First Few Days of Work

Here is what I've noticed from my first few week at work (well, internship / placement) at KCMC.

We go to work on a bajaji like tuktuks.

Bajiji with mountains in the background

Here is what I have appreciated and noticed on the first few days of the week:

• There is great professional development. There is a weekly lecture (clinical conference) from one of the departments at the hospital. There is a short  presentation time and the longer time for discussion (at least half an hour). Discussions in Canada always are left to the last 5 minutes of the presentation. There was also lots of discussion: many people asking many good questions

• The preceptors gave a brief overview of how the hospital system works: KCMC is a consulting / tertiary hospital started in 1971. They is also a history of occupational therapy at KCMC: in 1977 an expat doctor’s wife who was an OT saw a need. They partnered with the Ministry of Health to start up both the department and training. The first class was in 1997. Last year they started up a Baccalaureate program, before it was diploma. In no other placement have I received a "history of occupational therapy in this institution".

• One pediatric intervention is more done in a group, whereas in Canada it would be done with individual families behind closed doors. 5 caregivers and their kids come at a time, and the caregivers can share stories. There are three OTs rotating around. Meanwhile, it’s efficient while the therapists get to see every case. They see 10 clients over 2 hours this way.

• Each morning the OTs and OT students present cases and get feedback from more senior OT. It may be an intimidating environment for the students, but is actually great to hear and orate the cases out loud and brainstorm solutions. In other institutions there are monthly "OT practice meetings" but hardly anyone from the organization ever attend. I feel that in Canada OTs specialize a lot in one area (even though technically through licensing you're not supposed to specialize) and if you were to put them in another practice area, people would have to start fresh. But here they know a bit about everything.

• There are Tanzanian OT students here taking the Bachelor program and doing a placement that overlaps with ours for a couple of weeks. Some of them have already worked in occupational therapy for years before going back to school. As such, they are well-versed in a lot of different care and they get a bit of training in nursing and pharmacology as well. However, they talk a lot about nutrition as an intervention for acute care and try to stay away from pharmacological interventions (perhaps due to lack of resources, but still, maybe in Canada we are overprescribing medications)

Food Pictures

You know this is all that you've been waiting for!

This is found mostly at the eateries at the hospital (Jacob's) as well as some cafes around town.

Ndizi na nyama with pilau rice - sort of like with caraway (with sukuma vegetables)

Mandazi (like a thick pancake or donut or more fried egg waffles) with chai - what I get at tea time (10am) at the hospital

Grilled fishies and okra

Beef Makange

First Few Days in Moshi!

On Friday July 4 evening, after a day and a half flight with a short stopover in Zurich, my two classmates and I arrived at the Airbnb we rented for two months to stay.

We're in Moshi, which is a town at the base of Kilimanjaro. We're here as Master's of Occupational Therapy students on our last of four fieldwork placements in a program. We will be at the KCMC Regional Hospital - Kilimanjaro Christian Medical Centre - that regularly takes students from all over the world (most likely mostly Global North countries but we'll see).

Speaking of Kilimanjaro, for these first five days, I have not seen it even though in pictures of the city it features prominently. That's because it's been cloudy and cool and will be for the foreseeable future. Our Airbnb host joked that we brought the cold with us from Canada. It is currently going up to only 22 degrees during the daytime and about 16 degrees Celsius at night. It is their winter, but I suspect it's supposed to be hotter. However, I see that Canada, at least Toronto, is in a heatwave in the 30s and feels like 40. So here I am wearing a fleece jacket in Tanzania while people are melting in Toronto!

Which brings to mind a neat thing - the hot water for their showers are solar powered! But since there's no sun, we need backup electricity to run it. And since it's been so cold, it's hard to take a cold shower (one without heating the water). I don't want to waste the electricity but the alternative would be to do something like sponge bathe, as it would be too cold for me to shower. I can see how it would be refreshing on a hot summer (November - March) day though.

We were slated to start the placement today, July 7. Then, over the weekend, we heard from one source then another that there will be closures because of a national holiday (Saba Saba Day, which means 7/7 or July 7). According to the Wikipedia article I am reading at this moment, it was when the Tanganyika African National Union was founded. It is also a holiday in Kenya but for another reason (commemorating protests for free elections). Luckily when we communicated with the hospital coordinators last night confirming whether or not to go in, they replied pretty quickly and said no.

It also happened to be World Kiswahili Language Day the day we landed. Kiswahili is the language of Tanzania (other than English)! I am trying to learn as much Swahili as I can within these months so I can at least say some things.

One thing that is taking some getting used to is the sounds of a relatively less white noise filled place (because, for example, there are no street lights), but full of the zoom of motorcycles and other cars, and if not that then the animals: hens, whinnying guard dogs, cows and if not that, then music from a club that plays nearby at night. You are surrounded by sound, it's not that quiet!

An interesting thing to note is the ban on plastic shopping bags brought into the country. Then we noticed, like in other places, they burn their garbage. It's true that burning things like water bottles releases chemical toxins into the air, but it'd be great to see which one is better, or which one is worse rather: burning water bottles, or "recycling" them into a garbage pile so massive that it has to go into the ocean which then leaks its contents and litters the sea like in North America? I'm going to run this dilemma through ChatGPT to see what it says: it says for the long term dumping is worse, but for the short-term and human health burning is worse. Well, it then says to avoid plastic waste altogether. All good advice without taking into account human behaviour!

Okay, you didn't come here for my ramblings but some pictures so I will show some!

Outside of the Airbnb

Chapati with beans (not shown) and grilled peppers

The cafe where we at the chapatis

Size of the tree for reference! It's even cut off.

On My Way!

I’m packing to go for a placement to Tanzania! Stay tuned for more!