Today we had our first surgery in the new Operating Room. One little girl is now minus two tonsils. Everyone was very excited, double checking everything even though Dr. Duane has done literally hundreds of these operations and could probably do a tonsillectomy in his sleep.
Speaking of sleep, there was little to be had. On campus there was a late night emergency case that had the doctors out of bed. In town, there was a little bit of religious rivalry over the loudspeakers. I'm used to the Muslim call to prayer, singing out every morning over the PA at 5:40am. This morning, two of the Christian churches got in on the action with very loud, angry sermons being preached to the whole town over their powerful loudspeakers. They got the jump on the mosque by starting at 5:00am sharp. At first I was intrigued by the unique role of electronic sound amplification in religious practice here in Karatu. Now I just want to sleep a little bit longer.
I'm going to Arusha tomorrow, but I will try to upload pictures when I get back.
Thursday, January 16, 2014
Sunday, January 5, 2014
Logarithms
I've taken on a student.
Winnie is the 15 year old daughter of one of our nurses. Like many children from well-to-do families, she spends most of the year at some far-off, private boarding school. Now she's at home for the Christmas break, and her mother asked if I would be willing to tutor her in math because, as far as I can make out, her school didn't have a math teacher last semester. As a result, she is expected to know, and will be tested on, quite a few topics that nobody taught her.
Standardized testing is something of a national embarrassment for Tanzania. In 2012, over 60% of students failed the state exams required to continue on to higher education. Given the inflexibility of the standards in the face of teacher absenteeism, I am beginning to understand why. Keep in mind that at her private school, Winnie enjoys a level of educational quality out of reach to many if not most Tanzanian students.
In any case, I had been contemplating offering a math review class open to anyone on the staff at FAME, so I agreed to tutor Winnie, thinking this would be a good opportunity for a small trial run. Dr. Frank, and numerous other expatriates, had warned me about the catastrophically poor level of math education common in Tanzania, so I went into our first session fearing the worst.
I needn't have worried so much. It turns out that Winnie had a fairly solid grounding in basic algebra and was by no means mathematically illiterate. She could do arithmetic easily without a calculator, recognize most notation, and solve simple systems of equations. Getting her to demonstrate her numeracy, on the other hand, is not far removed from pulling teeth. Here is an example of a typical start to a lesson:
Me: "Do you know what a 'quadratic expression' is?"
Winnie: "Yes."
Me: "Great. Can you explain to me what it is?"
Winnie: "No."
Me: "Well, can you write down an example of one?"
Winnie: Thinks "No."
Me: "Why not?"
Silence
Me: "Let's just start from the beginning then..."
Her mother sent me a checklist of topics that Winnie should have been taught by her absent-bodied professor. Ranging from logarithms to linear motion, there were far too many things to cover in the short three weeks we had, so I elected to pick out the most important topics and try to use them as vehicles for building confidence and creativity in using the mathematical tools she already has. It's been while since I've had a student so young, and I think that Winnie is used to being one of three or four dozen in a classroom. As a result, I ask for a bit more than she is used to being asked for, and her reaction is sometimes to go into lockdown mode. I doubt she's ever been in a situation where a teacher was willing to wait however long it takes for her to answer a question, and she can usually get out of answering by hesitating too long. Not so with me.
My efforts to get her to come out of her shell and provide the same type of attentive instruction that I had have given me a new appreciation for the sheer enormity of the challenge that education presents in a country where the age distribution graph looks like an inverted funnel. If it takes me, with teaching experience, enthusiasm and a very expensive education, so much time to have an impact on one student, what results can we expect from overcrowded public schools with undereducated, underpaid and sometimes unpaid teachers?
Winnie is the 15 year old daughter of one of our nurses. Like many children from well-to-do families, she spends most of the year at some far-off, private boarding school. Now she's at home for the Christmas break, and her mother asked if I would be willing to tutor her in math because, as far as I can make out, her school didn't have a math teacher last semester. As a result, she is expected to know, and will be tested on, quite a few topics that nobody taught her.
Standardized testing is something of a national embarrassment for Tanzania. In 2012, over 60% of students failed the state exams required to continue on to higher education. Given the inflexibility of the standards in the face of teacher absenteeism, I am beginning to understand why. Keep in mind that at her private school, Winnie enjoys a level of educational quality out of reach to many if not most Tanzanian students.
In any case, I had been contemplating offering a math review class open to anyone on the staff at FAME, so I agreed to tutor Winnie, thinking this would be a good opportunity for a small trial run. Dr. Frank, and numerous other expatriates, had warned me about the catastrophically poor level of math education common in Tanzania, so I went into our first session fearing the worst.
I needn't have worried so much. It turns out that Winnie had a fairly solid grounding in basic algebra and was by no means mathematically illiterate. She could do arithmetic easily without a calculator, recognize most notation, and solve simple systems of equations. Getting her to demonstrate her numeracy, on the other hand, is not far removed from pulling teeth. Here is an example of a typical start to a lesson:
Me: "Do you know what a 'quadratic expression' is?"
Winnie: "Yes."
Me: "Great. Can you explain to me what it is?"
Winnie: "No."
Me: "Well, can you write down an example of one?"
Winnie: Thinks "No."
Me: "Why not?"
Silence
Me: "Let's just start from the beginning then..."
Her mother sent me a checklist of topics that Winnie should have been taught by her absent-bodied professor. Ranging from logarithms to linear motion, there were far too many things to cover in the short three weeks we had, so I elected to pick out the most important topics and try to use them as vehicles for building confidence and creativity in using the mathematical tools she already has. It's been while since I've had a student so young, and I think that Winnie is used to being one of three or four dozen in a classroom. As a result, I ask for a bit more than she is used to being asked for, and her reaction is sometimes to go into lockdown mode. I doubt she's ever been in a situation where a teacher was willing to wait however long it takes for her to answer a question, and she can usually get out of answering by hesitating too long. Not so with me.
My efforts to get her to come out of her shell and provide the same type of attentive instruction that I had have given me a new appreciation for the sheer enormity of the challenge that education presents in a country where the age distribution graph looks like an inverted funnel. If it takes me, with teaching experience, enthusiasm and a very expensive education, so much time to have an impact on one student, what results can we expect from overcrowded public schools with undereducated, underpaid and sometimes unpaid teachers?
Monday, December 23, 2013
High Tech
Just because Tanzania is a developing country doesn't mean we can't use technology. It's just harder.
No piece of technology more advanced than an inclined plane works as billed in this environment. You have to fight for every functional moment. Examples:
Dr. Joyce brought a conductivity meter to test distilled water. The machine came from a reputable firm, was factory calibrated, and arrived new in the box. Doesn't work.
We set up Dr. Frank's simple and reliable battery charger to do some electrolysis rust removal. Very basic setup: water, washing soda iron cathode, iron anode, solid electrical connections. Doesn't work.
I bought a brand new, light-up watch in the market. Doesn't work.
Backup Internet modem... doesn't work.
Lamination machine... doesn't work.
Microscope camera...doesn't work.
To cap it all, we have a long succession of failed hard drives.
One of the major problems is dust. Karatu is dusty all year except for the rainy seasons, when it's muddy. A big chunk of our most delicate, and expensive, equipment is located in a special room in the laboratory. This room is one of three on campus equipped with an air conditioner (the other two being the operating rooms). Last time we had a massive dust storm blast through, the windows were left wide open. Why? The lab techs said the air from the air conditioner was too dry, and it gave them a headache. Dr. Joyce (one of our lab volunteers) was ready to pull her hair out.
The most recent problem is ants. They live in the rafters and come trooping down every day to eat the serum that gets tested in the diagnostic equipment. Dr. Joyce has one of the techs clean the wall twice a day with bleach to disrupt their navigation, but still they come.
Every day the techs go forth to combat an unrelenting onslaught of swirling dust and swarming ants. Except for today, since it's pretty nice out. But usually...
In some ways, though, Tanzania is far more advanced. Even in largely developed countries, like the US, we don't have anything nearly as high tech as laser ketchup.
PS I have started shucking and roasting the coffee I brought back from Kessy's house at Kilimanjaro. Early attempts have yielded mixed results, but I continue forward, undaunted.
Thursday, December 12, 2013
Problem #7
When it rains, it pours.
The new surgical wing means that soon we will be able to do emergency C-sections, and that means we are on our way to providing labor and delivery services.
This means that we need a room to do it in. We have a room picked out, and a special bed on order, but the problem is that the room is right next to all the other patient rooms in the ward. This may lead to some unfortunate noise issues.
So my new challenge is to find a way to soundproof the delivery room using locally sourced materials and little to no money. The other issue is that my boss, Mama Susan, wants it to be an aesthetically pleasing space inside and out. It's a fairly large room, with two exterior walls, two windows, an inclosed bathroom, and a double door to the ward.
My resources are:
1. Me
2. probably up to $100 or so
3. a crew of groundsmen with extensive carpentry skills
4. a car (for fetching supplies)
I'm open to suggestions.
UPDATE microscope problem
It turns out that there is a problem with the camera itself, which I cannot fix. So I am trying to get the manufacturer, Olympus, to take it back for repairs. They aren't returning my emails or answering their phones so far though.
In the meantime, we are pursuing the stopgap measure of adapting a different camera. I already wrote about trying the point and shoot option. This has not produced very satisfactory results.
Thanks to Vickie suggesting phone cameras. As outlandish as it might sound, this may be a viable option. Thanks to Nathan for telling me about Skylight, a product that lets you take pictures with recent model iPhones through the microscope eyepiece. I've been in touch with them, and they agreed to donate a skylight for FAME. I hope we can work it out to arrive before the end of December. That just leaves the problem of finding a an appropriate iPhone. Mine is first generation, and it has very limited photographic capabilities. We really want a 4S or later model, and I thought that Dr. Frank had a stockpile of them somewhere, but it turns out that all of his are older models too.
UPDATE gym equipment problem
I finally got around to pouring my concrete weights. Below is a picture of one of them in the frame:
I borrowed some leftover bricks from the new volunteer bungalow, and built a fairly creditable bench as well. As soon as my shoulder gets better (I'm having some rotator cuff tendonitis issues), it will be ready to go.
The new surgical wing means that soon we will be able to do emergency C-sections, and that means we are on our way to providing labor and delivery services.
This means that we need a room to do it in. We have a room picked out, and a special bed on order, but the problem is that the room is right next to all the other patient rooms in the ward. This may lead to some unfortunate noise issues.
So my new challenge is to find a way to soundproof the delivery room using locally sourced materials and little to no money. The other issue is that my boss, Mama Susan, wants it to be an aesthetically pleasing space inside and out. It's a fairly large room, with two exterior walls, two windows, an inclosed bathroom, and a double door to the ward.
My resources are:
1. Me
2. probably up to $100 or so
3. a crew of groundsmen with extensive carpentry skills
4. a car (for fetching supplies)
I'm open to suggestions.
UPDATE microscope problem
It turns out that there is a problem with the camera itself, which I cannot fix. So I am trying to get the manufacturer, Olympus, to take it back for repairs. They aren't returning my emails or answering their phones so far though.
In the meantime, we are pursuing the stopgap measure of adapting a different camera. I already wrote about trying the point and shoot option. This has not produced very satisfactory results.
Thanks to Vickie suggesting phone cameras. As outlandish as it might sound, this may be a viable option. Thanks to Nathan for telling me about Skylight, a product that lets you take pictures with recent model iPhones through the microscope eyepiece. I've been in touch with them, and they agreed to donate a skylight for FAME. I hope we can work it out to arrive before the end of December. That just leaves the problem of finding a an appropriate iPhone. Mine is first generation, and it has very limited photographic capabilities. We really want a 4S or later model, and I thought that Dr. Frank had a stockpile of them somewhere, but it turns out that all of his are older models too.
UPDATE gym equipment problem
I finally got around to pouring my concrete weights. Below is a picture of one of them in the frame:
I borrowed some leftover bricks from the new volunteer bungalow, and built a fairly creditable bench as well. As soon as my shoulder gets better (I'm having some rotator cuff tendonitis issues), it will be ready to go.
Coffee, surgery and banana beer
Things remain interesting.
Our surgical ward is soon to be opened! Soon we will be able to do life-saving procedures here instead of referring them to Arusha-- some three hours' drive away.
The only downside is that the offices had to be reshuffled to clear out the surgical ward, and consequently I got booted from my nice big office to my new closet. This was not unexpected. When the most junior, least important staff member has the nicest office on campus, it's not a stable situation.
In other news, I just got back from a trip to Kongo, a little village on the slopes of Mt. Kilimanjaro. A friend of mine (who stays in the same house in town), has four weeks off work (he's a teacher), and he invited me to come meet his family. One five-hour bus ride, one one-hour dala dala ride (mini-bus), one boda boda (motorcycle taxi) ride, and one half hour walk later, we arrived.
Kongo and its environs are everything that I expected of equitorial Africa-- small villages clumped on steep tropical slopes, banana and coffee cultivation, everything green except the red soil.
I had a great time, and actually managed to take a few pictures too.
or this...
Our surgical ward is soon to be opened! Soon we will be able to do life-saving procedures here instead of referring them to Arusha-- some three hours' drive away.
The only downside is that the offices had to be reshuffled to clear out the surgical ward, and consequently I got booted from my nice big office to my new closet. This was not unexpected. When the most junior, least important staff member has the nicest office on campus, it's not a stable situation.
Old Office
New Office
In other news, I just got back from a trip to Kongo, a little village on the slopes of Mt. Kilimanjaro. A friend of mine (who stays in the same house in town), has four weeks off work (he's a teacher), and he invited me to come meet his family. One five-hour bus ride, one one-hour dala dala ride (mini-bus), one boda boda (motorcycle taxi) ride, and one half hour walk later, we arrived.Kongo and its environs are everything that I expected of equitorial Africa-- small villages clumped on steep tropical slopes, banana and coffee cultivation, everything green except the red soil.
I had a great time, and actually managed to take a few pictures too.
Here is a view of the landscape around Kongo.
Here is one of myself, my friend Kessy and his faithful steed-- the piki piki (motorcycle).
I also got a chance to learn about making coffee. It's one of the main cash crops in the area. I got some practical experience with every step of the process from planting to drinking. I knew surprisingly little about where coffee came from before. It turns out that the fruit is pretty tasty all by itself.
Here are some coffee beans in different stages of the coffee making process. From left to right, unripe fruit, ripe fruit, extracted beans, dried beans. The ones on the far right are ready for roasting.
I also learned about banana beer, the local home-made alcohol of choice. I had tried Karatu's local brew--millet beer-- on market days. That stuff tastes like someone ate a bowl of gruel, chugged a bottle of vodka and then vomited it back into your cup. Proper etiquette for drinking millet beer involves blowing the mold on the surface away from the edge of the cup before you drink. They serve it in giant plastic mugs that probably haven't been washed since they left the factory, and the men imbibe gallons of the stuff.
The banana beer on the other hand isn't so bad. It has a sweet flavor and not nearly so much mold.
Here is Kessy with a generous ration.
The hospitality I found at Kessy's house was very nice. The whole family was extremely welcoming, interested in teaching me about Tanzania, and interested in learning about America as well.
Here is the whole household together.
They sent me off with a kilo of coffee and an invitation to return. Then Kessy saw me to the bus station in Moshi, where we encountered a terrible choice.
I had brought a really excellent novel for the trip: The White Tiger by Aravind Adiga. It was so good, I finished it on the trip there and had nothing to read on the way back. Fortunately there was a book store close to the bus stop. Unfortunately, the only English offerings were this...
or this...
I'm sorry to say I made a horrible mistake. Next time I'll learn about juicing.
Quick thoughts
I don't have much time to write, so here are some quick notes.
1. People here wave with both hands, but they don't actually wave their hands. They wave at you by putting both arms in the air like freeze-frame jazz hands.
2. Squat toilet pro tip-- take your phone out of your pocket first.
3. There is always a rainbow and always a giraffe. If you don't see them, you just aren't looking hard enough.
4. I have a new project: trying to soundproof the future labor and delivery room. Women should be able to scream if they want to, but we don't want the other patients getting the wrong idea.
5. For some reason, a lot of people (mostly tourists on vacation) bring toothbrushes to donate to us. You can buy toothbrushes everywhere in Tanzania, and they only cost 500/- (about thirty cents). Why don't people bring things we actually need, like ant traps?
6. Our laboratory is under attack. The ants like the serum that gets tested in the lab equipment, and it's a constant struggle to keep our most delicate (and expensive) equipment protected.
Hope to have more time to write and post pictures tomorrow.
1. People here wave with both hands, but they don't actually wave their hands. They wave at you by putting both arms in the air like freeze-frame jazz hands.
2. Squat toilet pro tip-- take your phone out of your pocket first.
3. There is always a rainbow and always a giraffe. If you don't see them, you just aren't looking hard enough.
4. I have a new project: trying to soundproof the future labor and delivery room. Women should be able to scream if they want to, but we don't want the other patients getting the wrong idea.
5. For some reason, a lot of people (mostly tourists on vacation) bring toothbrushes to donate to us. You can buy toothbrushes everywhere in Tanzania, and they only cost 500/- (about thirty cents). Why don't people bring things we actually need, like ant traps?
6. Our laboratory is under attack. The ants like the serum that gets tested in the lab equipment, and it's a constant struggle to keep our most delicate (and expensive) equipment protected.
Hope to have more time to write and post pictures tomorrow.
Wednesday, December 11, 2013
Short Rains
The short rainy season has officially begun.
It started with a blast of rain and a plague of frogs. The rain lasted 15 minutes, the frogs for two days. I don't know where the frogs all came from. Hundreds of thousands of them appeared seemingly from nowhere. The kids chased them across the backyard. They hopped over everything, onto the porch, into the hall, across the road. Thousands upon thousands tried to cross the paved highway in a terrible, mass act of amphibian suicide.
In two days, they had all gone, disappeared back to wherever they came from.
A week later we got a second storm. It was raining barrels. I woke up at 5:00am to the strangest sound. At first I thought someone was running a big engine, but then I realized it was rain. Buckets and buckets of it. Mama roused out all the girls (at 5:00am mind you) to clean off the concrete patio while the water lasted. This was followed by a plague of termites.
In a rush. Will post pictures tomorrow.
It started with a blast of rain and a plague of frogs. The rain lasted 15 minutes, the frogs for two days. I don't know where the frogs all came from. Hundreds of thousands of them appeared seemingly from nowhere. The kids chased them across the backyard. They hopped over everything, onto the porch, into the hall, across the road. Thousands upon thousands tried to cross the paved highway in a terrible, mass act of amphibian suicide.
In two days, they had all gone, disappeared back to wherever they came from.
A week later we got a second storm. It was raining barrels. I woke up at 5:00am to the strangest sound. At first I thought someone was running a big engine, but then I realized it was rain. Buckets and buckets of it. Mama roused out all the girls (at 5:00am mind you) to clean off the concrete patio while the water lasted. This was followed by a plague of termites.
In a rush. Will post pictures tomorrow.
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