Uchaguzi!

Jambo from Arusha! Happy fall to you northern hemisphere dwellers! Hope this message finds you well, surrounded by the changing seasons, falling leaves, and aromas of the best season known to mankind. In the weeks since the last update, I have been continuing my work at Selian Lutheran Hospital. We were happy to welcome back two volunteers who had been in Arusha previously. One is Dr. Elena, a pediatrician from Australia, who had previously spent 3 years working in pediatrics at ALMC and Selian. It has been nice to have her back in Arusha and to gain from her wealth of experience. Another volunteer is a Canadian NICU nurse named Lisa who has come to collaborate with the NICU nurses at ALMC to continue improving the level of care for our littlest patients. It is refreshing to have new faces, with new perspectives and skills, to contribute to improving health care in Arusha. It has also been a nice time for getting to know the new interns, most of whom started in early October. As mentioned previously, the medical interns come fresh from graduating 6 years of medical school, which is usually (but not always) undertaken directly after secondary school. They then begin a one year internships, which rotates them through the four major specialties: OB/GYN, pediatrics, internal medicine, and general surgery. At least at Selian, when they stay overnight to take “call”, they must cover the whole hospital. That means performing C-sections, presiding over the whole medicine and pediatrics ward, and sometimes performing other surgeries. This was the way medical internship had been in the US in the past, however, I could not imagine having so many responsibilities! They seem to handle it well, and they have the back-up of more senior doctors on which to rely. The ones who have started this year are a good bunch so far; they seem to enjoy their work and are eager to learn new things. We have enjoyed doing weekly introductory teaching about bedside ultrasound and have reintroduced regular radiology sessions for X-rays (now that the X-ray machine is working consistently—thankfully).

Today, for the Swahili lesson, I wanted to introduce a word related to current events: uchaguzi. This word has the same root as chagua (to choose) and means election, as in the democratic process of choosing the nation’s leaders. It has been such an interesting time to be in Tanzania: witnessing the campaigning, the hope for change, and the general excitement of people. To explain Tanzanian politics briefly, since independence in 1961, a single party has ruled the country: CCM (Party of the Revolution). At first, this was because the country was designed to be a single party system. However, for the last 20 years, there have been other parties, though none have gained enough momentum to challenge the ruling party; that is, until this year. With an interesting background as a former prime minister under CCM, Edward Lowassa left his party to join the opposition, Chadema (Party of Democracy and Progress). With his influence and experience, along with increasing desire for change, Lowassa and Chadema presented a real challenge to the political status quo. With this backdrop, it seemed there were not many Tanzanians who were not swept up in the fervor of uchaguzi. Young and old, educated and laborer, Christian and Muslim, all seemed engaged in this monumental democratic exercise. The children, even, would hold up the sign of CCM (thumbs up) or Chadema (peace sign) or shout “Peoples… power”, the call of Chadema. Flags and placards were visible from almost every corner. It was difficult to understand exactly how the parties differed, though it seemed they were calling for many of the same things: less corruption, better education, health care, and infrastructure. It was hard to tell if one really would be better for Tanzania than the other, and if I had to vote, I do not know who I would vote for. But what was most interesting to me, besides the general passion for politics that Tanzanians show (a stark contrast to the ambivalence many of us feel during US elections—as demonstrated by poor voter turn out), was the deep hope for change. I heard many impassioned speakers explain, with such hope in their candidate, that they would bring about the change in this country that would give their children a better life than they have experienced. Many of them have known desperate times: struggling to make ends meet, suffering from preventable and treatable diseases, commuting on sketchy dirt roads, sleeping in poorly built and un-electrified homes, drinking untreated water running from dirty streams. They hoped for better infrastructure, consistent power, educational and employment opportunities, and a better way of life. Though I explained in my last update how change can seem to happen quite slowly here, people appeared ready for it to happen in a dramatic way with this election. With the results declaring CCM to have won, many people seem to have lost some of this hope. But, as an outside observer, it seems that this fervor for change goes much deeper than which candidate or party has won. I hope that this momentum will carry this generation into building a just, peaceful, and equitable future to pass on to posterity. The people are ready to build a better Tanzania, and I have faith that they will.

Ryan, Global Health Chief 2015-16