Renea Secondary School

We took a detour.

Trouble?

Naieshiye’s trip to the school director’s office probably indicated trouble on the horizon.  Nevertheless, she arrived as composed as a mature adult.

Lota, Patrick, Nehemiah and I visited Renea Secondary School.  Delivered letters to students supported by their church sponsors.

Naieshiye broke into a wide smile, as the director introduced her to a few complete strangers.  He introduced us also, after which we embraced and met each other for the first time in each of our lives.  We hugged and exchanged personal information and greetings in a way that are generally not possible through letters, alone.  Nehemiah took our picture, more than once.

Naieshiye stands less than 5 feet tall.  I’m a bit over 6 feet tall, so we needed to adjust our poses so that both faces fit the camera lens.  We figured it out.

She led us all to a room where the 23 waited like a classroom expecting 1st hour to begin.  I talked to the entire group, explaining where Colorado was, and the type of weather and terrain I lived in.  I asked if anyone knew where Colorado was on a map, but no one confessed.  I drew a rough outline of the United States, pointed out Maine, Florida, Michigan, the west coast states and Texas.  I produced a crooked square intended to depict Colorado, and even scratched out a bit of a mountain range.

Only one girl showed enough bravery to ask a question.  The rest stayed rather silent.  They behaved admirably well and respectful.  Nehemiah went to work again manipulating images from behind the shutter machine, perhaps catching a bit of posterity.  As we passed the science lab, Naieshiye pointed out the lack of any sophisticated equipment or technology, expressing some anxiousness about whether she could adequately prepare properly for her intended profession.  Not much I could say about that.

She wants to become a doctor, some day.  I told her that if she studied hard, she might do it.  I reminded her that my daughter, Katie, also studied hard and in fact, did it.

Nehemiah caught us up in some parking lot poses before we all climbed into Patrick’s Land Cruiser for home.

The Plaster House

One of the time-robbers struck again, today.  I told Lota (my fault) that I wanted to visit the various missions that my church supports.  So, at 3PM today, we set out to pay an unscheduled visit to the Plaster House.  Although the director of the center, Sara, continued her tour of the United States this week, Irene welcomed our surprise visit anyway.  We couldn’t contact the Plaster House prior to our visit, because their phone service wouldn’t take our call.  As it turned out, Sara’s cell phone number constitutes the official phone number for Plaster House.  Probably a good call, on Sara’s part, not to take our call from half way around the world.

Took some pictures and toured the facilities.  Noted my church’s plaque on the wall of supporters.  I also noted the relatively nice facilities that they have in the midst of dusty roads and rather ramshackle homes and vendor stands.  I left the place with renewed humility, in the context of the work that they do.  Even though I’ve served on my church’s Tanzania mission committee for 4 years, I never really knew, or sufficiently appreciated, the Christian mercy extended to the patients that they care for.  My lack of knowledge sourced from a combination of only passing comments on Plaster House’s worthiness, my inattention to descriptions of the work they do, and attention to financial and other competing matters discussed within the committee.  But having seen the patients first hand, walked through the various bunking (recovery) facilities, and heard/read about their outreach, my humility reached new depths.

In my seminars, I’ve emphasized the need for transaction based interaction between “do-gooders” and receivers of charity.  At the Plaster House, they ask each patient or patient-family to contribute (pay) what they can towards expensive medical care.  Sometimes it’s a bag of maize, or other in-kind payment.  It’s generally not much, I gather, but it is something that changes the dynamic of charity and turns it into transactions where the receiver no longer becomes the victim of “dependent-itis”, but the respected counter party to a valuable service.  After touring, Lota turned to me and smiled. “Sounds like Sara and you think alike!”

The scope of maladies treated or cared for goes way beyond broken bones.  I quickly lost tract of the conditions diagnosed and remedied.  But their 2015 “annual report” lists them, which include;

  • Fluorosis
  • Clubfoot
  • Osteomylitis
  • Other ortho
  • Cleft lip/palate
  • Burn scar contracture
  • Other plastic surgery
  • Spina bifida alone
  • Hydrocephalus alone
  • Spina/HC combined
  • Other Peds

Total patients served in 2015 totaled 478. Total outreach visits to 208 villages over 8 visits, 1,450 children assessed.  According to their report, “around 50% of these children would be appropriate for our corrective surgery programme however many of them were not able to travel to Arusha for treatment.”

Sara started the Plaster House in 2008.  Since then, it has obviously grown, and continues to grow.  The place impressed me greatly.  But, they are now building another facility across the dirt road.  It’s amazing.

As my church’s Tanzania mission struggles to achieve focus, the Plaster House deserves serious consideration.

Selian Hospice and Palliative Care Programme

Today Lota and Nehemiah accompanied me to Selian Hospice and Palliative Care Programme.  (They sometimes spell things differently, here.)  Elizabeth and Paulina graciously received us and described the Selian Hospice program to us.  They introduced us to Evangelist Kisani (I might have spelled his name wrong, or even interpreted it from a defective hearing endeavor).  Later, they allowed us to accompany them to visit a couple of the patients who they care for.  Just a note: it takes a very special kind of person to do this.

Godson (they call him Baba Four because he fathered two sets of twins), a volunteer, accompanied us.  He also introduced the second victim to the hospice program for their first-time visit today.  He’s carried out daily volunteer services for about 10 years, after having provided compassion to his brother, who died in the warmth of his earliest compassion exercise.

As with Plaster House, my understanding of my church’s mission and support of Selian Hospice expanded exponentially.  If you are reading this and have already grasped its significance, context and history, please excuse my attempt to catch up a bit.  Nevertheless, given my perception of the lack of program documentation, I thought it wise to transcribe my findings.

What is Selian?

Selian is the name of a river or stream that flows through Arusha.  Similarly, Engare Oolmotonyi labels a different stream, but the locals also call it Ngaromtoni.  (Engare means water and Olmotonyi means Birds in Maasai.  Therefore the name literally means water for the birds.)  Selian is not a township or any other form of district, as I understand it.  When Selian first started in the 1950’s, it took its name from a waterway.

How does Selian relate to Arusha Lutheran Medical Center?

 Arusha Lutheran Medical Center began as Selian Lutheran Hospital (or medical center).  Arusha Lutheran Medical Center grew out of Selian Hospital, through the work of Dr. Mark Jacobson and others.  Arusha Medical Center now constitutes the main hospital/medical center in the heart of Arusha.  I understand that Selian Hospital continues as such in its original location.  Selian Hospital and ALMC remain related.

Selian Hospice began around 1999.  A few years after that, the US Government began a 10 year program of funding various programs throughout Africa, due to the outbreak of AIDs in such a big way.  So, until 2015, Selian Hospice received significant funding from USAID.  That funding stopped in 2015.  Selian Hospice cut back its program dramatically, programmatically and staff.

I visited Selian Hospice and Palliative Care Center.  It continues as an administrative location, but does not care for any patients at that location.  Arusha Lutheran Medical Center built next to Selian Town Clinic.  The Clinic is separate from Selian Hospice, and serves as a Voluntary Counselling and Testing (VCT) Center and a dispensary of drugs for Selian Hospice, and likely for the medical center, also.

In a nut shell, Selian now refers to any of 3 different locations and services.  These include;

  • Selian Hospice and Palliative Care Center
  • Selian Lutheran Hospital (the original)
  • Selian Town Clinic (located adjacent to ALMC)

The hospice provides multiple services, but generally not on sight.  These include;

  • Home visits, conducted by volunteers and the core team once a week,
  • Day care, where patients or their loved ones transport them to a day care center, generally 3 days per week.
  • Community sensitization and mobilization (education and recruiting volunteers to provide compassion and minor medical attention).

Their brochure describes various other services, but per our conversation, these constituted the core of what they try to accomplish.

Geographic Scope of Services

Prior to 2015, the geographic scope of services extended to the entire Arusha region.  Since US funding stopped, it now covers 2 districts within Arusha.  Its outreach has significantly constricted.  Nevertheless, the community appears to support Selian Hospice with the engagement of about 300 volunteers.

What does Hospice mean?

In the United States, hospice means care for the dying, generally those whose remaining life has been determined by a qualified medical professional as likely lasting 6 months or less.  Hospice in Tanzania has taken on a broader meaning.  It includes palliative care for the chronically ill or afflicted.  Therefore, although many of Selian Hospice’s patients may count the days until their death, many others live for many years with chronically serious afflictions.  The majority of Selian’s patients battle HIV/AIDs or cancer, but I noted significant mention of tuberculosis.

According to Selian Lutheran Hospital’s brochure,

Hospice is a service of compassion to patients with chronic illnesses which creates feelings of hopelessness.  Patients suffering from cancers, heart diseases, diabetic mellitus, HIV/AIDS can all be cared for by this service.

In only a few words, Selian Hospice provides compassion to the chronically ill and dying.  Services enable the patient and family to prepare for, accept and recognize the end of life.  Patient and family receive peace, joy, sympathy and hope.

What is the Christian Role in Caring for the Dying?

A Christian’s involvement with hospice care appears to involve compassion, expressed through heartfelt love and sympathy for victims of disease and other physical affliction.  This is simply my perspective and understanding.  My church’s role as an institution seems to me to involve channeling individual members’ love toward Christian compassion.  Individual Christians cannot do it themselves like Selian can.  Geography obviously makes it impossible.  Furthermore, lack of training and aptitude for such outreach attends many of us, including me.

My perspective again.  Christ did not command the church, as an institution, to exercise compassion.  Rather, he challenged Christians, as individuals, to exercise compassion based upon love of one’s neighbor.  The church’s role (and hence, my church’s) involves inspiring members’ love for those less fortunate than its congregants, and enabling the individual expression of love through the leveraging of professionals, like those who work for Selian Hospice.

Many of us constitute “collection plate Christians”.  We give through our collection plate donations to the church, and sometimes unknowingly, because a committee decides how some outreach collections get distributed.  We know we extend Christian compassion somehow, but generally or often, don’t really realize how.  We don’t personally care for the folks we help; we simply do it as a sort of amorphous good deed.

Can We Make it More Personal?

As individual disciples, I believe that we can accomplish a more personal, and hence more genuine, love.  We could transact with those in need of compassion.

  1. We could interact and encourage with letters, videos, and personal expressions of support with the caregivers who extend compassion on our behalf.
  2. We could view videos of patients (with their permissions) and our designated caregivers in action, thus making our contributions and responsibility delegation more personal.
  3. We could then follow-up with designated giving, as the result of the Spirit working within us.
  4. We could pray not simply for the sick and dying, but for the specific individuals for whom we commission caregivers.
  5. We could empower the caregivers to honestly tell their victims that people from my church who know their plight are praying for them, specifically.

I explained to Paulina and Elizabeth that one of my objectives in coming to Tanzania involved the development of a business plan for a new organization called Christian Enablers International.  I explained that this company’s objective will include the assistance and encouragement towards self-sufficiency by those whose circumstantial backgrounds have prevented or seriously mitigated their opportunities for higher levels of self-sufficiency.

As part of our Christian mission team program design, we want to incorporate specific mission visits, such as to Selian Hospice.  I asked whether we could, together, create specific ways in which each mission team member could participate and contribute his personal involvement with Selian’s palliative care program.  Eyes brightened.  Elizabeth almost immediately suggested interaction with the kids.  They’ve got plenty of them, all needing personal attention.  I mentioned a program available through my church’s connections, called “Toys for God’s Kids”.  She said that the giving of such toys would certainly brighten the kids’ experience and make their visitation with Christian mission team members memorable, and a small part of their suffering less painful.

I intend to include Selian Hospice in the program for Christian Enablers.  I envision maybe a few missioners, foreign or domestic, to expand their expression of Christian love from collection plate Christianity to a more personal and meaningful form.  We would like to change lives.

Selian Hospice as a Church Mission?

As a former Tanzania mission committee member, and constant thinker of how my church should focus its Tanzanian mission effort, I also think about the specific missions that the church currently supports.  Today, I thought about Selian Hospice as a church mission.  The following constitute my unsolicited perspective.

Selian Hospice, and my church’s support, will likely not;

  • Contribute toward self-sufficiency in Tanzania,
  • Inspire myriads of enthusiastic supporters from the church,
  • Significantly change the world for the better.

On the other hand, Selian Hospice represents an opportunity to;

  • Extend Christian compassion to the most destitute of the world (consider the mission of Mother Theresa),
  • Distinguish the extension of Christian love in a way that many other churches don’t,
  • Engage individual Christians in the extension of love, if communicated correctly to members, and reciprocated with designated donations.

It appears to me that Selian Hospice support constitutes an appropriate mission for many churches.  It certainly allows for the engagement of Christian compassion and mercy.  However, I would recommend its continuance, only in the context of promoting and allowing for individual heart-felt extensions of Christian compassion.  I believe that collection plate Christians should be encouraged to mature into individually loving Christians.

I believe that, as my church continues to try to focus its Tanzanian mission, Selian Hospice should not become its primary Tanzanian focus.  It certainly deserves its consideration of such.  But I also tend to bias towards missions that can demonstrate a measureable difference, and that can, even in small ways, change the world for the better, through Christian (transactional) charity.

Rock Picking, A Self-Sufficiency and Culturally Related Opportunity?

On the way back to our compound, we stopped by the side of the road to observe a woman wielding a pick-axe like hammer.  She sat amidst a pile of recently quarried rocks of various sizes.  One by one, she pulled a big one from the big-one’s pile, set it on the ground, and swung the pointy edge of her hammer to its mid-section.  She kept swinging until the big one transformed into two or more small ones.  She tossed medium sized results into the medium-one’s pile.  She similarly tossed the little ones into the little-one’s pile.  Then, onto the next big rock.

Another woman a few yards away performed the same task.  Behind them both lay a large hole in the ground – the quarry.

Lota explained to me that this activity constituted their livelihood.  It would take about two months to transform big rocks into four cubic meters or 7 tons, which then would fill up a lorry.  She would earn about $90 USD for that work.  Just doing the math: $45/month times 12 months gives her an annual income of $540.

Lota handed her a coin, about 500 TSH (perhaps a quarter or so).  I told Lota that I would prefer to negotiate a better, maybe bigger, deal with her.  We could come back.

I’ll betcha that we could re-invent a small rock crushing machine.  With some creative minds right out of the church (or maybe, the School of Mines), we could overhaul an old idea or come up with a new one.  We could invent a rock crusher that mimicked her hand swinging labor.  Once we came up with a design, we could encourage an aspiring TZ entrepreneur to manufacture (maybe buy parts, then assemble) the machine.  We could empower the woman to operate the machine, save her the labor, and sell her volumes more efficiently to her employer or others.  Just an idea.

But the third world need not completely reinvent automation.  If we encourage our budding entrepreneurs to think creatively, then empower them to leverage good ideas into productivity enhancers, we might be able to observe someone taking one small step towards greater self-sufficiency.

As I observe more and more culturally related activities of the locals, I try to think of more and more culturally related activities in which mission team members might engage during their mission.  I want to go back to that woman and negotiate her participation in showing our mission team members how to break rock.  I want to incorporate rock-breaking into our activities, while at the same time, giving this woman, or another like her, the opportunity to earn a few more coins through her mentoring of our missioners.  And, rather than a charitable coin, I’d like to see her compensation for services get her ahead a couple months or so.  Maybe we could launch her into a new career involving the operation of a rock breaking machine.

Just a thought.  Or, maybe, just maybe, a good idea!

John

8/31/2017, 9/7/2017