MEDA Blog - Stories from the Field

Mis-Frustration

Some individuals could find their way in any place with others who speak any language and find a way to connect, I however, find this extremely difficult. Even though, Ninajifunza Kiswahili (I am taking Swahili classes), I still find many instances where there is a significant communication barrier.As part of my internship, I am currently managing our call center of four employees. When I started we had two employees in the call center collecting data from our retailers in the North and South on how many nets they have in stock. Now, due to donor demands on data that should be collected, we have four employees collecting data on retailers in the North and South, hard to reach retailers, eVoucher redemptions and clinic voucher stock outs. As the manager, it is my role to train the new employees, create the calling lists for each, monitor and analyze the data retrieved. This is all new to me in English never mind Swahili.As I am putting together these different lists, I confuse myself over the different retailers and clinics, whether they’re eVoucher or Paper Voucher clinics and who is collecting what data. Meanwhile, as I’m only confusing myself more, I am trying to teach one of our new employees what I am looking for her to do. As I ramble on, back and fourth she continues to nod her head and accept the tasks I have given her. I finish my explanations, ask her if she has any questions and when the answer is always, “No madam” I return back to my desk. A few hours later or some times even at the end of the day when I am looking to collect the work from the day to review, I receive an email in response that explains that she is unsure of what the task was and was not able to collect the data. This is not ignorance or lack of wanting to work, this is a conflict in communication.Growing up and studying in North America, I would expect if someone did not understand the task, they would ask for clarification but that is not the case here. I have started to learn in many circumstances that Tanzanian people tell you what you want to hear. Tanzanians are extremely polite and this is simply a part of their culture as they do not want to offend you so they tell you what will make you happy. When asking a waitress to get you something the correct phrase is “Naomba maji?”  which directly translates to, “I beg you to get me some water?” The cultural universals are based off of politeness rather than efficiency. This allows me to appreciate the way of communication a little more but it is most certainly not an easy adjustment for me to get used to.I am learning that is difficult for me to understand many things until I am able to actually experience them. Even through all my communication studies during school I don’t think I really understood the frustration of miscommunication. I am embarrassed to say but initially I was quite frustrated at the situation but that is not fair or right. It is up to both me and the employee to work together to be sure the other understands what is being said. It is up to us to learn to work together to accomplish the tasks. It is up to me to embrace the culture for what it is and rather than being upset of time lost, take the time to use these as moments as teachable opportunities. I am learning, it is difficult but I am learning both Swahili and communication norms.

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LIfe without ‘Kodak Moments’

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Within one second, they were all gone and there was nothing I could do about it. I guess that’s one reason why I should stop living my life through a camera lenses. So often when I take a picture the thought… “This is going to be a great cover picture!” comes to my mind. I think of the instant gratification from others with a facebook ‘like’ instead of experiencing every moment to it’s fullest.This past weekend I spent in the Ngorogoro crater near Arusha, North Tanzania. This crater is a beautiful, widespread mass of land that is home to many of Africa’s greatest creatures. I had the chance to see elephants, giraffes, rhinos, hippos, lions, hyenas, gazelles and so much more! Every time we saw an animal all of us reached for our cameras snapping an over excessive amount of pictures of that one animal which for the most part just laid there and watched us. As soon as we got the ‘perfect’ picture, we told our driver and he drove us to the next part of the road where vehicles were crowed around another magnificent animal. All the while, I’m taking these pictures I’m thinking about how I can’t wait to show my friends and family about this amazing experience I am having and I guarantee you, all of you would have been amazed. Too bad, someone had another plan for me and decided to teach me an extremely valuable lesson.This morning when I go to look to my photos and decipher which ones I would like to share, I notice an entire folder missing out of photo library. Trying to think rationally, I think maybe I just put them in a different folder or maybe I can get them back some how. I start the search. So many incidents seem to have led up to this casualty. I think maybe I can just re-download them but I decided to clean off the memory cards of my camera so I wouldn’t duplicate them on my computer. I emptied the trash on my computer to free up some space. I figured I could just download them to Iphoto yesterday and then today would add them to dropbox. It’s okay they should be in my photo stream…my photo stream was turned off. Wow. They were seriously gone. Permanently deleted.A few days ago, a coworker of mine taught me a very powerful lesson that has been coming up more times than I can count. He taught me about the power of now. He read a book recently that taught him to focus on the exact moment you are in. When all these problems seem so great and overwhelming the key is to focus on the now. “What is your biggest problem right now?” he asked as I was sitting on a beach on a small deserted island. Well, obviously I couldn’t come up with any problems at that moment but I was sure that if you got me in a really stressful situation that would be different. Since that moment, I have found myself in a few different situations where normally I could work myself up over the circumstance but I was able to think about my biggest problem at that moment which always came back to nothing. I had food, I had water, I had shelter, I had family and friends. I had a lot more than most people have in a lifetime. All of a sudden instead of feeling overwhelmed, I felt grateful.So even though, I have to end this post without showing you any photos of my amazing trip, I am still incredibly grateful. This weekend I was able to see Africa in a new light. I saw the beautiful terrain of the crater that was filled with magnificent animals of all kind. I saw the Massiah men show us a dance from their culture. I spent many great moments with friends sharing stories about their lives and their cultures. I got to experience something many people will never get the chance to see. I was so excited to share all those pictures with everyone to show how much fun I am having but I think that sharing these experiences and lessons learned is even more special. I often here the phrase, a picture can say 1000 words… but what about all the words, lessons and memories that the picture can’t get across to just any viewer. What about everything that led up to that picture?I am learning to experience life in the now rather than how that picture will be received later. Even with someone video taping my every movement here I couldn’t completely show how much I have already learned from these people, this culture, being abroad and learning to be independent while still maintaining the relationship with a community. Not a picture or a movie or an essay could explain that but whom I become from what I have learned throughout this experience will. That in itself will be evidence that I am on a magnificent journey.***Added Nov 29:Then, once I think I have it all figured out…everything always seems to change completely. I had come to terms with that fact that I had lost my pictures and actually wasn’t even the slightest bit upset about it anymore! Then when I go to show Shaunet just a few of the pictures I thought I saved somehow… they ALL appear! Life is a serious mystery! So I thought I would share just a little of my favourite moments and hopefully you can feel a slight glimpse of the magic I felt seeing all these beautiful creatures!

 

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Goodbye Personal Space

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This past week I was able to spend some time in Capetown, South Africa. So many things about this place reminded me of North America, it is definitely not what one would imagine when thinking about Africa.The uniting language between strangers on the street is English, the roads are nicely paved, the price they tell me, is the price I pay (No bartering…my worst nightmare)! It was definitely a very different scene from Dar es Salaam, Tanzania but one thing that was not completely different was the train station at rush hour.I spent the day surfing, while my friend Marina was at school and work. I jumped on the train around 5pm to head back to her place before dark. I sat third class as I normally do. At first it didn’t seem like a big deal, I was still able to get a seat but with in the matter of three stops the train filled up so much that I wasn’t even able to see out the windows. I wasn’t quite sure when my stop was so I decided to stand up which at least would let me see out the window so I could get out at my stop.After a few more stops, I must have had a look of panic on my face because a map had tapped me on the shoulder and said, “Where are you going?” with quite the questioning tone. I told him Observatory and asked, “This is the right train isn’t it?” He laughed and told me, “Yes but I was still about 7 stops away!” Phew, at least I wasn’t completely lost. He offered to tell me two stops before mine, and when to walk over to the door. Within the next few stops that train filled up so much that I was now spooning someone from every angle, there was no where left to stand, or so I thought but somehow they kept piling more people into this car.The kind man told me it was now my time to head towards the door. I looked to the left and the right, unfortunately I was standing directly in the middle of the train. I had no idea how I was going to be able to get to the door. I tapped the shoulder of the woman beside me, “Excuse me, can I sneak by?” and the man, “Excuse me, my stops coming up.” They all started to giggle a little and moved about a millimetre to let me by.  I had moved barely at all and new I had very little time until my stop so I started to push my way through, apologizing the whole way.Finally at my stop, they helped push me through the door. Once I stepped foot on the ground, the whole train started to clap and laugh at me. I once again was the centre of attention! I am not really sure how I get myself into all these situations where I seem to have all eyes on me but it sure does help me make friends easily.My trip to South Africa was wonderful, I was able to surf, climb Table Mountain, see the penguins and meet many wonderful people. It is a very different part of Africa, so much that some times I even forgot I was in Africa. I have only been to a few places in Africa so far but I am learning that the Africans are unbelievably kind, friendly and joyful. Even in the most stressful situations they are able to put a smile on my face!

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Life is a Beautiful Struggle

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Life is a beautiful struggle.These are the incredible words of my friend Elise that described the weekend perfectly. A group of us had decided it was time to made the trek to Zanzibar for those of you who don’t know this is a beautiful island right off the coast of Tanzania. Saturday morning we took the ferry, which for residents costs about $10 US. The 90minute ride I was filled with a whole lot of excitement as I had only heard great things about Zanzibar. When arriving in Stonetown, the main city of Zanzibar we had to go through customs even though Zanzibar is still technically a part of Tanzania. It seemed pretty quick for the most part until we noticed that one of us was missing. Elise had been pulled in for questioning. They were accusing her of breaking the law because she did not hold the proper visa. Elise is a student and has a student visa but the officers would not let her go until she paid the $200 US for a working visa. They were not budging; there was no negotiating to be done and after a long while Elise finally gave in and handed over the $200.Luckily, we quickly found a taxi driver to take us an hour up north where we were hoping to book a hotel, this is where we were told they have the most beautiful white sand beaches. From only one question our driver knew exactly the hotel we would like. All he asked was, “Price range- cheap or expensive?” Simultaneously we all shout, “CHEAP!” He knew the perfect place! We were able to get a hotel room with 4 single beds, right on the beach, free entrance to the beach party and free breakfast all for $20 each. It was perfect.From all the pictures I had seen on google about Zanzibar I knew it would be beautiful but I didn’t expect it to be half as magnificent as it was. The beaches were a perfect soft, white sand, the water was this phenomenal clear turquoise color, the staff was incredibly friendly! I was seriously in paradise.We spent all day swimming in the water, laying on the beach and even playing some American football! It was the relaxation I needed. Then at night we had a giant dinner buffet right on the beach while we watched the staff perform different dances and acrobatics. We finished the night off with their usual Saturday beach party that included dancing, bonfires, stars and great conversations. It was a perfect ending to the amazing day!It was too perfect. The next morning, I woke up at 6am ready to go for a morning swim before we were heading out to the spice tour. Elise just came in the door and told me that her and Curtis’s phones had been taken from our porch last night. The porch was the only electrical outlet that worked so they had left them out there to charge. We should have known something was bound to happen, everything seemed to wonderful to be true but I am way too naïve to think that way! So her and Curtis spent the morning talking to the staff, security guards, managers and watching video tape. Nothing could be found.Since I was no real help, I decided to take a swim before breakfast. This is where I had my first real, “I’m really in Africa!”  moment. Sitting on the beach with little to no one around, listening to the waves and the birds, feeling so refreshed from the cool blue water.  It was the most at peace I had felt in a long time. Without using too many cliches, the best way to describe it is that moment where time really does seem to stop. It felt as if all was good in the world. It felt as if everything was going to be okay. It restored hope inside me.After I met up with Elise for breakfast. We talked a lot about what could of happened to her phone, what could have been done to prevent it and how vulnerable it made her feel. I knew all these feelings because I had gone through a similar situation recently. In the midst of our conversation though she simply took a breath and said, “Life really is a beautiful struggle.” I was taken a back by this quote. We were in this perfect beautiful paradise where all these unfortunate events seem to be happening to her and she was still able to see the beauty in the world.The most amazing thing about travelling abroad is the people you meet! I am truly blessed to have this opportunity!

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Ninapenda Kula Chakula!!

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Chakula time! My favorite phrase of the day…food time. For any of you who know me, you know I am handicapped by any foods that are too spicy… or that have any spice at all really. All of you would be so proud. Although, not all the food here is spicy, hardly any of it really but they always have an option to make it spicier. Here at the MEDA office we are fed lunch everyday. We are given 3 or 4 options the day before; mostly the same options everyday with one new option, that again… I usually stay clear from. I have been sticking in my comfort zone with wali ne kuku (rice and chicken). Now this rice isn’t the same as rice in North America though. I never really enjoyed rice back home, I would only eat with some delicious sauce on top to let me forget about eating the rice but here it is a whole new world. I am told it is because this rice is whole and does not go through as much processing, whatever the reason may be… I can actually say that I crave rice. I enjoy my comfort zone, I feel safe eating that but my roommate/fellow intern Curtis thinks I need to be more adventurous. He often encourages me to try the new things on the menu that even he doesn’t know what they are. This is why… I have a strong suspicion that he changed my order one day. Sitting at my desk, I finally here “Chukula (food) is ready for all!” I was starving that day and could not wait for my wali ne kuku… only when I open up my container I find a whole samaki (fish). When I say whole fish, I mean whole… head and all. The little guys eyes were just staring at me! We are fortunate enough to get food every day, so I didn’t have the guts to say this isn’t what I ordered instead I just had to eat it. I was forced out of my comfort zone! I used the lid of my container to cover the head, I just couldn’t eat it with those eyes staring at me. It just felt so wrong. I looked around to see how others were attacking this meal. No forks and knives, just their delicate hands peeling the meat of the bones and then throwing it into their mouths. Oh boy… unfortunately Nichols College etiquette dinner didn’t prepare me for this. I forced down as much of this fish as I could. Wasting over half of the meat on the fish that apparently is in the head. I felt so awful but there was no way I could put any more of that fish in my body and I have a feeling my face gave off every ounce of misery I felt during that lunch. It is not all bad though, I have found quite a few foods that I enjoy. There is this wonderful sauce that I put on top of my rice; a sort of salsa that is not spicy but has the sweetest most flavourful addition to my amazing rice. As well as a form of rice called, Pilau. It is brown rice cooked with different spice that gives it an amazing flavour! Being in a big city though, we have a lot of selection such as Indian, Ethiopian, Thai and even Pizza. I can certainly find something to here that is not the problem. Also, I am lucky enough that Cutis, anapenda ku pika chukula (likes to cook food). I try to repay him by doing as many dishes as possible. Maybe one day I’ll make him an amazing grilled cheese sandwich!

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Numbers Are Deceiving

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Days out of office with the field staff are a good break from sitting in front of a computer all day. I enjoy seeing new parts of the city of Dar Es Salaam and viewing people going about their daily lives in this ‘Haven of Peace’. On field days with Kapaya and Gabriel the experiences are always unique and differ from the previous drives. I have visited more than a few dukas (shops), kliniki (clinics), and hospitali (hospitals) around Dar in districts of Illala, Kinondoni, and Temeke. I have quickly discovered some of the struggles, and issues with the current voucher system/health care system in place. As well as encountered the deceptive progress reports which are examined and shown to clinic staff. A few trends I have noticed are:1. Overworked staff. After regular kliniki (clinic) hours, only doctors may be working, and they don’t have enough time to hand out the TNVS voucher’s to women so they often write down their names and number and the nurses then have to give them the voucher on their second, or third visit. This translates to a time problem with the nurses, who along with their other duties have to catch up on the paperwork from past patients: fill in the MEDA logbook with the Hati Punguzo net sticker and information, write down the Hati Punguzo number on the Antenatal Card, and check off that it was given to the patient.2. Problems with competing bed net companies.  The two main suppliers of bed nets are A-Z and BestNets. On one occasion, we encountered a situation where the retailer wanted a certain type of net, and ordered it but there was no stock with the original supplier (who had the contract). The other supplier wanted to deliver nets, but a contract was already in place. The duka had already confirmed to receive even though they were not yet delivered. The result of this situation is that TNVS insisted the supplier not to confirm delivery before the duka (retailer) actual received the bed nets. The delivery is still pending.3. Potential for new duka contracts. One observation I noticed on a few occasions was the doctors and nurses at the kliniki (clinic) being helpful in offering new, more reliable, and closer dukas to sell the bed nets to patients. On one occasion we walked with the doctor to a very close duka to see the progress of their start up into the TNVS program. The retailer had been contacted by a supplier to sign a contract for bed nets, but hadn’t received a shipment yet.4. The above situations lead us to the problem of stock. Often times there are more than enough vouchers and e-vouchers being given out to patients but when the customers go to the dukas to purchase the bed nets they are out of stock. With only two suppliers with operations in Tanzania, and a very large country to cover and service, often times there is an issue either getting the bed nets to locations with drivers, or keeping up with the amount needed to service the clients. This creates a problem of a want for more dukas involved in the program, but not enough stock to maintain them. Thus, the need for more suppliers and competition between suppliers, which will bring down the price of the net, and allow stock to be maintained and readily available. As well, a solution might be if stock had to be ordered far in advance, then maybe availability issues could be avoided.5. As well the quality of the bed nets from the suppliers may differ. While all companies bed nets in the program are insecticide treated already, a user may have a preference for a type of net which may be out of stock. Also, most nets aren’t designed to last forever, and instead only last up to five years. At the start of the program the mother may obtain a second bed net for their child as well as herself. If the mother becomes pregnant again she may gain another net for herself as well as her 2nd newborn child and so on.6. Another issue is education of SMS, texting, shortcodes and phones. While most clinics and hospitals have staff that are well-versed in using a cell phone and its functions to report info to suppliers, there are a few holdouts. One kliniki we visited we had to educate the nurse to show her how to use her phone to SMS the supplier on bed net numbers. This is why the pamphlets and paper leaflets given to the duka owners and kliniki staff are a good tool to educate about the program. In some isolated cases repetition of SMS demonstrations is the only way to proceed. You have to have patience, especially with a generational gap with respect to technology, cell phones, and their use. Sometimes, a helping hand is needed to learn.7. Dukas playing their part. Dukas writing the numbers of the nets handed out in the log book (which sometimes doesn’t exist if they haven’t made one) and putting the net sticker in as well for confirmation in the MTUHA (Mfumo wa Taarifa za Uendeshaji Huduma za Afya) (record book). It is important for dukas to keep records, and be educated on the importance of being organized for the program. After all, they are benefiting from the process with profits and need to keep up their end of the bargain.8. Cell phone network issues, and signal problems. Often times different cell phone companies (Airtel, Tigo, Vodacom, Zantel etc.) have different reception problems in rural communities and one might work better than another in an area.  Investment in updating and providing larger cell coverage is key to the success of the e-voucher system. Also it is cheaper to SMS in multiple Hati Punguzo net numbers together in one message. This info could be compiled for a while, and thus reporting numbers may be off if the duka waited too long to report. It is not hard to figure out that if these problems exist in the large urban city of Dar, then they will be highly heightened issues outside in the rural areas.All of this translates to much lower reporting percentages and number for kliniki (clinics) and hospitals for how many vouchers are being sent out to women and children and the redemption rates for them. A large factor is motivation. The workers and field staff at MEDA Tanzania needs to make sure all of the suppliers, duka owners, clinic staff, nurses, doctors etc. know how they are making a difference and helping save lives every day by completing and maintaining their part in Hati Punguzo.An idea of providing a specific phone for each clinic to use has been thought of and mentioned a few times, as whose phone do you use for SMS messages? This is a difficult question, as there may be four plus nurses working on the program. An idea of a specific phone to be used for SMSing voucher codes might make sense, and be affordable for a larger clinic or hospital, but wouldn’t work in smaller cases. Whose talk time minutes do you use? Or, do you use those minutes to SMS a supplier about bed nets or call your family and children? A moral dilemma in some cases.Data shows significant achievements in the fight against malaria in Tanzania after Hati Punguzo was introduced, with the infection of under-five year olds declining to 10% from 18% in 2008. (http://medatanzania.org/) Also, the number of patients attending health facilities to seek treatment has increased since then. In July 2013, in the Dar Es Salaam region most clinics averaged about a 70% redemption rate for vouchers from the kliniki to the dukas and to the user.Even though some of the kliniki, and hospitali redemption rate numbers are low due to several issues explained above, the fact that the MEDA TNVS program is making a difference in pregnant women and children’s lives and helping them from falling ill to malaria is incredible. This is a far more important fact than any number or reporting figure!

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Karibu Tanzania

I have only been in Tanzania for 3 and a half weeks but I already feel I have so much to tell you. I could talk about the major culture shock I experienced or about having to dance my way through a church service or about having my purse stolen right off my neck. I have so much to share but I feel I should start with what the heck I’m doing out here.After graduation last May, I was offered a six-month internship with MEDA (Mennonite Economic Development Association). MEDA is a non-profit non-government organization that works to alleviate poverty through sustainable economic development in many different countries around the world. They work to encourage struggling rural farmers, to empower women, to motivate youth and more. In Tanzania, we work with Hati Punguzo bed nets.In Tanzania, malaria is responsible for more that one third of deaths among children under the age of 5 years and up to one fifth of deaths among pregnant women. Effective preventive and curative measures have been developed; however, sleeping under bed nets remains an important strategy for protecting. When the bed nets were given out for free though, they found that Tanzanians were using them for anything but a bed net. Therefore a small fee was introduced to create a higher value for the Hati Punguzo bed nets. To be sure that those most susceptible to Malaria were still able to get a bed net at a cheap price, a voucher for pregnant women and infant children was introduced.When a pregnant woman or a parent with their child goes to a clinic for their check up, they receive a voucher for a bed net. They take that voucher to the retailer where they are able to redeem that voucher and receive a bed net for 500 shillings, which is about $0.35 U.S. MEDA is the logistics manager in the whole operation. MEDA ensures that the clinics have vouchers; the retailers have nets in stock; the distributors are supplying the nets to the retailers on time and collecting data to keep track of the all the vouchers calculating the redemption rates for each region.I was hired as the impact assessment intern for the next six months and am a member of the monitoring and evaluation team here. We work with many field officers and collect data from all regions to compare, analyze and recommend new solutions to reoccurring problems.With only six months, I am working hard to contribute as much as possible as well as learn from the incredible coworkers I am surrounded by. There is a lot of behind the scenes work that I am starting to get a great introduction into and am constantly impressed with the work ethic of both those in the office and the field. I have been able to make one field visit so far and hope that there will be a few more in the next few months, as it certainly makes the numbers I am looking at all day have a lot more meaning.

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Present Bus System (Dala-Dala’s)

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With the future D.A.R.T. project underway comes the limiting of the Dala-Dala (mini-bus) licenses. These buses can still be used for getting around on the smaller road routes but should stay off the main throughways if the city is going to have a reliable bus system in the future.Being a geographer I wanted to get a look at the dala-dala routes before using this method of public transportation system. This information is hard to come by as I’m pretty sure it doesn’t really exist! These dala-dala drivers have a specific route they take, but the routes have never been mapped and it’s pretty difficult when the streets they take are not named sometimes. The closest thing I have found to a route map was done by Anson Stewart (an American who specializes in engineering and urban studies). While not perfect, this map is a good tool for anyone venturing out in a new city, and trying to make their way around using public transportation. These types of maps should be public knowledge, and distributed. When I showed this map to co-workers and even a dala-dala driver they were intrigued, and wanted a copy for use.For now, the dala-dalas are the main bus transportation system in Dar. However, in the near future the D.A.R.T. bus system will hopefully ease traffic problems. It is a major construction project and in order for it to be completed soon the contractor Strabag needs to pay its workers on the project. The workers are demanding up to two months in back pay. The over 1000 road construction workers if not paid could lay down their tools bringing the Morogoro Highway construction project to a grinding halt. The workers are not only demanding wages owed but are also complaining of ‘poor working conditions’ and are requesting the government to secure them a safe and more humane work environment. Thus, cooperativeness between the Dar Es Salaam Regional Commissioner, Strabag management, Tanzania Mining and Construction Workers Union (TAMICO) along with the construction workers need to happen soon to fix transportation in Dar!

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Urban Planning and D.A.R.T.

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I was lucky enough to get the opportunity to go out with some of the field staff within my first week at the MEDA office in Dar Es Salaam, Tanzania.  On the way to the dukas/clinics I was greeted by the traffic in Dar. It is a city which could benefit from a few changes to its current roadway and highway structure layout. The larger highways (Morogoro road, Mwinyi/Bagamoyo Road) have a smaller side road along it for bikers (boda-boda), walkers, people carrying items, sometimes motorbikes (piki piki), bajajis (3 wheeled vehicles), trolleys etc. Then, there is a large ditch, 2 lanes of traffic, a very large centre area (not often fully used, where you could easily fit in another 1-2 lanes) and the same setup on the opposite side of the road.  This is a city with a traffic problem. There doesn’t appear to be a time during the day when the roads are not clogged. I haven’t yet seen a highway in Dar which has more than two designated lanes in one direction. Adding more lanes would ease congestion in this large city of over 4 million people. A similar case is in Nairobi, Kenya (population of 3 million) where they recently worked on building the Thika Super Highway away from the city. With 4 lanes of traffic (on each side), it works well at dispersing people to and from work within the city centre. This combined with the bypass system for the north, south, and east should further ease congestion.Although I’m not here for Urban Planning, I am very interested in it! The ambitious Dar Es Salaam Rapid Transit (DART) project will first be building a bypass with dual four-lane carriage ways, which seems like a great idea for the city and its transportation future. The project is expected to save billions of shillings lost daily in traffic jams and provide relief to at least 300,000 Dar Es Salaam commuters (I work with many of them!) Completion of the project would result in shorter travel times for motorists, decongestion of surrounding roads, improved security, safety and convenience for pedestrians and cyclists due to construction of footpaths and bicycle lanes. The roads will form major alternative routes bypassing the downtown business area and as such would ease nightmares motorists encounter while navigating through the city.

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The sole Canadian at a Swahili church service

It was my first weekend in Dar es Salaam and Curtis my fellow intern/ roommate was in Kenya so needless to say I had to find something to fill my time. This is why when our security guard, Joseph invited me to church with him, there was no way I could turn it down.  We were a little late when we walked in, so most of the seats were already full.  As we walked right in front of the whole congregation, I could hear a whisper go through the crowd.  I took the last seat available and tried to listen as they rambled off in Swahili for a few minutes before turning toward me.  The pastor was looking right at me, I wanted to run.  He called me in front of the room, introduced me as “Sister Mary from Canada” and asked me to dance with the choir.  There was no way I could say no, so I tried to copy the choirs moves as best as possible.  When I finally get somewhat close to the step they were doing I lift my head up to see almost every one of them with a cell phone or camera pointed at me!  They had me dance a few times before they let me return to my seat. After the service, they were having a fundraiser for a new member to buy him furniture for his house.  It was an odd tactic but I went with it.  They had an envelope of money that was donated to him, then someone would pay money to open that envelope and show the congregation how much money was in the envelope.  Immediately they came up to me to be the first one, but all of these instructions they were giving me were in Swahili with a lot of hand gestures, one of them being the pastor pointing to the envelope then at the congregation.  So me still not aware of what I am doing and why, I gave him a few shillings and went to the front of the room.  I open the envelope, I pull out a 10, 000 shilling bill and I throw it into the crowd.  The congregation is roaring with laughter, my cheeks are bright red so I take my seat.  The next women goes up, pays her fee and opens the envelope, she pulls a bill out, raises it in the air and places it in the basket next to her as she sends a glance and smile my way.  Hmm, that makes more sense.  They let a few more people go by until they finally ask me to go again so now knowing what I am suppose to do, I am back front and center.  This time I have 5 bills in my envelope, the first 4 I did exactly what I was told but the fifth I faked a throw into the congregation and then placed it into the basket, again I had the whole room filled with laughter.  So needless to stay most of the service was spent laughing at me and my lack of understanding for Swahili but it was quite enjoyable.

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mHealth Meeting in Dar

Describing MEDA Tanzania’s transition to the eVoucher channel from a paper voucher for subsidized bednet distribution, never fails to interest an audience. As MEDA’s eVoucher uses a USSD platform, the simplest of feature phones, allow vouchers to be issued and redeemed by beneficiaries. It also makes it a lot easier for MEDA to track and measure trends to inform future decisions about the program.

Using ICTs and mobile phones in particular as part of health and development solutions are not new, and their applications are countless: SMS scratch codes are used to verify the authenticity of certain drugs, mobile phones are used to monitor and record data on teacher attendance etc.

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Use the key to lock the door for the civet

Kutamie funguo kufunga mlango kwa fungo So determined this week to master some words that have been tripping me up lately!

Funga: Close, lock

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Mitumba and More

The streets of Dar are your shopping centre. Any traffic light will feature machinga selling peanuts, pirated DVDs and buckets of bottled drinks. A corner near where I stay features hats/ caps and inflatable beach toys on the regular and sometimes features cute bunnies. Very logical combination.

Wandering salesmen of mitumba are similarly ubiquitous, with loads of hangers carrying a specialized clothing type, perhaps men’s office trousers, or dresses appropriate for Sunday church. These definitely cost more to take into account the time of the sorter to pick out nicer items, the labour as they go around town, and of course, well-earned profit.

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Parallel Processing

In Canadian culture, customers are usually processed serially.  When you go to a store and ask an employee for help or when you make a purchase, it’s usually one at a time and first come, first serve.  Not in Tanzania.  In the middle of a negotiation, it is okay for the seller to turn to another customer and start dealing with them at the same time.  In fact, it’s okay to deal with 3 or 4 people at the same time!  But I must admit, I was a little taken aback the first time that this happened to me in a work environment.  While in the middle of discussing an important problem, my coworker turned to somebody walking by and started a completely different conversation.  I was kind of shocked and stood there awkwardly…trying to figure out what I might have done to upset my colleague and instigate this kind of behaviour. Noticing my puzzled look, she laughed and kindly explained how things go in Tanzania.  It’s totally acceptable for you to put somebody on hold and it’s okay for somebody to put you on hold too!

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Mitumba Shopping in Dar

Before coming to Dar, I wasn’t sure what to expect for my downtime, but as I get to know Dar, friends and events better, I find I definitely under-packed my non-work wardrobe. Contact lens solution and packs of mango gummy candies took priority in my luggage!

I’ve been to Mlimani City once and it had a couple fast-fashion shops, but at prices I wouldn’t pay back home. Same thing with some boutiques on Kimweri: Forever 21 store tags still on some of these items, but with a 100% markup or more! Or attractive-from-a-distance blouses brand new from China, falling apart at the seams. 70,000 TSh polyester blouse?! Kweli?! Non-negotiable?! Kweli?![1]

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Mastering a Health Facility List in Tanzania

Alan, the IT Development intern, Dennis, the IT Officer and I just represented MEDA at a conference on the development of a national health facility registration system, Master Facility List (MFL). It was organized by the Ministry of Health and Social Welfare (MoHSW) and brought together representatives from various ministries, levels of government, NGOs, statistics boards and researchers.  (PEPFAR, NMRI, CTC etc). There sat us among several important officials (in a conference centre with the coldest air-con I’ve ever experienced)!

The final outcome is to have a master list that will have a comprehensive set of attributes, from location to services provided, of every public and private facility in the country. Importantly, they will be identified through an ID system harmonizing the several parallel IDs currently in use. It’s exciting to get a glimpse of the design process and the potential for use by stakeholders to better deliver health services and interventions. The MFL will be key to unify national strategy and equitable provision of services.

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I love my job

I find the intricate details of the world fascinating.I like reading stories of how humanity has investigated these details and learned to harness the power of nature.Theories of how the ancients might have birthed mathematics.Sometimes I enjoy just pondering the miracle of mathematics.It’s nothing short of a miracle that mathematics makes contact with reality – that it can be used to accurately define rules which the universe obeys.I like the stories of humankind creatively devising experiments to validate their conjectures.And how the journey has led to the creation of amazing technological tools, which have transformed our interactions with the world and even our interactions with each other. But I know the stereotypes about the Information Technology field.Countless times I’ve seen first interest and then consciousness itself drain from people’s faces when they’ve unwittingly asked me what I do. That’s probably why I shy away from talking about it…even though I absolutely love my job. However, a number of friends have asked me for some sort of description of what I’m doing in Africa.Perhaps the fact that I’m applying my training to international development will make the story a little more interesting.So I’ll keep the technological part to a minimum, and I’ll go in stages…leaving you with plenty of exit points as I drill into the details.

Okay. The big picture. If there’s only two concepts you remember from this entry, I’d hope that they are “malaria prevention” and “long lasting insecticide-treated nets (LLIN)”.Those are the end and the means of the Tanzania National Voucher Scheme (TNVS), which I am involved in.TNVS, as the name suggests, implements a voucher system.When a pregnant woman or infant (the ones at highest risk of contracting malaria) visit a health clinic, the health worker issues them a voucher.This voucher can be taken to a retailer to obtain a LLIN at a subsidized cost (funding by USAID and DFID).The price paid by the beneficiary is very affordable, and I think it’s more of a token amount just so that they have some skin in the game. Besides malaria prevention, the program also aims to jumpstart the market for mosquito nets.This includes creating both an awareness of and the demand for mosquito nets.In addition to driving down net prices through economies of scale, there is a second strategy.Initially, the program partnered with a single net manufacturer.However, we are currently working on introducing a second supplier into the program. The hope is that providing the beneficiary with a choice in net type will create a little competition between the manufacturers.This will motivate manufacturers to make better nets at lower costs.Don’t worry, LLINs must be inspected and certified which ensures no sacrifice in quality.The desire to drive down net prices stems from a desire to make nets more affordable to low income families after the voucher system is removed.The hope is that the LLIN market will remain even after TNVS shuts down.If it all works according to plan…net manufacturers will be creating more jobs and income, retailers will also have an increased income from selling nets, and the general public will have an opportunity to better protect themselves against malaria. Okay, now for some of the challenges.I’ll give just two examples of the types of projects I have been working on.The first one is automated reporting.The second is market actor profiling.Grab a coffee!!TNVS is a nation-wide program with around 5,000 clinics and 6,000 retailers redeemingjust over 370,000 vouchers every month.MEDA TZ handles the logistics of the entire program.MEDA TZ only has about 25 employees in the office (there is also another 10 field officers with drivers scattered throughout Tanzania conducting training).It’s a great opportunity for technology to help ease the workload! In order for a program like TNVS to thrive, it’s important to know which locations are succeeding and which ones are failing.This feedback is extremely useful to learn from success and nurse weaknesses.It’s kind of like a strategy game.MEDA TZ keeps a pulse on the health of the program through weekly reports.Weekly reports guide field officers to the locations which require attention. Performance indicators in the weekly report include figures like the number of issued vouchers, the number of redeemed vouchers, and the percentage of issued vouchers which were redeemed.Manually gathering and summarizing this information for all the clinics and retailers can easily take a half day of work. Every week.Similarly, the payment report, which tallies the number of nets distributed and the money owed to the net supplier, will take a half day to compile.It’s done every other week.To put it in perspective, one employee (I think it was supposed to be me) can spend well over a week of every month compiling reports.My first project was to automate the process so that the reports could be generated by a button click and save a lot of time and manual work. But IT skills can do much more than just improve the efficiency of report generation. The paper voucher system suffers from a problem. The problem is its limited visibility of what’s actually taking place in the field.For instance, we are unaware when a clinic runs out of voucher stock and stops issuing vouchers to patients.We are unaware when a retailer stops redeeming vouchers because they have run out of nets.Furthermore, we can’t detect if a clinic worker and retailer are colluding together to steal nets – they could get together and make up fictitious beneficiaries to issue vouchers to and redeem vouchers from…and then keep the nets for themselves.The voucher system needs a way to extend its sense organs into market actor transactions. This was the motivation behind the eVoucher system.It is an sms based tracking system which documents market transactions.Clinic workers must use a cellphone (everyone’s got one!) to text MEDA’s shortcode when issuing a voucher.Retailers do the same to inform MEDA of a voucher redemption.A retailer will only be restocked with nets for voucher redemptions which were reported.A voucher redemption will only be successfully reported if its issuance was also reported.Basically, the system works…and we have information about the time and location of every issuance and redemption.Information which allows us to profile clinic/retailer behaviour.This is known as data mining, and it’s another project that I’ve been involved in.I create algorithms which try to determine when a retailer is out of net stock.I also create algorithms which try to determine when a retailer or clinic is engaging in fraud. Okay okay, I’m beginning to realize how incredibly long this story is.I’m curious how many people made it to the end.Anyway, I hope I’ve given you a taste of my work and satisfied some of the curiosities floating around.Let it be known that it’s not ONLY exploratory adventures for me.I work hard too!
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Diwali

Yesterday, Marie (my colleague, housemate, and honorary little sister) and I traveled to the city centre, home of Dar’s skyscrapers.Diwali, the festival of lights, has enticed us downtown with the promise of fireworks.We were on an adventure to find “the courtyard beside the Indian temple”.And although we have become quite talented at using creative landmarks to find our way through Dar’s unlabeled streets, there are still other challenges which can confront us on our journey.

For instance, this evening one of the streets we need to travel is unlit…pitch black unlit.But seeing that the darkness only lasts 100 feet, we decide to brave the abyss.A mistake.About 50 feet into the blackness, my left foot disappears into the pavement.Of course it has to be the unlit street which is missing a storm sewer cover. My entire left leg was swallowed by the sewer.My right leg and both hands hit pavement."Pole!" Marie hands me a sock and wetnap to help clean the dirty water off…then we continue on our way.

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I am in DAR

I’m in Dar es Salaam. I’m typing from my posh office in possibly the nicest neighbourhood in the country. It’s populated with embassies and residences for said ambassadors and their families. It`s my second day at work and I’m supposed to be reading background documents to prepare for my impact assessment job. I’m too distracted. This is the third country/ continent I’ve stepped on the past 3 days, Canada, England, now I’m in Tanzania!

So much is going on here. It’s busy, it’s noisy, it’s exciting, it’s beautiful. There are hustlers weaving in and out of stalled traffic, hawking hangers, cigarettes, and inflatable beach floaties all at once. Conductors hanging out of dala dalas (public busses) yelling out their destinations as people jump on the vehicle mid-motion. Ladies by the roadsides crouch by their deep fryers, flipping chapatis and vitombua (rice flour balls). This article written by a longtime resident of East Africa gives a vivid sense of a drive through Dar’s asphalt arteries.

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Chickens, Children, and The Call to Prayer


Chickens, children, and the call to prayer. These are the reasons I can't sleep. Nope, it's not because of deep philosophical matters. Just the practical.

The call to prayer is trumpeted from Islamic mosques five times a day. There is a mosque just down the street from my apartment which has provided me with a piercing education that one of these calls happens at dawn. Every morning. Recently, however, I have stopped waking up to the call and continue sleeping.

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