How to tackle Poverty?

I have just come across on the Reuters AlertNet of a blog titled : What's the best way to improve developing world health?

The writer Peter Apps mentions several ideas that are constantly being debated upon; in the end he quotes the Liberian health minister Walter Gwenigale who said that he knows what would make a real difference in his country -- and it is the one thing Western donors will not fund. He told Reuters that what he really wanted was outside funding so he could pay doctors enough not to quit and go overseas -- and hopefully to tempt back medical staff who fled during the war and are now earning better money in other countries.

It is a problem that some experts and aid groups feel will get worse if the European Union introduces its "blue card" scheme to encourage skilled migration, which could also drain trained medical staff and nurses from poor countries.

In a way, I was mislead by the title of the article as my hopes were high to read a miraculous recipe, some innovative idea. Nothing yet. It prompted me to the following reflection:

Perhaps the problem has to be stated differently: health can not be isolated from education, housing, food security, employment, micro-finance, literacy... Poverty has to be tackled as a whole - with its many components - and governments of poor countries have to be the main protagonists of their own development. They have to be the core signatories of their own Millennium Development Goals. Goals that are realistic and that they assume full ownership, responsibility and accountability for. With the strong support, participation and even monitoring by the rest of the world - the rich countries and international organizations - within the frame of a world alliance.

Centro del Muchacho Trabajador - Quito- Ecuador

Images speak... Lunchtime at the Centro del Muchacho Trabajador where hundreds of mainly indigenous streetchildren and their families gather every day to receive a free lunch. Sometimes, this is the only meal they have for the day. The CMT also provides many other services to these communities: education, health, adult literacy, day care center, recreation and of course food and nutrition. Kids learn at convenient times, when they take a break from their street activities. Take a look at the pictures by clicking here.

Liz in Bukoba: "The Disabled Outing"

Let me start this communiqué with the Walk of Shame. I was walking home from Mugeza (the Bukoba suburb that sits on a hill about 8km away from the city) last week, my cheeks burning partly from the 88 degree heat but mostly from the shame that I was feeling. I took the dalah-dalah (bus) up to the disabled school and was unable to accomplish any of the things that I had set out to do up there. Because of the language barrier it was impossible for me to organize the children, either individually or in groups! I hung out for about an hour, chatting (mostly just greeting everyone and laughing and smiling and giving high-fives) but to get anyone to listen to me proved impossible. Even the teachers who speak extremely limited English could be of no help. I was so embarrassed and upset that I was on the verge of tears for the first leg of my march back to the city. I had two hours to sort things through in my head all the way back to Bukoba and part of my calm was delivered to me by an amazing woman who spoke no English at all.

I met this woman about half way down to Bukoba town and we fell into step. I was happy to have a companion for the remainder of the walk as I was feeling very lonely and sad and once we had exchanged all of the pleasantries that I know in Swahili and I had told her my name (she never told me hers) we had a series of comfortable silences that I found as inviting and peaceful as a hug from my Momma. When she had arrived at her destination which was a few minutes from my own, I had the equivalent of 2 dollars for her in my palm as a shook her hand and thanked her for her company. She has no idea how much I appreciated her, but considering a well paid housekeeper makes around 20$ a month here, I think I gave her some indication.

When I arrived at Raza's home we agreed that one wonderful and rewarding project for next Sunday would be to take all of the disabled children on a picnic at the beach if they cleaned their dorms and bathrooms first on Saturday.

Upon arrival at the disabled school in Mugeza on Saturday we were greeted by a wonderful teacher who told us that the other teachers were in the city for the day renewing their teaching certifications and that they would be gone all day and the cleaning could not happen that day. I pretended to be disappointed and even a bit angry but thinking quickly I struck a deal: when the teachers return, they must recruit the students to help in the cleaning of the dormitories and the restrooms (concrete blocks with a squat hole) and I will return the following day and inspect their work and if I am satisfied I will take them all on a picnic at the beach. The teacher said it would be done so we left.

Sunday morning I was told that the transportation that had been arranged would be at Raza's petrol station at 9am. I asked if this meant 9am Bukoba time or New York time and Raza laughed and assured me that although the driver was African he would be sure to let him know that there was a mzungu (white person) waiting for him so that he should not be late.

At 11am we are finally in the truck en route to Mugeza. I am sitting in the front of a flat bed truck that is used for shipping cargo with the three orphans Hussein, Abdullah and Hamza (who like to go everywhere with people and are the most active people in Bukoba!) and I fear for my life. The roads are very bad but the driver is speeding out of control and I know there are no shocks or seat belts in the front and I cringe to think of what the disabled children are going to do in the back! We get to the school and none of the teachers or students seem very surprised that their transportation looks more appropriate for moving crates of soda than disabled children, so I pretend that I am okay with it as well. It seems that this is the way that they are hauled around when going anywhere together. Laughable when you think about 'short buses' with those elevators that go down to the sidewalk and the slowly come back up again. Have you ever felt like just picking up the wheelchair- or crutch-bound person and sitting them in the bus in order to speed things up? Well that is exactly what we did, and while some of them were not easy to lift, most of them are small children and I could just follow the lead of the others and hoist them up onto the flat bed and direct them to a relatively safe area, much less time consuming than those elevators! Most could get in with a small boost and climb up but several were just passed in like sacks of potatoes.

I inspected the dorms and the restrooms and they were very clean with all of the beds made and the mosquito nets tied nicely. Although the women's dorm still had a faint smell of urine the teacher said that that was permanent and she didn't know what it was from (it was worse the last time I was there, so at least there was improvement!) and I said that I was satisfied so we loaded the kids into the truck along with the Head Mother and Father who mentioned that some of the children were still on holiday.

I then came up with the brilliant suggestion that we count the children and there were fifty-six of them plus the Mother and Father and the teacher and I sat in the front with the three boys. I am not ashamed to admit that I was too chicken to ride that flatbed. Fortunately because of the weight of the load and the bad roads, the driver was forced to go very slowly (1st gear) all the way down to the beach (and on the way back our load was so heavy again that he had to go slowly or the truck would not have made it up), whew!

We got to Spice Beach at around 11:30 and stayed until 2pm. Most of the children were screaming happily for the entire duration of the outing. The boys got naked and jumped right into the waves while the girls took about an hour of edging far away from the boys and then slowly jumping in. It was so beautiful to see them smiling and laughing and splashing and I was very glad for my life guarding certificate because, lest we forget, most of these children are severely handicapped. That did not matter and they did not care and so, keeping a watchful eye, I did not intervene at all. One of the blind children (there are about a dozen) was sitting in a chair and I just grabbed his hand and made him walk with me at his own pace while I held his hand right into the water! He was so cute and laughing and happy, it was so much fun that I found myself laughing along with him. I did the same thing with the other blind children and it was a blast. No language skills are necessary to explain what they are walking towards and how it makes them feel.

I was so proud of these children and their bravery as well as their natural ability to take care of each other and themselves. They hung their own we clothes out to dry, loaning each other wet shirts and clothes for swimming to keep maximum clothing dry. Also it was so sweet to see who takes care of whom, for example there is one girl who is mentally handicapped and she is the guardian of these two girls who are blind. Another girl who has just had eye surgery and now can see is always giving a piggy-back ride to another girl who has extremely stunted growth and deformed legs and takes a long time to get around on her crutches because she is about 2 feet tall. Another thing that was so amazing was seeing the children who have club foot or other leg deformations running in the sand! They have a hard time getting around on land because if their toes are pointing to the sky and completely externally rotated they are walking on a very sharp point at the end of their leg that is like a heal. This is painful and typically they cannot put all of their weight down on that leg (in many cases it is both legs that are affected) but on sand this problem is much less severe and they were running around. It doesn't hurt to fall on sand like it does to fall on packed earth so all of the children seemed a little more carefree.

At 2:30pm the driver came back to the beach to get us (because I made sure that he knew he was supposed to be there at 2) and we loaded the kids onto the flat bed and headed over to IZAAS where some of the older orphan girls along with 2 of the women who work for Raza and Mama had cooked a lovely dish of pilau with meat and rice, veggies, potatoes, onions and tomatoes and spices as usual.

Interestingly the disabled children have very different eating habits from the orphans. Partly because they are used to being catered to due to their various disabilities and partly because they are fed regularly and are never worried where their next meal is coming from. Another thing that I noticed was a group of sulky girls who sat at the back and didn't eat, some of them eventually decided to start crying. It took a long time for it to be explained to me that these girls are vegetarians and would not touch the pilau. I was surprised but impressed and began to wonder what kind of gourmet food they are served up at their school that they can afford to be so picky. Mama cooked them some plain rice and gave them bread and fruits and the salad that was served to everyone and then I distributed the sodas and the children were happy (sort of). If you want to make a child happy, give them soda.

Around 6 we loaded back up to return, the children seemingly grateful that such a tiring, if not exciting, day was coming to an end. I caught a glimpse of us in a store front window and it was so comical looking that I was not surprised when the police man pulled us over at the permanent police check point at the outskirts of town. He asked where we were going and the driver said "Mugeza". "Carry on then." As though he saw nothing wrong with 58 people riding the back of a flat bed truck up a hill where there are basically no roads! To me we looked like a cross between someone shuttling Mexicans across the California boarder (only we kept the tarp on the truck open) and really bad accident waiting to happen.

It was such a positive experience for the children and for myself I was on cloud nine the entire way home. Much different from my walk on Friday! It turns out that the last time they had a group outing like that was a full year ago. I felt so badly for them when I heard that and it is such an easy thing to organize. It only took a little initiative and a very little bit of cash. The total cost for a day at the beach including truck and driver, lunch for 60, petrol for Ruta's vehicle and soap and cleaning supplies was less than 150 USD. Best money I have ever spent. Seriously, I feel like if they only get this type of opportunity once a year, they will remember it for a long time!

One of the projects that I would love to organize for the children is the purchase of a vehicle similar to the one that we used to bring them down to the beach. It would be between 10 and 15,000 USD and enable them to go on outings whenever the teachers (who loved the distraction and change of scenery as well!) decide to take them, they could go to town, or visit other disabled schools, go to the beach and the fisheries, I feel like it would be a very worthwhile project.

Liz in Bukoba: "The Disabled Immediate Needs"

After spending quite a bit of time up in Mugeza at the disabled school and getting to know the staff and children quite well, I have narrowed my focus to some very worthwhile projects that are tangible and varying in size and difficulty to achieve. I think that this is the best way to go about it because I really have no idea what my capacity to raise funds will be (I have never tried it before the efforts for this trip) but I hope to succeed because these projects will be very impactful on the lives of many children who do not have it easy. There is one girl who I have gotten especially close with whose name is Antoinette. Her story is so sad and relates the difficulty that these children have been suffering since birth. Although some of them have better relationships with their parents than this particular girl, she is a very good example of what happens here when a child is seen to be handicapped in any way (mentally or physically).

Antoinette crawls. Her family has no interest in purchasing a wheelchair for her because they have decided that she is not fit to live. When she was a baby and her limbs began to grow crooked and she did not start walking her parents were confused but ignorant and so they did not seek medical attention (more common here than not). Once they figured out what was going on with her, they decided that she was not fit to live and so they stopped feeding her and caring for her. She was dirty to the point where she had to have some of her nails removed due to fungus as well as starving and had been eating grass when she was brought to Raza (it was unclear by whom, I will assume some sympathetic villager as is often the case). He decided to sponsor her entry into the disabled school and that is where she now lives. He mentioned to me that she never smiles and if I could get her to smile that would be an amazing accomplishment in itself. Well she is such a cutie, and while it was difficult to get her to smile at first, she warmed up to me eventually and now she smiles almost freely at me when I greet her. I think it may be my Swahili that she is smiling at because it is so bad and very crudely accented, but whatever works, right?!

There are 4 children at the school who need wheelchairs but do not have the funds to purchase any, and so they crawl. Even the ones who have wheelchairs have very old ones that have been abused over time and are breaking down, but at least they can move around upright. I would like to get wheelchairs for the children who have to crawl like Antoinette.

I was mistaken when I said that there were a handful of blind students. There are twenty-eight and more are expected next year. Not all of them live in the dorms at Mugeza and that is why I underestimated their numbers. The school is actually an integrated school with disabled and able bodied children who live locally. I now know that several of the blind children live at home but there are a fair number living in the dorms. For these 28 children there are 4 functioning Braille Writers. The teachers, Mussa and Tabu (the one who was at the beach outing with me) who live at the school can both read Braille and have been trained to teach the blind, among other specialties. I loved watching Mussa read the Braille with his eyes: that was so cool! The Braille writers that they currently have were made in Watertown, MA but he mentioned that they are now making some in South Africa as well. Each student goes through about 4 packs of Braille paper per school year. The government, which is supposed to be running this school, is also supposed to be supplying them with paper, writers, etc. But from my observations, there this school is very under funded and it is not adequate in supporting and furthering the lives of these most vulnerable of children.

In truth they are not miserable, and it is nice to see them enjoying themselves and hanging out with each other, taking on leadership rolls where they can and always lending a helping hand to one another. When I dropped them off after the picnic they were happy to be home and were singing to me as I walked down the road. It is just sad to see that less than a mile away there is the school for the Deaf and Dumb that is run by nuns (not the government) and is SO MUCH better. The children at Mugeza live in two dorms one for the boys and one for the girls. At lunch they eat ogali--wheat or maize paste that has the consistency of cream of wheat cereal cooked without enough water that is sticky and gummy (in fact that is what it is!). It is also perfect for food fights, but they never play with their food (I guess when you have to eat with your hands, the temptation is somewhat diminished) and they get red beans with that. At dinner they have rice with the same beans. Twice a week they have mtoke (the green cooking banana that I have described) with beans and then the same for dinner with rice. I was surprised with the quantity of pilau leftover after the outing but they are in a very different situation than the orphans, because they are fed on a very regular schedule and although it is not gourmet food, it counts.

The acquisition of a flat bed truck for the IZAAS program could really benefit the disabled school as well as the orphans. Raza has assured me that if something is purchased for the school itself and kept at Mugeza than thieves will come and if I return in a year to see what has become of the truck, all that will be left is a shell. He is realistic on most counts and, because I have no frame of reference, I would be inclined to trust his judgment on that. He employs a night watchman who sits in front of these apartment/shops and said that a truck would be safe there (he has two of his own SUV's in the same location) and that it would be used for the right purposes.

The need is so great that there are many more people who can be helped by operations and the purchase of crutches but for several reasons, for example the unreliable medical care here coupled with the complete lack of aftercare, I feel that these three projects would be a great start. These are what I see as the short term needs of the school for the disabled:

• 3 wheelchairs

• several more Braille writers (25 would be ideal but I have no idea how realistic)

• hundreds more packages of Braille paper because they never go out of style

• and a flat bed truck for outings to add fun into the lives of these children

Who's with me?

Liz in Bukoba: "The Home Visits"

Last Friday, after the giant feast at the orphanage, I decided to visit some of the children's homes. It was very interesting and so this past week on Friday again, when they are well fed and energized and are excited because they have no school, I told them that I wanted to do the same. It was decided that I would go to a particular neighborhood Kashai, which is located behind the airport and where several of them are from.

When we finished our Friday feast, often the only full and nutritious meal that the kids know they can count on during the whole week, we began the home visits. As usual there were some hangers-on from other hoods who were just there for the trip and to hang out: I am having so much fun with these kids! I know that I came here to spend most of my time with the disabled children up in Mugeza, but it has been so difficult for me to organize and communicate with them because of the language barrier that it seems as though I am spending much more time than I had originally anticipated with the orphans. I have been planning a large outing with the disabled children on Sunday so if all goes well (or not, which always makes for better stories somehow!) my next article will be about them.

Raza chose Kashai because it is known as a rough sort of place in this small, peaceful town. I wonder how he would feel about my old 'hood in Brooklyn. My overall impression of Kashai is that it is not so bad: It seems that Raza chose the children with the worst living conditions for my first 4 visits (as I told him he should) leaving the more typical situations for my own discovery. I do not want to create the illusion that these children are living in the lap of luxury, this is not the case at all, they are all in desperate need of help and that is why they are a part of the orphan program at IZAAS. These hoses for the most part had 2-3 rooms and half were made of mud bricks sith tin roofs while the other half seemed to be more permanent structures. It was nice to figure out which children were siblings as I asked each to pose with their families in a room of the house. Since I have always seen them in large group situations, occasionally smaller groups with the girls, it was hard to tell who was related. In several situations the family was too large to fit everyone in the frame from the range allowed by the house so I had to stand on a piece of furniture or outside of the room while taking the picture.

Most families have more than four children with extra children around the house making it hard to decipher where they belonged, but one thing is for sure, there was very little adult supervision, if any. Seeing a group of three- and four-year-olds hanging out by themselves behind a building or under a tree with an older sibling, maybe two years older, but charged with watching them is a very common occurrence. This also clarifies another question that I brought up in an earlier article about the small, avoidable injuries becoming major disabilities, for example the hand burn victims. Siblings and peers just don't watch as closely as a parent would, although they make fine short term babysitters they do come up with some very typically childish games that are risky at best. The other day I was in a very large truck (more on that later) driving down a bumpy highway and there was a 4 year old child who had made a kind of wagon by cutting open one side of an old plastic oil can and attaching a rope to the handle. He was dragging his baby sister who was a few months away from walking age along the road, the 'highway.' When the children noticed the truck coming they ran and he forgot to pull the can/baby so she was sitting in the middle of the road as we were barring down on her and finally she was pulled away.

Back to the home visits. These children are living in such severe poverty that it was very sad to see. They are laughing and skipping and can't wait to get home to their families, but I can see why the IZAAS orphan program is such a positive experience for them. I saw several of their peers just hanging around with nothing to do or causing trouble, while these children that Raza has 'adopted' into the program are very well behaved and have a positive environment to hang out in after school and where they make friends who have similar interests. In one of the homes that I visited there was a front room that contained a desk and a chair, but besides that house none of the children have a place within their home to study. They will either be outside or not studying. None of them have electricity, so night reading and study is impossible.

At one of the homes there were two adorable sisters at home with their mother and older brother. They were sitting in a front room and I asked for the grand tour which included a back room separated by a very dirty curtain. In the back room there was a little boy sleeping (the brother said "baby is sleeping") on a mattress on the floor but then I noticed a tiny lump in the bed that was pushed up to the other wall. Tiny little baby who was 3 weeks old. So cute! Of course when your house contains two young girls, two boys, one teenager and one toddler as well as a mommy and a tiny baby, the sleeping arrangements become very interesting. It was hard to figure out but one thing is for sure, none of these children have the luxury of a bed to themselves. I know how I felt growing up about the impossibly of sharing a room but I could not imagine ever being forced to have my entire family share my room (although the room that I called my own from age 3- 19 is actually bigger than any of the entire houses that I have visited here in Bukoba!).

Of the houses I visited this week, all had at least one parent or guardian at home, except for one situation. Annette's house was the last house that I visited and I met her adorable younger brother who was sitting on the stoop. Their house is very dark and part of a single structure with multiple entries which presumably house other families. There is a rear exit to the area that they would call a bathroom and shower but as in all of the other situations it is just a muddy patch with a semi-private enclosure of hand-woven dried palm fronds and a gas can full of water next to an empty large plastic bowl. This house seemed very dark and the ceilings were extremely low. The two children were the only ones in the family and shared a private room while their parents had their own room. There were a total of three beds and three mosquito nets. I was impressed so I asked where her parents were. It turns out that her father was just admitted into the hospital in another city four days ago (most likely HIV/AIDS) and the mother went to accompany him. "When will they be back?" I asked stupidly and I was met with a blank stare. Clearly they are gone for an unknown period of time. What will you do in the mean time for food, money, etc? Well I was proudly escorted back outside the house where I had not noticed but the brother was selling things on a table, mini-piles of 4 tomatoes for 50 cents and they were beginning to wrinkle. I can only assume that the mother left them with some things to sell, quickly approaching worthlessness. How will these children fend for themselves? I bought a bunch of tomatoes and distributed them to the 3 children who were my escorts home. I also gave the little brother the extra pack of roasted nuts that I had bought for all of the children who were escorting me around (at one point when I saw that one of the orphans whose home we had just visited had later set up a low table where she sold these little roasted peanuts in newspaper rolls for five cents a bag). I went back later in the day with two huge avocados and some almonds (from Dubai duty free!) and the equivalent of five dollars specifically for food for them. Two days later I discretely gave her another two dollars and told her not to tell any of the other children. She may have because later that day I received requests for money from two more of them which I denied. It may just be that they know I am leaving soon and so this is the time that they make requests ("Leeza! Give me my bicycle!" "Give me my radio!" are both demands that I have heard in the past 48 hours but typically they are very understanding, they are used to being told "No").

It is amazing to see in action all of the good training that they orphan program has provided for the older children involved. They are extremely responsible for the younger ones and those who are natural leaders have plenty of opportunity to shine. For the girls, a group of six of them were recruited by Mama to help make the food (same style pilau) for the disabled outing that I sponsored on Sunday. They did a very good job and were rewarded by being able to eat as much as they could of the food once all of the work was done. They cooked, cleaned, boiled, chopped, stirred, distributed and cleaned every dish and the entire room after the outing. They have not only learned good manners and school smarts but cooking and cleaning as well. My final impressions about the IZAAS drop-in orphan program is that it caters to a huge need here in Bukoba and it is a very well run program. The children learn amazing life skills and create bonds with their peers who have similar interests. They are all attending the program out of their own free will and each have at least one sibling who does not attend, proving the fact that they could just as easily stay at home or hang out on the streets. Raza helps the families with money for these children's school fees and provides them with a positive, healthy learning environment and they love it. I feel so lucky that I have been invited with such open arms into each one of their homes, their families were very welcoming and happy to have had pictures taken of them and not one of them was at all unhappy to have me come into the house and look around. It was also a great bonding experience between myself and the children to have me come and see where they live, instead of just being some strange woman who plays Pictionary with them in the afternoons!

Liz in Bukoba: The Word Spreads

A few years ago in the middle of Raza's campaign to help the disabled when he was most focused on the Jaipur limb project, he helped a man from a bush village (actually about 10, 000 people in said village but very spread out with universal language) about 200 miles away from Bukoba. This man had been crawling for his entire life due to an early amputation necessitated by a snake bite. Needless to say his fellow villagers were extremely surprised to see him walking upright into the village upon his return. They had a huge celebration and everyone was in awe of his new leg. None of them had ever seen anything like it, let alone heard the word prosthetic. On Tuesday the same man came with a big group of disabled people from the same village, and an able bodied man who was put in charge by the head of the village. Both the man in charge and the first man to receive the limb could speak fluent Swahili and were herding the group of people around for days.

Besides carrying a letter from the head of the village explaining that the man in charge was responsible on behalf of this village elder and extending warm greetings and thanks, these people carried nothing with them. Not a bag or a bite to eat. It is not a rich village and they could not afford to pay for their dalah-dalah ride to Bukoba but they somehow arranged with the driver (or waited until they found a driver who was satisfied with the arrangement), that Raza would pay for their fare upon arrival because he had been known to help the disabled. Keep in mind Raza had not heard of their coming or plans at all.

Upon their arrival, the leader paid and was happy to see the man that he had helped walking proudly into his shop after so many years. One woman had elephantitis of the legs with huge feet and calves. Another woman had a severe club foot and was using crutches that were for a child- they were so small! In fact when she heard that she could have an operation to fix her club foot she actually requested that the foot be amputated so that she could have a nice new limb like her friend! Raza and I strongly discouraged that, and we tried to explain that you are better off fixing and keeping your own body parts. A third woman had a very short leg and crawled in crab-like walk because she never was given crutches. Her smaller leg is perfectly formed, just miniature. It ends at about the knee of her regular sized leg. One man was holding a 6 month old baby who had swelling of the brain so severely that she could not hold her own head up. The final woman was an amputee due to gangrene at her mid-calf. She used a stick diagonally across her body wrapped around her involved leg in a hop-sort of walk. The final person to come in was a woman holding a club foot baby. Once her husband realized that the baby was handicapped he left her and now she is living with an old woman in the village.

Raza is sending them all to Kagondo Hospital to see what his friends there say about their conditions. Their accommodations and food will be paid for while they are here, along with whatever surgeries they end up needing be it in Kampala or Nairobi for the more severe cases. The word has spread even to the far away villages that there is a man named Raza who runs a program called IZAAS, that will help the disabled who are in need.

Liz in Bukoba: More Pictures

Dear Reader: if you are interested in seeing more pictures of Liz in Bukoba then please go to: http://picasaweb.google.com/palmsforlife
Visit this site on a regular basis as we will be adding more and more pictures as they come in.

Liz in Bukoba: A Typical Day

Well, as anyone who has ever lived in Africa can tell you, the days here are very varied and interesting. Matthew and I were discussing how when he lived in New York for 2 years he became bored very quickly and couldn't wait to get back to Africa for some more action! It is a different kind of excitement here: there is plenty of waiting around because little things take much longer to do, however the excitement happens all around you every day. I can see what he means by being bored in New York. There is plenty of action there but it is predictable. Here in Africa the days are never predictable and there is always something exciting happening. In response to an extremely popular question I will try and explain my environment here in Bukoba as well as daily life here to the best of my ability.

Each morning I jog from my apartment down the main street of Bukoba town down to the shore of Lake Victoria and around the lake. The climate here is ideal: each afternoon it reaches about 85 degrees (F) and has yet to dip below 75.

The locals eat Mtoke which is also know as a cooking banana. I know what you are all thinking, "plantains!" Well that is what I thought too, but could not have been more wrong. The skins of these bananas are bright green when they are ripe but they are not very sweet at all. Instead they have the consistency and flavor that is probably best compared to that of a potato. The Tanzanians cook them in water with spices and serve them with a few beans. Typically a huge bushel of them costs around 5 dollars and feeds a large family for a week. They eat their food off of one communal plate and with their hands. There is also an abundance of fruit and veggies for me to eat, but typically the locals stick to Mtoke because it is cheap, readily available, high in energy and quite filling!

Raza's wife Mama is an amazing cook and they have me over for lunch or dinner almost every day to ensure that I have at least one hot meal. They are both of Indian origin but both are Tazanian natives so the food is an amazingly delicious mix of Indian and local African. There are several types of bananas eaten here, a typically sweet one that is cooked like a sweet plantain similar to the Mexican and Cuban style as well as a medium size banana like in North America but a bit darker in color and finally the mini bananas that I love so much as well. There are also several types of oranges, mini and large all very sweet and yesterday when I went to Kagondu with some of the disabled children they were harvesting pineapples and they were sweeter than anything I have ever tasted: full of flavor with none of the sharp pineapple bitterness that I am used to. They were about 50 cents for 3 of them! I eat at least one passion fruit every morning, they are small and sweet and delicious and also come in several varieties, as well as the delicious tomatoes and gigantic avocados that I also eat daily. There are fish in the lake--tilapia to be exact--and chickens abound making eggs readily available. It is amazing to me the variety and quality of the food that they can prepare here considering that most people are cooking over charcoal and wood burning piles using one or two pots! As I mentioned every day here for me has been different and while I am not trying to achieve a regular schedule the rhythm of life is so much different here that it has taken some getting used to!

The mornings are usually spent taking care of personal matters, for example laundry (by hand and dried on a line), email (twice a week but over a connection as slow as molasses running uphill when it is working), going to the market to buy fruit or veggies (every two days because I have neither fridge nor Tupperware to preserve things in and my outdoor kitchen ensures that the bugs help themselves). During the daytime so far I have been doing different things based on Raza's suggestions and I will later write about the goings-ons at IZAAS during a typical week. Basically I spend that time observing what goes on around the IZAAS medical project which has a rhythm to it, although it is chaotic, and takes up most of my day. At around 5 on week days I will head over to the orphan center and play some games with them, typically the boys chase the tennis ball that Matthew was kind enough to leave with me, while the girls hold my hand and touch my hair and work up the courage to smile at me and laugh with me. They are very shy girls and the boys are for the most part, crazy. They are so cute and I have become very attached to them all, especially the one whose houses I have visited.

Their circumstances are all very unique but for the most party they live with relatives in tiny and not child-proofed homes without electricity or running water. In all cases there were other children at home during the times of my visit who were of school age but not attending school due to lack of money and the necessity of working to provide income to feed the family. The orphans are supported financially by Raza and the IZASS project for school purposes but not all of the children attend his program. The smart and dedicated ones do. Tin roofs and mud walls are the norm and there are absolutely no frills or personal space. Most sleep two to a bed but some have more, and there is not one situation that I have seen where the road that they travel on to get to these homes is not covered in garbage. Some good news is that they seem to all have mosquito nets over their beds due to a very successful educational campaign that occurred here a number of years ago. The other good news is that these children have Raza's program to go to every weekday afternoon in order to have a positive influence and a clean safe and positive environment to learn in and to play in. They have been so receptive to me and every day that I do not come by the drop in center I hear about it from them and their teacher. Amazing how far the game of Pictionary can go! Because my Swahili is not very good and their English is about as proficient, Pictionary has become our favorite game by default.

Every few days I go up to Mugeza, where the disabled children's' school is and I also head over to the "deaf and dumb" school. With the exception of a handful, the disabled children were with their families until yesterday when they returned to the school, there was some kind of holiday, but that worked out quite well because I was able to establish a rapport with some of the girls making me seem like an old friend returning to hang out with them as opposed to a stranger coming to tell them what to do. For the remainder of my stay in Bukoba I will be heading up there daily in order to do physical activity with them based on their individual needs. Mostly it will be basic exercises for those who can and just playing and having fun rolling around in the grass. Although I have not helped the disabled children with their physical needs as much as I hoped that I could by working with them for a month, I have seen what goes on behind the scenes of IZAAS and have been working with Raza on a plan that hopefully will improve their lives for the future.

My evenings are very quiet, on the nights when I am not eating with Raza and Mama (they tend to eat quite late so I opt out of dinner more often than not) I am in my apartment by 8 or so in order to beat the malaria mosquitoes to the punch (I hear they love you more when you eat bananas so I think I would be in trouble if I didn't!), then I write in my travel journal and plan out my blog articles and I spend some time reading under my mosquito net before I nod off. My apartment is part of the building that Raza grew up in and was left to him by his father. Also a great philanthropist, Mr. Fazal was a family man and built 4 large apartments in addition to the one that his family lived in growing up, all on top of the storefronts that he owned. At one point there were 22 people living in the apt. that Raza and Mama now occupy alone.

My personal pad is above the drop in center (medical and orphan, they are adjacent) and is quite huge. There are 4 large rooms all bigger than my current room on Eldridge Street and as wall a toilet room, outdoor kitchen, and a balcony. I am giving the impression of luxury and although it is spacious I promise I am not living like a typical Tanzanian but it is really more like the shell of an apartment. My first two weeks here I had serious difficulty sleeping, although I would read to try and get my mind off of the activities of the day, there was never enough distance from the activities of the day and the journaling for me to get my mind off things before sleep. I try to journal and plan my articles early in the evening now so that I can read and get into my books. It makes it easier to sleep: I find the need here so overwhelming that if I try to sleep thinking about the activities of the day and what is to come tomorrow, and try to work on my grand plan for my return, I cannot sleep there is too much going on in my head. I have read 3 books in my two weeks on the road, it is the only way. For those of you who are concerned, for the past few nights I have finally gotten some sleep, so I think my body has adjusted to the time zone and I have finally figured out a way to control my mind. It was hard to take in everything at first, but now that I have started to work on a plan for the future with Raza and narrowed my focus to what I can personally achieve to something tangible which is easier.

So that, in long, is what I have been doing on a daily basis here in Bukoba. There is alot of 'hurry up and wait' that goes on and makes the days frustrating because I am so goal oriented and I am only able to achieve half of my daily objectives in each 24-hour period, but I have been very active with no leisure time thus far. Although I don't mind working 7 days a week for a short while it will be a hard pace to maintain so I intend on making up for it at the end of my trip. With Raza's blessing and guidance I have begun planning for a safari (the Swahili word for "journey") where I plan on seeing much more of beautiful Tanzania! I hope I have painted a vivid picture of my daily life here in Bukoba, surely a hard task as everyday seems completely different from the last.

Liz in Bukoba: A week at IZAAS

What goes on at IZAAS in a typical week? This program, founded by a businessman named Raza Fazal, is very multidimensional, but essentially there are two major divisions: the orphans program and the disabled project. Every week so many things happen here that it has taken a while to step back understand the flow of the whole place. I will do my best to describe what happens and how the aid is distributed on a weekly basis citing examples from my own personal observations over the past two weeks.

Raza owns the building that he lives in (I live there as well in an apartment in the back) and it is above several store fronts. He owns a hardware shop, a travel agency, and a cellular phone distributors on this premises. He also has other very successful businesses in other locations around town. The mornings, he says, are dedicated to these ventures: take care of your businesses first and in the afternoons see the needy people who drop by for various types of assistance.

In the back of the building next to the orphan drop-in center there is the IZAAS Medical Project Center. Having heard of Raza's program, many villagers from the surrounding Kagera region come to see the doctor here every morning. Because the IZAAS program has helped so many disabled people it has gained a sort of notoriety with the locals. Consequently, people who could easily be treated elsewhere end up here simply because they don't know what to do or cannot afford to go to the government hospital.

Last week, for example, I saw a mother and child at the medical drop in center from about 10am to around 2 in the afternoon. The child had a very large and severe burn on her leg from a cooking incident (very common here because stoves and fires are on the ground) and should have been taken to the government hospital for immediate care but they sat and waited at the drop in center until someone saw them and directed them to the right place. I can't imagine sitting around patiently waiting for help while one's daughter had a huge open wound on her leg covered by a dirty wrap, slowly becoming infected. This is one of the reasons that there are so many disabled people in this part of the world, often a simple injury becomes much more severe, in many cases permanently crippling due to delayed, absent or insufficient care. Even when the villagers do know where to go to receive a certain medical treatment, lack of transportation, and thus time, into town often prevents them from doing so.

In the afternoons people drop by the hardware shop and request financial aid from Raza and his helpers. His right hand man, Ruta, listens to the requests of the various applicants and then makes his recommendation to Raza who reviews each situation and most of the time follows Ruta's suggestions as far as how much to give each applicant. Their methods are precise and well thought out.

On Monday of last week, for example, as I was standing in the shop a woman came in requesting about 95 USD in aid. She has five children aged 13 to 22 her husband has died of HIV/AIDS and she wants money to send the children to school. After reviewing her case Ruta decides that they can give her about 25 USD and Raza makes this the offer. Everything is recorded. In several of these cases that I observed that the applicant was turned away to go back home and get proof that the aid that was given previously (some are first time visitors but it seems that most have a history with them) went to the proper place in the form of a receipt or report card.

The next woman to drop by the shop was disabled. She walks with crutches and has a prosthetic limb. This limb was paid for by the IZAAS program in 2002 and is now broken. Raza will pay for her transportation (by bus known as the "dalah-dalah") as well as for the new limb: a total cost of around 200 USD. She receives full payment for her claims because she is helpless and lives alone. Several more people dropped by the shop with similar claims as the first woman, the most common scenario being that they need help paying school fees for their children. Although they cannot all be compensated for the total ammount that they have requested, if some type of proof is provided regarding their needs and their responsibility in using previous funds properly, they are never turned away empty handed.

I was very impressed with the formality of the process and clearly there is a reason why Raza is such a successful business man. He runs his charitable organization with the same honesty and diligence that he runs the other ventures. Some of it is by instinct, but most of the flow of money is based on factual information. Ruta keeps every record in a giant book so that it is a known fact and recorded how much of the of the businesses' and how much of Raza's personal money is going to help these needy people. It turns out that a very significant amount, somewhere around 100, 000 USD every year!

Along with the typical day to day drop ins to the shop and the medical center, there are also 'special events' that occur regularly. Every Tuesday for example, you will find about 30 to 40 people hanging around outside of the shop starting at 11am ranging in ages from a few months old (babes in arms) to around 80 years old. They are all HIV positive and they come for in-kind food donations that is distributed by Ruta at around 3pm. They prefer to give them food as opposed to money because they know that at least one good meal a week can make a huge difference in their health, regardless of their age.

Fridays are a very special day at the orphanage: Mama, Raza's wife and some other women, both paid and volunteer, work all morning and into the afternoon to prepare a meal for all of the children It is uncertain what, and if, they have been eating during the rest of the week, but at least once a week they are very well fed. Cooking for 65 children seems like no great task, especially when these 65 eat like they are 150. They are literally starving for nutritious food and it is obvious by the way they dig in! The way here is off of communal plates and I have never seen 5 children sit around a giant heap of steaming pilau (rice, meat and veggies stewed all together with spices: delicious!) and eat and eat and eat until they send the youngest back with a bare plate for more. Most of the children have about two platefuls polished off with the rare treat of a glass full of soda. I ate less than 1/5 of what they were each consuming and was very full.

Saturday the drop in center is open early and Sunday the children are mostly on their own, occasionally another orphanage invites them to join in a communal meal. Up at the disabled center the weeks are much less varied, the children have class and they are fed but they get no exercise or serious stimulation except for the rare times when there is the occasional visitor or when I come up to play with them as I have been everyday now. They sing songs and hang out and are happy but there is not too much going on in their lives. It is fun for me to see them as I always get an extremely warm reception as do all visitors. This week I will be bringing up some friends that I have met here: my neighbour and an

Irish girl just to get the children excited and make them feel like they have more playmates than just me!

A marketplace of shops, an orphanage, walk-in clinic, center for the disabled and home -- these are the many different things all going on in Raza's humble building with its dedicated helpers. As you can no doubt see, there is so much work over the course of a single week that goes into assisting the many people who are helped by IZAAS.

Liz in Bukoba: Initial Impressions

So here I am in amazing Bukoba, Tanzania! It is beautiful- the earth is bright red and everything around it is green and lush. Huge banana trees, flowers, and plants dot the landscape. The fruit is amazing, passion fruit is the big thing here, you can just bite into the skin (or cut the top off if you are me!) and then drink out the seed/juice mixture. The pineapple, mango and oranges are also delicious.

The people are extremely genuine and friendly; they love to greet one another as they pass. When I jog in the morning on the shore of Lake Victoria I have to say the Swahili greetings about 100 times! It is so funny. They love watching me run- I think they are mostly looking at my sneakers. Here the typical footwear is flip-flops or any type of sandal.

I have had the opportunity to meet Raza, the man who started IZAAS. He is a true visionary. He started the project 10 years ago working with the disabled. Originally he was mainly focused on getting artificial limbs for amputees. He expanded to helping people with many types of disabilities but has since narrowed his scope to children on the advice of a Dutch physical therapist who came to Bukoba for a 2 year stage as a volunteer to help IZAAS (she left in 2003). The work he does is amazing- he is truly committed to the children he helps

That is all for now but there will be plenty more to come. . . . .

Liz in Bukoba: Nameema

I am walking with a well dressed woman, Jonio, from where the dalah-dalah (taxi-bus type thing) has dropped us off, in a very close suburb of Bukoba. I follow her and her daughter, also well put together, clean looking and well fed down an unpaved rocky path towards their home. Earlier today they had come into Raza's shop requesting financial aid from IZAAS and I asked if I could do a home visit. From my experience here it seems to me that they are what I would call middle class Bukobans, by appearance only, and I want to see how they live. We walk for about 15 minutes downhill. Jonio is pointing out the various highlights of this neighborhood, the school, her friends' houses etc and we arrive at a small house. Her son Dedas is sitting on a rock listening to a disc-man, so I conclude that I was right, middle class. Nameema greets me warmly and comes over to shake my hand. I ask to see the house and she graciously invites me in. Through a cloth curtain outside door we enter a room about 6x6, with a straw lined floor and they spread out a cloth for me to sit on. We all sit and start chatting in broken English and very broken Swahili about life in general. After a time, I ask to see the rest of the house, there is another cloth door behind them and I am curious. I stick my head in (there is not enough room to walk in) and it is another room, about 6x4 with one large bed and one smaller bed, some plastic containers and some wooden shelves. Nameema explains to me that her sister and her sleep on the small bed, her mother and other sister on the big bed and her brother on the straw of the adjacent room. I ask about the father and they laughingly mime and explain that he is a drinker and he is abusive and they are happy when he is not around, like now. Where does he sleep?

I follow Nameema into an adjacent structure, also with low brick walls and a tin roof, this part of the house consists of two rooms, one has a bed, with standing room all around, and the other is what she laughingly calls the sitting room, there is a wooden futon frame, but no mattress. Now she is laughing hysterically and so is her sister, Beth. She decides to continue the tour in a very MTV 'Cribs' fashion. She takes me to the bathroom, the shower, a woven straw corner with what looks like and old gas can full of water (this suburb is quite far from water supply and I see several people trekking around with these gas cans) and then I get to see her garden which has newly planted pineapple and cassava sprouts along with some other beautiful plants. This is not a temporary home, the garden tells me that she plans to live here until they give fruit. (pictures to follow)

My tour is finished and I have to ask what they are laughing about because I don't see anything funny about this situation, but they do so I stop asking and laugh with them, so that they don't think I am mean, but I feel more like crying. This is a very typical situation and they are not poorly off. All 4 children have finished primary school and at least started secondary school, so they are making it work. Nameema is the most articulate, happy and beautiful youth that I have met she is also disabled. Nine years ago she was hit by a car and she had to stay in the hospital in Kampala, Uganda for 6 months. In the past 9 years she has had 5 surgeries and she still uses those silver crutches with the handles (not sure what they are called). She broke her femur in 4 places and did something very severe to her lower leg that I could not figure out but there are two huge parallel metal rods sticking out from her leg that each contain a series of pins, so I assume that they are holding her leg together.

Jonio, her mother, came to IZAAS because Nameema has to go back to Kampala for (at least) 2 more surgeries and she needs money for the trip, doctors and a visa. What happens when you are living at the poverty line, making just enough money to house, school and feed your children and suddenly one of your children needs expensive operations and trips to another country? How can they manage the expense? There is no way, this is where IZAAS came into play. For the past 9 years Raza and IZAAS have been paying for every trip, doctor's visit, visa and surgery for Nameema, otherwise, without the proper care, her leg would have had to have been amputated.

Smiling and requesting that I come back for another visit tomorrow, Nameema walks with me as far up the path back to the road as she can. The going is tough, it is uphill, rocky and winding, so she turns back after a few minutes. I wave farewell and turn to watch her make her way, slowly and carefully down the steep path. I am so glad that she will get her funds for her trip to Kampala but I wonder after 9 years, what is the best expected outcome for her? Is it possible for her to ever walk again unassisted? Without the proper aftercare I really have no idea, so I can only hope that with the money that she will get from IZAAS this next operation will be the one that cures her...I am doubtful, but hopeful at the same time.

Liz in Bukoba: The Disabled

The disabled children live about 7 km from Bukoba in an area called Mugeza. There they have very basic facilities, no frills. There is also a 'Deaf and Dumb' school very close by, operated by IZAAS. Unfortunately, the children do not have access to organized exercise or physical therapy. There are a few doctors who volunteer for Raza and his IZAAS program: Tanzanians, Americans and Europeans alike. They do everything from screening and registration with the medical system to actual operations.

Amazingly, there have been several cases where the child has been disabled for years, deaf for example, and due to lack of medical attention and money the families have no idea, or the ability to find out, that a simple operation can cure them! The doctors have screened over 200 of the deaf children alone and there are several dozen who are on the waiting list for an operation which is expected to cure them! It is very difficult to find the funding and Raza puts up his own personal money, along with whatever he receives from the occasional donation that comes in to help these children. Raza's system is very well organized and he has budgeted that he can pay for 3-4 of these children's operations per month. This is in addition to the immense amounts of money that he allots to various other needy cases each DAY! He is truly an inspiration and lives a simple life according to my standards but EXTREMELY well for the standard of living for locals here. He has been a successful business man and has continued his late father's way of living to help the needy.

It is difficult to imagine being disabled for your entire life and finding out that there was a simple operation that could cure you, or at least improve your life dramatically, and not being able to afford it. A few hundred dollars couldn't even get you IN to most of the doctors' offices in NYC and here it would cover the transportation cost to Dar es Salaam or Nairobi where there are major hospitals, along with the entire operation and prescribed medications! Sadly though, even after the operations have been a success, there is little to no after care available. However, they manage to get along better than before (walking with a limp is much better than being wheelchair bound due to a severe case of club foot- VERY VERY common here for some reason).

There are about 75 children living at the disabled center at present. They are SO sweet and friendly and love talking to visitors. Their spirit is amazing and inspirational! I love going up there and playing with them, it is really heart warming.

Liz in Bukoba: The Orphans

Between the recent history of the Rwandan genocide and the war in Uganda there were many displaced children that Raza, the founder of Izaas, encountered coming to his program for the disabled. Some of them were orphans and all of them were very needy, but not always in the same capacity that he was used to helping. However, if a child came and the need was great, he began to assist in whatever way possible.

Tanzania is famous in East Africa for its peaceful history. Other regional countries look to it as an example; this is one of the reasons that there are many refugees here. There were many displaced and vulnerable children in Bukoba due to the wars in neighboring countries and the city’s proximity to the Ugandan and Rwandan boarder. Raza was like a father figure for these children and he helped them either locate their families or funded transportation to a city where they had relatives. Sometimes he even housed them himself.

Raza now has a very basic house with bunk beds and a room for cooking where only children in extreme need are housed. Even children who are not orphans come to him for help. They may need assistance with school fees, may have been abused (not very common here in TZ), or may have parents infected with HIV/AIDS (VERY common here in TZ).

The orphan program is now what can best be described as a drop in center for vulnerable children. There is a large classroom-type setting with desks and a chalkboard and there is a teacher who comes every afternoon (Raza pays the salary) that helps them catch up on their lessons, gives them some moral coaching, and gives them a safe and reliable environment to meet at every day. Some of them have parents who have died from HIV and AIDS, some of them have one parent alive, some of their parents have left or been killed by accidents or infections or any number of reasons.

It is therefore difficult for the families to send all of the children to school. Most of these children are years behind because they had to drop out due to lack of funding. It costs about 200-300 dollars to send one of these children to school for the entire year, depending on if it is primary or secondary education. This includes school fees and the cost of the uniform, as well as books. (I remember spending that on a pair of high heeled shoes that I have only worn twice!) Often if there is a child who seems very promising and is dedicated to their studies Raza will try to find a way to fund their schooling so that they can continue after primary school. Sadly the opposite is true for those who do not show the same promise. Can you imagine how many people you know who would have had their education taken away from them if they had not shown much promise by grade one?

I was privy to a discussion about 3 of the boys who are extreme cases and housed in the orphanage, Hussein, Abdullah and Hamza. I spent the entire day with them and Matthew, another Izaas volunteer and employee of the World Food Program posted in Uganda. Like Matthew I fell in love with the boys. Over dinner, Matthew was talking to Raza and Mama (Raza’s wife) about these boys and they seemed to have decided that Hussein is not very smart and they will not be able to continue to send him to school. He looks to be about 10 years old and the others are around 8. Matthew, who has taken special interest in these boys, insisted and then offered to personally pay for their schooling if it would be possible to organize the enrollment. He has about 8 children enrolled in school currently! He agreed to transport them to wherever they could be enrolled. Martin, his driver for our trip from Kampala to Bukoba, a silent observer to all of our activities up until that point, said that he would help the boys by finding somewhere for them to live in Kampala so that they could attend a good school there. That gesture touched me so deeply that I almost cried, right there at the dinner table. This is how people are here. They will put themselves out to help someone in need. If they can do anything at all they will do it. It is beautiful.

There were about 60 orphans at the drop in center today. I can only imagine what is in store for them, hundreds have been helped and hundreds have not. I asked them to sing a song for me and taped it. They LOVE being in pictures and on camera and are so used to digital photography that they ask to see the photo right away!