MAASAI HEALTH SYSTEMS
16714 91st Ave. E.
Puyallup, WA 98375
a tax exempt 501 (c)(3) charity
NEWSLETTER # 49 October, 2016
October 2016
I have been in Tanzania now for 5 months. The experience of working here has been extremely variable – rewarding, anxiety producing, intimidating, overwhelming, joyous. I was told in advance that it would take 4 months to feel like I was worth having on the staff. After 5 months, I am still not sure that I have reached the stage of being an asset to Selian Hospital. Some days, I feel that I made a difference in the patient care and was valuable to the hospital. Other days, I feel overwhelmed and useless. Selian Hospital has no intensive care unit so all these horribly sick people are on the medical ward. It is still hard for me to decipher when the problem of uncertainty and difficulty in treating these critically ill people is due to me not knowing enough and when it is that our resources are so limited. I know that having a good clinical laboratory that could do a wide variety of tests including cultures would make my job much easier, but it hard to not take less than stellar care personally. I will tell you more about adult care in the next newsletter.
What I really want to tell you about is the Neonatal Intensive Care Unit (NICU which is pronounced “Nick-You”) at Arusha Lutheran Medical Center (ALMC). In addition to salary support to help with retention of surgeons, MHS is helping underwrite the NICU baby care. Some the babies come from families with the money or insurance to cover the cost (by Tanzanian standards, very high cost, although the cost is low by US standards) of NICU care, but many don’t. In addition to this, the decision has been made at ALMC to not charge for babies born at Selian Hospital and then transferred to ALMC for NICU care. This is the only NICU around so all of the sickest babies in the region end up here. They provide a very intensive level of medical and nursing care for Tanzania. This includes intravenous fluids and medications, nutritional support and oxygen/positive pressure respiratory support, but not ventilator-type lung machines. While the technology available in the NICU has improved dramatically in the last 2 years, the staffing and technology for full ventilator support is not available.
I want to introduce you to Anna and her Mama. Anna was born on September 6th of 2016 at an estimated gestational age of 30 weeks. Babies born before 37 weeks of gestation are premature. Anna was almost 2 months premature. She weighed only 1.09 kilograms which is 22 ½ ounces (1.4 pounds). The average baby born in Tanzania weighs 7 pounds.
Anna lives in an incubator for now. This provides the warmth and protection from germs that she needs. She has 2 tubes going up to her nose. The one that wraps around her head is a type of oxygen tubing called nasal prongs. She needs extra oxygen because her lungs are not mature enough to be efficient at absorbing oxygen from room air. When she gets older and her lungs mature, she won’t need that. The other tube is a feeding tube. Mother’s milk is pumped through that tube to provide the needed nutrition. Baby Anna is too young and weak to nurse. That will come later.
Anna’s Mama provides the milk and also participates in the day to day nursing care. If Anna goes home with any special type of support, Mama will be able to operate machines and do the special procedures that may be needed.
Anna is one very small example of the care that MHS is supporting this year. As always, MHS has no salaried staff and our only expense is this newsletter. Your tax deductible donations go directly to the project. I thank you in advance for your support.
Don Rowberg, president, Maasai Health Systems.
Below is an excerpt out of one of Don’s recent letters added to MHS by ‘editor’ Byrna:
My work days have a lovely start. Every morning at 7:30 the staff meets for chapel.The liturgy is matins, Sala ya asubuhi, The chaplains start right on time. The congregation doesn’t. The attendance at the start is about a quarter of the attendance at the end which is pretty African.
The speakers are sometimes the chaplains and sometimes hospital staff. They are all inspirational. At least they sound that way, not that I can understand what they are saying. It is all in Swahili so I know about 5% of the words. The typical homily sounds something like, “You …. because ……. this …… God…….we….three etc.” The ellipses contain 95% of the words.
The reason I like chapel so much is the singing. Imagine going to church where the whole congregation is in the choir. They sing a cappella harmony. It is fantastic and not like anything I have ever heard anywhere else. I can’t hear 4 parts. I think the men and women sing the melody or harmony. Their three part harmony sounds so different from Euro-American harmony. My musician sons would be able to hear it and know what they are doing differently. I don’t know, but it is so African. On top of the harmony, some male or female descants are thrown in.
Some hymns are imports from the German/American Lutheran hymnal. “Yesu ni rafiki yangu” is “What a friend we have in Jesus,” translated into Swahili. Other hymns are pure African. Most are sung all together. Some are antiphonal with the two halves singing different parts. There was one call and response hymn during communion that a staff member just started singing. She belted out her flawless soprano part and the congregation would respond in 3 part harmony, of course. It was one of those exciting, shivers-down-your-spine moments. Absolutely fabulous.