Asante Sana…squashed bananas.

Greetings from Tanzania!

So it turns out not even a blog can encourage my communication skills when travelling! Apologies for this coming almost 6 weeks into my time here in Tanzania. Reaching half way into our research project and about to set off on a cheeky quick trip back to Glasgow to see my best friend get married, has finally spurred me onto share a little about what we have been up to here!

We have well and truly settled in to life in Moshi. A relatively built up town boasting not only a supermarket but also one that sells REAL CHEESE, Moshi sits at the foot of Kilimanjaro and is where we will be based for 3 months. I am here with 3 friends from my Tropical Medicine Diploma which I completed in Liverpool, and 8 final year medical students from Newcastle University who’s masters projects we are volunteering with. It is so nice to be surrounded by people from two places that I have so many happy memories from!

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Our little home set within the doctor’s compound of Kilimanjaro Christian Medical Centre, the tertiary referral centre for Northern Tanzania and with an avocado tree at the front door, Freda our housekeeper and a terrace for sunset yoga, has proven to be more than comfortable. Even daily power cuts, some form of mutant massive moths invading our living room and a most likely rabid dog ( affectionately “Nipples”) taking over our garden, cannot dampen my love for our little home away from home here and compared to most houses in this area it is pretty luxurious.

Arriving into Kilimanjaro International Airport, my fear of flying takes over and I struggle to open my eyes long enough to take in the sight of Mount Kilimanjaro. I focus on the warm glass of wine I’ve quickly acquired. The car journey doesn’t help. We pass a commotion at the side of the road, and my driver says a motorbike has run over and killed a child. The way he says it, shows sadly that this is a regular occurrence here and reminds me sharply how different life is. All within 20 minutes and I am reminded how the culture shock of Africa is not to be underestimated.

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It takes at least a week to get onto “Africa time”. You forget what it feels like to be clean for maybe 7 minutes of the day before you have to leave the house. Or the chants of “Mzungu” that accompanies us on our runs throughout the town. These are infinitely better than the slow applause or even the “nice walk” we got recently (I AM RUNNNING!!). Our efforts and sweat are always slightly surpassed by the child carrying 60 bananas on her head walking past us, as we stagger forward in the humidity.

 

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I wanted to gain some experience of doing research in Africa as I spent 3 months in Liverpool, listening to stories of medics performing studies with apparent ease in this crazy continent. It turns out they left out some pretty vital information. To even get a study up and running, after multiple hoops to gain ethics have been jumped through, the meet and greets within a community start. You learn quickly that without an introduction to all the main players in the medical community here, your project might as well not exist. Part Tanzanian culture, part African bureaucracy, if you let it, this process will dishearten you. 2 steps forward, 3 steps back is how our first week progresses and I am feeling frustrated. Our project which centres around cognition in HIV patients, is based at Muwenzi District General hospital in the HIV clinic. This busy, humid, frantic area of activity assesses up to 60 patients a day, manned by usually one doctor and an army of nurses lead by Sister Anna, our formidable matron. However, as the weeks have gone on, with broken Swahili, constant smiles, a thousand “asante sana” (thank you very much) and promises to marry Sister Rosie’s son, (Sister Anna’s slightly less scary pal) we are slowly beginning to feel like we are making progress.

We are also involved in projects running within the Hai District, a mountainous region close to Moshi. With rainy season upon us, reaching these remote communities is going to be challenging. Made even harder by our land rover discovery, Tembo (elephant in swahili) dramatically losing a wheel on a dirt road driving home from our easter getaway. By wheel I mean…wheel, axle and a rogue “flange”. And by lose, I mean flying off into the bush at high speed, so quickly my first thought was “Ooops someone has lost their wheel” until the car quickly told me as it started to skid, that it was indeed ours. Fortunately, no one was injured and a son and father combo called Mohammad and Ibraham promptly stopped to offer us help.

The next 15 minutes passed in a blur, with a plan quickly made to split the group in two, with one staying by the car and the other (myself included due to my tendency to burn within 18 seconds in the African sun) jumping quickly into the air conditioned and four wheeled chariot that kindly took us to the nearest town, Tanga. From there, Mohammad sourced a pickup truck, a mechanic, a welder to re-attach the wheel and “flange” while Ibraham regaled us with stories of captaining a boat from Dubai past Somalia to Zanzibar and living and studying engineering in Sweden.

We were taken to their house and stuffed with chipatis, squid and “fries”(a late addition due to us being mzungus). They insisted we joined them and their family for dinner too and by 12pm the following day, our wheel was glued firmly back onto Tembu. They wanted no payment, insisting on karma being their reward, believing that what was us today could easily be them tomorrow (I said I doubted that given that their car alarm doesn’t go off 3 times when you open the doors…another “quirk”). This deeply religious family, welcomed and helped us without an agenda and I left Tanga with a renewed belief in humanity…just obviously not in Land Rovers.

What would have taken 2 hours of debate and discussion and phone calls in the UK, took an infinitely shorter time in Africa. People are very keen to help you here, they have none of our British mannerisms that prevents us from even making eye contact on the subway. Life here depends on help from neighbours, friends, family- as shown by the gentle, kind and dedicated way in which their elderly are cared for at home and in hospital by family members. You will rarely see a bed sore and the health system relies on this army of willing volunteers to ensure patients receive food, bed baths and medications while inpatients- as so little nursing staff mean relatives are vital members of the team.

Maybe it is because growing old here is such a privilege and if you do, you have most likely overcome a multitude of challenges throughout your life. My favourite patient so far has been my 104-year-old, World War 2 veteran with Parkinson’s disease who greeted us with a nasty gash on his forehead, which he sustained while building his latest mud hut. My grumblings of the lack of diet coke were quickly silenced and I am still in awe of everything he has overcame to survive to that age here.

So as I prepare to fly home today, to be a bridemaid for one of my favourite people, I am unbelievably excited and thankful for everything this year has brought so far to me. But if I am honest, I am already dreaming of returning to see what other adventures and challenges Tanzania and beyond has to offer, before I head back for good in August to start Anaesthetic training in Glasgow. Thank you for reading (or looking at the pics) and I am loving hearing what everyone else has been up to this year, especially my diploma crew- you beautiful, inspiring, brilliant bunch of people. Keep the stories coming! xxxx

 

 

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Calais: a week in a refugee camp, tear gas attacks and striking similarities.

It is difficult to put into words our week in Calais. But I want people to know how I personally observed the camp and the refugees. I also want to give you lovely, generous people who gave me some of your well-earned cash an insight into the needs of the refugees and how your money has been spent.

I recently completed my Diploma of Tropical Medicine and Hygiene in Liverpool as part of a career hiatus. This course was truly eye opening to some of the most pertinent issues impacting global health including migration and the refugee crisis affecting the Middle East and Europe currently. The images of refugees, their struggles and desperate dangerous journeys across Europe are a constant throughout the media and I wanted to see first hand the consequences of our current approach to managing this crisis. Coupled with that my current lack of steady employment (a parent’s dream) as I wait for a training position in August, there seemed no reason for not committing at least a week to heading to France.

Through a Facebook group called, “ Refugee First Aid and Support”, a group set up by previous volunteers in the camp, Vanessa (my friend from Liverpool, also a medic) and I started to plan our trip. This organisation has produced a busy weeklong roster, filled mainly by doctors and nurses working in the UK, who journey over for whatever time they have whether a day or a week to man the first aid clinics in the camp.

As I read more it appeared that taking either donations or money down to add to their contribution was what most medical volunteers were doing. My dad was already putting aside some of his old jackets and my mum was glued to the computer researching previous donations. I on the other hand, started googling “large van hire”…this did not initially go down well with Anne and Hugh. Pointing out very politely my lack of ability to drive a manual car (I can, I just think its best for everyone in the UK and the planet if I don’t) and the distance from Glasgow to France. However, the real game changer was a generous offer by Ruth McDonald, one of my mum’s partners from work, saying she could ask her priest to make a “small” announcement at her church and we could see what we got. This photo sent that Sunday night made up our mind….we didn’t just need a van….we needed A MASSIVE VAN.

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As the enormity of the task ahead of us hit Vanessa and myself, her boyfriend Chris (sensing impending doom) stepped in with the offer of driving the van from Glasgow to Calais. Once the van was booked I felt elated- a van, a driver and now we just needed to move the donations from the church to our house for sorting (and to give the church back some pews!)

So one saturday, a week before departure, the McCartney clan got up with military intent. By clan I mean Hugh and by military I mean more dads army than SAS. But it became very clear when we packed our 70th bag into the van to take back to Briar road, we would need a plan. Special mention should go to the kind parishioners who interrupted their rosary to help load the van- another example throughout this process of people’s kindness and willingness to help that never seemed to run out. The below plan was Hugh’s attempt at a sorting warehouse in our house.

It definitely made sense to Hugh. Just not to anyone else.

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So from morning till 6pm we sorted and labelled the mass of donations received- overwhelmed throughout by the kindness and generosity of the people of St Albert’s of Pollockshields. There were very little unsuitable donations and a great deal of thought had clearly gone into them. Special mention to Pauline MacKay, my mum’s cousin who commandeered the generous parents of Our Lady of Mission School in Glasgow. Through her, we were donated much needed beautiful children and babies clothes.

Helpers in the form of my school friends Richard and Amy Ferguson, Breda Sweeney and Ruth McDonald made what could have easily been a weekend’s work, achievable in time to watch The Voice and that was it- we were definitely going to Calais. I had to now, or my mum would never get her lounge back.

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Day 1

A week later, the van loaded and with a final send off/safety warning from Anne and Hugh we were off! Only marginally hampered by storm Gertrude, we made it down to London to stay with Vanessa’s parents that night.

Day 2

We left early, again to nervous waves from another set of supportive parents (thanks Charles and Nicky!) and arrived at the queue for the Eurotunnel. We briefed Chris on what his response to the waiting police check would be… “we are here for LEISURE”. Unfortunately Chris buckled and we were immediately sent over for a police search and what turned out to be the first bad encounter of the trip. A well wishing (I think) policeman told us “these people are not like us, they are tribal and do not have the same morals or view women in the same way.” We nodded slowly, keen to move on, our excitement of reaching Dover instantly gone and silently drove through to wait boarding the train.

Only 30 minutes later and we were in France. Calais cast an even more grey shadow on the day. It is a place clearly deprived of money, opportunity and for want of a better word- soul. It didn’t help the weather made Glasgow look tropical. Grim is the only way to describe it. Our first stop was dropping our donations off at a warehouse for the volunteer organisation, Care4Calais. These would be sorted and distributed that week and there was a hub of activity of volunteers from around the UK and beyond, painstakingly sorting the mass of donations. Many were there just for the weekend, some long term.

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That night we caught up with 2 nurses, Jane and Carol, who had manned the clinics for that week. Older and wiser, it was clear we were daunted as our faces greyed as they confirmed that an extreme right wing/ fascist march was due to take place in Calais the next day. This was not something we had prepared for. But we were also told being in the refugee camp would be the safest place to be and after much debate we decided to head in the next day and see what happened. It was not the most restful of nights!

Day 3

Making our way into the camp (with google maps help!) the first thing that strikes you is the riot police presence, the Compagnies Républicaines de Sécurité or CRS. Along the motorway, the flashing sirens of their van would become a familiar sight throughout the week and play an important part in the events of that first day. I felt VERY nervous. I wasn’t exactly sure why – the CRS and their schwarzenegger like body armour and guns, the impending fascist march, or maybe just the fact I have never driven into a refugee camp before!

As we arrived and as we made our way down the “ high street” it became clear a significant effort had been made to make this a community- there were shops, restaurants and shelters. It felt familiar. We attracted a few stares but clearly people were used to British vehicles throughout the camp. My Scottish accent would be a different matter!

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We opened the clinics, old donated caravans and within minutes saw our first patients, a queue quickly forming. Basic, cold but well stocked and organised, in these small areas we saw coughs, colds, minor cuts and scrapes. One of our interpreters arrived making everything instantly easier, Salman a refugee himself who had previously lived in Norwich for 6 years. While never attending school in Afghanistan he could speak 7 languages and was infinitely useful.

We had lunch at an Afghani restaurant, the White Mountain. As we walked back to begin the afternoon work the camp atmosphere instantly changed, with refugees running towards us in droves, shouting “Britannia! Britannia!” About 100 men were running towards the fence and a rare traffic jam of lorries beyond the fence that were waiting to board the ferry.

We stopped to watch, as Salman explained “they are just trying their luck” as the men whooped and ran towards the fence. The lorries moved off and the refugees quickly dispersed but the CRS started firing tear gas and rubber bullets towards the retreating group.

We quickly realised the wind would carry the gas towards us and started walking towards our clinics, then running as the gas surrounded us and we struggled with its effects. Its brutal, instantly burning the back of your throat, stinging your eyes and was very frightening. And shocking. The refugees were unarmed and quickly retreated from the fence. But the tear gas attack was relentless plus the use of rubber bullets; bulky, can sized bullets fired continuously for the next 15 minutes. We then started seeing the injuries from the attack- a smashed finger from a bullet, eyes and throats needing washed out and a likely broken facial bone from a tear gas canister being fired at a refugees face. He was about 15, in complete shock and crying. We didn’t really have much to offer him- a cold compress, lots of TLC and advice to attend the hospital. We were called to a shelter as an emergency; a man has chest pain following the attack. He is grey, pale and sweaty and should be taken to hospital. The only way of transporting refugees to the nearby hospital in Calais is by using a volunteer owned car. During that time, we try to comfort him with what we have alongside his friend, a Syrian man who prompted by his friends, quietly and modestly tells us he was a maxillary- facial surgeon in Syria. It was a sobering end to an exhausting day.

By law the CRS are not meant to fire tear gas above knee level. That afternoon was an example of the nature of the relationship between the CRS and the refugees- strained, imbalanced and increasingly violent. We left the camp as it became dark- from a side exit as the police had barred the main entrance, stunned by what we had seen and in need of a hot shower and sleep. Both now seeming luxuries, not basic needs as we left people attempting sleep in tents and wooden shelters shaken from the violence of the day.

Day 4

The camp is so quiet as we drive in, more CRS vans than yesterday. We discover that the camp is usually quiet in the morning as the refugees play “the game” overnight- the nightly routine of walking 3 hours to the train station (and back if unsuccessful) to attempt to board one of the Eurotunnel trains to England. The camp therefore is a mass of sleepy, broken men after the 6 hour round trip led them back to the jungle and the clinic is quiet until about 11am. The name “the game” is misleading, as some of the most common injuries were due to this dangerous, extreme and desperate activity. Broken heels, wrists and a broken back were just some of the injuries we witnessed during just a week, sustained as the refugees either launched themselves onto the trains or found themselves flung off them. The more common injuries unfortunately are from police. Posters line the caravans in multiple languages encouraging refugees to report incidences of police brutality to MSF, who have been collecting evidence since 2009. You learn quickly to recognise the hallmark bruise of batons on legs and faces and despite encouragement, many refugees are loathed to report them- many feeling that is it futile especially given yesterdays attack.

Lunch is again in the Afghanistan restaurant where we pay very little for fresh hot naan, spiced vegetables and spinach. The restaurant “ The White mountain” is a large tented area, built by volunteers and refugees last year. Pictures along the wall depict the time line to completion. It is just one of the many restaurants, shops, churches and mosques that line the streets throughout the camp. It sharply reminds you of where there are people; there will always undoubtedly be a sense of community that grows- that is human nature.

Throughout the afternoon, it becomes clear we have already established some regulars. Cough is one of the biggest complaint- poor housing, indoor stove fires, smoking and generally malnutrition mean once someone is sick, it is very difficult for them to get better. Viral infections are rife and therefore we can only really provide TLC, simple pain relief and reassurance to the majority of people. The men seek out “ sherbet”, our sickly sweet cough syrup, many feigning dramatic coughs to win a spoonful! We laugh but oblige!

It is funny how much can be conveyed without speaking the same language. Our translators are invaluable but when they are unavailable, some skilful sign language and actions means that most basic problems can be identified and managed, even if all they are looking for is somewhere warmer to stand for a couple of minutes. That was one of the most difficult things about the week- the relentless cold. It would drive you to extremes and make you very frustrated as a refugee as gas for fires is in limited supply. Despite not always having a solution to their problems, everyone is so grateful, for at times so little. And generous- an older man quickly offers a T-shirt I have given him, to a younger thinly dressed teenager, despite his obvious delight at it still having the price tag on. It is difficult to not feel emotional when you see something so simple but yet so kind in situations as desperate as this.

Day 5

There is a measles outbreak in the camp. With so many displaced young people, a generation have missed their vaccination programmes and Medicin Sans Frontiers and Hands International, another NGO are running an intensive programme throughout the week, which we are publicising. Patients are keen to be vaccinated and even come back to proudly show us their vaccination certificates. The difficulty throughout the week is seeing a generation of young men that will experience this camp at this critical time of their lives. Many state they are over 18, but the majority of younger men cannot be over 15 and are largely travelling alone. It brings up stark comparisons about what I was doing at 15- holidays with parents, security, and a brilliant education. Regardless of your views on immigration it is difficult to see this other than a global tragedy that this camp and lifestyle is the foreseeable future for these boys.

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My most memorable patient of this day was a young boy with chickenpox. He was 15, Sudanese, living in a tent with a friend. He was utterly miserable with this and his heartbreak and distress at being told he would need to wait for it to improve and take his medications was visible. I left the camp feeling completely shattered for these people who’s lives had been reduced to this and was overwhelmed by the enormity of a problem which has no clear or easy solution.

 

Day 6

With more medical staff arriving to help man the clinics, we have time to have a tour of the camp. We are taken to the 100m wasteland immediately before you enter the camp, which previously housed hundreds of refugee’s tents, churches and mosques before it was suddenly bulldozed with little warning. This area is now littered with empty tear gas canisters and bullets.

We are shown the women’s centre, the climbing frame where 2 young blue eyes Afghani sisters call us to play, the Ashram kitchen which provides hot meals daily through donations and volunteers and the foreboding enclosure housing the new stark white units provided by the French government. This highlights the level of distrust with the French government, that the refugees would rather stay in their tents than enter these enclosures, for fear of being forced to claim asylum in France.

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We asked many refugees about their stories and why they wanted to travel to the UK. What became quickly clear is they have little awareness of our benefits system or even the legal difficulties awaiting them in acquiring asylum. The majority just seek security and peace. Many could speak fluent English, many had family there, many had lived there previously but on returning to their home countries had been refused re-entry. There is a strong British volunteer presence and most held the UK in high expectations about how it viewed refugees. The refugees I encountered were mainly from Syria, Afghanistan, Sudan, Iraq and Iran. On request, they would show you photos on their phones of their homes before and after being bombed, their businesses destroyed and the families that were now scattered worldwide in an attempt to find safety and a future. Most travelled over land or by boat, with one describing their journey using hand movements, to depict the time the boat capsized and they swam in the night towards shore. It is difficult to imagine how scarring these experiences are for these people.

Today I meet a boy from Syria, an architecture student. His family are in Turkey, his dad a lawyer, his mother a university lecturer. He is clearly very intelligent, speaks fluent English and living in a shelter, which he has decorated with home made shelves and ornaments. His childhood is one so strikingly similar to mine and again shows the similarities with the people we met this week, not the differences. This to me is what is most overwhelming about this crisis, that privilege is what differentiates us from the refugees and in a similar situation it would be difficult to say you would not do the same and seek out a better future for yourself and your family.

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Day 7

As the week is drawing to a close, my attentions turn to where our donated funds can be best spent and with heart breaking demolition of the south side of the camp and an uncertain future for the Jungle, my initial ideas have now been directed towards more pressing needs. The need for warmth and shelter is even greater now and we have donated money in part to:

  • The Hummingbird project, which is a group of individuals from Brighton who I saw making a real difference with projects throughout the camp. Useful for anyone down south who want an organisation to volunteer with. https://chuffed.org/project/thehummingbirdprojectbrighton
  • Mobile Crisis Support units, who donated the caravans we used as medical clinics. Faced the task of relocating the caravans in the wake of the demolition, all funds are useful at the moment. http://caravansforcalais.org.uk/
  • Care for Calais, a volunteer organisation which distributes clothes and gas throughout the camp. Always desperate for volunteers even if you only have a day. http://care4calais.org/

We also spent a further 1000 pounds on new shoes, warm jackets, socks, hats and gloves plus medical supplies when we arrived in Calais.

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I hope people feel their money has been well spent and well thought out. I can’t thank everyone again for how kind and generous they were throughout this whole process, including my parents who not only humoured the idea but also whole-heartedly supported it and have listened (patiently) to my reflections on the experience.

It was really difficult to leave the camp; it is a beast, which changes daily as the current situation shows. It is also a place where we were treated respectfully, kindly and with huge gratitude at all times. I have thought a lot of the policeman words of warning as we left Dover- of moral differences and tribal rules that make refugees not like us.

Othering: The process of perceiving or portraying someone or something as fundamentally different or alien. 

By making these people different, our responsibility towards them and this problem can be distanced. By making them morally different, we can justify the treatment of them, the lack of humanity in how they are treated by the public and authorities and the lack of compassion they have been shown. But all I saw were the striking similarities and felt a sense of despair that this was not being recognised and that this could have been me or you. And if so, how would I hope to be treated?