Several months ago, I planned to spend Wednesday in Moshi at the Kilimanjaro Centre for Community Ophthalmology, so that I could perhaps get a feel for the kind of work being done in an East African health clinic. So that morning, I parted ways with Katie around 07:00 and then hailed a taxi to get to the clinic.
I must say, I am impressed by the flagrancy and boldness of the locals in their negotiations with tourists. Prices are almost universally quoted at 4-5x above the normal price; the results is that often the amount one pays is the same if not more for how much one would pay in the States or Europe. It took me awhile to find a taxi willing to take me to the clinic for only double the normal amount ($6 instead of the normal 2 or 3).
The complex in which the clinic lies is quite impressive. It, the Kilimanjaro Christian Medical Centre, was founded by Christian missionaries about 40 years ago. It has since evolved into an entire health science center, with a teaching hospital, outpatient clinic, medical school, and other training departments and space for (mostly foreign) research groups.
When I found my ophthalmologist contact, I was a bit disappointed to learn that she had incorrectly written down my date of arrival by a day, so rather than go out with a team into the field, I would end up spending most of it at the centre. It proved to be an interesting day, nevertheless though. I spent a few hours on her grand rounds as she supervised residents and also had time to interact with her Tanzanian staff which I also thoroughly enjoyed. They nearly all had masters degrees and I found that we had quite a lot of things to talk about. During lunch I noticed that I also wasn’t the only mzungu there; I saw a few young residents from UV and a handful of other young, idealistic visionaries.
The most striking sentiment that I heard was one that has become increasingly more common for me to hear. Many of the Western doctors had also worked in Asia and they expressed a certain frustration with the work they’ve done in Tanzania. They said that Africa’s health problems are unique because of its relatively low population density as well as what they characterized as a significantly decreased sense of “work ethic,” or more broadly speaking, perhaps less driven towards the self-help route. Amazingly, each cataract surgery costs about $75 (almost all the supplies are imported from India); the clinic usually gets about $15 of payment from the patient. In spite of this, many people opt not to get the surgery. Generally speaking though the clinic was quite well stocked and the physicians sufficiently proficient.
Not wanting to pay a lot to return back to the hostel, I simply crammed in with the locals into a daladala. Interestingly, along the road from the hospital were a number of tiny shops selling coffins. It was quite eerie seeing them outside, just along the road as one left the hospital.
We were thrilled when Thursday arrived and, by midday, we finally made it to Zanzibar via a noisy dual propeller plane. What immediately struck us as soon as we arrived was the island’s Muslim population. Our guidebook suggested that perhaps around 90% of the island is Muslim and I would certainly believe it– every woman had her head covered
and some still wore a full nigab. Though we were a little disappointed in our hostel as it didn’t have quite the beachfront that their pictures online seemed to suggest, we figured that its prime location in the center of the island would be very conducive to making day-trips.
Stone Town, the largest town and capital of Zanzibar, is a fascinating city. It’s streets are unable to accommodate cars but not bicycles or scooters, so it is often necessary to hug one of the alley’s walls as someone unhesitatingly zooms by. Much of it reminds me of Venice, at least the eastern residential sections. Though a few maps exist of the city, it is unlikely one would even find one to be useful– few of the alleys are labeled and to find something in the city one must really just walk in that general direction and hope to find it. Shops are quite narrow and the owner often just peaks through a small opening in his huge wall of goods to speak with a customer.
One thing we are a bit exhausted of is the the innumerable touts that we encounter. We almost wish we could just be invisible– it is impossible to walk seemingly anywhere without some “friendly”individual offering to take us to his “favorite” shop. Worse, it makes us a bit jaded whenever we do encounter genuinely friendly people who simply want to meet and chat with foreigners.
To combat this ever growing problem, Katie and I while in the city speak to each other in Spanish and whenever a tout approaches us wanting to buy something from him, I speak to him in Polish and claim that my English fluency only extends far enough for me to be able to say, “No English,” all the while giving him an innocently huge smile. It has been fabulously successful.
On Friday morning we crowded onto a daladala to head to the northern-most point of the island, the village of Nungwi, where some of the best beaches and diving spots are supposed to be. It is interesting how comfortable we have become with our surroundings; namely, getting cramped in the back of a converted pick-up trucks ($1.10 one way, per person, 90 min drive), or seeing cows stroll alongside the road no longer surprise us.
We were thrilled when we finally arrived at the beach—the water was the clearest blue-green we had ever seen. It actually didn’t take too long to find a reputable diving center either. I ended up spending the better part of the next several hours diving off two coral reefs. What surprised me as well was the number of Slavs here. One older gentleman on my boat was from Warsaw and several of the other people my age were Slovakians living in the UK. The diving was superb except for the very strong current and choppy waves on the surface. By the time we finished, I was quite exhausted.
What has been most striking in the past few days has been how limited the “infrastructure” is. Very few receipts are ever given for financial transactions, sidewalks don’t exist, and roads are limited. Along the way to the beach, the bus was stopped at several police “checkpoints” and I saw a lot of bills being discreetly handed out by the driver. That night after we had gotten some food in Stone Town, to turn on the bus’s only light, there was no switch to flip. The daladala boy simply twisted two metal wires together. It is also quite sad to see how much trash is simply left alongside the roadway.
We had planned to spend our Saturday on a completely different side of the island, in the eastern village of Paje. We had made a mistake in not asking our hostel how much to expect to pay for the ride over there. Since hardly anything in Tanzania seems to ever run “by the book,” we learned later that we had been overcharged twice as much, though it still frankly wasn’t that much.
Pretty much all of Saturday was spent lounging on the beach and reading on some empty lounge chairs we had managed to find for ourselves. We also ran into the two Polish physicians that we had met on our safari several days prior.
Obliged to accept their offer to share a drink with them in the late afternoon, we returned to Stone Town in the later evening and made a dinner from various street-vendors by the wharf. Of particular note were these inventions they called “Zanzibar pizza” (bread filled with cheese, vegetables, and meat that was baked in a charcoal oven) as well as fresh-squeezed sugar cane juice that was also infused with spices and lemon!
On Sunday morning, we were struggling to find the Catholic church that we had passed by several days prior. When we started to get worried that it was only a minute or two before mass was scheduled to begin, I noticed that on one alley were several women who were walking with neither their heads nor their arms covered- nearly scandalous by the standards that we have seen thus far. We thought that perhaps we should follow them at a distance. Sure enough, they were Catholic and heading to mass as well. An interesting note about mass is that the church was separated by sex. We spent our final hours in Zanzibar taking pictures of all of our favorite buildings. Upon returning to the hostel, sweaty and dirty, all I could think about while showering before the flight was that Cairo would be having cool weather!
Tommy,
I’m jealous about scuba diving. It’s been awhile we did this together. Do you have any underwater photos?
Dad
Unfortunately no. One person in the group had a camera but he pre-set the focus for short distance photos (<30 cm). Next time!