Fingers crossed

I'm on my way to Tanga in the hospital car, charged with enough self control to renew our visas which expire today after the last extension. Feeling a little anxious as I was meant to be going with the hospital superintendent who supposedly has smoothed things over and agreed a straight forward renewal. But it's the hospital secretary who is accompanying me instead and I fear things may not go quite to plan.
I am practising my mental mantra: keep calm and smile sweetly!!!

It was a long long clinic day yesterday. Inevitably drawn out slightly as I had invited 2 Norwegian nurses whom we'd met at Peponi to visit. They are volunteering in Tanga for 3 months with a Norwegian nursing program doing school health and community mental health. One is a cancer nurse so I was delighted at her enthusiasm. I hope it may spark an interest to develop a further link.
We several new patients. All of whom reinforced my thoughts for my hospital presentation next week: the focus of which is communication!
Whereas in the UK we have gone to one in extreme in the creation of endless paperwork and documentation, here in Tanzania it is the other end of the spectrum. It is good that as a GP I am used to starting from scratch, as 2 of our patients had just been told to attend the palliative care clinic after attending the hospital, but not been told why. Nor did their hospital notes enlighten me. Both once I suspect have late stage cervical cancer so entirely the right thing for us to be seeing them, but frustrating that the whole process could be a lot easier.
Similar difficulties arise with patients who have travelled to Dar es Salaam for cancer treatement as there is no correspondence system between hospitals. It is hard to deduce what investigations or treatment has been done.
I've decided my challenge for this last few weeks is to see if I can improve written communication between hospital and hospice and between hospitals!

Our day finished delightfully with an invitation to dine with Sister P and her fellow nuns. She is the chief anaesthetist (nurse) so M spends large chunks of time with her.
We borrowed the hospital car for the evening and drove out of Tanga into the low lying hills to the south. This small gain in altitude gave a welcome drop in temperature. Their blue and white house on a hilltop surrounded by large trees and their farm felt idyllic with the evening breeze lifting us.
We brought beer, as they are beer drinking nuns! The girls were treated to passion fruit fanta and a tour of the vegetable gardens and animals. Much disappointment that we turned down the offer of a piglet present!

Checking out the piglets

The good stuff..

Thank you for bearing with my offloading of negative thoughts. A deep breath and a bit of space has given me a chance to recentre. The photos below are all from this week...a visual reminder to me that despite my doubts, even what has felt like a bad 7 days, has been plenty full of amazing moments and happy family time. 

At the coast, we barely see the girls as they head off on sister adventures.

Checking out the 'new' café in town, or perhaps we just hadn't noticed it before. Deep intake of breath...yes my children are drinking sugary fizzy drinks.....a new experience which we have avoided thus far in life....but when you're dripping sweat and that's what the café sells, hakuna matata!

Precious cuddles

Gerry is still with us & grubbier than ever!

River trip to look for crocodiles. Not sure if we were more relieved than disappointed not to have seen any!

Birthday boy.....yes, we did find wine!

Our 'honeymoon' candlelit beach supper to go with our honeymoon suite

Family nirvana to manage civilised evening meals.... bonus entertainment when you can 

go crab hunting between courses!

Yo-yos

Why is that when one goes up, the other comes down? Such a common pattern in relationships, but as M makes a come back from feeling blue for a few days, I have switched places to feeling like I’ve had enough!Is it okay to say that?!
A run of home schooling and sleepless nights has put my reserves into the red and suddenly 6 weeks feels like an awfully long time! I’m running out of energies too with my efforts to help the hospice become more efficient. The efforts of trying to make days fun and make sure everyone else is ok are taking their toll. I suspect the biggest thing is there’s nowhere to go to take a moment out, no friends to take a walk or a cup of tea with, no ‘me’ time....stepping out of the house is just too like heading into a sauna.
I’ve booked us a weekend for M’s birthday at our wonderful Christmas destination (no coincidence that this was the last place everyone slept well), but missing my mum’s usual birthday present to himself of a weekend away for us both without children! Best present ever!!
When I take a step back and reread the above, I get a reality check at how lucky I am to have those complaints. Compared to the lives outside my door, my moans are trivial; I’m not worrying if my children can eat, or if I can afford medicine when they’re poorly or if my roof is going to leak with the coming rains.
Water supplies are running low, the land around Muheza is scorched dry with large swathes of burnt areas where fire has taken hold. M tells me the real-time heat has been 48 Celsius the last few days with the humidity of the air. The world feels like it is holding its breath waiting for the rains. They are close. The clouds are gathering - the first shower fell yesterday and with it such a welcome drop in temperature. The rains will be in full flow as we leave and I don’t doubt we’ll be wishing for wellies by then.
This morning I was on the verge of booking flights home. This evening we have had a harmonious family meal on the edge of the sea and I am now relaxing in the upstairs of the‘honeymoon’ suite (the family rooms were taken!). There is a tapestry of stars above the palms outside, the gentle breaking of waves is the only sound. Perhaps we can imagine there aren’t really 3 young ladies downstairs for whom we are responsible. Would be a shock for the next real honeymoon couple if we left them!
Without a doubt family life is a yo-yo of emotions. Or is that just me?!                                                

REFLECTIONS

All tired out this week despite a lovely weekend at Peponi (where we are now considered 'extended family' and were allowed to stay Saturday night as the only guests!)

Heat is draining, yes, and I suspect we have started that shut down phase where you know things are drawing to an end so everything starts to feel an effort. 

6 weeks left and girls are counting down. We're all wondering how long it will take us before we start taking for granted things like; water that comes out of a tap that you can drink, cheese, fresh milk, toilets with loo roll, not having to wash your feet before getting in to bed at night (or in B's case not being asked to wash your face for the umpteenth time). They are especially looking forward to not standing out, though I suspect this won't be the case for the first few weeks back at school with everyone wanting to catch up!

Another tolerant bunch of medical students are proving a nice distraction, seemingly all too happy to have small girls turning up on their doorstep to 'play'. A great outlet for all of us to have new company each month and refresh our view of Muheza. 2 of them have birthdays this week, so of course the girls all had to make cards and cupcakes to take round after school today - albeit a psychedelic green with B's enthusiastic addition of the only food colouring we have! A good warm up for M's Birthday next Monday.

We've been doing a lot of reflecting on our time here and deciding what we want to do with this last stretch. It made me wonder at how I'd do at answering many of those questions bubbling around my head back in November...

Why are we going? (Altruism;itchy feet; to open the girls’ eyes to the world.....TICK)

How many deadly snakes are there in Tanzania? (I’m sure R did tell me......but they won’t come anywhere near us...will they. SO WE HAVE YET TO SEE A SINGLE SNAKE)

And do we need to check under the toilet seat? (Hmmm....hopefully not in our house. ONLY TO SEE IF THERE'S ANY WATER IN THE CISTERN. NO CHANCE OF ANY SNAKES GETTING IN THROUGH OUR FRONT DOOR)

What are we doing there? (M will be operating & training, I’ll be helping in the hospice....maybe some other stuff eg ecg training, family planning. SOUNDS ABOUT RIGHT, ALTHOUGH I'VE BEEN MAINLY SWALLOWED UP INTO THE HOSPICE)

Do they cane children in school? (Help...I hope not. THEY'RE NOT MEANT TO, BUT...…..)

Do they speak English? (The hospital staff and teachers do....YES, PLUS ANY TOURIST PLACES DO)

Are there great white sharks? (No....they’re all out at reunion island. !!!!!!)

Can we drink the water? (Definitely not.....except from the filter in our house and the amazing water to go drinks bottles we’ve been given. WE'RE NOW DOUBLE FILTERING OUR DRINKING WATER WHICH SEEMS TO HAVE PUT A STOP TO FUNNY TUMMYS. SADLY THERE HAVE BEEN CASUALTIES AND OUR SPECIAL DRINKS BOTTLES ARE DOWN TO 2)

Are there African tooth fairies? (Absolutely, though I’m not sure what size they are. WE HAVE PROOF......THEY LEFT B PAPER MONEY, THOUGH WHEN WE ASKED THE SCHOOLFRIENDS WHAT THEY DID WITH THEIR TEETH THEY SAID THROW THEM ON THE ROOF FOR THE TOOTH FAIRY!!!)

Are we getting paid? (NOOOO...…..STILL A NOOOOO)

How many Tanzanian shillings are there to the pound? (About 3000)

Why is it called Tanzania? (L has answered her own question....combination of Tanganiyika and Zanzibar)

How many cupboards does the headmistress have and how many cats does she have in each cupboard? (????DESPITE CLAIMING SHE DOESN'T REALLY LIKE CATS THERE REALLY ARE CATS FALLING OUT OF THE CUPBOARDS AND BOXES FILLED WITH LITTERS OF KITTENS.....TOO MANY TO COUNT)

Will they like me? (Why would they not? PERHAPS TOO MUCH, HARD TO BE THE NEW GIRL WHO EVERYONE WANTS TO PLAY WITH ALL THE TIME)

Can girls wear shorts or do they need to cover their knees like women do? (Answers please. MOST GIRLS ARE IN SKIRTS/DRESSES BELOW THE KNEE)

How much suncream should we take? (Total indecision.....do I buy an industrial 1L or take out shares in Piz Buin? TURNS OUT THAT DESPITE THE INDUSTRIAL SIZE, WE STILL DIDN'T BRING ENOUGH SUNCREAM. LUCKILY THE LATEST BATCH OF STUDENTS HAVE BROUGHT US MORE SUPPLIES)

Does Father Christmas stop in Tanzania? (Of course, but only to people who celebrate Christmas, and he is respectful of local customs, so children in Tanzania may have different things in their stockings compared to the U.K. or Australia....where apparently they get iPads!!!WE PUT IN A SPECIAL REQUEST AND HE CAME :))

Hot Hot Hot

It is with some reluctance we boarded the bus back to Muheza after our break in Arusha & Moshi, not least because it is significantly cooler up there! We had got used to cooler evenings and even needing a light jumper in the mornings. Stepping off the aircon bus in Muheza the heat hit us hard, but greeting our new batch of medical students, who are wilting, made us realise how we have rapidly adapted to the climate.
I have never been a great sun worshipper, nor particularly good in the summer heat waves but now we just go about daily life with temperatures heading towards the 40s. We're coming to the end of the dry season and the water supply is feeling it too. The house tank didn't fill on either of the Mondays we were away so we have come back to an empty tank and relying on the the hospital driver to bring us barrels of water. To be honest it's barely phased us other than reminding the girls not to flush unless absolutely necessary!

So back to work and back to school of both the Tanzanian & home variety. We are predicatably starting on some mountain and volcano projects as well as the human boday, to answer all those questions about the effects of altitude on the body.
Lots of lovely packages waiting for us at the post office.....thank you lovely friends and family.....brightened the post Kili blues. Excitingly for R was a huge bundle of letters from her English classmates whom she has set up as penpals with  her class here in Tanzania. We had sent the first batch from Holy Family School back to the UK before Christmas and have eagerly been awaiting replies. I went in with her to share the post out this morning in class to lots of thrilled recipients.

A bunch of patients needing doctor review awaited me at the hospice this week. A stark return to reality of life for the every day Tanzanian. One lady whom I'm hoping can afford a procedure for her to examined under anaesthetic. She has a history of cervical cancer but now keeps hosing blood which I didn't quite believe until I tried examining her myself. I fear her cancer has eroded into a blood vessel.
Another lady distraught at being unable to pay either for tests or for antibiotic treatment for rapidly spreading sores on her head. Her family has abandoned her at the hospital so she is relying on the generosity of other patients for food at mealtimes. I'm not quite sure what happens about the payment for her actually staying in the hospital. How privileged we are in the UK to know that if we are unwell we will be treated regardless of whether we can afford it or not.
Sad news too of the lady I mentioned last month with the possible liver cancer. I met her brother in law as we passed in the street today and he asked me if I remembered her. Of course I did. Her children are the same ages as mine. She died on Sunday. At least her pain was kept under control until the end.

To the Roof of Africa and back again

SO SO proud of R and more than a little relieved that she & M made it safely back down The Mountain!
I hadn't really given it much thought, when before we came M said he'd really like to climb Kilimanjaro. I'd have been happy to give it a go too, but don't have the same burning desire to get to the top of things as he does, so when it became evident that we couldn't just leave our children at the bottom for a week on their own I graciously offered to look at the mountain instead!
The way things usually go in our household is that I organise our life, and with M immersed deep in the surgical world of Tanzania I inevitably did most of the research and booked them their excursion, but with a mounting anxiety about what I was letting them go off and do. We bowed to the advice of the expedition organiser as to which route they should go, but having read M's account of their endurance I wonder whether a different one would've suited them better. I stressed on many occasions that they were to take as many days as they needed to acclimatise on the way up.
I definitely needed the distraction of my safari not to be mulling over all the horrible facts about mountain sickness or the fact that on average 10 people die each year trying to make the summit. And that's just the tourists. I think many of the poorly paid porters do not fare well with minimal clothing for the extreme weather up top.
I never doubted M would get to the top. Those of you who know him will likely agree that when he sets his heart and head to something he is completely dedicated to that goal and will give more than 100% if that's possible. I rather forget sometimes to be wary of what direction to point him in!!
R is just as determined but I wasn't sure how her fitness was after our months of sedentary heat evasion. I hoped that she would be the factor to make sure M went 'pole pole' (slowly slowly) which is the only way for success. But to be honest I have also started to take for granted that our eldest daughter is capable of pretty much anything she sets her mind to, if she wants to do it!

They say absence makes the heart grow fonder.....certainly helps with sisterly love:

Swimming pool recovery time

If you want the blow by blow account of their mountain expedition then click over to M's blog: shimsurgicaladventures.blogspot.com

Ruth is Back

I CLIMBED KILIMANJARO!!!

Serengeti

Echoes of David Attenborough in my head as we set off into the Serengeti today.

My last minute extravagant decision to take myself and the younger two on another safari started off with a glorious flight. Not a teeny tiny plane, but small enough to give us amazing views of both Mount Kilimanjaro & Mount Meru at the same time.

B's delighted cry shortly after take off from Kilimanjaro airport was - we've just climbed to the top of Kilimanjaro, it was so easy - brought a few smiles from our fellow passengers. I spent the entire flight with ants in my pants (metaphorically speaking, in case you were concerned I'd picked up a few fire ants!). Each girl had a window seat with equally amazing sights for me to keep crossing the aisle as we passed Lake Natron, Lake Manyara, the Ngorogoro crater and the enormous expanse of Serengeti. Such luck for completely clear skies, it was like flying over a geographical map of Tanzania. We finished off with a descent towards Lake Victoria (which is one of the largest lakes in the world) and Mwanza, also known as rock city. It's name very evident as we flew over strange towers of boulders scattered around the landscape and through the buildings. Huge towering rocks as if a giant had been playing with toy blocks.

To be honest my rapid research into Serengeti safaris was brief, but having ruled out driving 12 hrs from Arusha to get to the Serengeti, a flight seemed the least painful option. I was swung on this option with the chance to see the huge lake. The camp we are staying in sits 2km outside the Serengeti on the edge of multitudes of channels leading to the big water. It's aptly called Little Okavango Camp for obvious reasons, but it took all my persuasion to get L to agree to a canoe trip out on the waterways.

A hefty dose of crocodile fear eventually gave way to enjoyment. We even ended up saving two turtles who had become trapped in the local fishermen's wires.

B was in slight crazy over tired mode for our elegant dinner overlooking the weaver birds, cue a lot of 'pole sana' to our attentive cook. We were the only guests for our first night, so luckily L and I made up for it by eating our 3 courses with gusto. Doesn't help that B also has a streaming cold at the moment so looks even more a grubby urchin than usual.

Today was spectacular. African Savannah just as imagined. Plenty of Lion King songs trailing out of our safari vehicle.

Our car was essentially a Chitty Chitty Bang Bang version of a 4WD which quickly evapourated our concerns about close encounter with wildlife. We had seen a few lower slung versions on our last safari and had been concerned for the passengers welfare as they went through a troop of baboons, as well as the glare of the hot African sun. Ours was much higher up and amazingly cool, somehow the shade managing to cover us at all angles, though that may have had something to do with the fact we had 3 rows of seating to choose from!

Lion viewing had an added dimension of tension with a 5 year old wanting to ask loud questions watched with lazy eyes by the semi dozing pride.

We particularly enjoyed the river bursting to the seams with roly poly hippo and our first sighting of crocodiles.

Gerry the giraffe made a short bid for freedom in sight of the river, but thankfully avoided a swim, and a quick thinking driver who jumped out to get him instead of the appetising small child who had started to climb down the sides of the car. We did manage to lose one sunhat, and attempted to lose another after a rare encounter with cheetahs. L & I were unanimous in our relief that it was a distant viewing, having both recently watched the youtube clip of safari tourist sitting with a cheetah in the seat next to him. According to our guide this is not that uncommon as the cheetah are very curious, although supposedly not dangerous!!!

We barely saw another car on this trip, compared to the Ngorogoro where it was like a safari drive through. Both experiences completely awesome, but definitely something magical about being on our own in the middle of the bush. We shall be watching wildlife programs with renewed interest for quite some time.

Tomorrow we fly back to Moshi to meet up with M & R at the other end of the weekend. Not quite sure of our plans yet but suspect may involve visiting a Masai and his goats....

What a difference a day makes....

Thanks to the open generosity of our new friends we have had a weekend of complete rejuvenation.

An amazing opportunity for a glimpse into what life can be like if you live overseas permanently. This family are on their 3rd African country and I suspect it's the little things they've built up over the years that make all the difference. We are in awe at the home made jams, pickles, passion fruit lollies, waffle maker and yoghurts that are part of daily life.

Cold enough for a fire!

Mt Meru - Africa's 2nd highest peak

For us it has been a true escape from the intensities of living in amongst our Tanzanian neighbours with the incessant red dust. Here at the bottom of Mount Meru the climate is cooler. We've needed jumpers in the mornings and duvets at night. The heat of the day is far less overwhelming. The children have roamed free in the luscious gardens and the cool pool, enjoying their delightful friends' toys and pets.

It seems likely a heavenly existence but I am very aware that if you make countries like this your life, you need a home environment that lets you enjoy life as a family and not just survive.




We are particularly envious at the description of the International Baccalaureate school.....sounds like the educational ethos that we aspire to as parents but is sadly lacking in the British schooling system. 

But to have a life like this you need a salary. There is only so much volunteering you can do before the money runs out!

M has, predictably, launched himself into his surgical/educational position here with his usual enthusiasm and drive. Inevitably questioning and pushing himself and those around him to improve things beyond what anyone else would conceive. Having pushed him myself to step off the travellator of a surgical career in the UK, I have, as usual unleashed his passion in yet another direction in life. I suspect we'll be having a whole lot more to do with this continent.

The girls are going to find it hard to tear themselves away from here. Thankfully there are new medical students back in Muheza to engage us on our return. L, B & I have gratefully accepted the offer to stay on for an extra couple of  days here in Arusha before fulfilling my desire to see the Serengeti. Whether or not we'll hit the wilderbeest migration remains to be seen and I can't quite pull off my Birthday request for a hot air balloon as the minimum age for children is 7 years. Don't think I can leave B to her own devices with the game on the ground. Either way I'm feeling very self indulgent!

Ready for a little walk

Where are M and R during this time?
Well they've popped off for a bit of daddy - daughter hill walking. Along with a guide, sous-guide, cook and 7 porters. I'll leave it to R to explain - she's long overdue a post.