Eight Days in Tanzania: The Tungamalenga Dispensary

The Hurley family (Randy, Kari, daughter Angela and 7 yr old grandson Wyatt) were in Tanzania 10 days before the medical group arrived to coincide our visit with Wyatt’s Christmas break schedule. We were able to visit Barnabus Khawage, the recently retired clinical officer at the Tungamalenga Dispensary. The new clinical officer is Dr Asajili Sanga; Dr Asajile was born and raised in Ilula Tanzania and is a graduate of the Ilula Clinical Officer training school. As it is here in the USA, it often is hard to attract health care professionals to serve in rural locations. In the USA, as in Tanzania, most training programs are located in urban areas and once finished with training, it is often difficult to attract health care professionals to practice in rural locations. One of the original goals of the Ilula Health Institute was to identify local students, train them locally then have them serve locally in rural dispensaries operated by the Tanzanian Lutheran Diocese. Mission accomplished: Dr Asajile is a great example of that philosophy in action! Tungamalenga is paired with Shepherd of the Valley Lutheran Church in Apple Valley: they recently completed construction of a lab at this dispensary.

Randy and Kari Hurley

Dr Asajile at Tungamalenga Dispensary

The recently constructed outpatient lab

Examples of lab tests available: (for comparison Tsh 2500 is approximately USD $1) UPT: urine pregnancy test; Widal test is a typhoid test; MRDT (Malaria rapid diagnostic test) and HIV testing are provided by the government at no cost

Meet Happy

 It is finally my turn for jet lag to kick in as I lay restless in my bed. I guess it is a good time to post to the blog. I’d like to tell you about Happy, the social worker at Ilula Hospital. Ilula Hospital is a faith based institution and is the reason for Happy’s pull to this place. She started at Ilula as a community officer and went back to school to obtain her bachelors degree in social work. I admittedly did not know much about social work in Tanzania and was inspired by how she leads and drives every decision with her super big heart. A very caring heart. She is compelled to advocate for the children and specializes in social work for children who experience abuse (sexual, physical, emotional, neglect).  On a typical month, she helps find a safe home for 15-40 children. Yes, each month! 

I had the opportunity to hop into the hospital vehicle with her and a few colleagues Meade, Diane and Katelyn. The vehicle fit 2 people in front, three in the middle row and one “seat” in the way back (the back did not have a seatbelt and Meade graciously took that spot and was an amazing trooper along an extremely bumpy ride). We drove about an hour and a half east of Ilula into the mountains, driving along a congested highway of truckers (and some monkeys!). Happy brought us to a region called Nyanzwa ward and we stopped to pick up the chief of police from Ruaha mbuyuni police station. Her name was Umpendo. The two of them have been partnering together since 2019 to educate the community about child abuse, the laws that pertain to it, and how to safely report. We continued another 30 min down more bumpy roads to the schools. The duo spoke at 4 schools (elementary and middle school aged) and educated the children with songs (No Touch-y Touch-y) and teachers (stern reinforcement of the Tanzanian law). We ended our day in jail. No, not locked up but rather to see Umpendo’s police station that she governs.

Happy is an important person at Ilula Hospital. Her services are needed in this community and is yet another way for Ilula Hospital to continue to serve its patients, including those who do not have a voice. She has a goal to return to school for her masters degree. When asked why, she of course brought it back to the children of Ilula area and how to better serve the hospital. She hopes a masters degree with increase her knowledge of Tanzanian law to better represent the Ilula children in court. In addition, she hopes to bring government supported research to the Ilula area, looking into areas of child abuse. 

Happy is all heart and a critical role to the Ilula Hospital team. I was so glad to be able to get a small glimpse into her work and share memories with everyone along for the bumpy ride to the villages. 

Shana

Heartwarming hospitality

 A group of us (Kent, Cindy, Jennifer, Alan and Diane) traveled to Ihimbo Dispensary (medical clinic) today.  We were joined by Dr. Petro, Secretary of Health for DIRA (the Iringa Diocese) and Kirsten Levorson, Director of Bega Kwa Bega. We were warmly greeted by staff and given a tour and an update of the current usage of the Dispensary. This was personal for Alan and me, since Alan’s parents, Will and Jan Carlson, helped fund the facility, which was expanded and dedicated in 2009. Sixteen years later, the rooms are clean, records are organized and the facility is well maintained. We were impressed.

As moving as the arrival at Ihimbo Dispensary was, the best was yet to come. Next up was a service at the church at Ihimbo, where pastors and many church members gathered to extend their hospitality and appreciation for having the medical facility available to them. Alan and I were truly humbled and in awe of their gratitude. We were treated to the gift of song by two different groups. At the end, our entire group was given gifts from the local people to show their gratitude. Next up was lunch at the pastor’s house, prepared and served with love by community members.

It is hard to put into words all the emotions of today. People are people, no matter our skin color, nationality or financial status.  To respect each other and show love and gratitude is a a gift. I am joyfully overwhelmed and pray to show love and gratitude to others as we were shown today. 

Diane 

“We live well together” - Meet Dr Mussa Nguva

This post is dedicated to Mussa Ngova and his role in patient care at Ilula Lutheran Hospital. As the solo dentist in our group, I. have had the privilege of spending most of the past two days in the one room dental clinic, with dental therapist Mussa Ngova. 

Immediately, as we had our first few discussions and patients, it was clear that Mussa is engaging, witty, and very knowledgeable. As the hours continued, I observed his deep compassion and empathy for his patients, and his skills as a clinician. He has been at Ilula Hospital since 2014, and upon asking him what has kept him staying there so long, he answered simply: “we live well together.” I was a little confused at first, I had to clarify… he then explained that he has a great relationship with his coworkers and the leadership at the hospital, that he is happy to be a part of the team caring for his patients alongside the other department providers. He spoke also about his passion for oral health education; in Tanzania, preventive dental care (routine twice yearly exams/xrays and cleanings as we have in the US) is not available/practiced, rather patients appoint only when they are having pain. And so we both agreed that “patient education is the prevention.”  He desires to do more in person outreach to the surrounding villages to educate on oral health and prevention methods, but he said the funding to do this (paying for transportation, gas etc) just isn’t available right now. 

As we spent the morning with his patients, I observed Mussa functioning as a dentist would in the US - examining, diagnosing, and then completing treatment (local anesthetic and extracting teeth) and writing prescriptions/giving post op instructions. But unlike in the US (with a team of reception and dental assistants) he also charts, sets up and cleans up after each patient, and sterilizes the instruments. And he does ALL of this for every patient BY HIMSELF - he is the only person in the dental clinic. This alone is a feat - it is grueling work without a break - and he had a very steady and busy stream of patients both days. On top of this, include the emotional drain of caring and calming each very anxious patient; he spent time re-assuring his patients and was empathetic. Side note - yes! in case you were wondering, fear and loathing of the dentist transcends cultures 😂.)  We were both also curious about many things, and asking each other lots of questions, and this definitely added more to his plate.     Lastly, and of most impact, is that Mussa’s working with vastly different resources and technology than what you would find in a typical dental office. 

And yet, Mussa did this all with SO MUCH JOY. And I kept thinking, he has worked hard caring for patients and “lived well together” with the Ilula Hospital team for 10 years - what an amazing health care provider, with such an incredible contribution to the Ilula community.

Arrival

 We’re here! Our long travel day to Tanzania went very smoothly. Flying from Dar es Salaam this morning, I was amazed by the view of the Tanzanian countryside. Driving from Iringa to Ilula was equally picturesque, with lots of activity along the road. We were greeted warmly when we got to the hospital. We had a great tour of all the buildings and were brought up to date on the current projects going on. I can’t wait to see and do more tomorrow. The week is packed with opportunities to get to know the people who live and work here at Ilula Hospital and the Iringa area. 

There will be lots to write about as the week goes on, but getting a good night sleep tonight will be the best way to kick off this Ilula adventure 

Diane 

Today’s the day!

At long last, the departure day has arrived and I am a little jealous. Shana has done a marvelous job organizing. If something does not go as planned, it won't be her fault! As it turned out, almost everyone departed from MSP. Katie flew in from Vegas for a short stay with Uncle Ken and Auntie Birdie, Cait arrived to fly out with the group and Jenn changed her flight to leave with the group. They will catch Cindy in Amsterdam at Ski-Pole. Then off to Dar. Here is a photo of Team Shoulder to Shoulder:

Returning to Ilula

 Good day fellow travelers and other readers. This is a small experiment to make sure that I can post a blog - it's not something I do everyday! I am looking forward to reconnecting with my friends at Ilula Lutheran Hospital. I first visited Ilula Medical Center in 2006 as part of a mission trip with my church, Lord of Life Lutheran in Maple Grove, Minnesota. 

As a health care administrator I was curious about the life and responsibilities of Ilula's administrator. What I found convinced me that health administrators could contribute to Ilula's success in serving their population. After many conversations with Global Health Ministries, we launched Global Health Administration Partners (GHAP) in 2007 with Ilula as one of two pilot programs to test whether we could add value. 

Since that time and through the considerable efforts Shoulder to Shoulder and Ilula's board of goveners, Ilula has grown to be a full-fledged hospital. GHAP has continued to travel to Ilula every few years, walking with the hospital leadership to study issues such as inventory management, medical records management and governance. We have also participated in a few of the Minnesota - Ilula Medical Conferences.

I'm looking forward to seeing the progress Ilula continues to make and to meeting again with Dr Saga and Alamu Kikoti in particular, as well as my fellow travelers from Shoulder to Shoulder.