Author: Annika Nambiar

Week 2: Karibu! Asante!

Posted on by Annika Nambiar

Hello from Dar es Salaam! We arrived late in the night on June 21st and Dr. Christine Bohne’s driver, Josh, picked us up. Although we were exhausted after a full day of traveling, Josh took good care of us, relaying Christine’s words of advice and keeping the energy up on the drive to our airbnb. He taught us a few essential vocabulary on the way, explaining that “Karibu” means welcome and “Asante” means thank you. Once inside, we were greeted with a kind note and snacks from Christine, welcoming us into our new home for the next several weeks.

The next day, Josh helped us exchange cash and buy SIM cards before we met with Christine for the first time at lunch where she told us about her background, the incredible work she has been doing with NEST360, and general tips for living in the city. Together, we shared our reasons for working in global health, leaving me more resolute in my decision to pursue my Master’s in Public Health and work with like minded individuals. One of Christine’s suggestions was to become comfortable navigating within the city, which led to calling our first Bajaji, or rickshaw, to take us home!

Our first time hailing and riding in a Bajaji

 

Urojo (Zanzibar Mix)
Fried Cassava with Masala Powder

We met up with Christine again for dinner where she introduced us to the Slipway, her favorite evening spot. It was a lively place with an international crowd and music and conversation in every corner. In the background were the lapping waves of the Indian Ocean. Christine encouraged us to try a Tanzanian dish called Urojo, or Zanzibar Mix, which is a hot potato stew made with various spices. All of us remarked how comforting the dish was, reminiscent of an Indian kadhi, creating a sense of familiarity in a new environment. We also tried fried cassava with masala seasoning, introducing us to a root vegetable we would soon find across several restaurants.

 

On Friday, we attended the 11th annual Muhimbili University of Health and Allied Sciences (MUHAS) Scientific Conference. Partners with the Tanzania Health Ministry spoke about their efforts at addressing maternal and neonatal health at a large conference hall packed with people. Some of the speakers were from NEST360, like Dr. Nahya Salim, who spoke about how most technology is not validated for newborns so by creating linkages with manufacturers, they can create quality improvement policies in this context. Her presentation was made even more meaningful by her introductory words about approaching care, it is “not about few of us, it’s about all of us together,” which I took to mean in the context of a global landscape. It is not just about the possibilities we can achieve in a high income country, but our ability to bring all people up to the same stage, low to middle income countries included.

A selfie at the conference with the lush greenery of Tanzania behind us (Shrutika, Me, and Ojas)

Feeling curious and enthusiastic,

Annika

Week 1: Preparing for Tanzania!

Posted on by Annika Nambiar

Over the past week, the Rice 360 interns and I have been getting ready for our respective trips. In preparation, we have been training in various topics from ethics and respect to working with communities and assessing our value-based goals. We have also been learning more about our cohort and the diverse skills and motivations each person brings to their project.

In a week, I will be heading to Tanzania with Ojas and Shrutika! The three of us are working on interdisciplinary projects. The project I am working on is an analysis of the capacity of biomedical workshops in health facilities to maintain and repair medical equipment in Malawi, Kenya, Tanzania, and Nigeria. While in Tanzania, I will have the opportunity to visit these facilities and talk to the employees in the workshops to better understand their experience and inform my analysis. In Houston, I have been reading WHO guidelines for the assessing, procuring, and decommissioning medical devices in low to middle income countries (LMICs) to gain some perspective on the challenges they face and how they are advised to address it. I have also searched through the literature to gain a sense of the situation that most LMICs face regarding broken equipment and experience using the equipment they receive. Additionally, since this my first time analyzing a large dataset, I have been looking through the methodologies of some research papers to inform my own methods in this project.

Before working on this project, I had not considered that equipment maintenance could serve such a vital role in the hospital. As someone who is interested in the medical field, my conceptions around patient care have focused on the practice of medicine and the inclusion of social determinants of health into that criteria as a means to treat health. At a more fundamental level, the availability of resources and the built environment can become a barrier just as strong as any other. I hope that through my projects and those of my peers, I will gain a better understanding of the complex factors that contribute to patient care, remain humble in my own experiences of care, and be open to the experiences and knowledge of the people in Tanzania I have come to learn with.

One more week before we head out to Tanzania!

Feeling excited and contemplative,

Annika