The Village of Shimbwe - Health Caravan Day 4

Set in the foothills of Mount Kilimanjaro the bus ride to Shimbwe offered stunning views of the mountain we would be climbing soon. 100's of people are already waiting to see a doctor when we arrive in the village. We have rented the facilities of the local church in Shimbwe to run the caravan. I was running HIV tests today and the second one I ran was positive which really caught me off guard and I was crying. The patient received counselling and follow-up, however, it was still a bit shocking. Steve, a medical student from Tanzania, was nearby and I asked him how he maintains his composure with so much sadness around him. He agreed "it is very sad" and he found himself crying over a sad situation yesterday. Steve and Karen became friends when he helped her with Malinga, her adopted son. When Karen first brought Malinga from his orphanage to Moshi (en route to Canada), Karen was struggling with helping Malinga deal with his new surroundings, a new mother etc. and Steve spent some time with Malinga and was a huge help. He is a kind-hearted man who will make a compassionate physician. He plans to climb Kilimanjaro with us as the assistant for our camera man, Gary Kibbins, who is helping to film the documentary of the journey of the Tanzanian women with HIV. The film will be called "The Women and the Mountain".

Today we met an impressive young woman from Norway. Evelyn is a social worker who has been living in Tanzania for a year helping build schools and works with a local NGO (non-governmental organization) called Mnjeni, that helps poor people from the area of Shimbwe to access transportation for health care. Evelyn has a good grasp of the local language and helped us organize the crowd of patients in Shimbwe today.

A man came to the clinic with vitilago feeling very self-conscious. The pigment he had left on his skin made him look like he had eyeliner on and a goatee pencilled on his fact . Unfortunately there is not much we can do for him and I can only begin to image the stigma he faces in his community.

One woman came today with four children looking to escape her violent home. Her husband beats her every time he drinks. Her home is peaceful until he consumes alcohol.

The pharmacy is busy every day of clinic and it was particularly busy in Shimbwe filling 1500 scripts that day.

Many people come to the clinic complaining of 'pain pain' - their whole body aches. They work hard digging in the earth to plant food for their family and carry goods on their heads so it is not surprising that their bodies are sore and tired. It seemed we could have used a massage therapist at the clinic. A chiropractor from Canada joined one of the past health caravans and he worked long days helping deal with all the aches and pains.

After a long day in Shimbwe, we went back to Moshi for dinner and experienced and there and the power was down in the town. We went out to an a Italian/Indian restaurant for dinner that was no affected by the power failure since they cook their food over fire.

When we first arrived in the town of Moshi we were told it is a wealthy town which was hard to believe, but after being in Shimbwe we now understand. It is wealthy by African standards because many Europeans, Canadians and Americans (aka Mzungus which is a term used in East Africa for a white person) have set up missions here and brought their mzungu dollars with them to share with the community. The tap water in Moshi is 'safe' to drink thanks to a combined effort between the Tanzanian government and several European countries, primarily Dutch. The Catholic church has a large presence in Moshi and there are many western style restaurants.

The contrast between those of use who have come to the clinic to work and those that come for help is stark. Today a woman came for HIV testing. She has 5 children, no husband and no family. When I attempted to give her an HIV test I was unable to get any blood. She was hungry and dehydrated and she had a baby attached to her, fortunately breastfeeding. We pulled her aside and gave her a meal and some water. I was unable to eat my own meal in front of her so I gave her my lunch which she prechewed and shared with her baby. Half of the day is gone and there are still >100 people lined up waiting in the hot sun to see a western doctor.
There is so much poverty and illness, at times it seems hopeless, but then we look at the smiles on the faces of the people around us and the hope in their eyes and we too feel hopeful. Even the HIV+ patients are happy when they realize there is hope for them.
On his 90th birthday Nelson Mandela said the only regret he had looking back on his life is that he did not see the HIV epidemic coming and was unable to prevent it. He wished he had done more. While we are here, counselling, educating, testing and treating for HIV and raising money for the center so the work continues, I feel we are working for Nelson Mandela, one of the greatest human beings to walk the earth.