Crocs Snails and Nightingales

Days 8 and 9

A first African weekend

Mwenye pupa hadiriki kula tamu
A hasty person misses the sweet things

After a leisurely Sunday breakfast we took a road trip in a taxi, joined by Sarah and Rhi our two new arrivals at the guesthouse – by coincidence also from Birmingham. I was pleased to see that, unlike in every other vehicle I’ve been in so far, this one was equipped with seatbelts. Unfortunately we had more bodies than seats (or belts) and so the safety equipment remained unused. Heading east on the main road we soon turned onto a treacherous and tortuous dirt track that stretched the capabilities of our most definitely “on-road” people carrier. After a slow and bumpy 40 minutes we reached our destination, right on the border with Kenya:

Lake Challa is a beautiful volcanic crater containing inviting clear deep blue water. The area had sweeping views across the African plains and an abundance of wildlife – mostly lizards of all shapes and sizes, but we also spotted praying mantises and a chameleon. The others claim to have seen monkeys too. Unlike at the hospital, it was not pouring with rain and it was a novelty to be too hot (and dry) for the first time.  A lengthy dusty scramble down a hill was required to reach the lakeside where we found a small jetty to sit and eat our packed lunches. These were prepared by the driver and consisted of a variety of deep fried items (samosa-like items, potato-like vegetables, doughnut-like cakes, rice-like sweets) and a banana. What we didn’t eat the fish cheerfully polished off.

The guidebook and hearsay warns against swimming due to crocodiles, but after first investigating some suspicious-looking logs we concluded that the reptiles’ existence is the stuff of legend and so we pressed forward and had a pleasant but cautious dip. We spent the rest of the afternoon blissfully horizontal, reading by the lake.

The walk to the lake

Another animal that might have been encountered is perhaps more dangerous but many times smaller, and not explicitly referenced in my guidebook. Further, its presence (or hopefully absence) gives me a flimsy excuse to write a few lines about something more medical: Schistosomiasis (bhilarzia) is a parasitic disease caused by a number of trematode (worm) species found in freshwater in Africa and elsewhere. The juvenile form enters the human body through the skin where they cause an itchy rash. The parasites mature and migrate to the liver (where they may cause fibrosis) and lungs (causing respiratory disease) where they grow into worms about 2cm long, before moving to the bladder (schistosomiasis is the leading cause of bladder cancer worldwide), urinary system, intestines, and veins (abdominal pain, portal hypertension). 

Schistosomiasis causes diverse symptoms and problems not limited to those in the brackets above. Eggs are released either in the urine or faeces, and these early forms infect and develop in snails to complete the worm life cycle. Over 200 million people are infected with schistosomiasis worldwide; about 20,000 die each year.

Having re-read that last bit swimming suddenly seems reckless and my justification is quite feeble: our driver told us there were no parasites in the water, plus it seemed unlikely given the clarity and apparent purity of the water. And indeed the water was lovely. I’ll pop up to the hospital for a test if I get any symptoms. Effective anti-worm treatment is usually easily available if required.

Day 10

Florence Nightingale day

We found the hospital in a frenzied state this morning; women were hard at work with huge pots over wood stoves, choirs were practising and sound systems were being tested. We found out at church that today, Monday 12^th May, is Florence Nightingale Day, and apparently an extremely big deal in Tanzania.

We had attempted to find some doctors in the morning and were perplexed that they all seemed absent from the hospital, along with most of the nurses. We soon realised that they too were in celebration mode and had all completed their essential tasks double quick early on. Everyone we spoke to was astonished that we weren’t familiar with the Florence Nightingale day and could not believe that we didn’t celebrate it in the UK (“but she was white!”,  “what…not even the nurses?!”). We learnt that Celebrations occur all over Tanzania to honour Florence Nightingale and to recognise the continuing hard work and value of nurses and nursing students. Mr Mushi ensured we were extremely welcome to share in their celebrations – which were spectacular.

Firstly we saw the nurses and nursing students parading around the front entrance of the hospital to an exuberant marching band. Not sure of the correct etiquette we joined the procession as it danced around the courtyard, culminating in church for the second service of the day. By the end of the service each nurse had a candle and the parade continued loudly through the hospital, lighting candles in the wards. Apparently a very skeleton crew of unlucky staff stay behind to look after the patients.

Pink  nursing students at the hospital entrance

The procession then moved to the main hall which had been made up as if for a decadent wedding; decorated with the nurses’ whites and pinks, and also the colours of the Tanzanian flag: green, yellow and black. There were buffet tables of strange food enclosing rows of chairs like a school assembly, with a soundtrack of very African music booming from the speakers.

We sat quietly at the back to listen to whatever came next but Mr Mushi found us and in an, astonishing and kind surprise move, made room for us at the VIP table at the front, facing the rows and rows of nurses, nursing students, and the other attendees behind them. The MC introduced the esteemed guests (with whom we were sharing the top table) and we sheepishly stood to receive applause when it was our turn, waving awkwardly.

There were long energetic Kiswahili speeches and touching gift ceremonies for some of the long serving and respected member of staff. We understood very little of the content but all of the enthusiasm and joyfulness transmitted across the language barrier. At the end of the speeches we were treated to a late lunch of stewed bananas, beef, rice and fruit to complete the strangest and cheeriest day at hospital yet.