Windsor Law Alumni Summer Social Justice Fellowship Program University of Windsor, Faculty of Law Written by Linh Dang, Law II August 20, 2005 Summer Experience with Malaika Project in Tanzania
To begin, I would like to thank the Windsor Law Alumni Summer Social Justice Fellowship Program Committee members! With the stipend that I received from this fellowship, I traveled and experienced in-depth northernTanzanian culture and worked on HIV/AIDS programs in that country. HIV/AIDS prevention and treatment, internationally and domestically, is a social justice issue that has important and urgent implications for people living with the disease. Although HIV/AIDS has infected people around the world, its devastation is most poignant in sub-Saharan Africa; adult prevalence rates have reached as high as a reported 37% in Botswana and 8.8% in Tanzania. Exact numbers are difficult to obtain because people are afraid of being tested for the disease due to financial and/or discrimination barriers. Conservative estimates places the infected rate at 40 million people worldwide, while an estimated 30 million people have already died from the disease, creating the phenomenon of AIDS orphans. The majority of those infected and those who have died from HIV/AIDS live in subSaharan Africa, including Tanzania. HIV/AIDS should not be seen as simply a problem that can be dealt with in isolation by separate African countries. A worldwide coordinated effort is required to prevent the spread of this disease. In fact, in 2004, the United States recognized the urgent need to respond to this epidemic by pledging an unprecedented $15 billion dollars over the next five-years towards this cause, in the way of education to African people and researching a cure. Furthermore, the most recent G8 summit in July 2005 put a spotlight on African poverty and underdevelopment, of which HIV/AIDS and other diseases casts a shadow over the future of African prosperity. To summarize my amazing summer experience in Tanzania, East Africa has been quite a challenge. However, I have made an attempt to describe my experiences as completely I can remember. For more information, please feel free to contact me at linh_dang@hotmail.com.
Reflection on the summer experience This was my first time traveling to the African continent and my first time working on a public health project in a developing world context. It was an eye-opening experience! For ten weeks, from early June to August 2005, I worked in Nyamuswa, a rural village in northwest Tanzania. I was a volunteer with Malaika Project, an Americanbased non-profit organization that works in conjunction Zinduka Development Initiative Forum (“Zinduka”). Essentially, Malaika Project recruits North American and European volunteers to work with Zinduka in Tanzania, while Zinduka coordinates the volunteers’ activities on the ground in Nyamuswa, where that organization is based. Zinduka is dedicated to supporting the human rights of impoverished people of rural Tanzania through increasing access to education, healthcare, water and sanitation, micro finance, youth activities as well as advocating equal rights for women and children. Zinduka Board Members provide volunteers, such as myself, with housing and food during their stay in the village. My intentions for living and working in sub-Saharan Africa are numerous; however, the main purpose was to work with people living with HIV/AIDS. My goal in Nyamuswa was to increase access to HIV/AIDS’ services for the local
community to promote greater social justice, as any HIV/AIDS prevention or treatment approach should be based on universal ethics and scrupulous respect for human rights. Through education programs in primary and secondary schools, HIV/AIDS community education forums and other means, I worked to educate the villagers on getting tested for the disease. In addition, I also supported Zinduka with their development initiatives in the village. For example, I paid for the construction of windows for a girls’ dormitory that is set to be completed in December 2005. The purpose of the girls’ dormitory is to provide girls, ages 15-20, with a place to stay during their studies at secondary school. This reduces the need for poorer girls from distant villages to engage in prostitution (a recognized problem in Nyamuswa) in order to pay rent in the local village while going to school. Before working for Malaika Project, I spent three weeks traveling around northern Tanzania and participated in various tourist activities, including a spice tour in Zanzibar, hiking in the Usambara Mountains, a cultural exchange program with the Masai people in Longido, and a safari in Tanzania’s northern circuit. Tanzania is a beautiful country, complete with extremely diverse landscapes that make it the perfect tourist destination. When I arrived at my placement, because of the three weeks I had spent traveling around various cities in Tanzania, I was accustomed to the Swahili culture, foods and language – more than other volunteers who had not spent the time to see the rest of the country prior to arriving in Nyamuswa. For me, the biggest culture shock in Nyamuswa was the lack of hygiene and noticeably less motivation among the local population. Please see my explanations that ensue. As a female traveling, I would be very hesitant to travel alone to Africa, at least for the first time. Foreigners are easy targets for petty crime such as theft and pick-pocketing. Violent crimes are not common, but extra caution should be taken. Traveling with another female or male would make for a more enjoyable trip and decrease the sense of loneliness. Street-smart goes a long way, as does a sense of adventure. In the cities, many people speak English and may be able to assist you if you do not understand Swahili. However, in the smaller towns and villages, Swahili reigns. English is virtually non-existent.
Fellow’s evaluation of the host organization In 2002, Malaika Project was founded by Jennie Howland, currently the organization’s Program Coordinator. Ms. Howland is an American medical student, completing the first year of a very demanding residency at a Massachusetts’ hospital, often working over 90 hours per week. Ms. Howland was extremely busy and often only accessible via email. Given this situation, she was of little or no assistance after I arrived in Nyamuswa. She was only helpful in recruiting volunteers and answering initial questions about coming to volunteer. After arriving in Tanzania, it was the Zinduka Board Members who assisted me in the village to get started on my HIV/AIDS programs. My placement at Zinduka/Malaika Project was a good one that provided me with the experience of working on a public health advocacy project in a developing world context. I do not believe that anyone can really be prepared for an experience of this nature; however, Zinduka was helpful in introducing me to the relevant doctors, community leaders and various other people in the village, with whom I needed to meet in order to successfully complete my project. I would not recommend a placement with Malaika Project for everyone. On the one hand, one must be prepared to live in very primitive conditions: There is no electricity. The host family will have many young children. Water is precious and is conserved, as the local well is generally a few miles away and there is no running water in most homes. One must learn to bathe with only a few litres of water, provided by the host family in a bucket. Privacy is extremely hard to come by as everyone wants to assist and accompany you wherever you go for safety reasons and for their own curiosity. There is very limited communication with family members back in Canada, as there only one land line in the village. The use of mobile phones is extremely costly.
Although email is the best way to stay in contact with friends and family at home, it can only be accessed after a 1.5-hour uncomfortable bus ride to the nearest Internet café. There is a lot of idle time as people do not usually work with a sense of urgency. There is a generally less motivation to start and complete projects even before looking into any options. The transportation system is poor – it usually takes two buses to get to a city – which compounds the feeling of isolation of being in a small village. Poverty is pervasive, as are big families in this male-dominated society. Alcoholism is strangely tolerated as people do not confront open drunkenness, even around children. In Swahili, the word for “foreigners/white person” is “mzungus,” which can be used as a neutral reference or as a means to taunt new foreigners. The latter usage is used commonly by few members of the community and is very unwelcoming in a place that seems so far away from home and in a place where you have come to help the community unpaid. There is little variety in the food and the standards for hygiene are very low. The day is completely dictated by the weather and by sunlight, as there is very little (or no) electricity available in the village. For me, this meant, I took advantage of the sunlight to clean my room, eat, do laundry, bathe, and work on my projects. After sunset, all work comes to a halt as the only two oil lamps in our house were used for cooking and providing light among the ten people living in the home. Essentially, not much work is accomplished past 6pm and the average person is awake shortly after sunrise. On the other hand, once you can look beyond the factors listed above, there is a beauty to Tanzania and more specifically Nyamuswa. In Tanzania, the climate is diverse, as there are mountainous ranges and flat arid regions. Mount Kilimanjaro, the highest peak in Africa, is situated in Tanzania. Lake Victoria, Africa’s largest fresh water body, borders this country providing the population with a seemingly endless supply of fresh fish. The wildlife variety is nothing short of amazing. Tanzania is home to the famous Serengeti National Park and the Ngorongoro Conservation Area, a seventh world wonder. Tanzania has bragging rights for having the “big five” animals living in its borders. The big five animals include elephants, rhinos, lions, leopards and cape buffalo – all of which I saw while on a safari expedition in northern Tanzania. Best of all, Tanzania is a peaceful and democratic country; turmoil in neighbouring Democratic Republic of Congo and Burundi are contained and unrest has not spread to this country. As a matter of fact, I witnessed a democratic by-election in our town as one of the Zinduka Board Members succeeded in his campaign for public office. The victory celebration was euphoric! In Nyamuswa, life is not complicated by computers or phones, as most families do not have either in their homes. People live very simply because most are subsistence farmers or small business owners. The children are untouched by the North American wasteful materialism. The parents and children work extremely hard to provide food on the table and nothing is wasted – and I respect that. For example, after people eat, the dogs and cats eat the leftovers, and after that, the free-roaming chickens and goats get their chance at the food. In addition, there are no preservatives in the food, as everything is farmed and cooked fresh before each meal. Many children, although poor, are gracious, polite and grateful for the food they are provided and for the chance to be educated. They do not see food and/or education as an inherent right. Primary school is free; however, the cost of uniforms, books and school supplies can be prohibitive. Higher education is valued as many cannot afford to attend secondary schools. Moreover, disobedient children are not tolerated by their parents, who unquestioningly run the household. If the parents work, older siblings often are left in charge to take care of their younger siblings, so there is a real bond between family members, including siblings. Lastly, families and family values are sacred, as children work alongside parents in the farm or around the house in completing chores or getting water. Community life means everything. Selfishness and the “me-thinking” culture are inconsistent with the way in which this community functions. Possessions, if any, are shared among friends and family. The best part about this placement was the unique experience to live, learn and experience life in a completely differently culture and continent. I became fully immersed in another environment for three months and observed so many unforgettable things. I also made lasting friendships with the other volunteers and with the villagers, especially my host family. I came with an open-mind and an open-heart to fully embrace my new living situation and in that
sense, I feel like I am a better person for it. I have grown to be patient and to enjoy the wonderfully frustrating and self-enriching experiences in which I found myself. I learned that there are many ways to accomplish one goal and that the way in which I was accustomed is not necessarily the best way for this community context. For example, in terms of work efficiency, although it is desirable to complete a building project early in North America; if the work was completed early in Nyamuswa, it means that somebody would be making less income, as workers are usually paid on a per-diem basis for their labour. As a result, completing work earlier was not always preferred in this community as that worker could feed his/her family for one additional day with each day of labour.
Description of the work completed In terms of the project, my first approach was to assess the community’s needs as it relates to HIV/AIDS. The first few weeks were spent information-gathering through speaking with many service providers. I met with various individuals, including Zinduka Board Members, local doctors, and nurses in Nyamuswa and at the district level in a neighbouring town, called Bunda. I also met the Chairperson of the non-profit organization called Service Health and Development for People Living Positively with HIV/AIDS (SHDEPHA+), the Village Health Worker and the Nyamuswa Drama Group. I toured the local Health Clinic, especially the laboratory, where the HIV/AIDS testing is conducted. For people who are already infected, there is another local non-profit organization, called Local Community Competence Building (LCCB) who counsel and assist those living with HIV/AIDS to make contingency plans for their children and to counsel them (and their partners) on the unsafe practice of having unprotected sex. I discovered that voluntary HIV/AIDS testing is free, as is the counseling, and both are performed by a doctor at the local Ikuzu Health Clinic (IHC), a five minute walk from the Zinduka office. Moreover, condoms are provided free to the villagers at IHC. Anti-retroviral drugs (“ARVs”) are also free at this health clinic and at the Bunda hospital (the closest hospital, a 45 minute-drive away). However, the lifesaving ARVs supplies are not always available. As an alternative to ARVs, other HIV-infected people have instead opted for traditional herbal medicines. In terms of the HIV-test results, for those who have tested at that IHC, the HIV prevalence rate is approximately 10% in the community, however, it is estimated that only 1% of the population has been tested for the virus. There is a lot of stigma and discrimination that still surrounds the HIV/AIDS disease. Many people are afraid of getting tested because they do not know how to cope with the result of a possible positive test result. As well, there is little infrastructure and education to care for a person once infected. Secondly, I conducted a door-to-door survey of 35 households and five commercial sex workers to find out more information on the major barriers to HIV/AIDS testing and to educate these participants that condoms and HIV/AIDS testing are free at the IHC. My message was clear: if a person has multiple sexual partners, they should get tested after each partner or more often as necessary. As expected, everyone we had surveyed had heard about HIV/AIDS, but lack of education, poverty and ignorance remain the key barriers for the villagers to get tested, as well as stigma and discrimination associated with testing positive. Thirdly, I co-organized a community forum where 40 people were given HIV/AIDS and Malaria (number one killer in the community) education by the Village Health Worker. At this forum, men, women, young men and young women were educated on HIV/AIDS prevention and treatment. The Village Health Worker also answered questions of the villagers and encouraged the participants to help themselves to the free condoms we provided. In conjunction with providing education to the village through the door-to-door visits and the education forum, my efforts to educate continued through the use of the Nyamuswa Drama Group (“NDG”). (Drama Groups are common in rural communities in the developing world where lack of education and illiteracy is a problem) NDG is an existing group that uses performance education and works with Zinduka and its volunteers to perform plays publicly on health education topics of concern to villagers, for example, HIV/AIDS prevention and transmission, Malaria; and other social issues, including poverty, the right to education and domestic abuse. NDG performs twice per month on Sundays, when there is a market in town, in order to increase their audience reach. Using the research from the door-to-door survey and the focus group, I worked with them to tailor the messaging to encourage those with multiple partners to get tested for the disease and to use a condom with each new partner. I worked with them on peer
education techniques, providing them with accurate HIV/AIDS education facts, and coordinated their performances, including setting a performance schedule for primary and secondary schools in the ward. With NDG’s Chairperson, I helped secure the permission of the Nyamuswa and Hunyari (a neighbouring village) Ward Education Officers to grant NDG permission to perform their plays in the local primary and secondary schools. I also used some of the stipend from the Windsor Law Alumni Summer Social Justice Fellowship Program to pay for bicycles, drums and T-shirts for the NDG. The bicycles will be used by NDG to reach remote neighbouring villages, where no drama group exists, to perform their educational plays. The drums are used as a prop to announce the beginning of a play. Lastly, the T-shirts have joint HIV/AIDS testing and Malaria messaging that will be worn by the NDG members. As well, some will be given out at the Sunday performances to promote awareness and to fight complacency towards the disease in the community. My efforts did not end there. During the month of July, I taught English to the NDG members in an effort to increase their level of English knowledge. As they are natural leaders in the community, enabling them through education will hopefully have a trickle-down effect. They can become positive role models for children in the community. I completed my placement in the village with visits to three secondary schools to provide HIV/AIDS education to students, ages 14-24. Approximately five to six hundred students heard my message and responded positively with their own questions and comments. This was unarguably the most rewarding task during my stay in Nyamuswa.
Any problems encountered Given the following problems encountered, I did my best to work with the existing infrastructure in Nyamuswa to execute on my projects. On a macro-level, the communications’ infrastructure in Tanzania is very poor, especially in the rural communities, like Nyamuswa. There was only one landline in the village and mobile phone use is extremely costly. For example, it was cheaper to spend 2 hours traveling to the closest city to book an appointment with someone for a later time, rather than calling them to set up a meeting time – a phone call that would take 5 minutes. The reception for mobile phones was sporadic at best, as phone calls would terminate mid-conversation. As well, the closest email access for me was a 1.5-hour bus ride into the nearest Internet café, a trip I only made once per week. Contacting other local and foreign non-profit organizations to ask for help/funding or to coordinate activities proved fruitless because I could not follow-up with the contact person for at least one week at a time. As well, the transportation infrastructure is even worse than the communications’ infrastructure. Roads surrounding Nyamuswa were not paved, so it took 45 minutes to drive to the nearest big village that was only 24 km away. Minibuses (the only “reliable” form of transportation in and out of the village) are all privatized and would only leave the station once it was full of passengers. There is no set schedule, which means that one could wait over one hour for the mini-bus to fill up only for a 45-minute drive. This long waiting time occurred on numerous occasions and was factored into any timeline, which delayed the execution of projects. Moreover, visiting a nearby school by mini-bus for a 2-hour education session could literally take the majority of the working day. On a micro-level, much of my work was self-directed, as only one other volunteer, a medical student from the England, was interested in the HIV/AIDS work and her placement with Malaika Project was only three weeks long, whereas I stayed for ten weeks. With her, the research costs were equally divided out; we paid the Village Health Worker, an Interpreter, and 40 forum participants and 40 survey participants over many days of research and education. However, after that volunteer left, I bore the costs for the research myself, including all transportation (taxis to the very remote places or mini-buses to the various schools and for meetings) and communication (telephone cards) costs. This became quite cost-prohibitive, as I was working under a set budget from the stipend. The idea of work and projects are not the same in the African context as in the North American context. The pace of life is much slower, there is less motivation, and there is no/little sense of urgency to accomplish a project. Furthermore, the information I received from speaking to various people for my project was never complete. I was
finding out snippets of information from a variety of sources, piecing it all together and then reconfirming the information with the group of people with whom I met originally. This happened very often at the organization and in my personal relations with the local villagers and was very frustrating, coupled by the fact that nothing was written down or recorded anywhere, i.e. the various projects completed by past volunteers. For example, I did not know there was a Village Health Worker until at least my second week at the placement and I did not know of another HIV/AIDS-related organization that operated in the same village until my third week! As well, there is the formidable problem of translation. Although English and Swahili, jointly, are the official languages in Tanzania, Swahili dominates in rural communities, such as Nyamuswa, where the majority of people do speak any English at all. I often hired a Swahili language interpreter when I went on an assignment or education session. This was a good short-term solution, but became cost-prohibitive. My limited Swahili language skills failed me on many occasions, even with a Swhaili phrasebook/dictionary in hand. From a legal education perspective, I did my best to promote the human rights of people living with HIV/AIDS. This was mostly accomplished through education sessions in the various schools, the community education forum/door-todoor visits and through the very valuable Nyamuswa Drama Group. The situation of poverty in this village rendered that the biggest concern for every person was obtaining adequate food, shelter, and fresh water. Staying diseasefree was only a secondary concern, as women and girls would engage in unprotected commercial sex work to pay for food, as they did not have the power to negotiate the use of a condom for each transaction. There is not a lawyer within a 250 km radius of Nyamuswa. Given this context, lack of access to the legal system and justice was not on anybody’s priority list but I worked to ensure that HIV/AIDS was not a forgotten disease and that complacency would be futile. I reiterated that the villagers had free access to testing for the disease and to free condoms. In the major cities, like Mwanza, Dar es Salaam and Arusha, the situation is certainly different; human rights is upheld and government HIV/AIDS prevention and treatment programs are seen everywhere. Researching the violations of specific rights – such as the inequitable access to health care (for rich/poor and women/men), discrimination in the workplace and schools, disinheritance of children orphaned by AIDS and women widowed by AIDS, and domestic violence – which individually or combined, contribute to HIV vulnerability – might have been possible in a different context, i.e. in the bigger cities in Tanzania. However, in Nyamuswa, it was the health-service providers and teachers who had the very difficult role of providing the villagers with this education. Although progress has been modest, awareness levels are increasing.
Suggestions for improving the experience in the future As time passes and more volunteers arrive to work with Zinduka and Malaika Project, I have no doubt that their budget will increase and thus more work could be accomplished by these two non-profit organizations. As with many smaller non-profit organizations, there is currently a very loose organizational structure at Zinduka, while it relies mainly on donations from foreigners, including past and present volunteers, for their project needs. Each volunteer, including myself, is expected to bring the equivalent of USD $200, minimum, to be used towards a program activity of their choice. This money is insufficient to complete some of the bigger projects of construction. As well much of my money went towards paying for transportation to visit the various schools, for translators and for conducting education sessions for the community – rather than actual projects, i.e. sustainable education programs. Moreover, this summer, the average length of time in which a volunteer spent in the village was only three weeks. This was not a sufficient amount of time to start and complete a project. Rather, most volunteers would begin a project and hope that another incoming volunteer would help them by taking over the project mid-way. This hope was not always realistic given that most volunteers arrive in Nyamuswa with projects already in mind that may or may not complement the existing projects on the ground. I had a distinct advantage because I stayed in the village for 10 weeks, where I could start and complete projects on my own. I would recommend that volunteers stay in Nyamuswa for a minimum of five weeks, however, ten weeks was too long as more could be done for the community once back in North America, where there is a reliable communications’ infrastructure and transportation system. This is the irony.
I would recommend that future HIV/AIDS work be better coordinated with another village or with a medical services’ personnel in one of Tanzania’s larger cities. Again, with reliable telephones and email systems in the community, this will be a reality. * * * I hope that I have been able to shed some light on my experiences in Tanzania this past summer. I left the village with bittersweet feelings, as I will miss my host family, especially the children, with whom I grew very close. As for my work, I do believe that I had made progress on educating the community on HIV/AIDS. If I made a difference in the life of one person in that village, I would be very content. However, rural life in Tanzania is not for everyone. I was ready to leave at the end of the ten weeks and begin to travel once more around east Africa. After my placement, I traveled to Kenya for a week-long vacation before heading back to Canada in mid-August.