Over the first obstacle

This week wasn't quite as planned. Even now I am typing this during the second power cut of the day – thank goodness for lap-top batteries. I am also unable to use my modem so am publishing this on another computer. Hey ho - This Is Africa!!

We did our first 'solo' 50 mile round major shopping trip to Dodoma on Saturday. Although you can buy a range of basic items, fruit and vegetables from the daily Mvumi market' for other things, such as Cornflakes, meat, fish and hardware, it is better to go to the 'big' capital city. The single fare is about 90p each – not bad for 25 miles and a two hour journey!!!! We pre-booked seats which was just as well as the bus is crammed with standing passengers for most of the journey. Unfortunately you either have to catch the 'luxury' bus at 6.45am, or you can have a lie in to catch the only other bus of the day, 15 minutes later!!!!

Prices for locally produced goods are low. We bought a yard rake / broom, a large shopping bag and a 'brush' (a bit like a bunch of twigs) for about £1. A pack of cuppa-soup would have cost £2.50, but was quickly returned to the shelf. We have learned the term 'a Dodoma day' as it takes far longer to do things like shopping than you expect – and nothing seems to go to plan. On our return journey (the 'other bus') there was an unplanned stop for about 30 minutes as they replaced one of the tyres – one of the other passengers calmly told us that the same thing had happened the week before. The roads are a grave-yard for tyres (and suspensions, and battery boxes)

Since then Malcolm has had three more trips to Dodoma, and has the bruises to prove it:
• on Sunday we went to the Diocese's farewell presentation to the Education Officer who had worked in Tanzania for 13 years. As is normal she was presented with a number of 'Kangas' which are large square of coloured cloth and form a popular part of Tanzanian dress having many purposes such as an over-skirt, shawl, carrying babies. No doubt Irene will try one before the 6 months end
• On Monday the Florence Nightingale day was postponed as the District Medical Officer died over the weekend, and Malcolm attended the funeral with a group of managers from the hospital. It was a typical African Catholic ceremony. We arrived at the house for the mass sometime before 1 pm, stood in the sun during the service until about 4.30pm. Left early (missing the opportunity to view his body) and following a brief stop for refreshments on route to the grave-side on his farm, left before the end at about 6.30pm. Some of the interesting points were:
o the women sat completely separately from the men throughout the service, and looked very smart in their 'kangas'
o at one point at the grave-side a woman came from the back of the crowd of about 2000 people, wailing. Malcolm was told she was not the widow but as she made her way forward the other women joined the wailing. Perhaps that's why the men sit somewhere else?
o Malcolm was surprised that what looked like an iron mesh used to make reinforced concrete was placed over the coffin. Later he was told that the coffin would be encased in concrete to prevent the body being stolen for witch doctor magic – not a problem Malcolm had to face at any authority he worked for.
• On Wednesday Malcolm visited an Inspector for the National Social Security Fund (the equivalent of National Insurance) to discuss the hospital's debt of over 100 million shillings, half of which is penalty for non-payment. Although 'only' about £45,000 this is a fortune for Tanzania ) over 10% of the hospital's annual budget) and beyond the capacity of the hospital to clear. We had a good meeting with the Inspector being as helpful as he could be. Not so long ago Malcolm would have been in his position meeting with someone who owed the Council Business Rates or Council Tax, so what the Inspector said was very familiar. He seemed pleased that the hospital now has a professional accountant who he was sure would find the money. Malcolm explained he had left his magic wand in England!!
In between visits to Dodoma Malcolm has started looking at next year's budget, with a meeting with all Heads of Department today. The financial year starts on July 1st, and as the hospital will become a Designated District Hospital there will be major changes to the funding which he is slowly coming to grips with. In addition he continues to look at how the security of the Hospital's financial procedures could be improved.


Irene has started on two tasks. The first is to sort through crates of clothing given to the hospital, so that they can be given to members of the village by the hospital chaplain. It will also free-up a room to become the medical store for the hospital. One thing she has learned is that no matter how well-meaning the donor is not everything given is of use. The tradition in the village is to wrap new-born babies in kanga's so small baby clothes and baby-grows are of little use. Neither are knitted hot water bottle covers, though surprisingly knitted jumpers for babies are a prized possession, even though there is a risk of over-heating. There is also a box of pillow cases – which is a shame as Tanzanians do not use pillows and there are none in the Hospital. The hospital has the same problem with some donations of medical supplies. Tanzanians generally have small hands and narrow arm, so large gloves and canulas are of little use, yet cost a lot to ship into the country. It has reminded us of the importance to ensure that gifts are appropriate for the recipient.

Her second task is to organise the new filing room for patient's files. This is a gargantuan task as there must be at least 50,000 files which have been filed according to about 3 different filing methods which now have to be brought into one. Fortunately she is doing the organising, other staff should (repeat, should) do most of the sorting.

So – what will next week bring:
• tomorrow, Malcolm is on 'call'. Not, he hopes in case he needs to carry out an operation, but in the event of some other civil emergency. He's not sure whether his Emergency Planning training in England will be too much help here.
• on Sunday St. Andrew's church is holding a building fund-raising day where Malcolm will present a gift (speaking in pigeon Swahili, maybe) from Emmanuel Church, Chesham
• on Monday is the next routine Magistrate's Court hearing concerning the debt of 100 million shillings to the NSSF. Someone from the Diocese should attend to represent the Hospital.
• the postponed Florence Nightingale Nurses day bash is on Monday
• further work on preparing the Hospital's budget for submission to the Diocese Board on 28th May
• and Malcolm needs to find a dentist to replace a bridge – Oh joy!!!!!