Today is my last day in Tanzania for this trip. I know I will be back; I plan to be back for a short visit in November. For my last day, we took children to Comprehensive Community Based Rehabilitation in Tanzania (CCBRT) in Moshi to see a Speech Language Pathologist and Audiologist. And again we determined that the children did not have those issues, but just needed some extra help with academics, which the project will provide in the coming months. And again as with the KCMC visit, there was an unexpected outcome where we got an appointment for one of the parents to see someone there to help her. We think that if that parent can be supported then it will help the child as well.

But for me, the most surprising unintended consequence of today was the mingling of parents and children for various types of specialists. CCBRT has a few key programs, namely working with people with clubfeet, polio, cerebral palsy, and other developmental disabilities. Today, the neurologist was also seeing patients and there were several children with varying degrees of cerebral palsy and some intellectual disabilities waiting in the same area and using the stair trainer, gait trainers, walkers, and stretching on a mat outside.  I noticed the teacher with us and the parents looking around and intently watching the children and parents (mostly mothers). I walked over and asked how they were and was asked if I had ever see children like these. I told them that I used to teach children like these and with more intense medical needs in my classroom. They were surprised.

As a real life reminder that children in Tanzania are sometimes still hidden or not part of community when they have intense physical or cognitive disabilities, these adults were sure they had never see children like this in their community. To further this statement, I was told by one teacher recently that there were no children in the school with disabilities, but when probing found that her definition of a children with a disability meant a child with a visible physical disability or a cognitive disability that was significant and obvious.  Education of the community is still needed and it is so important to help our teachers and partners see the capability and value of people with disabilities in their communities.

On my last day of school yesterday, we held a meeting with the key people in the school and community we are working with to report the progress so far and discuss the road ahead, namely the various appointments we are arranging for children and families and additional instruction the Sarah and Veronica will be delivering starting next week to the students were have identified. The meeting was very successful and they were all very pleased. It was nice to see the community support from the local leaders and the school leaders.  I gave them all presents from Boston and/or UMass Boston as a token of my appreciation for their cooperation and hospitality during my stay.

My Kitenge from the classroom teacher

The teacher in our classroom had not realized that it was the last day I would be in the classroom. She insisted we hang around after the meeting of a while until her granddaughter could bring a present for me and present it to me in the traditional ceremonial way. It is a lovely traditional kitenge (the cloth they use for making their clothes, mostly women).

Yesterday, I tried to offer a general overview of the climbing experience and the two biomes we saw and provide pictures for people who have not been on Kilimanjaro and/or may only want to live vicariously through other climbers.

The first 8-9 km are truly in the deep rainforest. Here is a video I took of the path. You can see it is an incline, but not steep in this section.

Machame Hike Video

The path has been made through the trees and sometimes includes the trees and their complex root systems.

The trees are part of the path.

As for the practical aspects of the trip, there are pit toilets available along the path but there are also many little paths on this trail where you can go off into the woods when nature calls.

A pit toilet on the Machame route.

It is necessary to carry all of your supplies with you. For our day trip, we carried them ourselves, including a little over 100 oz of water for the trek. I drank about 80 oz on the trek. Methley, our fantastic guide, carried our lunch. And this was not a camping lunch that you might think of like sandwiches or freeze-dried food. We got the gourmet treatment.

Methley preparing our lunch

As I mentioned yesterday, he was not only the guide but also the chef and he does this for his full treks as well. When he is doing a full trek, he will cook the dinner fresh for you right there, but we didn’t carry a stove up for this short trip.

Freshly ground sea salt and peppercorns

He made a lovely tomato, onion, and chili garnish with fresh herbs and garlic for the tilapia he had grilled at home and carried up. He also brought us a beautiful avocado and sometimes serves this dish with a baguette. He also topped it with a hard boiled egg. This light and healthy meal was perfect for providing us energy for the long trek back down.

The garnish for the meal

He did much of the preparation while we were resting at the Machame hut including seasoning it to taste with our desired level of spice.

A grilled tilapia filet with a tomato relish, hard boiled egg and creamy fresh avocado slices

We also had a beautiful view for our lunch of Kibo. After lunch, we took some more pictures including this one of Sarah at the Machame Huts.

A view of the vast mountain with Kibo in the distance

Sarah at Machame Huts

I also watched the porters and support staff for the climbers going to the top setting up camp for their groups.

Porters setting up camp for climbers

Then we started our journey down. I looked at my watch and remember it was around 4pm or a little after. He told us it was 3 hours down. Methley frequently reminded us to drink up. We needed to stay hydrated. As we went down, we passed several groups of hikers on their way up to camp for the night.

Methley reminding us to hydrate.

You could see Mt. Meru from Mt. Kilimanjaro, the other peak in the area. It only takes three days to reach the summit, but it is a more technical climb that most Kilimanjaro routes, but still doable.

Mt. Meru as seen from Kili

As we descended, it was getting dark. I was able to capture this one picture of the forest around sunset.

Sunset on the path

In the end, we walked the last 30-45 minutes in the dark and that slowed us down. Sarah and I used the flashlights on our phones to help us see, but there were big piles of rock along the road we were trying to avoid that had been placed in intervals on the road, but not yet spread evenly on the road to help with traction for ranger vehicles on this lower section.

We got to the gate and her car at about 7:30 in complete darkness and very tired. The descent was much worse than the ascent because of the pounding on our calves and my less than appropriate shoes did not help one bit. Walking poles for the descent would have helped tremendously, proper shoes, and finishing in at least a little light.

Nevertheless, it was an incredible experience and I really enjoyed it. The day hike makes me want to go up to the summit even more and gives me confidence that with continued endurance training and getting the right equipment I can have a good chance of success. I am still worried about altitude sickness as I go up, but I will plan and prepare and take what comes.

My dusty, broken shoes on their last adventure

And the shoes are being retired. They have been with me since 2007 and my first trip to Tanzania. They have gotten me through many miles in Lushoto, some in Arusha, Dar, and Zanzibar, and now many in Moshi. They have been good, but are done. For $50 J-41 shoes, they were awesome (on sale).

Today was a day of waiting and waiting. We took several children to the Kilimanjaro Christian Medical Center for various checkups, including vision examinations, blood work, and seeing pediatricians and neurologists. We were generally pleased with the results of the day and with the quality of the care. Several of the children are returning in two weeks for additional appointments.

On one hand, we were happy that none of the children had serious vision issues nor do they need glasses. On the other hand, that means that in several cases, we have ruled out hearing and vision issues as a cause of their difficulties in school, but now we have consider that several of the children were are most concerned about may indeed have intellectual disabilities. Given the diagnostic tools at our disposal or lack there of in Kiswahili, particularly for psychological assessment we cannot diagnose some children definitively as having an intellectual disability as opposed to having a learning disability. As I have mentioned in a previous blog entry, we are working from an RTI (response to intervention) perspective where we will try various interventions with children who are remaining in an inclusive setting. If that does not make a difference in the six few months, we will search for an more intensive setting that is still inclusive, such as the Gabriella Centre for additional children. Our goal is to keep children in inclusive settings and neighborhood schools as much as possible because this model is more sustainable and could be better replicated across the country.

Tomorrow we do our trek up Kilimanjaro. I will take tons of pictures and am SUPER EXCITED!!!!! I can’t wait.

Happy Fourth of July!

It really pays to have connections and stay connected with people working for a common goal, especially when there are not that many people in this country currently working on services for children with learning disabilities and mild intellectual disabilities. There are more services for children with sensory impairments and more well-known services for children with physical impairments and moderate to severe disabilities. But, since these children tend to blend in at least for some period of time, they go to school and do not succeed. There are not many good options in Tanzania for a child who doesn’t finish primary school and hasn’t learned additional vocational skills. After talking to my friends and colleagues from the Irente Rainbow School, I was referred to Brenda and Anton at the Gabriella Centre, the directors and people who have worked with Rainbow staff for a long time through a community rehabilitation network group.

Today we visited the Gabriella Centre. This center offers various services for children learning disabilities, high functioning autism and intellectual disabilities, including children with Down’s syndrome. Their website states the following as their goals:

Gabriella Children Rehabilitation Centre is a non-governmental organization started in July 2009 to ensure that children with disabilities are identified early, properly assessed, and trained to become acceptable community members. The centre consists of an integrated primary school for both disabled and non-disabled children, as well as full-time boarding for those who need it. The on-site occupational therapists and teachers assist children with autism and learning disabilities, and provide assessment, education, and disability awareness to parents, teachers, and the community at large.

We were very grateful to meet Brenda this morning and some of her staff and see the facilities. We were also very impressed with their services and we think that they are a real possibility for a few of the children we are most concerned about who we do not feel can be successful in the present government primary school system; they need more individualized supports. Our next step is to bring the children to the center with a parent for assessment and evaluation. We will provide our assessment results and notes from our interviews with these families to support the evaluation process.

The playground…they are building a football pitch (soccer for Americans)

For the younger children, they offered inclusive classroom instruction with typically developing students and Montessori activities to teach problem solving, functional academics, and self-care skills. In addition, they have rabbits that the children learn to care for to practice responsibility and animal caretaking skills.

A rabbit cage

As the children get older, they learn various vocational skills such gardening, weaving, beading, and clock building.

Bracelets in progress in the arts and crafts room

A clock waiting for its mechanical parts

They recently started building a chicken and goat area to help the children learn those skills.

They also teach business skills such as selling soda and telephone vouchers.

The kids learn to sell soda from the cooler.

We heard a story about a young woman who has learned to sell soda and vouchers and in the near future they will help her set up a shop in the area to sell independently.

Teachers from the center will continue to follow her and make sure she is doing okay and being successful. I was most excited to hear that they were not just teaching the skills, but offered concrete plans for how the child will move out of the sheltered environment and be reintegrated into the community. So exciting!!

Because their key staff are trained occupational therapists, they offer occupational and physical therapy (these two types are often combined in my experiences in Tanzania and usually offered by OTs). This a homemade Tanzanian trampoline that they made after the American one broke. The bottom is woven tires. Great recycling of materials.

A homemade trampoline with woven tire strips

WARNING: Today’s blog is a gross for some readers, but some pictures are also fun. Please proceed with caution. I would like to thank my husband Keith for inspiring this entry. He suggested that I needed to write about some of the things that are forthcoming and I decided that today’s entry would be about the gross and icky things you encounter in the Tanzania and similar countries and some of the “fun” experiences you have to pursue you research and your work.

I was inspired by the book, That’s Gross!: Icky Facts That Will Test Your Gross-Out Factor, by Crispin Boyer.

When in Tanzania, there are many different animals that you will encounter. Some purposely on safari, and many that you thought could have left you along.

For example, during my 2007 trip, I met this lovely tortoise on an island of the coast of Zanzibar. I was a little worried he/she might eat my hand, but they were very beautiful and fun to watch and encounter so closely.

Feeding my new friend

In Zanzibar, we also visited seaweed farms on the edge of the ocean and found this baby starfish in the water.

Our new friend, the baby starfish

On the other hand, in Lushoto in 2007, these flying cicadas invaded the school during the months of May and June. I used to have conversations with them at night in my room trying to get them not to land on my bed or my head. Luckily, this was not a normal occurrence. They exist there normally, but not at this high population every year. The children collected them and fried them for a snack. I tried one or two. They were not that tasty and certainly too small for any real fortification.

They tried to be my friends and failed.

I ate them in the name research and repertoire building with the people at the Rainbow School. I also went fishing on that trip for my research. This was not line and pole fishing. They drag the net along the bottom of the dammed pond and then pick out the fish that are big enough to eat and toss the rest back.

Getting right in the water

Before going in, you have to put Vaseline all over your exposed arms and legs to discourage the fish from biting and nibbling you. I guess they don’t want you to have a full body cleaning like the fish pedicure I have seen advertised. The water was very cold.

Greasing up before fishing

After finishing, they cleaned and scaled the fish and the children and staff ate it for lunch the next day.

Cleaning the fish

Sometimes you wish the bugs would just leave you alone. I got a Nairobi fly bite on my leg a few weeks ago. The Nairobi fly is actually a beetle that crawls into your clothing or under a watch band or ring. When you feel it you generally swat at the spot and that squishes the bug and then it emits a chemical that burns your skin and hurts and itches a lot. If you touch the chemical area while still infected, you can spread it to other parts of your body. It will eventually heal as you can see below, but you are left with a battle scar from your trip. Keith was bitten by a Nairobi fly under his wedding ring in 2008 and still has his scar.

My Nairobi fly scar

And then the preventative things sometimes get you too. This mark on my arm is from some of my vaccinations for my trip and it had never healed completely.

My vaccinations scar

Finally, this country has a lot of clay, mud and dirt, depending on if it is a dry or rainy season. Much of it is this red color seen used to build this traditional village home from a village near Lushoto.

Mud brick house in Tanzania

When I go running in the mornings, I come back covered in a layer of red dust and my white socks are not white anymore. Another side effect of all the dust is that when you blow your nose, even for routine cleaning when you don’t have a cold, your boogers are a dark red or usually look more black. You can turn an entire Kleenex black in minutes trying to rid yourself of the dust and dirt mucous boogers. In the science book for class 1, children learn that the nose is used to smell but it is also used to keep clean air coming in and out of your body and so your little hairs in your nose catch all that dust. Luckily for all of you, I don’t have a picture of my black boogers. Riding on the bus as I did on my way to Lushoto, guaranteed black boogers in the evening.

Finally, here is my daily survival kit. I carry in my bag everything except the nail brush. Of course I have cipro for stomach emergencies and neosporin for cuts and other things. But, these items are essential.

The hand sanitizer is critical for a variety of reasons but particular for cleaning your hands after using the bathroom when there is no water. The ziploc bag of napkins is your travel toilet paper for local bathrooms. The gentle face cleaning wipes work to clean the dust off your face, clean your computer screen, and work on your hands to clean them as well. The nail brush is used once or twice daily, because my nails are almost always getting dirty with dust over the course of a day, but don’t like them so short that I would bearily have a nail bed. I am glad I have never bitten my nails, because I can’t imagine what might be under there.

My survival kit

We all must do many things to become community members and support the furthering of our research and our understanding of the community and people we work with. In Tanzania, that includes eating a lot of food when you are hosted at people’s homes, including things you may not want to, like the time I ate a chicken liver. In often times means trying new experiences such as fishing in the pond with nets, but it can be fun as that was.

While many of these experiences or “opportunities” may seem uncomfortable at first or something you wouldn’t do, but I can’t tell you how happy I am that I was able to step out of my comfort zone because it made all the difference in connecting with people and building relationships with people I will have for the rest of my personal and professional life. You never know where black boogers, fried bugs, and a few scars might lead.

We are into the final stretch of this trip. Today is another lovely day at Kilimanjaro Union Café doing computer work related to the project and a few other things I need to do.  Therefore, today’s blog will be another entry about my trip to Lushoto.

I stayed at the Irente Farm or the Irente Biodiversity Reserve.

Locally, it is known as the Irente Farm. Anette and Peter Murless are the very kind and knowledge managers there and were wonderful hosts to me. They offer nice rooms at very reasonable rates with wonderful hot showers with tons of water pressure and the prices include a huge breakfast with German dark bread, freshly made jams and cheese, yogurt, veggies, a banana, and your choice of tea or French press coffee. They use a lot of solar power so you have lights when there is no electricity and they work very hard to protect the environment and educate guests and locals.

My yummy dinner

Interesting facts about the location

Mkindu room at the IBR

It was delicious and more food than I could eat. They will also cook a hot dinner for you either vegetarian or with meat for a small price. The picture below is my dinner from the first night, Tuesday.

On Wednesday, I met Flora (a former teacher at the Rainbow School where I did my dissertation research) for tea and then was treated to lunch at Peter and Anette’s house. For dinner, I went to Lutheran Hostel and Restaurant in town for dinner with Mama Munga, the head of SEKUMO, the special needs university where Keith taught the whole year we were in Lushoto and I taught one course. I was invited to dinner to meet some American professors and students from Kansas State who were in town to teach a learning disabilities class at the university. I almost forgot that I met Yassin, the principal of the Rainbow School in the afternoon and Kirsi, the new outreach coordinator at the school.

The view from Flora’s house toward Lushoto

On Thursday, Flora sent a pikipiki (motorcycle) for me to go from the farm to her house for lunch. I was nervous because I had never ridden on a motorcycle and these dirt paths with ruts from the recent rains and the mountains with their ups and downs are like an Indiana Jones ride. Yes Mom, I wore a helmet. It was fun in the end and I didn’t feel like I was going to fall off, but I will not be adopting this as my method of travel in the future. Below are pictures of her house and some of her neighbor’s kids and her son, Ibra. Her house is located partway down the mountain to town. The pictures are to give people who haven’t been to Tanzania, an idea of what a typical Tanzanian house looks like.

Flora’s house

Ibra

After lunch, we walked to her duka (shop) where she sells various staples such as flour, corn, sugar, tea, soap, steel wool, soda, cigarettes, and other telephone vouchers. Tanzanians are always so hospitable, and will feed you their last bit of food in the house and go hungry, rather than not offer you something when you visit. At Flora’s shop she wanted to give me a soda, but insisted on paying for it. I told her that she had a business to run and I was going to be a paying customer.

Duka la Flora

Then we walked to she Mama Mashaka’s (her sister) shop on the way to see her nieces and nephews. They are all part of the Shedafa family and I have meet many family members over the years.  At Mama Mashaka’s shop, she offered me a soda and maandazi (Tanzanian donuts). I had my soda bottle still, so I just graciously accepted the delicious donuts.

After walking another 30 minutes, we arrived at the Shedafa house where I met more Shedafas I didn’t know and they started cooking me dinner. Unfortunately, I already had plans to eat dinner with Robert (the former Rainbow School principal and friend) so I only took tea. They were very disappointed I didn’t stay for dinner and I was rather embarrassed that they were making me dinner.

We then walked to town to meet Robert and he and I went up to Irente by foot to his house. I was glad to get to walk at least 6 miles that day to make up for all the food I was being served. It was all wonderful, but I was full by the end of the day. Robert’s wife had cooked a lovely meal for me as well.  It was nice to see his wife and daughter and meet his new son.

On Friday, I went to the Blind School for the celebration I talked about in yesterday’s blog and had dinner with Kirsi, Petros, and Yassin.

On Saturday morning, Anette and Peter were going to Moshi so I was able to get a ride with them and that was very kind. I was glad not to have to ride the bus again.

I ate my way through Lushoto last week with the wonderful generosity of all my friends. I could have gone to the houses of several Rainbow School parents who I saw as well, but my time was just too short.

A really great visit!