamu’ the respectful greeting to an elder)

We moved onto Gallipoli, touring the battlefields, and seeing first hand remnants of the trenches and orienting ourselves to WW1 and how it related to this part of the world. From there to various ruins: Troy, Ephesus, Aphrodesius, Hieropolis (ancient spa city built adjacent to the amazing Pamukkale) and we are seeped in ancient history. Learning tons !!! Amb more knowledgeable than I, both of us staying one step ahead of the kids orienting ourselves to the ancient worlds of the Hittite, Roman, Byzantine, Selyuk, Ottoman etc empires. Amazing to see these places with structures and artifacts dating back to 2000+BC. It is truly humbling and overwhelming to see both all the layers of history here but also the scope of civilization so long ago…

Anyways it has been wonderful to share this time with the kids. They are both great travelers coping very well with the many museums of anthropology and sites of ancient history. Although, I did hear simon grumble recently as we planned our next few days, “ah, not another ruin !!” Certainly the fact that we are traveling through the heart of pistachio and Baclava country helps; food has been fantastic, but with the usual challenges of finding the authentic ‘local’ hot spots and not the more easily visible touristy crap. We are getting pretty good at packing up and relocating, which will be the nature of our existence for the next few months. The bus system is amazing here, efficient, cheap, frequent, comfortable and super easy to go just about anywhere. I guess is reflects such a huge population that makes it so effective. The buses all have a ‘flight attendant’-type person who brings coffee (instant horrible stuff) or tea or fanta orange pop as well as a cake thing usually, although as I write Griffin is worried this ride (2.5 hours) is too short to be eligible for the cake part. Have done 2 overnight rides to date. They are grueling, I find at my advanced age.

Next we went on to Capadoccia (google it). It is a magical region of unusual geological formations due to erosion by wind and rain of repeated layers of volcanic rock. The rock pillars that were formed “fairy houses” as they are called, were carved out into rock houses that were inhabited by (amongst others) persecuted earliest Christians (pre-Byzantine) and the sites to see include amongst the earliest churches carved out of the rock dating from the first and second century. Amb and I did a couple of amazing hikes through the area around Goreme and it was all really quite spellbinding. Incredible visuals of undulating curves and pillars of rock of all shades of reds, pinks and yellows.

Then we left Capadoccia in central Turkey and the well hewn tourist trail and headed south east to the Kurdish part of Turkey. It is amazing, the reactions of subtle disapproval on the part of the Turks in other areas who say there is nothing to see here. The split between the 2 cultures of Turkey persists and is historically complex and we will learn more about it I am sure as we venture into the Kurdish heartland….

We are at the same time looking forward and thinking about the cycle and taking advantage of google maps while we have the fast internet access (frequently with free Wi-fi in the hotel room !!) to research the upcoming weeks and Bulgaria, Romania and Serbia. Have been watching Michael Pallin’s Eastern Europe series Rose burned on DVD for us, which has been a great adjunct to our own reflections. Paula sent a wonderful book called “Balkan Ghosts” which I am devouring in an effort to make a little bit of sense of the unbelievably complex and tumultuous history of the Balkans…

Griffin is working away at learning how to use the GPS which we will trial on the cycle. The plan is to create the day’s route on the laptop and upload to the GPS for the day (in addition to the variable quality paper maps we have located to date). Thanks to the help of Shauna and Jane who have searched out some hard to locate Eastern Europe GPS maps, and thanks to Susan for getting them to us from Cambridge, this technological learning curve is slowly coming together. Certainly we will not be heading out on well trodden tourist trails! But hopefully the roads will not be too bad ie not too many punctures, as our UK Muheza colleagues would say.

Our only big challenge right now has been ongoing skin stuff particularly for Ambrose, and we are now certain we have brought a serious case of scabies with us from Tanzania!! (It was quite atypical at first, but over the last 2 weeks has become quite classic in its distribution and now spread to me). We have gone around the block twice now with the available treatment here (Kwellada) and washed all the clothes, even borrowed an iron from a hotel to iron them all as a hot drier is not something that seems to exist here. We are hoping this has taken care of it (I have a slightly less severe version, kids spared for the moment, but treated anyways) I have a worry in the back of my mind that I heard at one point Tanzanian scabies is quite resistant to treatment…. but we will have to see how the next week goes…

As inconvenient as it is, we can hardly complain if this is our most serious health complaint to date from Africa !!

Will keep you posted !!
Please look at the photos Griffin has posted of some of the Turkey exploration. Follow the links he has provided if you want to see what we have been up to!
Hello to all and love all around.
Xo Leah

2009-03-21T07:43:00.000-07:00

Beer, Baklava and Buses

Beer

Tanaznia
almost completely lagers
very tasty ,when cold on a hot day
760 Tanzanian Shillings when bought by the case 600 cc bottle ( 1000 TzSh.=1$Cn aprox)
1300-3000 when bought at hotels and bars

UK
I almost totally drink bitter
a truly favourite drink of mine . usually delicious, always different
great memories or great pints and pubs

2.50 -3.20 (pounds don't ask the conversion just drink it)
I only drink them in pubs.

Turkey
most are pilsner , one is a Double pilsner???
Efes the most popular also makes a dark
2.17-2.56 Turkish lira in grocery store
4-5 TL in restaurants and bars
( multiply by .75 for Canadian dollar)

Baklava

mmmmmmmmm
It is bought in Baklavari ( like Patiserie)
Big glass windows- trays and trays of honey oozing Baklava
All shapes and sizes a variety of ingredients and tastes

How can one resist

12-22 TL/kg ( we have Never bought a kilo at one time) usually buy an assortment

Buses

In Turkey a mix between VIA trains ( Canadian) and planes

quite a change from Tanzania where price is not a concern but you feel like a sardine and you hope that the bus will make it.
Reminds Leah and I of our bus rides in Chile.
New, big, clean,Turkish TV
Refreshments served by Attendants ( almost always male) juice, water, cakes ( usually with raisins so Ambrose gets 4),tea -always with sugar and COFFEE..
Usually Nescafe 3:1 packets bad instant coffee,milk powder, sugar.( it satisfies Leah's addiction but nothing more).
The buses are never over full, they have large areas for baggage.They are reasonable but travel in Turkey is more expensive than we anticipated.
We took 2 overnight buses-saving money-losing sleep

No washrooms on buses so you have to WAIT

we travelled across Turkey on buses and enjoyed them thotoughly

Photos of Our trip

2009-03-20T10:36:00.001-07:00

Please check out some of our photos

Gallipoli : http://www.facebook.com/album.php?aid=69561&id=584266324&l=d52a5ee257

Troy : http://www.facebook.com/album.php?aid=70489&id=584266324&l=72762d687c

Ephuseus : http://www.facebook.com/album.php?aid=70697&id=584266324&l=6405208f8f

More Pictures from istanbul

2009-03-15T08:19:00.005-07:00

Photos from istanbul

2009-03-15T08:13:00.001-07:00

Out of Istanbul

2009-03-12T08:57:00.000-07:00

just some thoughts from Selcuk ,Turkey

We left Muheza less than 2 weeks ago!!! -it seems eons ago and distant in memory

struggling to keep it close to our heart and mind.

-after calling Muheza 'home' for 6months...."meet you at home" " great to be back home" we are now on the road as tourists and home has again become Hazlitt Creek Rd.

- after being hot all the time , i haven't sweated in 13 days and we are cold here in Turkey.

-travelling by bus here in Turkey is more like our time in Chile and much different from the speed, crowds and 'sense of safety' in Tanzania

-Turkey the land of baclava, olives and feta for breakfast...all good

-bus ride yesterday from Cannakkale to Izmir and saw an old Turkish man as sheep herder and contrasted that with the young Masai boys we saw as goat and cow herders.

-Turkish language is a challenge to pronounce or remember vocabulary, yet the people are very friendly nd willing to cope with our sign language( we will have to get use to this a s we travel in Eastern Europe. We sometimes slip into Swahili pleasantries.

-Turkish toilets cost, yesterday we spents 5.50 turkish Kira in .50, and .75 denominations

-home schooling this week included Galipoli(WW1), Troy( and that silly horse), and today at Ephesus a spectacular archeological site of Greek and Roman remains

Thinking about points east and also planning our first stages of cycling from Thrace to Greece and into Bulgaria

Boys traveling very well

Out of Africa into Canbridge

2009-03-01T02:24:00.000-08:00

Muheza -Cambridge now there is a contrast.

There are banners for the 800th Anniversary celebrations ot the Cambridge University ( wonder what was happening near Muheza 800 years ago)
Their one similarity is a dependence on bicycles for local travel.

Cambridge is so familiar from visits before and so different from where we have just been.

We had pears, croissant and wine
we saw green grass and field lacrosse and 'our breath' (5 degrees)
We had a day trip to London ( including an overwhelming map and travel store for the next legs)
pints of bitter

wonderful to see and hug Susan and Philip

and packing and repacking
For someone who likes to travel light and simply this combination of 'Trips" with varying weather and varying activities is a challenge and Books , numerous and heavy.

we would have very much struggled without our friends here in Cambridge( Kate and Tim, Susan and Philip)

We will sleep at Heathrow tonight since our flight tomorrow is 0930 and you must be there 0730 (not like Victoria) and bus travel to Heathrow takes 3 hours.

Trying very hard to enjoy the next chapters without making Muheza only a dream.

I miss it.

2009-02-27T02:49:00.000-08:00

It is Harder to leave a"scrappy little junction town" than one might think. ( tears in eyes)

Kwaheri Tanzania!

Badi??????

Pancake Breakfasts

2009-02-24T06:26:00.001-08:00

In writing report mode and got a bit carried away Sunday morning

A Plan to Think about Starting to make Pancakes for Breakfast

Ferbuary,22, 2009

1)Prayer
2) take attendance and identify the number of consumers of pancakes
3)Plan ETC ( estimated time of consumption)
4)Plane ENC ( estimated number of consumption)
5) Maple syrup 5.1 how to divvy it up, /pancake
/person
5.2 plan for leftover MS
6) cooking
7) table setting
8) eating
9) cleanup
10) debrief and problem solve for further pancake breakfasts

Pancake Breakfasts

2009-02-24T06:26:00.000-08:00

Dinners in Muheza

2009-02-17T06:33:00.002-08:00

Dinners

With less than 2 weeks to go ,
And most dinners consumed,
It felt like time to finish this series.

I will not tell you what I(we) miss( the list is not really that long)

Typical Tanzanian diiner items
Ugali ( a corn flour ball) very bland best enjoyed with anything with flavour
The more impoverished the local the less associated dishes
Meat with a saucy gravy tomatoey sometimes spicey( peppers) sauce is typical.
I have had it 3 times.
Boys stopped have school lunches because of it

Beans and rice.
Loads of beans options.
Best eaten with hot sauce.

Mchicha boiled/steamed and then fried bitter greens( generically spinach) usually with onions
The greens seem to be a variety of types depending on what is
available ..Paula was able to imitate the proper preparation and cooking better than I using the ‘Kazan’ technique of cooking bitter greens

cassava, grilled tough corn

meat dishes are either grilled meat ( beef or goat, chicken)
or meat in sauce beef, goat, chicken

being on the coast fish is plentiful
typically small fried bony fish about 3“ or a salted anchovie –like fish, bought dried in the market , served in toamoto sauce ( which I finally tasted last week)
but here on Sundays the fisher come to Muheza and we have fresh fish, steaks ( often called ‘tuna’) of all kinds,small to medium whole fish fried and twice large whole fish baked

but ingredients for musungu cooking musungu food in Tanzania are abundant

veggies – classic
carrots, cabbage, tomatoes, potatoes onions, garlic, peppers( green or hot)
occasional eggplant, zuchini, leeks

less classic or familiar
okra
eggplant- like yellow veggies
(eventually pictures will be added)

-pasta, cheese, tomato sauce ,meat sauce
-pizza veggie and meat ( bacon, mince)
-chapattis/paratha frozen or freshly made by juliette go with anything but we also make a taco like rollup with options of ground meat, cheese, onions, cucumbers, peppers, yogurt,
tomatoes
-frittata looking not much different than at home.

at home ( our Canadian home) we have stolen a recipe from Sally and Rose –‘Tuscan Chicken’
roasted splayed whole chicken on a bed of fennel, lemons, olives, garlic cloves, herbs

here we have ‘Muheza Chicken’ –same whole splayed chicken( a bit scrawnier and stringier), definitely free range, tender up well, in a similar roasting pot
on a bed of leeks or onions, green peppers, occasional other roast veggies, garlic cloves, limes, salt and pepper. Served with mashed potatoes made the way my dad taught me (warm the milk before adding)

at home ( that same Canadian place) often on Friday is nachos night at same sally and rose- previously mentioned- ‘s house ( is there another sally and rose really??)
No nachos here
But we have Chips and miyai( eggs) occasionally with sausages added
Chips made by street vendors , picked up at just the right time by Griffin ( and now Sy occesionally joins him) added to whipped egg as it fries
Sausages are lame packaged breakfast sausage( i do miss galloping goose sausages.. OK I said it)

Virtually all is 100 mile diet ( although condiments-hot sauce,pickle/chutney soya sauce , and our one true luxury olive oil do find there way to Tanzania and our table)

Salad is either tomato/cucumber/avocado( 10-20 cents each)
Or “Deb’s “ salad ( yes our dear friend deb lefrank) purple onion, mango( less than 10 cents each),lime and tomato… colourful and deelish

SO what is missing
You got it
Dessert, treats, postres, sweeties,kitindamlo

Fresh fruit ( often pineapple or banana -which I have eaten more of than in the last 10 years) can go only so far

We do miss sweets although cookies can be bought and a local dryish and less sweet cake is available and enjoyed - it ain’t Flan, chocolate mouse, chocolate anything

If Susan Griffith is reading this she might think about this as she hosts us in Cambridge in less than 2 weeks
No late night ice cream for me ( although last week while visiting friends in Arusha before our safari-lots of chicken, lots of rice- we were treated to PISTACHIO ICE CREAM…. MY FAVOURITE FLAVOUR)

Wine has been less than 5 glasses in 5.5 months although we did try a Tanzanian Rose ( once). Cold lagers work fine , the colder the better
Lots of water

And as I wrap up this final installment and we wrap up our final days here I will go have a small nip(60.2 % alcohol) of a’bunadh speyide single malt . brought by joel already a month ago.
cheers

Living Deep and Wide

2009-02-17T06:33:00.001-08:00

We are nearing the end and I haven’t blogged for a while. Hello out there ! Amazingly it feels like there is no time for reflecting in a blog!! How can that be, that we are so busy here even at altered African heat-pace ?

Lots to reflect upon. We had wonderful visitations by friends in January, first by Joel and Paula, overlapping by one night with my previous office partner Fiona Manning and friend Stephanie and their lovely 11 year old daughters. Joel and Paula made the epic journey for just 2 weeks with us, and they were wonderful to be with, such ardent explorers, keenly interested in anything and everything. Made us feel like we were living at the end of the anthropologic rainbow here in Muheza, and like our little family adventure was unparalleled. It was so nice to see Fiona, with whom I have shared so many clinical hours and reflect upon the medicine here with fresh eyes. Stephanie had lived near Mt Kilimanjaro with her family for almost a year, last year, and was now visiting her placement in follow-up and was a wealth of stories for comparing and contrasting our experiences.

Most recently we spent a week “on safari” which was other worldly. We had an amazing time !! We spent 3 full days in the Serengeti, then one each in Ngorongoro Crater and Lake Manyara. These are unbelievable places teeming with wildlife you can hardly imagine. I know I will both date myself and trigger childhood memories for many of you when I mention Mutual of Omaha’s Wild Kingdom on Sunday nights and say that it was surreal to actually see all of these great beasts in action and linger for long minutes and hours just watching. And these are not distant sightings !! We were metres away at times from 4 of the “big 5” (lion, water buffalo, leopard, rhino and elephant). It is like a giant (massive) reverse zoo, where we are the ones in the captivity of the car while the animals wander around us, seemingly quite oblivious to us (of course, simply desensitized to the thousands of vehicles who quietly watch them annually).

We were greeted by huge herds of migrating wildebeests and zebras (who travel together as one has good eyesight complimented by the amazing hearing of the other…have already forgotten which has which), and they were calving so saw lots of wee ones. Huge numbers into the tens of thousands and a real sense of a ‘migration’. Then it all unfolded over the days with multiple sightings of elephants, giraffes (my personal favorite!) tons of different gizelle/impala type creatures, water buffalo, cheetas with vultures post kill, lions (again lazy and satiated post grizzly wildebeest kill) , hippos and crocodiles in the wet pools, wart hogs, hyenas and jackals to name a few ! Ambrose became obsessed with the birds, and our guide Lawrence was highly knowledgeable and we identified over 100 of the 530 species that grace the park. They were the most beautiful colourful and curious of creatures, in all shapes and sizes of bodies, bills and feet. We will need to do a separate slide show just of our safari as it was truly an experience overflowing with the wonders of mother nature. The role and presence of the Massai also another interesting layer of local history and modern age lessons in traditional land use vs conservation (reminds me of first nation issues in Canada).

To think that we had contemplated not doing safari, as we were put off by the intensely unpleasant ‘vicious’ (as one medical student put it) aspects of the Safari business! Fortunately we were able to find a quite painless connection via the husband of a nurse at the hospital and we got a great price and wonderful guide and had the time of our lives. It was wonderful to see the kids so enthralled, especially Simon, who gleefully exclaimed “I could do this forever…”. This was why he came to Tanzania really, and now that the Safari is over he is quite ready to move on…

After Safari we returned to Muheza to no water and no power, and still find some North American ability in us to whine, and moan (it is 35 – 40 degrees after all) despite the fact that no-one in Muheza has water and everywhere we look, the industry of water transport and selling is milling about like activity in an ant hill. I find myself secretly thinking about a hot shower in Cambridge, and the temperature being cold enough to want one. I am also thinking about riding my bike with gears and silence (no clunks) without sweat pouring off and then dried in an uncomfortably itchy crust.

And so we are down to the last 2 weeks of work life here. We still have a few important teaching wrap-up sessions at Bombo, and the nursing school and in fact I am procrastinating on the final power point prep to write this blog ! Just before Safari, Ambrose and I shared the highlight of our time here when we funded a 2 day palliative care workshop (with some of the donor dollars from all of you!!) at Bombo Hospital. ‘So what ?’ you may say….BUT what is important is in the details. I had suggested we do an intro to Palliative Care lecture (thinking of an hour or 2) for the new satellite CTC clinics (the name given for clinics that care for people with HIV) that were opening in the Tanga region. Our little team took the idea and ran with it and before we knew it, it had become 2 days and 23 participants that included not only the new CTCs but also TAWG (Tanga Aids Working Group who do home based care), the Red Cross (home based care) and the head nurses from all the wards at Bombo Hospital. The best part was that several of the sessions (pain assessment, HIV related pain, and communicating bad news ) were delivered in Swahili by our new PC team at Bombo. This was so amazing, to see the confidence and passion that they brought to the teaching and how competently they had taken on the role of being leaders and educators in PC. This was a moment of great pride and satisfaction for Amb and I, and we now feel like a seed has been solidly planted. There is of course lots of next steps, we are discussing with them (more training needed for these leaders, money for a program, and staffing…etc) We will have our fundraising work cut out for us upon our return…However, this work becomes a joy, when we feel such affection for the individuals and have such a positive sense of their caring and their leadership skills.

Dr. Violet Bakari, the leader of the team, continues to reveal her powerful self to us in a quiet understated manner. Just yesterday, she had our family to her house for lunch and we were welcomed in a fully Tanzanian way, and had the opportunity to make a deeper connection and planning for the future. She shared with us her HIV + status (which had escaped our knowing over the last several months) and more about her health history and work accomplishments. She has worked closely with Dr. Mtatifiko over the last 3 years and has developed the Bombo CTC herself into the thriving functional arm of the hospital that it is. She only began her own ARV treatment in 2004 and was very sick prior to that, so this is really a remarkable accomplishment. She is now a picture of good health and is a success story of ARV accessibility. And now she quietly creates the palliative arm for the hospital, competently bringing the right folks together and building capacity in them. Gladly we will be able to work with her from afar over the next months and years as we look to the future.

Things at Teule, however, continue in a sea of politics and dysfunction. Amb has really given it the college try as they say, using his wonderful management and conflict resolution skills, that he brings from being Chief of Staff at SPH. But to date we have not shifted the milleu, and the 2 sides are deeply divided, and when we leave, so will leave the palliative care in the hospital. At Teule Hospitali we ended up doing precisely what we did not want to do, which was to provide direct service (some 80 plus consults between us) but not build capacity in Tanzanians. Those patients I am sure benefited from our presence here but sadly we will leave (unless some miracle happens in the last 2 weeks!!) without a lasting impact on program development. The reasons are complex and educative (of Tanzania, resource poor settings, of tribal traditions, of HIV/AIDS foreign aid sequelae, of religious leadership, of personality and leadership) but too long for a blog entry.

The whole thing of ARV (anti-retroviral) care in Tanzania is mind-boggling. These are complex treatments with side-effects, and need for absolute unwavering adherence to avoid viral resistance. The system of delivery is new since 2005 or so, constantly changing and expanding at an explosive rate to large numbers of people. However, the anthropology of its impact is not simple and completely different from the introduction of ARVs in a place like Canada. We met a young German MD at Bombo, whose partner is in fact a social anthropologist looking at peoples experience of ARVs both from clinician and patient/family perspectives, and I will be keen to stay in touch with them and learn more of this important research. In Canada, introducing treatments like active HIV care is difficult even when the health care delivery in general is advanced and layered and rich. Here, they are grappling with this complex beast when there is no reliable water, or power or basic medicines, shortage of health care professionals, and the majority by a long shot of the populous live in remote rural villages!

But most importantly I have realized, is that it is a completely different starting place in terms of the lay knowledge base around one’s body and health and disease. For example I saw a patient at Bombo who had advanced breast cancer. Her right breast was consumed by a large mass (peau d’orange for the medical folks) visible spread of the cancer along lymph nodes just under the skin one could see as a lumpy track heading for her arm pit, big lump under her right armpit, and swollen right arm, visible enlarged liver full of metastases. My point is that this cancer had been brewing for years unknown to her. She came to hospital because her right arm was swollen and painful. Think how quickly a typical woman in Canada would have been into her doc had she found a breast lump!! By contrast this woman, had no idea anything was wrong with her breast, and had never heard of cancer. This is a single story representative of a very common scenario. So in the HIV context we can not expect any knowledge base around the idea of germs, bacteria or viruses, let alone viral mutation, infections, or disease transmission. Of course this is changing especially now that treatment is available. Sadly, we are seeing a 2nd wave of deaths, because of course people feel well on ARVs and then think they don’t need them anymore, or side-effects (such as appetite stimulation in the context of not having enough food to eat) make it impossible to continue. All of this is a tall order for HIV educators and care providers, like Violet, and we are blown away by their adaptability, and resilience.

Bus crashes have been a terrible recent theme. Traffic/driving here is unbelievable scary. Speeding, reckless passing, poor vehicle conditions ( 5 gallon portable gas tank at our feet in the dala dala…) . By far and away the most risky thing we have done is to travel to Tanga twice a week and take the bus to Arusha for Safari….Terrible fatalities in the last month on our little stretch of highway, both speed related on the part of careless bus drivers, have resulted in dozens of fatalities. I will not miss this aspect at all. Always feels like a terrible leap of faith to get in a car/bus and go somewhere.

Anyways enough heavy stuff. Ambrose and I look at each other on a daily basis and marvel at the time we have shared here. For all the ups and downs, it has exceeded our wildest hopes as an experience for our family. We have been blessed with a safe and fascinating time here, and solid connections to individuals who have touched us and welcomed us despite our lousy Swahili acquisition, and odd Canadian way of being. I am cherishing the last few bike rides with the boys up to school, and my solo weekend rides through the sisal fields (now much more able to identify birds etc post safari). We are dividing up the last of the donor money between funding vulnerable children to school, provisions for palliative care, support for home based care, and a myriad of other little bits here and there. We feel honoured to have been trusted to share this money around, and grateful to have such concrete directly helpful spots to put it. We will prepare a report of all the homes it found.

It has been unbelievable to watch the boys develop and blossom and adapt. As my mother would have said, “my buttons are bursting with pride”. Each in their own way in their own time, they have come, and learned and shared of themselves. They zoom around Muheza on their bikes, competently exchanging the long multiple Swahili greetings, visiting the various fundi, bargaining at the market and generally taking it all in. Since returning to school in January, there is suddenly a young lad named Ally who rides with us to school, and a gaggle of boys have appeared at our house daily after school. Language still a barrier, but they have the commonness of curiosity in each other. I am so glad we persevered with Holy Family Primary School and didn’t bail to the International expat school in tanga.

And to watch my sweetie Ambrose dive into this time in Africa, has been an affirmation of love and wonder. As we all have seen him give, for this and that, and shared in his endless ability to just ‘get stuff done’ and find the time for everyone and everything, so he has given to Tanzania in the same Ambrose style. (Not that I don’t get very tired of being ‘Mrs. Dr. Ambrose’ and quietly accepting my less visible role….) But together we are a good team (it is the first time we have worked together so closely), and have had the gift of a similar way of seeing things, and endless discussions about life and death and HIV , foreign aid and Africa and human-ness and parenting. I will cherish these six months as a rich and wonderful journey. As one friend wrote in an email, a time of ‘living deep and wide’.

Quick Blog

2009-02-17T06:30:00.000-08:00

2 weeks ago I was struggling with the idea of leaving

the safari trip took us away
made us tourists
and gave us time to talk about end game, goodbyes, final reports

add to that , upon our return in Muheza, no water and no electricity with high heat
and the thought of leaving seems easier and clearer

in actual fact leaving and a transition to a new part of this trip , will happen whether I am ready or not

departure looming

2009-02-07T04:44:00.000-08:00

As departure looms

Roasted and Ground last kilo of coffee (sadly)
Turkish coffee not far off( not so sadly)

Wonder if I ill be able to get back into the routine
of morning showers for cleanliness
Instead of nightly showers to cool off

What will we miss?

2009-02-03T05:58:00.000-08:00

What will we most miss?
The ants ( by the thousands)
The bats ( by the hundreds)
Or the gheckos (by the dozens)
What ya Think!!!

A lovely day

2009-02-02T07:22:00.001-08:00

Kid’s Club Goes to the YaCHt Club

YaCHt Club because Swahili is phonetic , all letters are pronounced( no silent ch). It was a non written language “ translated “ or transcribed into the English alphabet by Missionaries.

So today the Diana Center ( the palliative care center in Muheza ) took 91ish kids plus support staff to the YaCHt Club of Tanga for a semi annual outing.

All these kids are HIV Positive. They are a mix of ages from about 4 to 15, boys and girls.
Their health is variable
Coughs are common , some small for their age, some malnourished.
Many ,not all, are on ARVs( anti- retrovirals)
They come weekly to the center for health and social activities
Some are orphans( in Tanzania the loss of even one parent qualifies you for that title.)

The kids started assembling about 0800( 0200 swahili time)
Parents, family members or guardians dropping them off and those that lived in the ‘burbs ‘ of muheza were picked up.
Those with some sort of finery were wearing it, a number had good jeans, better shoes and dresses and some wore the best finery they had ,that was sadly less fine.

Simon recently ruptured his ear drum while swimming and snorkeling, came with us but could not indulge in water play, he is being a trooper with drops and pills for a klebsiella/pseudomonas infection in that ear( for you medical folk out there). Griff had gone in earlier with friends and their kids who are having sailing lessons and he sailed on his own in one of the dinghies, his first sailing experience and he enjoyed it.

We packed into 4 Dala dalas ( the local transport- Toyota panel van sized vehicles full of seats always overfilled and today was no exception.)

We headed off and not a kilometer out the small thin little boy next to me began too vomit, too soon for car-sickness, maybe excitement, or maybe an unwell lad. A plastic bag appeared and eventually a cloth and he fell asleep on my lap occasionally raising his head, looking for the bag and retching a bit more.

There was some bus singing( more on Leah’s dala dala) and then the YaCHt club was invaded.Many had not been on a Dala dala before but even more had not even seen the ocean.
So beach play-soccer balls, skipping ropes - sodas and samosa for morning snack and then a fairly unselfconscious change into swimwear , or not, for a play in the shallows. These kids are not swimmers. There was some concern that they may be drowners.

The next treat in a day full of treats was a boat ride around the bay in a sail boat owned by a displaced Zimbabwean musungu ( white guy) . Just motored but they loved it. Leah was asked if she could swim and when she answered in the affirmative she was invited on the ride in case of disaster( which would have been a terrible disaster) but all went without a hitch.

There was a 45 minute ( wasungu or Swahili time) period where lunch was not yet ready and the children were restless and the Diana staff who really came for a day at the YaCHt club themselves were enjoying their second or third beer,and kids starting wandering all over. There was a small hint of looming chaos and a ‘never invited back’ sort of scenario. But some of the non beer drinking staff made up games and songs and lunch was eventually served
Sodas again, rice, plantain stew, chicken, and stewed bitter greens called mcheecha. All deelish.

AND THEN

Ice cream and cookies!!
I had not seen tubs of ice cream since being here and there they were, vanilla AND chocolate .We did not give them a choice ( would they know what they were choosing between??). It was all consumed.
My little vomiting friend with the large sad eyes wanted dessert too but the coordinator thought better of it much to his sadness so I gave him 2 servings of cookies, small not too sweet, seemed reasonable. He was not happy about that but ate them without hesitation.

Clean up , pack up, final beers for some. Connecting lost swimsuits or finery with its proper owner and then up to the buses

On my way up I collected a plastic bag for my little friend assuming he would sit beside me . Besides the fact that I was assigned to a different vehicle I did see him on my way to the dala dala with a Bowl of CHOCOLATE ice cream. Hope his ride was uneventful.

All in all a heart warming experience in an already warm place.

27 days to go !!! AARRGGGHHHH

2310 hrs ( wasungu time) 31/1/09 and it is raining!! Always appreciated

goodnight

Lunches in Muheza

2009-02-02T07:21:00.000-08:00

Lunches in Muheza

Before I start I should let you know that I did get a few responses about the definition of Foodie and wether I am a member of such a club ( and even if I where the badge with honour.both e-mails and letter referred to official definitions and general habits. I enjoyed the correspondence and the comments gave me something to chew on.

Trying to avoid labels most of my life ( exept ,father, friend, doctor,husband…) I think my essys are more a way to share some of what we see here and maybe part of what we can slightly understand here so that you can get a feel or even a ‘taste ‘ of our time here. Consider it an anthropological assessment through the eyes and mouth of a person who can appreciate socity through it foods and…… no never mind let’s call it foods for thought,as best as I can see or taste them , no more no less from a person who rarely misses a meal or leaves food behind.

Lunch really has only one word- Juliette –
She is in charge of lunches at “hillview” from Monday to Friday ( except holidays and on the weekends we make do or eat leftovers from Juliettes weekday lunches.
There is little variety ( although some). Yet I ( for one O never tire of them
I think the general theme dates back to Richard and Karilyn( we see this now after spending 2 days with them and enjoying a delicious lumch of soup and bread.

So that is lunch soup and bread.

The variations include condiments and additons to the soup like cheese, yogurt, hotsauce and bread variations chapattis -2 types , classic bready greasy and a crepe-like batter with onions. MMMMM, and recently rose’s banana bread (now part of Juliette’s repetoire)
Although Juliette cleans and does our laundry ( irons too although not our socks, underwear and T-shirts anymore) lunch is something she insists on being involved with>
Leftovers from diner, +/- eggsalad , tunafish or peanut butter and jam sandwiches can be added to lunch but they are more common on weekends. By lunch time cold water is essential.

So the only other lunches of note , besides those when traveling to new destinations –all unique and none worth reporting- are our lunches in Tanga either on weekend errands and swim or our almost twice weekly visits for teaching and rounds.
The Food palace atsy Indian curries and western food, very slowly created , but tasty.
Mkonge hotel( site of rose’s last catan victory in Tanzania), overpriced remnant of colonial days, swimming pool, colour TV with soccer regularly available, good food just too much guilt associated.
Yacht club -ditto to Mkonge without TV or pool, ocean swim available.
But lately samosa to go from patwas diner with or without fruit juice or lassi.

Lunches are tasty , usually a chance to slow down and get out of the heat, nothing special but rarely disappointing.

We Don't Want To Leave

2009-01-29T06:26:00.000-08:00

Departure 4 weeks tomorrow
Getting excited about next adventures
Cycling group e-mailing and planning too
BUT
I (we) are in no hurry to leave MUHEZA

Swahili time,Mzungu Time,and Recent Logistical Errors in Tanzania

2009-01-22T06:32:00.000-08:00

1) Swahili Time….. the time in Tanzania told by Tanzainas is different than ‘our’ 24 hour clock
It doesn’t affect us usually because most hospital, school, bus… events have been converted to our clock. But it was curious to learn that 0600 our time is actually 0000 hrs. so 0900 is 3o’clock for locals and 1400 hrs. would then be 8 o’clock Tanzanian/Swahili time. This is a generally functional system because it seems things slowly start around 0600 hrs. and since we are close to the equator ( but clearly less so as you go south) the days are not very variable in their sunrise/ sunset pattern with sunrise around 0600 hrs.. There you go. FYI

2)Mzungu time…...We experienced a vivid example of this today….We are at a resort on the Indian Ocean with Joel and Paula ( called Peponi) and Leah and I are travelling to a small town Pangani where ware doing some palliative care outreach ( to far to drive back and forth from muheza daily so we made this into a break for the kids too)
I texted the hospital palliative care team at Pangani on Tuesday to set up our morning meeting. I suggested we arrive at 0900 ( our time -ignore previous essay ) and Edith Chuma the ‘matron’= Headnurse said that 0800 would b better for the staff. So Leah and I got up at 0600 ( 0000 Swahili time –refer to previous essay) had water and Paula’s banana bread deelish .. NO coffee (refer to essay on breakfasts in Tanzania) and we walk out to the road and eventually a passing Dala Dala takes us to Pangani ( our boys and and Jand P still resting comfortably). Walk in Pangani to hospital arrive 0810 and Edith is just arriving and we are escorted to the DMO’s ( District medical Officer) office, sign the guest book, “de rigeur” and eventually start our lecture about 0910!!

Last week a meeting was called at 1400 hours- important strategizing meeting. Leah and I and Sally were there at 1401 hrs … meeting started at 1425 hours . we all laughed
.Even here( after 5 months) we can’t slow ourselves totally to the pace or the apprectiation of time as the locals do

3)Logistaical Nightmares of the week

We met a few weeks ago in Dar es Salaam a cab driver who was very helpful ( our friend Juma was not available) he gave us his card .. Jonas” Logistical Expert”
This week I should have had a Logistical Expert.
i) Monday we contact Edith Chuma at Pangaini District Hospiatl ( see 2 above) to confirm our arrival. This after numerous text messages and e-mails and attempt at faxes in December. Much to my horror she was expecting us next week. This after we had coordinated time at Peponi with the boys, and Joel and Paula and then to connect ( in 2 days) with Fiona Manning and Stephanie and their girls( friends from Victoria) for a further 2 days here. The next day she texted back and said she would work things out.

ii) We arrived at peponi and they had no record or our reservation!!!! after numerous calls and e-mails by Leah in December and January. Although it was initially a bit stressful , they did get us into the family banda (sleeps 6)… Curiously the place is empty except for us so I am still not sure about the initial hesitation.

iii) Last night was the inauguration of Barak Obama we dined here at Peponi after a lovely day of travel and and a before dinner swim. They have a TV here so we were excited to se his speech. Dinner was started with Paula’s beans and cold beers (all quite fartogenic) at the banda and then delicious fish and prawns and pasta for dinner. Paula offered to treat the adults to a brandy and locally famous Peponi Brownies for the boys as we watch the speech .I (I) had calculated the time difference at 9 hours earlier even though I knew Victoria was 11 hours earlier and I am well aware it is 3 hours different between the west coats and Toronto/Washington DC. So we sat down as Barak kissed Laura Bush goodbye and sadly realized that we had missed the speech, we had missed history, I had miscalculated.

Where are those Logistic Experts when you need one.

4 days in Muheza

2009-01-16T05:21:00.001-08:00

When everyday is new and unusual and sometimes difficult,here is an intriguing set of 4 days

Only the funny,disturbing, interesting, frustrating -story- telling bits

DAY 1( was a Friday) while I was in Tanga with griffin ,working and successfully erranding Leah was discovering and cleaning the maggot ridden, dead rat that had shorted out our stove so that cooking had been impossible and breathing even worse. While cleaning the stove with some eventual help from Juliette and Athmani they also discovered that our running water was dirtier than usual and the holding tank was found to be holding surface insects and had a bottom full of black slime that also needed cleaning.
All nauseophilic events.

Day 2 found Leah ill with nausea and malaise and I had bad diarrhea ( no more details necessary) unlikely related to the water issues ( see day 1) which was probably a newly discovered chronic state.
After a history of recurrent power outages and blackouts ,day 2 developed POWER SURGES- where the fans felt like they might lift us off the ground or blow us away- and POWER FADES- where lights dimmed to almost imperceptible and the fan blades circled slow enough to be counted. We didn’t trust the stove so chips and miyii( eggs) and meat (unnamed) skewers, from street vendors for dinner.
Even before dinner some local lads ( new to us) came to our door. I thought, to borrow a soccer ball. We had decided only to lend out the ball to boys we knew ( as a general policy not because of any historical losses). They didn’t want a ball. They had a big plastic weave bag that once held 25 Kgs. of flour.They seemed to want to sell me the contents.
So I looked in.
A 2 foot ( maybe ½ meter) in diameter tortoise!! Why should I be surprised?
So I called all family members and friends and friend’s family members to see it and watch it poke its head out and run( ya right) for cover.
After our curiosity and wonder had been satisfied and pictures taken( hopefully attached), I realized they did mean to sell it and if we did not buy it they would terrorize it, or kill it, or sell it to someone else who might do similiarly nasty things to it. So I bought it.
2000 Tz. Sh. Down from an opening gambit of 5000.
Now what.
First I waited until its captors, who were trying decide how to divide up their windfall, hd left. I would have loved to have understood that conversation.
Then more pictures including video as it (he/she) wondered off.
I needed to insure that the initial captors were not watching my compassionate act with thoughts of recapture and resale.
All went well,including the tortoise.
So for about 25 minutes I owned a tortoise in Tanzania.

Day 3 more fades than surges until later in the day so we were able to cook fish and play Catan. ( Griffin and an Aussie student named James-the problem being the other Australian medical student’s name is also James.
Leah felt better and my bowels settled ( no details necessary).
Around dinner time (before Catan) we realized we had no running water. Was this due to local water rationing which until now we had seemingly been protected by or was it pump failure due to the electrical variability.No idea.
No prebed showers.

Day 4 sadly at 0400 hrs Alex and Emily had their house terrorized by 4-5 men and an attempted burglary was thwarted only when we( Hatibu –our night guard- and I)arrived and Alex surrendered some money. It was only the noise of our arrival not any physical presence that scared them away.We did not actually see them, but the evidence of their attempt was physically clear and Emily and Alex were very shaken.
The next day found us with no water , no new pump available and the whole community quite upset and worried about the assault. Until their house is made more secure they will stay with us.

4 Days in Muheza.

Breakfast Foodie Blog

2009-01-08T10:26:00.000-08:00

Breakfasts

Breakfasts have 2 general themes – simple and special .

For Leah there is also the simple and special breakfast theme but ……NOT BEFORE COFFEE ( since I described coffee with beverages in the previous ‘foodie’ blog I will give no more details except that griff tried his first coffee yesterday)

Simple breakfasts are on work and school days.
Cereal available but expensive, not in our 100 mile diet and not popular amongst us and the Rice Krispies didn’t really go Snap Krackle Pop very well.

Toast and Tanzanian peanut butter made in Arusha.- Arusha is North Central Tanzania on the way to the Serengeti ( very tasty and no added sugar) and/or Tanzanian Jam also made in Arusha ( more like jelly and lots of sugar added) with a variety of flavours classic strawberry and raspberry but also mango, watermelon,safari mix , pear, apple and others.

We make granola with oats,cashews, groundnuts, local honey and I eat it with raisins, but as many of you know the rest of my family have a psychological aversion to raisins, created and reinforced by their mother.

Lately Griffin has been making oat porridge ( Neil Neate will be proud of him for that)

Eggs are very plentiful ,15-20 cents each . clearly free range( the chickens are everywhere and we have a local rooster alarm clock) scrambled, boiled ,fried always an option and still simple.

But Special Breakfast ahh there is a treat.

Omelets, Toast, French Toast, Pancakes and Bacon are courses in one combination or another qualifying breakfast as special.
Fresh fruit bananas, oranges, jack fruit, pineapple also makes special breakfast nutritious too.

But really the topper to special breakfast is CANADIAN MAPLE SYRUP. ( clearly disqualified from any 100 mile diet in Tanzania but patritic too) First brought to us when Sally and Rose came to visit ( just having S&R here made it a special breakfast) and then Leah brought some back during her Canadian interlude ( she even brought an extra litre for Emily and Alex’s Christmas gift , now the have ‘special’ breakfast too)….. used sparingly except by Simon the CMS makes our special breakfast ( the most important meal of the day) oh so special.

Pictures from Zanzibar

2008-12-31T00:27:00.000-08:00

Not Really a Foodie in Muheza Part 1

2008-12-31T00:24:00.000-08:00

Not Really a Foodie in Muheza

I love food.I love traveling and trying new food as part of the cultural enjoyment and discovery. I am fairly convinced that I am not a foodie .Food loving is not food obsessed.I am not limited by my need for rare and expensive ingredients and there are few things I wont eat ( OK I have never had a Tim Horton’s coffee and I don’t eat KD)
A few recent pieces of information have further convinced me that there is another level of foodie out there( extreme foodiism) that I don’t fit into.

A recent Saturday New York Times food section Brought by Leah after her trip to Toronto , included pages about drinking ‘Cocktails”( except for the occasional marguerita and one Manhattan many years ago to celebrate the life at the death bed of a patients of mine’s manhatten loving mother , I don’t drink cocktails). Seems as if it is a generation X, Y or Z pastime.
In the same section there was a wine auction announcement ( I thought there was a terrible economic recession out there) including a case of 1982 Chateau Ausonne MAGNUMS( and although I do love big red Bordeaux and have actually had a bottle of Chateau Ausonne - bought at the vineyard- the thought of a case of magnums is a bit much).
And most recently at the Red Monkey Lodge ( Zanzibar) where we passed our recent Christmas and dined Christmas Eve with Germans and Scandinavians ( their seasonal meal) on Barracuda, octopus,lobster squid,and goat I found a Penguin Book of Food and Drink ( 1996) to add literature to my salivation ( not salvation).

But I thought sharing some of our food experiences with you might be fun.

Although I have a very few cravings ( NOT Fantastico lattes-see below) occasionally cured meat even though there is good bacon here (see later) .If anything , fresh salad greens- very few available and safely washing them without wilting them to death is basically impossible. ( oh ya I forgot English Micro Brew Bitter but I will get that in 2 months)

So I will start today with fluids and will follow with meals and treats at some later point.

Liquids

Water ( Leah would start with coffee), not safe out of the tap, we filter and refrigerate and it tastes fine. Better tasting, cheaper and less polluting than the local bottled water that is everywhere ( as are the plastic bottles).the biggest problem is drinking enough especially if your pre-trip eGFR ( doctor talk) was 52

Coffee , except for a treat in Zanzibar last week no Lattes. Instant coffee from Tanzania available, Different than the few instant coffees I have had ( those of you might remember that I came late to coffee well past the Maxwell House Days)
Coffee is grown in Tanzania and the raw beans are available here in Muheza . bulk can be a bit of a mélange of beans, husks,other plant material and stones but a packaged ‘export quality’ is also available – still needs some going through- less stones-1500 Sh./kilo
( $1.50)
We then roast it in our oven which makes the house like a sauna and watch it closely ( try to) and make some variable blend of dark and medium roast ( with the very occasional hint of burnt). Our neighbours Sally and Ben have a hand grinder and Jay and Sylvia gave us a very intriguing large syringe like filtering system ( they forgot it at our house and kindly turned into a gift) that works perfectly ( if you do not over grind the beans) and tastes wonderfully. 1-2 cups daily

Tea also a Tanzanian crop. Local tea harder to find. A roibus-like Tanzanian tea ( drank with tons of sugar “sukari” or milk “raingi”(coloured) is available .English tea bags abound and we got gifts of these from visiting English guests so we are fine and just to be sure Sally and Rose sent us some Murchie’s #10 Blend for Christmas

Fresh squeezed juices and smoothies- overpriced are rarely bought.
We should squeeze our own more.

Ceres juices (from S. Africa) not really from the 100 mile diet and expensive.

Sodas – mainstream, Coke,Sprite, Fanta orange plus a variety others- fanta passion ,pineapple, black current( don’t see these back home)
Bitter lemon, tonic, sparletta, ginger beer called tanga-wizi and a brand Mirinda ( a pepsi prouct) orange,fruity,lemon-lime. Cold they help break the monotony but the sugar quantity is not insignificant. 40-50 cents for 350 ml bottle. Fortunately a deposit is mandatory , in fact without a return it often is hard to get a bottle,so glass bottles are not part of the litter (same with beer see below)

Milk, local cooperative pasteurized and packaged in plastic for 25 cents for 250 mls. We just today bought some raw, boiled it ( pasteurized) and will drink it and try and make yogurt. I am finishing this entry the next day and am glad to report that milk and yogurt are delish and this will be our new routine

Finally alcohol
Beer is the staple at 70 cents for a 500ml bottle ( again No bottle return No beer to take away) all lagers, but very tasty cold. Most from Tanzania but a few S African ( Castle) and Kenyan ( Tusker ) available.
There is distilled alcohol available and except for a bottle of gin that I think Sally and I split early on we have had none ( I even passed on duty free scotch) and the wine is S.African and expensive and not their best and I am not knowledgeable about them ,so for now cold beer.

Next Week Breakfasts and Lunches

A Simple Comparison

2008-12-25T04:36:00.000-08:00

RED MONKEY RESORT (ZANZIBAR)........YELLOW POINT LODGE( LADYSMITH BC)

east coast of zanzibar ..........east coast of Vancouver Island
beautiful sunrises ........... beautiful sunrises
group meals .......... group meals
hot ocean swims ...........hot tub
small simple cabanas ...........small simple beach cabins
chritsmas 2008 .......... annual anniversary celebration
afternoon tea and sweets ...........afternoon AND evening tea and sweets
bike rentals available ( don't do it too hot)...... bike rides
ocean sports-snorkeling, swimming ...........ocean sports kayaking, TOO COLD to SWIM
birding ...........birding
reading, resting, writing ...........reading, writing , resting
cheaper to bring your own alcohol ............cheaper to bring your own alcohol
some interesting people some not so ............ some intersting people some not so
80$ plus meals = aprox.150$/night ..............about 150/ night
no fire place although BBQ for lobster ..............fireplace
long walks on beach .............. long walk in forests
lunches from village-local food ...............Crow and Gate Pub
Cottage industry -growing seaweed and.............. herb farm and Barton Lear Galleries
crafts

41 DEGREES ................. rarely over 25 degrees

MERRY CHRISTMAS to ALL

Hardships (Beefs)

2008-12-14T23:11:00.000-08:00

I felt it would be reasonable to discuss the difficult parts of this trip and not just glowing event after event, story after story.

For me (Ambrose) there are 3 issues that can affect my day adversely that are regularly an issue.

These differ from the day to day unpredicted challenges of work and play here in muheza …resource poor, sick people, difficult to make arrangements or the fact that we can’t really understand all that is going on due to language and culture. As a rule I can accept those challenges

1)the heat.. it is sapping and slows you down and makes you walk at a Tanzanian pace. But even though I am down to a daily shower from 3-4/day at the beginning, the heat affects daily events and comfort and nightly sleeps ( even with the fan on full all night0

I sweat through my shirts frequently and even without rain I am soaked

2) my skin…even though we have avoided major or significant illness my skin has been a big bother

bites… mosquitoes here are small and silent . daytime mosquitoes are supposed to be more likely to carry dengue fever( have not heard hide nor hair of dengue fever since we got here) and nighttime mozy’s are supposed to be more likely to carry malaria( a big concern and a significant killer here) for us they itch severely but fortunately for only about 20-30 minutes but usually worse just before bed.

The night mozy’s seem to like the lower altitudes, under tables, under desks and along the floor so sitting up late becomes unappealing and we start our nights itching and even our mosquito nets are not 100% effective. And then there are other itchy persistent bumps and welts and rashes ( causes and vectors unknown) that make me uncomfortable in my skin. Usually ignored or tolerable during the day , they are more obvious or symptomatic at night and if you add 1( above) this sense of persistent dislike of ones body ,this discomfort( not severe pain) can drive one a bit batty and make for irritable comments and restless sleeps

3) computers, computer access, e-mailing ( or the lack there of) , blogging…..

I am not 10 or 13 or 23 ( coincidental ages chosen?? I think not) so computers at the best of time are not my friend.

Now they have become some weird essential part of traveling, yet I think back to trips through Europe, Africa(1982) and south ameica1994 where we traveled well , kept in touch by mail and had NO computer access and managed just fine

I remember going to belize in 1999 with graham and the boys and the internet café becoming an important part of graham’s sanity

Here where power is inconsistent and recently where internet signal access is gone and when available speed ( what is speed???) variable, the whole mood of individuals and the family unit is affected. Our most irritable is when we have to use an internet café rather than hospital access and although cheap 1000 shillings =1$/ hour there is pressure of time and shared access and little time to read blog comments or check world news and SPORTS or follow links friends may have suggested.

Add power outages, water shortages,water rationing and recent water lack ( pump broken) and some days can be more challenging than others

Those are my complaints , I will soon return to the joys of this trip which are many and more important

The Mangoes are Ripe!!!

2008-12-14T23:10:00.000-08:00

“The mangoes are ripe !” A welcome reality as I step back into life in Muheza. We are enjoying daily mangoes for pennies and delighting in our ½ km diet (backyard avoes soon to follow). “The mangoes are ripe” can also be a saying (in Swahili of course) that adorns kangas (the brightly coloured rectangular cloth that wraps around the waists of all women here) so its always good to get the translation of the saying on your kanga before strutting around town!

I had fretted more than a bit about sliding back into life and work here; from the cold and grey and ‘luxury’ of Toronto, thinking of Muheza’s heat and sights and hardships and especially the problems at Teule Hospital had made me quite anxious. However, the transition back has been easier than the transition to Canada! In talking with Sally and Rose, I realize this may in fact be forshadowing of things to come for the Marsh-Norgrove reintegration down the road , as S and R have found themselves missing Muheza big time and their African life here, and the transition back to regular life in Victoria harder than expected…

So although power outages, no running water for 3 days, no internet connection, 30-35 degrees, tough clinical cases have characterized my first few days back, I am very quickly feeling “in the fold” of the family (we are a tight unit here !) and engaged back in our journey and work life here. This is a bit of a catch up blog so I hope you have a few minutes open to join me.

It was so good to be part of dad’s recovery phase. By the time I managed to get a flight (thanks Sally for your help) and make the trip (really it took 2 full days door to door) Dad had hit rock bottom of a huge GI bleed and was in the ICU beginning the long road back. It was a crucial time to be with him and to be reminded with fresh eyes of the challenges of being 81 and critically ill in the big machine of a huge state-of-the-art urban hospital (more than 700 beds between Scarborough general and Grace). He received very competent and compassionate care, with a few especially shining stars and fewer low lights. By the time I left, Dad could walk the hallway (with walker) and was beginning to do stairs. I talked with Charline last night (her loving care and support has been a wondrous sight to behold) and hear that he is now days away from discharge. Dad received about 17 units of blood and plasma during his time there….

The contrasts between medicine in Toronto and medicine here could not have been more starkly juxtaposed. I am back where the prompt scoping (the procedure to look beyond his stomach into his small bowel to identify the bleeding and stop it) that Dad received in Toronto (in fact he had it 3 times in all) is not something we can offer here and such a medical situation would quickly turn into a death. Alex (UK doc here) relayed to me a case that ran parallel to my father’s that he had cared for while I was away. Young man, previously well, upper GI bleed, no scope…..blood products very limited (a family member has to donate unit for unit of blood to the blood bank…not always possible , therefore no or very limited blood for a patient) and sadly general apathetic lack of willingness to trial surgery (a poor but possible second best to identify source of bleeding). Needless to say, this man died.

The time in Toronto has solidified a couple of themes on the work front that have been evolving in my mind. One is that part of our internal struggle is the notion that we are weaving palliative care into situations frequently where people ought not to be dying (or wouldn’t be in Canada). I know , I know…. Seems obvious, but it continues to rub in a very uncomfortable way. So often it is young women with children in the prime of life dying of HIV related illness. It feels a lousy second best to be ensuring that the overwhelming headache of her cryptococcal meningitis is relieved and that she is not suffering as she dies, rather than ensuring her survival to raise her children.

Yes, there are ARVs, but there are probably less than ¼ of the treatment options we have for people at home (Chris Fraser help me out here). The reality of ARV’s in a ‘resource poor setting’ is totally different than in Canada. The notion circulated at home is that ARVs turn HIV from a death sentence into a manageable chronic disease. This is not entirely accurate here. Ease of access to ARVs , stigma, nutrition, co-morbidities (TB, other infections, cancers), competing religious/spiritual beliefs regarding the need to stay on ARVs once healthy, all affect adherence to this life-long treatment and survival. Sadly, the introduction of ARVs is not an instant switch to survival but rather a slow evolution, and we are early on in that continuum. Being HIV positive still means high likelihood of death…perhaps months or a year or 2 or 3 later.

And where is the husband of this woman dying of HIV related meningitis ? Perhaps already died…or likely not yet identified as HIV +, not willing to be tested or receive treatment (even though he probably infected her). She was perhaps identified via obligatory pre-natal testing when she had her last child, or voluntarily out of her concern for her children and for her survival to raise them. Anecdotally, three quarters of the patients waiting for ARVs at Diana centre are women and this is a profound curiosity to me. That stigma is so huge, he would rather die than be identified HIV + . Apparently many women attend and don’t even tell their husbands of their status for fear of being abandoned by them.

So the emotions and ethics of building a palliative care program in a setting where many of the deaths feel needless is confusing and distressing. In Canada palliative care providers have the luxury of feeling confident “everything was done that could be done” or at least everything that people chose to pursue was done. Elements of choice and access to lifesaving treatment are not present here in the preamble to a palliative care program. A very profound difference. And yet people continue to die and need comfort and an organization of care services to support them, until the slow wheels of change come around.

The other major reality is the profoundly different experiences we are having at the 2 hospitals in which we are working. At Teule morale is poor; “morning meeting” (daily discussion of critically ill patients and the deaths overnight) is either characterized by non-participation, or more often turns into a mutual accusation-fest. At Teule, if you write an order, the meds are frequently not given to patients or only some doses. Patients may even go for days, critically ill, without being seen due to abject neglect by certain clinicians.

Gratefully, gleefully for us, Bombo is so different. The basics of medicine are functioning. Patients are seen every day, histories taken, patients examined. Orders are carried out, care teams/consultants seem to work collaboratively. The leadership is excellent. There is a sink on each ward to wash your hands, and the wards seem cleaner (nurses are responsible for cleaning !!) We are welcomed and we feel proud and privileged to be mentoring the new palliative care team there and so grateful to be having this contrasting experience, still a ‘resource poor setting’. It has made us understand what a difference leadership and moral and local history make and probably a whole lot of other things we will come to understand over time. It does also feel better to be palliating where, at least we know that everything that could be done here in Tanzania, has been done and usually done well. (Not so at Teule)

An emerging urgent concern is the nationwide shortage of something called paraben, a chemical used to stabilize oral morphine solution. Apparently supplies will run out by January and the order is mysteriously not available from the usual S. Africa. This could mean that morphine will cease to be available to Muheza from Ocean Rd Cancer Institute, just when we are expanding its use dramatically and formally applying for its distribution to Tanga/Bombo. We have begun emailing collegues/pharmacists/neighbouring Uganda to try and urgently secure a supply of paraben. Any ideas from you medical types reading this would be most welcome !

We leave in a week for Christmas in Zanzibar ! Imagine that !! Have been enjoying biscotti from the LeFrank/Neate parcel (thanks Deb) trying to drag Ambrose into the Christmas spirit. He did however manage to arrange for the traditional Christmas puzzle to be here…amazing. I can see the kids are a bit more unsettled without school, and approaching that favorite time of the year without all the normal rhythms and traditions.

We look forward to visits in January from Joel and Paula, and Fiona (my old office partner) and her daughter Haileyy with their friends Stephanie and daughter. In February maybe even Pam and Anneka !

“Wuzungu” (white European) dinner was renamed ‘Wednesday dinner’ as this crop of medical students from London, Eng. are, of course, not white. Griffin continues to be my steady companion for the late afternoon cycles, a cherished time with him where I can hop on my gearless wonder and roam the sisal fields and villages and finally relish the African sun, well past its prime of the day.

A Special Day Now That Leah Is Back

2008-12-14T23:09:00.000-08:00

Leah got back almost a week ago.A relief to us to have her back, a relief to her that her father has survived numerous complications( including the need for 16 units of blood) and was back in rehab and improving quickly.

Jet lag ( she talked to me until 3 am the first night and leah is NEVER awake at 3 AM)

Culture shock ( no malls full of Christmas shoppers)

Temperature shock( the weather had moderated while she was gone and now has climbed back to high 20’s and low 30’s) all experienced again for her

She brought us requests ( books, a new rubber spatula, chocolate … very melted and rushed into the fridge) and gifts from , graham , unle bill and auntie shauna, bop and Charlene ,deb lefrank et al including Christmas biscotti and poor imitations of our advent calendar .. but the boys got caught up on the chocolates quickly anyway.

Fortunately for leah and in fact all of us she got home late on a Saturday and the Monday and Tuesday were holidays( muslim eid and national celebration respectively) a chance to get back into it slowly.

I planned a few better meals including Tuscan chicken a la Muheza (ask sally and rose) and newly found feta cheese from Arusha about 200 miles away( oops there goes the 100 mile diet)

Our friends emily and alex joined us for Sunday dinner

On Monday leah convinced me to join her and the boys for a family cycle.

She and the boys have cycled daily to school( the boys managed brilliantly with friends and on their own while leah was gone) and leah and griff have cycled locally for fitness and curiosity

I had cycled occasionally, the bikes are challenging in configuration and the roads are challenging in condition and I have been playing a bit of soccer for my fitness.

But a family ride seemed a great idea

So leah and griff showed us all kinds of sites ( birds nests, sisal factory,villages) rutted routes and ups and downs, some of the downs with crazed speed and laughter.

New birds were sited but really to identify them they need to sit still in an open area (obviously not a normal bird habit)

We brought cold water which is gulped when breaks demand it

And as the sun was setting ( cycling usually occurs at about 430 for an hour or so because of the heat)we headed back only to get caught in a warm drenching rain that we pushed home through anyway.

Smiling, soaking, happy to be together again

Still hard on my knees , but I am sure we will do a few more family rides if only for the memories and laughter they create.

Last Minute Blog Entry Before Cleaning the House Because Leah Gets Home Tomorrow

2008-12-05T03:41:00.000-08:00

The size of snails and millipedes in Muheza is astounding
. hopefully we will have a photographic record to share on this subject
. the escargot are to die for if you were French ( or maybe to die of)
the storms are more frequent and intense ( a video clip from such a storm in Dar es Salaam will hopefully get posted)

We have survived 16 sleeps without Leah ( although I honestly did not sleep as well). She is in transit as I type and arrives tomorrow.Ross is slowly recuperating and resuming rehabilitation after a rocky complicated post-op period.
While Leah was gone we were busy. The boys finished their first term of school and had a week on their own( continuing their home schooling- Thank you Eva again),cribbage, blogging, videography ( new video soon to be sent to rose for posting), marbles, cycling and reading voraciously ( another true colattral gain from this trip is the 2 boys have turned into readers and we have all enjoyed reading again) , we have also developed bottle cap Texas Hold ‘Em at present Simon is surprisingly ( except to him) whooping us.

The first w/e leah was gone we went to a local nature reserve –Amani, and camped with Alex and Emily ata curious NGO resort> we were hosted by an American born Brit ( Althea) while the owners were at a craft fair in Dar es Salaam..Walks, reads, Frisbee, at a bit of elevation the nights were actually cool…’where are my socks’. The highligt was a guided night walk with A&E and our Irish teacher friends where we found chameleon,stick bugs, large crickets.astoudind and the chameleons so so unusual..

Leah and I were just ramping up with speaking and educational engagements when she left and I was able to meet all of our commitments here in Muheza as well as in Pongwe, Mgamiani and Tanga. I am sure they all missed Leahs slower and clearer delivery but generally it went well.
During the second week the boys were willing to stay on their own because some of my travel days started at 0530..power outages, water rationing and no local internet access has been that much harder with Leah away.
Even though Rose is gone Catan has continued with the medical students. I even leaked out a victory.

Alex and Emily have somehow motivated the powers that be and got housing on the hospital property, eliminating their daily pre work work out. I is nice to see them almost settled, there was painting last w/e and cleaning and shopping
Big news for us is a new cold bigger fridge!! Not North American in girth but neither am I anymore.
Ilse our roommate is gone to New Orleans (her first time in ‘ America’) and then home to Holland for Christmas so we have the house to ourselves for 3 weeks. Anyone want to visit??

The second w/e we went to dare s Salaam so I could meet with some people about improving the availability of morphine to the region. Moderate success but only time will tell. It was strange to be back with Wazungu (white faced folks) travelers, all with their copy (some translated) of the LPG.Long walks through interesting neighbourhoods especially the textile (katan, Katanga) areg and long cab rides through rainstorms and terrible traffic on my way to meetings. We also found a very good quite expensive (but how could I refuse-see above) English bookstore. The highlight and lowlight was the Africa Cup qualifying Match on Saturday. Tanzania vs. Sudan (how does Sudan have a team?) 3-1 for the home team in a very comfortable half-filled (capacity 60,000) Chinese built new stadium. In our celebratory mood we were led into a funnel of crushing people, scaring Simon and me and then I was pickpocketed but realized at the last moment and was able to scare the perp so he dropped my wallet. Sadly we discovered hours later when buying our return ticket to Muheza that Griff was successfully pick-pocketed from a front zippered pocket in his shorts for money and a mobile phone. He was devastated and I was saddened ( and maddened)that we needed this rude awakening.
We were in the Indo-African part of town and found some great eats and fortunately for Leah and did not bring any barfi back for her (her year in India put her off barfi for life)
During Leah’s time away I did have roasted cassava (good),ugali ( not bad)and jack fruit ( OK).
So we have a 4 day w/e for Leah to settle in (Muslim holiday and a national holiday coincide) the house will be clean she can get used to hot temperatures and humidity again and I will make sure the toilet seat is down again (3 boys can slip into old habits quite quickly)

So we hear of constitutional/political turmoil in that backwoods hamlet called Canada ( not making CNN international news) and that the canucks are doing well at hockey
Snail mail is arriving but I have saved it for leah’s return
Christmas in Zanzibar is the next excitement and teaching right up until then. Tutaonana, baade.

Photo Post From, Ontario!

2008-11-10T15:46:00.000-08:00

Hello all,

Graham has finally received passwords and has found 15 mins (admittedly in the middle of class -discussing Western European "catch all parties" is not so riveting on a Monday evening) to post photos!

Hope everyone enjoys.

Another Post (one of very little)

2008-11-05T06:53:00.000-08:00

It has been an incredible month of new discoveries, comings and goings of friends and family and visitors. A month of settling into the life here in Muheza. This past week we have hosted “the Anglicans” as they came to be known in our family (10 visitors from a church in Sunningdale, UK with a long history of significant donation to the workings of Hospitali Teule) who were here for less than a week and had a whirlwind exposure to Muheza, the hospital, the Diana Centre (Muheza Hospice Care and HIV Care) and even the boys’ school. It was strange to suddenly be the hosts and be the ones who “knew” and to be showing others about life in Muheza! In a curious way I think it helped us to realize we are settling in and becoming more confident and comfortable in life here and especially for the boys to receive such interest in their school and commending words of support for their adventures in Africa.

The boys are a joy to watch. Griff is back to his pre-mefloquin self and we are so grateful for that. Took about 2 -3 weeks for his confidence and poise to return, and now he is chief market bargainer and probably has the best Swahili of the family. He is super bored in school, but takes his home-schooling math book we brought with us and is working through his own math. During their Swahili, he works on “teach yourself Swahili”. He came forward with the scary experience of seeing his classmates hit (hard with a yardstick to the point of tears) and managed this with remarkable emotion and maturity. Fortunately, Sister Gwynneth has total intolerance of corporal punishment and for the moment the situation has been ’managed’. However, it will likely rear its ugly head again for him or for Simon as it is apparently the norm amongst Tanzanian teachers, despite there being a recent law forbidding corporal punishment in schools.

Simon has been a wonder, especially when I think of how far he has come from his initial huge fears of being the only white kid at school, and of missing out on everything at home. He is making friends, and making thoughtful comments about what he is seeing around him. For a couple of weeks it was really hard for him to go to school, but he seems over the hump of the early days of unbelievable adaptation to everything different. He is with kids a year or 2 older and the math work is actually about where he left off. My sense is that he is thriving with the family time and is pacing himself for the months and adventures ahead. No easy feat for a 10 year old. He has such a keen eye and appreciation for all the birds and insects and reptilious creatures here. We look forward to taking him on a nocturnal ‘camelion walk’ up at Amani Park on one of the upcoming weekends (and of course a safari at some point !)

They are both learning important life lessons such as how to navigate on a gearless bike at top speed the deep unpredictable ruts of the trails to school (especially after a rain when the slippery mud congeals between your tire and your fender), how to win at marbles on the playground (several different complex games) , how to take enough showers and drink enough water to stay alive in 35 degrees, how to sleep through the call to prayer at 4 am and the moaning cow across the road, how to avoid ugali and macheecha (Tanzanian staples) and squat toilets.

Graham ‘dropped’ in for a couple of weeks, in the middle of his university term. He got a good taste of life here although I am sure overwhelming for him and far too short. I am glad that he can now picture where we are and imagine the stories from afar. It was an epic journey for him to pull it off and we are grateful for the effort !

Our bodies feel in a state of suspended animation waiting for the damp cold and rain of a fall in Victoria to begin. Instead it gets hotter and hotter and hotter. Muggy days too with intense humidity that lifts only briefly after short unbelievable deluges of tropical rains. The other day I borrowed Rose’s little thermometer and attached it to the back of my bike as I rode up to the school for the afternoon pickup. We stopped on the way home at the hottest open patch and it read 40 degrees. Yikes! It is good that the kids are off school Dec and first half of January through the “hot season” !!!! It is all very survivable as long as the power is on, and the fans are working. Otherwise (recent outage for 3.5 days) the nights are long sweat-fests. We are all shedding pounds, just from the new rhythm of life, gratefully not from any serious illness.

Tonight we are entertaining Alex and Emily (2 young volunteering docs from UK) and the menu includes chicken on veggies, mashed potatoes, mango/avocado/tomato/red onion salad (your recipe Deb !) all well within the 100 mile diet. We are certainly eating well and enjoying fruit salads of mangoes and pineapple from our backyard, cooking with modified recipes from home.

One of my hopes for this trip was that time would slow down, and balance of life would improve and certainly I am loving the hours we have together, and all the reading aloud and games and discussions. The 6 of us (including Sally and Rose) are reading aloud “The story of the World: History for the Classical Child, Volume 4: the Modern Age”
(Thank you Eva for the suggestion) It is great to fill in our collective significant gaps in history especially around the colonial eras and how they have affected places like Africa.
The boys are becoming voracious readers and finding the joy in curling up with a good book.

On the work front it feels like we are making good progress. There was certainly a real low for a couple of weeks, where a feeling of futility and overwhelm would descend on a regular basis, but that seems to be getting better. We are engaged in a process now and feel significantly less ‘out of the loop’. We are doing consults on the wards pretty regularly and following a group of ever-changing patients, with cancers (always advanced and completely untreated) and HIV and end-stage this and that. We are building relationships with nurses and what are called AMOs and COs (assistant medical officers and clinical officers) and docs. Most of the time we are able to find someone who can translate for us so that we can have a decent exchange with patients and family, but not being able to speak Swahili remains a huge limiting force. The positive flip side of this is that translating for us actually places nurses and docs in the position of ‘role playing’ and practicing moments of information sharing, answering questions and ‘breaking bad news’ etc that are not typically part of care of the dying patient here (more often continued focus on inappropriate active care and/or general neglect of the patient). At the same we continue to be very aware of the different cultural context of illness and death and to tread very respectfully. My guide is the patient and family and try to let them show me what they need and want.

The politics of the ‘divide’ between the hospital and the Diana Centre are becoming clearer as we hear more and more snippets of the history of the last 8 years or so and the complex layers of government, NGOs, funders, egos and at times corruption that has shaped the delivery of first palliative care and then integrated active HIV care in Muheza. We are trying to keep neutral and focus on patients and certainly it is beyond us to maneuver. We have begun some formal teaching (with power point no less !) a series on palliative care that will provide a framework for what one can do in the face of incurable illness, and suffering. It feels like medicine at home, but 30 years ago. Ambrose recalls noticing on rounds as a medical student that the patients with incurable cancer were visited less often and for a shorter time, as death got closer. In fact, palliative care grew out of the gaps and lacking of acute care for these patients. Here palliative care is being born and growing up in response to a totally different context, the HIV epidemic. The definition of PC here is very broad, eg to “look after people with incurable illness, relieving their suffering and supporting them through difficult times”. So it is woven into active HIV care in a very different way than at home. We are learning, learning, learning.

Down the road in Tanga we are beginning the ‘roll-out’ of Palliative care and the use of morphine. We gave our first talk there last week at Bombo Hospital (big regional hospital) and took 20 handouts (based on the response in Muheza) and there was a HUGE audience of over 200 !! The questions were wonderful and the discussion after, more than we ever could have hoped for. They are keen, keen, keen and although the particulars of getting over the morphine access hurdles still need to be worked through, it feels very hopeful, and something we can really sink our teeth into. We will lecture, but more importantly attend ward rounds with the newly forming palliative care team, and teach at the bedside. We are feeling quite optimistic about this chapter….feels unencumbered by the unique history that burdens the development of palliative care in Muheza.

I am continually struck by how things here are both completely different and the same as at home. For example the politics of the hospital: the details are unique to Tanzania, but the heated human emotion feels very familiar. Also the patients: here they are in open wards, dressed differently, being cared for differently, different diseases and disease processes, but really in the end just the same. People are people it seems to me. Not to underestimate the huge importance of culture, language, history…but somehow a comfort to be finding common ground.

Religiosity: “at the same time both extremely important and not important at all” (Rose et al in conversation Oct 20, 2008). We are certainly the oddities here to be white and not Christian. But we are welcomed and not criticized it would appear. Perhaps it is because Christians and Muslims live side by side in complete harmony as do dozens of different tribal cultures. This is the legacy of Nyerere (the first post independence president) who set the tone of nationalism and one language of Swahili, insisting on peaceful co-existence that has been long-sustained.

That’s all for now. Thank to all for keeping in touch. Letters/snailmail very welcome !!
Love all around,
Leah

Contest Winners

2008-11-05T06:50:00.000-08:00

The contest winners need to get announced

Our blog title was successfully translated by a number of you but there was definitely an order of receipt

GOLD MEDAL our friends in the highlands THE WENSTOBS/FLEMING

Not sure who of the 4 Kevin, Sarah, Erik or jack should get credit

SILVER MEDAL Bop and Charlene Leah’s dad and Charlene are very wired and resourceful I am sure this was a combined effort

BRONZE MEDAL back to the west coast The Svordal/Scarth family

With 4 very bright children I am not sure the parents should get much credit (except for creating them).

Congratulations to all

And a big congrats to Barack Obama

It is cool to be near his home country.

Finally a post

2008-11-05T06:49:00.000-08:00

Rose and I just beat Simon and Graham 2 games straight at cribbage. Now it is time to reflect on our last few weeks.
You have heard from Leah lately and if you are reading the boys blogs you have even more idea of our tales

Got a speeding warning yesterday ( 85 in a 50) initially there was a suggestion of a 20,000 TZ.SH. fine but the more senior officer suggested a warning which garnered a hearty asante sana from me.

At a slower and hotter pace we still have a full life.It does end at 930ish at night although Leah and I watched our first movie ,since flying,the other night and stayed up to 11!
‘The Visitor’ highly recommended.

The ‘full life’ just has other less stressful and usually less time dependent issues. Going to the market to get today’s produce. A small fridge means daily market visits. Or roasting and grinding our own coffee beans. Using jay slater’s traveling coffee press technology we are hardly missing our Café Fantastico lattes (leah says’not’)

At present we are many .Graham is here which makes us whole at 5, Sally and Rose,plus we have daily visits from our new friends Alex and Emily , another couple who are docs here from England for 10 months.
They are staying with the nuns at the guest house at the school where the boys are attending and have lunch with us most days( Juliette’s soup is daily, different and delicious)
Ilse our last roommate( a dutch MD doing pediatric malaria research) has been here variably as her parents are visiting Tanzania for the first time from Holland and she is spending as much time with them as possible.

School for the boys is tolerated as they have other distractions ( Graham) and the courses work is a bit boring ad although lunch is provided.. beans rice and ugale (corn flour porridge) is not very appealing.They cycle with leah both ways every day ( unless a rain storm)This is strenuous and hot( afternoon rides can be up to 34 degrees C.) ,but they are getting fitter and fitter and the hills are flattening out. They started bringing a small lunch today and Leah meets them with a treat and water before their return sweat.

Rose has been teaching introductory IT up at the school to the 3rd through 6th formers with mutual enthusiasm.Sal is helping rose and dabbling in about 3 other projects . I think the boys like have them up at school( very familiar faces)

Much to our dear friend Paul Best’s chagrin we have started talking about Christmas and are making plans to go to Zanzibar.

I have been reading as much as I can both books ( slowly slogging through Paris 1919, embarrassed at my lack of knowledge of events that occurred before July 6 1954)newspapers, economists,walrures brought by Graham are being slowly devoured.

Not real happy about Canadian election results very sad for Brione Penn.
Highland political updates make me wish I was home to help during
the election.US election more promising. We get some info on line when power and internet connection and certain indeterminate stars line up appropriately. also I just found out that I can access CNN at the Diana center on some days

Can someone please lend me $$3.275 trillion or so?
those of you who know Dan Nevin( you should all know Dan.N.) should get a copy of an editorial he sent me ( and others I am sure) about the ‘Banksters”

Soccer a number of days a week is how I get a sweat up. Usually with a bunch of younger friends but once with men Graham’s age ( yes graham is a man) Griff stopped watching after awhile. It was not a pretty sight.After the game a fellow asked me if I would give him my soccer boots, I guess he felt I was wasting them or he realized there were many untapped goals still in them.

Silvia is in France for Paula’s 50th (I am not actually sure of the occasion but I am sure it is not her 60th) with Paula ( really) and joel.I found out our dear friends Suasan and Phillip ( who recently lost their wonderful son David)are meeting them and I seriously considered surprising them but just not enough notice to pull it off.

So for me this week was a perfect example of the wonders of this trip with all its ups and downs

Downs

-Graham left
-Sy not keen on school on Monday
-Long discussion with palliative care leadership( karilyn Collins the english MD who encouraged us to come and who developed much of the palliative care here during her 6 years here is visiting) executives of one of the Sainsbury trusts ( considering some funding). The challenges, the personalities, the politics felt quite overwhelming
-No power for over 50 hours( no fans!!,limited cooking- finally got kerosene cooker up and running for morning coffee)
-sally sick with GI complaints ( no further details necessary ) for 36 hours
-a poorly managed , poorly palliated pediatric death – very troubling and representative

Ups

-boys school routine better every day
-griff invited a new friend home for marbles and xactica( card game)
-10 visiting brits( Anglican donors-don’t usually hang with Anglican donors) brought along with their faith a grand enthusiasm- and another new card game Wizard.we assisted in hosting them even with a candlelight meal their first night here and other meals and times together. If you come and visit we found a great “bar/restaurant” the we call Frankie’s ( after the”Maitre D”). we had dinner there for graham’s last night and had 2 large wasungu dinners there over the last week.good food, cold beer, great conversations
-I finally won at Settlers of Catan.. a slightly hollow victory as simon made a late trade out of sympathy rather than strategy . but for now I will take it
-leah and my biggest highlight this week( after a few tough days in a row) occurred when we prepared ( adapted and improved) our local ( muheza) palliative care power point presentation( introduction to palliative care)it was met here with reasonable interest but low attendance, for presenting in the regional capital Tanga at their large hospital Bombo Regional hospital.We made 20 copies of the presentation , only to walk into a room of over 200 people.the presentation went very well, well received, and good discussion after. We will be following up with further didactic teaching and ward teaching over the next 4 months. It made us feel like we can do as we hoped and improve and help develop a sustainable palliative program in the 2-3 major hospitals in the region
next week is a 5 day workshop that had been previously planned to further develop a palliative care presence and we will be assisting in its presentation. It too is in tanga so there will be logistic issues both for our to and froms and the boys schooling. Fortunately sal and rose can help
-simon has restarted violin practice( with the encouragement of financial support for a dirt jumping bike when he returns…he has also developed quite a skill at playing hearts which was the second ”adult” card game I learned after crib
-and finally a wonderful card ..our first snail mail… sent by our dear friend deb lefrank with messages from a large number of friends congregated for a thanksgiving meal at debbie and dan’s place. Thank you so much deb

sadly this is sally and rose’s last week and we will all say goodbye with heavy hearts and leah and I will have to create a new chapter and routine

I heard this week that my dear friend nou’s father died suddenly( he had been in poor health but his death was unexpected)
It has been a peculiar year for life and death juxtaposition( sadly I believe this is the new stage many of us are in)I miss not being there to support him as has me for so many years.

This an adventure ……life is an adventure

Stay tuned don’t touch that dial……

Ps. Hopefully graham will soon download some pics from his visit onto the blog

PPS leah will soon add her thoughts to the blog.. as I said earlier it is a full life and electronic communication is only one of our
Priorities

a

winners

2008-11-01T05:02:00.000-07:00

Update

2008-11-01T05:01:00.000-07:00

ughhh....hhh..hhhhh...hhhh

2008-10-16T06:21:00.000-07:00

Graham wants to cry this internet is so slow...

Sorry to anyone waiting for email replies.

Lots of sun, rains, and good company...

Graham.... for the family...

My birthday post

2008-10-11T07:51:00.000-07:00

Today is my birthday and I keep forgetting as it seems so out of place in this context without all the usual cues and prompts. Birthdates are clearly not as important here and are often unknown. As I write referral letters for patients in Teule to send them to Dar for cancer treatment at the Ocean Road Cancer Institute, there are no birthdates to confirm the identity of someone, only names and approximate ages.

We have been here almost a month and the passage of time feels simultaneously both disturbingly fast and amazingly slow. Fast as day after day passes in the work context with little outward evidence of us doing anything, while a cacophony of discussions and ponderings go on inside my head and out with Ambrose and others as we try to make sense of the medical scene. And painfully slow as we focus on the computer screen waiting for an individual email to be successfully sent (or not) or a webpage to pull up (or not) in the brief hours when we can access a computer and the power is on.

Gratefully, a big theme of our existence here is the bicycle. We have purchased 3 and daily rides have become a wonderful part of our routine. I had worried that we would have no bike fitness leading into the cycle trip, but I think that will not be such an issue! The boys’ school is about half an hour away over some seriously hilly but beautiful and un-trafficked terrain (except for pedestrians and other cyclists). We are a curiosity here for sure, as wazunga’s (white people) don’t usually ride bikes but rather are driven around in big white land rovers. Some folks are getting used to us, and simply greet us as regulars, but usually the ride stimulates some comments and shrieks (usually amused and encouraging) from onlookers. We have been strongly advised that the boys should be accompanied out of concern that they could be stopped and have their bikes stolen. Property security seems to be a very big issue here (you should see all the locks on our doors) but gratefully not personal safety.

Mostly I am riding the boys up in the morning, leaving home around 7:30 and at that time the air is still tolerable. I am back by 8:30 and a quick shower is in order before the work day can possibly begin. The ride home (3 pm pick-up) is more of an epic daily dehydration fest, truly feels like you are exercising in an oven, sweat pouring down all surfaces. We carry loads of water with but never can we seem to be able to drink enough. The bikes are made in China, single-gear clunkers that take me back to my blue CCM bike of childhood, although these are noisy (cheap), heavy (cheap) and feel like driving a shopping cart. We are regularly at the bike fundi (repair person) as bits and pieces rattle loose and drop off and inner-tube valves crumble with attempts at pumping up tires. Repairs always cost 500 Tsh (about 50 cents), so that’s tolerable. However, the initial flurry of problems and repairs seems to have leveled off (now that we have prophylactically removed baskets (cheap) and lights (cheap cheap) and we have had a good week of rides without a peddle falling off.

The boys are having a hoot with the bikes. Simon’s is a blue very comfortable slightly better quality with a cushy back seat for doubling someone. Sometimes a friend (Kevie) rides Griff’s bike home and Griffin and Simon double over the bumpy muddy terrain laughing their heads off (until Sy falls off and the heat catches up). The birds and insects usually show us some new species every day and Simon loves to see all the new creatures and try to identify them. It is a curiosity of timing that Sy was just launched into a serious love of mountain biking and dirt-bike jumping just before we left home. His friends have been sending emails detailing their adventures and new jumps they have built and it is just about killing him to hear of their exploits without him !! Hard to reassure a 10 year old that it will all still be there when he gets back…His bike here and our rides over the deep red earth (and mud post torrential but brief bursts of rain) of Muheza district, are a metaphor for how profoundly different everything is here for him. He is coping (in fact thriving) remarkably well. He said to me yesterday.. “can you believe that a month has already gone by ? Don’t you think its going very fast !! “

Griffin has had to face a few more challenges on the other hand. Chiefly he has had a terrible time the last couple of weeks with mefloquin side-effects, the anti-malarial he was on. What began as nocturnal nausea and vomiting (preceeded by non-specific anxiety and claustrophobia characterized by an intolerance of mosquito nets!) eventually (after a normal week without any problems) lead to full on decompensation complete with hallucinations (crawling ants and monkeys) and a couple of completely sleepless nights fraught with intense anxiety and mental restlessness. Poor kid. He has been a trooper through it all as we discussed the symptoms with others and helplessly watched the thing unfold. (We got out the ativan and curtailed the 3rd night) Sadly, Mefloquin is a long lived medication given weekly, so the final effects are still lingering I would say even though it has been 11 days since his last dose. (Some say it can take weeks to completely wash out !!) We look forward so much to seeing him back to his normal self, as he was the first couple of weeks, venturing to the market, playing soccer with the local kids, and reflecting so competently on his experiences in his writing and blogs. ( I will have a thing or two to say to the travel doc we saw in Canada who confidently told me children never get the neuro-psychiatric side-effects of mefloquin!!)

Otherwise, tummys have been reasonable ok and we are enjoying local market shopping and cooking mostly adapted Canadian meals. Sally and Rose have arrived and it is wonderful to see them. The first few days we kept shaking our heads at the sight of them here with us, but now we are settling into a new expanded family and configuration of routines. Rose has already been up to the school and today she met with Sister Gwynneth (the Welsh nun who runs has built and run the school over the last 6 years) and is preparing to teach the newly developed Tanzanian IT curriculum for forms 3, 4, 5 and 6 (todays late-breaking news!!). Sally has a few tasks dropped in her lap researching the ordering or meds for the hospital, and reproducing charts detailing the patient flow systems for the Diana Centre. I will introduce her to the orphan program folks there this aft and see where that leads her. (see their blog for further details of their safari adventures before they joined us).

We went away last weekend with Sally and Rose (as well as Sally and Ben and kids and Alex and Emily) to Peponi a low end rustic beach resort on the Indian ocean and had a wonderful (except for poor Griffin’s bad night) time swimming in the sea and visiting the sand island (white seashelled beach exposed only during low tide) and snorkeling along the coral reef that runs along much of the local coast. It was fantastic snorkeling with colourful coral, fishies, urchins, starfish and tubular mushy things. It was lovely to get away although the contrast of life in Muheza and the resort was a bit jarring, and perhaps a bit early in our time here. That being said I am sure we will re-visit the coast and enjoy those spectacular beaches many times.

Graham arrives in a couple of days and there is great family excitement anticipating his arrival. He has managed to take a couple of weeks out of life at university and fed ex and we hope this is not too detrimental to his studies. It feels right that he come now and share in the early weeks and be able to picture our adventures better from Ottawa. This will be his first real foray into a ‘resource poor setting’ and I’m sure will feel truly surreal in the middle of his school term.

Work continues to be an unfolding adventure of revelations, ponderings, discussions and tiny planning steps forward. We are learning tons about HIV, TB and malaria. We certainly are helping with consults and direct patient care (endless and could consume all time if we chose to), but understanding the big picture of the troubled forces and resources that fuel patient care and palliative care here is much more complex. Sadly, in Muheza what was a relatively thriving palliative care infrastructure since 2003 ish has largely fallen apart over the last two years due to a complex web of problems. What is worse is that there is bad blood in its dissolution and the hospital is not a wholly receptive environment to palliative care and is strained by extreme human and material resource shortages. Perhaps we are fresh faces who can try to redevelop the palliative care foundation in Teule hospital in a sustainable way, but perhaps the division between Muheza Hospice Care and the hospital is also too deep and complex for our timeframe here. We are more hopeful that we can be of benefit down the road in Tanga where the history is different and the interest to learn about palliative care and pain relief appears keen. Every effort to build even the smallest of capacity here and in Tanga that will persist after our departure, remains our goal. So while Muheza has been absolutely ideal from a family adventure perspective, there are unfortunate extra layers of challenge that encumber the work.

Internet access continues very difficult, often extremely slow, characterized by crashes and power outages. It looks hopeful that we will get our own hook up at the Diana centre, but the schedule for this seems definitely on an African timeframe. This would really help and then we could access more reliably as long as there were power. In the meantime blogs and emails will appear in bits and pieces and we thank you for your patience.
Our snail mail address is

C/o Dr.Leah Norgrove
Hospitali Teule
Private Bag
Muheza, Tanga District
Tanzania

Our first week

2008-09-27T02:23:00.001-07:00

We have not yet been here a week and already it feels like we are settling into a rhythm. First impressions reminiscent for me of India: overwhelming cacophony of noise, smells and visuals….In a few short days I already feel a bit desensitized to what is so new and amazingly different. I am amazed as how quickly we adapt.The long journey from London went well without significant problems. The boys were wonderful enjoying the freebies of Air Emirates and the swing of travel. We arrived in Dar immediately smothered by the hot hot air , all bags safely with us and eventually met by Juma the taxi driver (amazingly, via our UK contact to Muheza, Dr. Karilyn, we were able to text Juma from Hereford UK and set up a pick-up in Dar/ hotel and bus tickets for the next morning to Muheza !)Five hour bus ride on “Scandanavia” lines, the ‘better’ bus company, without ANY shocks, unbelievable (SCARY) speeds, but free bottled water, biscuits and juice included in the price. Met by Dr. Sally and immediately we are indebted to this lovely family from the UK who have been here 6 years already and planning for 4 more. Sally is a ob/gyn and Ben doing malarial and pediatric fever illness research. Their 3 boys Zach/Max/Piran (8/4/4 mos) blended with ours in that amazing way that kids instantly do and introduced us to some of the local kids who hang with the Wazungas (white people). They fed us lunch and supper, and walked us around Muheza which is a few crazed streets of tiny shops selling their narrow range of stuff, fantastic open and covered market and mosques alive with Ramadan (Moslem festival we have stepped into the middle of this month of Sept). A far cry from the Lonely Planet guide’s description of Muheza as a ‘scrappy cross roads town’ that could easily be left off the travel itinerary. On the contrary, feels like a perfect size for this Canadian family, and full of unique Tanzanian life for us to explore and find our way.Our house is great, shared with Dutch MD researcher Ilse and we quickly unpack stuff and watch the kids stake out their domains. She has stocked some food so really there isn’t even a scary low of “what will we eat and where do we get it ??” The house known as Hillview, is spacious and obviously built by Wazungas (complete with sit toilet, water filter and shower which wouldn’t be the norm here) and we feel lucky and comfortable. The house comes with ‘house girl’ Juliette who makes us wonderful soup and bread for lunch, washes the clothes and dishes and cleans. Imagine! She is lovely and welcoming and will teach us a lot of Swahili.
The next day Sally and Ben bundled us off to Tanga (larger town down the road) where provisions like cheese and yogurt and safe meat and a bigger market are to be found. We stock up and then spend a lazy afternoon at the Yacht Club (sounds posher than it is) for our first swim in the Indian Ocean. Warm salty water…what a concept.We are greeted in Muheza by a couple of brief power outages which we learn are frequent but usually short events. Uncharacteristically, there is a major outage of a greater magnitude that begins shortly after we arrive involving the hospital, in particular the lab and the hospital based internet which we learn will be our lifeline to the outside world. So for the first few days here access is not easy and we eventually find an internet café on the other side of town with very slow access to get off a few brief hellos to announce that we have landed safely.The power issue is big for Ben and his years of research samples, tiny vials of blood and serum that need to be stored at minus 70 and there are a couple of frantic days as Ben tries to find temporary freezer homes for them. Ultimately, they are shipped off down the road to a different part of Tanzania to another research site.The week settles into the daily jobs of buying a bit of food, figuring out what to make for supper (yes the question follows us across the world), walks, explorations, and gentle introductions to the hospital. We feel very welcomed by all. “Karibu” or Welcome in a million variations. We attend morning rounds (overwhelming reports of deaths in the night, new admissions and unintelligible monotone summaries of critically ill patients). We try to get our ears into English as a second language with Swahili as the first, let alone the Swahili. Sally tours me through the wards which are ‘Nightingale’ style open wards, male or female with 30 beds closely lined up beds with each holding at least one patient if not 2 or 3. No curtains. One or maybe 2 nurses. Although I know it is exactly what I expected and knew to be the reality, it is still hard to absorb.
The Muhueza Hospice is quite separate (called the “Diana Centre” as the monies for its development have predominately come from the Diana foundation) and that is where we will be based. We are learning about the necessary shift of focus of the palliative care team in the last short years (2-3) who now provide ARVs (anti-retroviral treatment) for the HIV patients, rather than simply supporting them as they faced certain death. The two services (active HIV care and palliative care) will separate in the timeframe we are here and that transition will certainly shape our experience. The layers of politics, both Tanzanian and Wazunga will take some time to understand. We will go gently and learn more than we give for quite some time.The boys have already made friends, partly via Zach and Max, but also via the now daily late afternoon game of soccer that has started. Amb and the boys wandered over to a dirt soccer field (generous description) with a ball and were quite instantly surrounded by 10- 15 boys. A couple of kids, they discovered go to the same school our boys will attend, and so there will be familiar faces. Their English is marginal, but better than our Swahili (!) and enough to make a good connection.We all plan and prepare for school next week. Turns out the school they are to attend is about a 45 minute walk out of town, so we decide to buy bikes to make the daily journey more realistic. A couple of days ago we walked up there and despite our best intentions found ourselves walking in the peak of the African sun without enough water (3 bottles was no where near what we needed). We collapsed for the rest of the day and drank drank drank. The boys seem fine with it all, and find humour in the seriously ugly green gingham shirts and green shorted uniforms, rather than despair.We are so proud of how they are doing with all of this. We can see already that they will speak Swahili much better than we will by the end. Muheza is certainly a setting where they will play with and attend school with Tanzanian kids, and that affirms for us our decision to come here, despite the currently indecipherable complexities of the work situation.
Have bought coffee beans in the market and roasted them myself for the morning brew! Ambrose says it is not up to Café Fantastico: I am awaiting the frother when Sally and Rose arrive next week and then we will have lattes.

Our first week

2008-09-27T02:23:00.000-07:00

London-Dubai-Dar Es Salaam-Muheza

2008-09-15T02:31:00.000-07:00

We have made it this far

1) Emirates Airline is "SWEET" ( Griffin's description)
tasty food
free Economist ( after i bought one for 4 pounds in heathrow)
2) good entertainment options
3) free shaving kit for DAD

all official hoops ( immigration and customs ) jumped
no lost luggage
our driver friend Juma showed up a bit late which increased our sweating
hotels meals and buses all on time

All eyes very wide open as we have walked through Muheza and Tanga
even got a swim yesterday at the Tanga Yacht Club ( more la dee da than it sounds but pleasant just the same)

We have bought and figured out how to use cell phones and now looking into bikes for the boys to ride to achool.
school and work wont start for us officially for another week

great to have stopped moving and lugging

2008-09-11T11:51:00.000-07:00

No picture
Heathrow Airport
4 HOURS before our flight

Our time in UK has been a great transition
Good pints
good visits
wet weather
A slew of driving stories
Griff and I watched England 4-Croatia 1 last night -hatrick for Walcott
Travelling throgh heathrow gives you a small sense of the size of the world

Metting Karilyn and Richard in Bodenham gave us a great fell for some of the challenges ahead.
She has been very excited and optimistic about our time in Muheza

Wonderful to see \Kate and Tim ( and their Angus too)

So now off to Tanzania
We will post when it becomes possible

Wales and Simon's Birthday

2008-09-07T11:52:00.000-07:00

The last posting of the day.
Today is Simon's 10th birthday ( double digits!!)
Clearly memorable because he is celebrating it in Wales.

For Simon, who is feeling better ( persisitent nausea seemingly the effect of mefloquine), the highlight ( obviously besides the gifts secreted from victoria) was a short horseback ride and well wishes from friends and family by phone and skype.

Griffin with First Cousin Once Removed Tilly.

A 16th century renovated farm house,fog covered, rain soaked hills.gaggles of sheep.
Leah struggled with her family's famous lemon sponge pie baked in an AGA with avariety of unique ingredients.

Our days with Patrick

2008-09-07T11:10:00.000-07:00

After a day wandering around Cambridge- a highlight being Leah's haircut done in the central market area by a inexperienced but pleasant hairdresser.
After a pleasant dinner and pint at the Cambridge Blue Pub (recommended in the real ale guide)
After a surprise visit to our friends Kate and Tim (No ,the bike have not arrived yet, but Graham is still working on it)
and
After a windy, rainy, horrific (for some) drive from Cambridge to Loughbrough we had the honor to attend Patrick Baud's first ever presentation @ the Anarchist Study's Network Confrence at Loughbrough University.
Surounded by Marxists, Leninists, (probable the occatassional Trotskiite) and Anarchists, Patrick did a admirable job in presenting his theisis and responding to questions.

We said our goodbyes leaving Patrick to make more contacts and enjoy the debate at the confrence and we headed off on a epic journey to Wales.(More details to follow in next posting)
Patrick was a wonderfulconpanion in the first leg of our adventure and we wish him luck in his first year at UofT.

Goodbye

2008-09-07T07:56:00.000-07:00

As can be seen we made it to the airport.Some of the afore mentioned friends (assistants) came to the airport to make sure we actually got off and weren't going to be a bother anymore.

The big adversity at this stage was the weight limit on our luggage.

Packing for a trip of this length, with 3 legs (Tanzania, Turkey, Cycling in Eastern Europe) had significant packing challenges.

The greatest weight factor was books. Reading will be a new found luxury after the last 6 months and even though we will not be doing a large formal home schooling program (This next bit is a secret to the boys), there will be some academic expectation and Leah had done a significant amount of research (with Eva's assistance) and there was significant weight attributable to educational supplies. Toiletries, firstaid suppiles, medical needs, some light camping gear, palliative care teaching supplies, soccerballs ( yes yes we deinflated them) and a little bit of clothing added up to over 200 pounds of stuff.

In contrast to many of Ambrose's departures we gave ourselves loads of time so the reshuffle and repack was not under any time stress.
The flights were uneventful with a highlight being our Calgary-London leg being undersubscribed and there was extra seats to stretch out on so we all got a few hours before landing.
From touchdown to arriving at King's Cross train station was only 2.5 hours including immigration, non-customs, left luggage, changing money and a 23 stop tube ride. Heavy schlepping (sp) but otherwise easy and Patrick met us as planned.

With Thanks

2008-09-07T06:08:00.000-07:00

Before i begin ( although this has actually ben added after this page was initially posted) we need to let you know that the title of our blog is a puzzle of words and languages pertinent to our travels which describe our adventure concisely. Please e-mail your answers to us and we will post the winner and the winning solution when it arrives . good luck

Please note our flickr link for add pictures that you dont see on our blogs is http://www.flickr.com/photos/tanzania08/

So we are off (i will try and use spellcheck) goodbyes occurred for days and weeks.

The above picture was treats and goodbyes from Saanich ( i am even using CAPITALS) Peninsula Hospital. Thanks to Maureen for organizing, Dawn for finding budget allocation for the treats (did she know about this?) and everyone who attended, signed the card or sent regrets.

We had a similar party at Sally and Rose's with friends the week before (Sally and Deb organized) with pot luck deliciousness.

One commonality of both was really quite unforeseen by either Leah or I and that was the generosity of everyone in making donations for us to distribute as we see fit (as we discover) in Tanzania. This generosity extended to patients and friends through our practices too.

You will have to take our word for it that we would not have made it to the next picture without the help of many, many friends and family. Hyper cleaning (deep cleaning) was much more time consuming than we could have anticipated. Those of you who know us well might nod knowingly at the thought of this process chez nous but you will have to understand that we also took this opportunity to clean, discard and organize to a greater extent than we initially envisioned. Others helped us by lending us vehicles, taking care of our children, IM/IT

support, meals....

Graham and Griffin prepared the FedEx vouchers for transport of the bicycles to Cambridge in Graham's name (employee discount !) which needed to happen also in that crazed timeframe of the countdown to departure. Yes, yes we know we owe you big Graham !!

Sadly our departure is also greatly affected by the sad news of a bicycle accident involving the son of our dear friends Susan and Phillip, and we are thinking of them constantly as they sit by David in an Oslo ICU.

So to all and everyone thanks for your help, your best wishes , your emotional support and your generosity.