Update from Tom Feldbauer

Our friend, brother in Christ and pharmacist volunteering in Northern Tanzania near Arusha at the pharmacy in the Karatu Lutheran Hospital wrote this lengthy email to his wife, Pam.  He copied me, our pastor and several others.  It is funny, insightful, innocent, heartwarming, heartbreaking and sweet all in one.

Please keep Tom and his family in your prayers that God continues to walk with him in service, love and life.

Jambo Mama – I think that would be close to the Swahili for “Hello my Wife/Our Children’s mother”. I hope you are feeling well and work was OK this week. Is your weather hot yet? Any rain? Hopefully George is not having to mow our yard too often.
Friday started out cool but gradually warmed up nicely. I missed 7:10 am bus by about a minute so I started walking to the hospital. Obviously I am very recognizable, because the “later bus” driver stopped and picked me up along the way. After church (always in Swahili) every morning, I sit listening to the Doctors’ clinical reports which can continue for over an hour. They report patients treated\admitted the previous evening\night. Each short diagnosis\progress report is given in English (very quietly and with a bit of an accent). All responses and discussions regarding the patient’s care or anything else on the mind of the staffers is in Swahili. I still don’t understand any of the Swahili, but Thursday evening a child was treated for a lower arm fracture. Mother said no impact\accident caused that injury, but child told Doctor he had been beaten by his mother. Long discussion then resulted during clinical meeting and reporting Doctor (who occasionally spoke in English) said child should be kept in hospital even if just to protect him, otherwise more beating may occur causing more serious injuries and child may have to return for more treatment. I don’t know how that discussion ended, but afterward I asked Doctor Henri, the med student teaching Doctor, if a report to police would be necessary\appropriate. I also told him it is a law in U.S. that Doctors must report if they believe child abuse may have occurred. He said a report is not required here. I told him that perhaps asking the tribal leader to tell the mom to stop child abusing could protect this child and possibly prevent her from beating other children or having the Doctor tell her that her family may lose this child (or other kids and so much of their future lineage) if abuse continues, just might make her decide to stop. He did not respond to my suggestions. I presume child abuse is common here in some families and he may not think a Doctor can stop it. I heard a second story Friday regarding endangered children – On my way to the pharmacy from that clinic meeting, I passed the TV in the public waiting area. It is the only time I have heard it playing in English. It was the BBC playing a U.S. report that the U.S. is expecting about 60,000 children to try to illegally cross in from Mexico this year without any accompanying adults. A U.S. reporter interviewed a head U.S. border guard in a certain Texas\Mexico border area and the guard said they are facing dramatic increases in attempted entry by unaccompanied children, some children have been reported as being between 2 and 4 years old. He said it adds a lot to their other guarding challenges, by needing to find children before they die while trying to illegally enter and then housing them until they can arrange deportation. The reporter said some South American teenagers have recently been arrested because they were thought to be leading\assisting some of these very young children in their attempts to cross into the U.S. My questions include: Were those teenagers involved because they could make money from the children’s parents “by helping their children cross over”? If yes, is that a unique form of parental desperation or is it child abuse via disrespect for the child’s safety – such as “here’s money, now take my kid to a better life and if they die along the way, Oh well”.  Thank God our children have you, a very special care-giving and loving mother, Pam! Especially since they both have chosen to cross out of the U.S. for at least a while. Say “Hello” to Bob and Mary for me if you talk to them
and also “Hello to Jessica and Greg”. I hope Jess feels better and Greg is healthy. In case Jess can’t read this message, please ask her to add this goal to her Human Rights efforts of the future – “An Urgent Request that all countries, world-wide, make regulations that require any Doctor who examines a child and believes that child has been abuse by someone must report those exam results to the police in less than 24 hours after the exam”.
The rest of Friday I worked non-stop in pharmacy storage area (about 2\3 size of your pharmacy) from 10 to 4 pm, putting away items the pharmacist (Daniel Sullen) brought from the supplier yesterday.  Daniel placed pharmacy order 2 weeks ago and recently supplier said they would not prepare it until July because they are “doing their annual inventory counts starting this Monday”. Daniel took public bus and went to supplier on Wednesday and begged that they prepare all they could promptly. They said OK if he came back tomorrow with a truck they would get some of it ready. So Daniel stayed overnight and hospital “borrowed a truck and driver” from the Lutheran district school office in Arusha to enable Daniel to pick-up that part of his order. Daniel said he and driver arrived at hospital on Thursday about 4:30 and unloaded the med boxes, a microscope, 8 boxes of exam gloves, some other supplies and 2 boxes of bed blankets and 8 bed mattresses.  Friday, after Daniel said he would tell the person in charge of hospital beds, etc., I saw 2 students come and move the blankets and mattresses. I shelved all the other meds and supplies Daniel brought and I shelved was sitting in previously arrived boxes. Of course I arranged the shelves with “first expiring to the front”. In tot al, I emptied about 10 large boxes. I also repositioned other boxed supplies. I think more space available will help make storing their next big order easier. Hopefully the hospital’s June 30th “count everything” annual inventory goes well too.
Another little hospital detail – the dispensing pharmacy has a refrigerator but the in-patient wards do not have refrigerators. The wards only have “cold boxes with ice packs” and don’t stock extra “must be kept cold meds”, so if extra insulin is needed when the pharmacy is closed (nights or weekends), getting it can be a big problem. I asked if there were any other “round-the-clock refrigerators” anywhere in the hospital. Easiest available 24 hour refrigerator is in the Lab, so on Friday I recommended to Daniel Sulle that at least some extra bottles of insulin be kept there “for use only if needed when pharmacy is closed” and Bin Cards be kept with them so “any use must be logged by user (i.e. Nurse, Doctor, etc.)”. Daniel said that would need approved by the Lab Director so he will talk with the Lab Director. The hospital only carries 2 types of insulin (Soluable = Regular and Suspension = Lente), so two to four bottles can’t take up much space in the Lab’s refrigerator. If the Lab Director refuses, I will bring it up for discussion at the next Therapeutics Comm. meeting.
I boarded the 4 pm “transport bus” on time ( actually their “bus” is like US minivan with bench-like back seats along each side – Side note – during another recent ride I was in the back with 16 other people. I was one of the few sitting down with no one on my lap). I did not know it, but today our driver must of been given a “wait for a certain hospital staffer before you leave” order.  I and 3 others sat in the bus at the hospital for over 1 hour 20 minutes (it did give me some time to write this long message), finally I decided it was time to walk home. After walking awhile, same bus driver stopped and picked me up so I could ride the rest of the way into Karatu.  Good thing I always wear my hat so I am easier to recognize.  Actually I am the only non-black person I have seen walking in Karatu since I have arrived. The other whites I’ve seen were sitting in Safari transports (which are typically Toyota Land Cruisers) or going into local hotels for the evening. Thursday night, I spoke with Kristen Westermann and her associate named Pidge Morgan, who arrange aid funding for med related student’s education (they stayed overnight at my previous location), I told them that one night after dark, I was warned by a loud local voice yelling to me whites are not allowed in Karatu after dark and “call the police if I have a problem”. Pidge said she knows whites are not even supposed to be in Safari vehicles after dark. So now at almost dark, I walk away from center of Karatu toward home. According to local signs, I am still “walking in Karatu” while heading home from Grocery or WiFi, but no one else has ever said anything to me about walking at night and no one has ever tried to stop me. During the day the only people that stop to talk to me can speak English and want to sell me something, offer me a ride (to get paid to transport me of course) or ask where I am from and why I came to Karatu.  And now that I am so recognizable, why worry.
Friday After my hospital bus ride, I stopped at my usual grocery store and Owner introduce me to his wife. She has goiter (swollen throat\thyroid), sound familiar? He asked if I knew how she could get Iodine, since that was what she was told to take for her goiter, but it wasn’t available.
I said I had not seen any oral iodine at hospital, but I would ask pharmacist and Doctors. (I doubt iodized salt would help much). While there I did buy loaf of brown bread, jelly, sunflower cooking oil (1 L), napkins and a refrigerated Coke Zero (500 ml). Grocer’s frig is cooler than mine and mine is set to max cold. Total cost about $8.25.  I planned to WiFi Friday, but due to the long waiting and shopping, I ran out of time before dark. I hope you felt effectively productive this week and had time to eat some decent gluten-free food at work.
I slept in Saturday morning. Part of my wake up was hearing what I believe to have been a musical group and singers marching down the street in front of my home. They played and sang very well. I guess they were churchers because the last word of their verse was “Halaluya”. I spent most of Saturday doing laundry – expect to finish today. I stopped for WiFi twice but first time they had no power, second time no connecting ability, so No Way that day Jose. So I went to the Farmers market and bought 2 bananas (out of the likely 1000 available from all the different “vendors”) and paid the common price of about $0.25 for both. I also bought 1\2 kg (about 1 lb) of red (kidney?) beans for about $0.38. Saturday night I ate at the Lutheran Hostel (where I stayed previously). The supper meal was 1 chicken leg + all the mashed potatoes, green beans and cucumber slices I could want to eat + a piece of watermelon + all the really spicy tea I could want to drink – total cost was about $6.25.  I will be going to church Sunday morning at the nearby Karatu Lutheran church. They have built a large new church beside their current one. I looked in a window and the interior has not been started yet. It might also include their auditorium, etc., but no basketball hoops, cooking areas or stage that I could see.
Saturday night the young man who is my home owner’s security guard (presently my night-time, outside security guard who sleeps in a separate small one room building next to the house) talked to me Saturday night and I think he was trying to tell that me he has malaria. I told him go to the hospital, but he did not leave last night. I tried to call John to ask him to speak with young man about what he had tried to tell me, but could not connect to John, so I got up at 6:30 this morning planning to help young man to go to KLH to see a doctor and then wait with him f or his diagnosis. I did not want to wake him early, so I kept waiting to see or hear him, but when I finally knocked on his door and said hello at 8:15 am, no answer. I checked the front drive way gate and by the position of the lock he must have already left. I don’t know if he went to KLH or any other medical practice, so I will have to wait until he comes back this evening to know if I should try to help him get to KLH then.  I did go to the second church service at 10 AM. The 7 am service ended about 10:10 AM – each service does last about 3 hours – and there were 3 young white people leaving that service, but I did not get to meet them. My service was full inside and people (many of them were younger children) also sat outside on 4 rows of plastic chairs facing side of the church. Everyone dresses nicer for church. The windows on each side were completely open, I presume so outsiders could hear the service. They had about 27 choir members with very nice voices, 2 guitar players and also played recorded music.  They had 2 loud speakers inside and at least 4 handheld microphones. One male pastor and maybe a female pastor (looked like she wore a white collar) and 3 other white robed assistants. I was the only white person in my service. I sat in next to last row, end seat, beside a man (probably about 40 y.o.) who held the service manual and the bible and would show me where to be singing or reading prayers or scriptures – all in Swahili of course. Three baptisms were performed. They kneeled during their baptisms. I could see their blessings by the pastor, but could not see water being sprinkled. No communion during service, but visitors were welcomed. I probably should have presented myself as a visitor, but didn’t since I did not understand the pastor’s Swahili and was not approached by an assistant like some of the other visitors being called forward to “sign in as visitors attending”. There were 2 contribution collections (everyone from outside comes in to contribute first, then starting from the back all people of each isle come up middle and return via sides. Regular members do have envelopes and use to give cash or put their en elopes in with the item they are donating for the “end of service auction”. I did contributed cash during this service and each of the other services I have attended. They did briefly lose power during this service. Pastor paused awhile then continued without his microphone. At one point during service members use microphones to speak – I assume to thank congregation or ask for prayers. Every service ends outside with attenders in a big circle around assistants auctioning the donated items (often fresh produce  – separate bags of corn, squash, green peppers, beans, green leafy edibles – or clothing, etc., after pastor says final prayer people chat with one another or leave.
After using WiFi today, I will also stop and get Swahili money at National Bank of Commerce’s ATM, go to Farmer’s market and grocery store (not too far apart). I plan to buy 2 potatoes, 2 carrots, a little frozen bacon, fish or chicken (to pan fry after it has unfrozen in my frig), some bagged rice, honey or sugar (because I am now out of Splenda) and maybe some oats to cook if I also find some low fat milk – whatever on the list is available.
I hope your eyes are comfortable and you will enjoy this weekend. Tell me if you speak to Jess or Bob. Tell your Dad, Cathy and Jack that I said “Hello and I’m fine and I hope they are fine too”. I promise next message will be shorter or I’ll write it as a book with public availability. I love you.  Tom



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One thought on “Update from Tom Feldbauer

  1. Tom, your letter is beautiful and a reminder to us all just how much a world beyond our walls needs our help and support. You are truly a blessing

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