Mervyn Dean on power cuts in a hospital

Mervyn_DeanThe power went off about 40 minutes ago. It wasn’t an unexpected happening. I was told when I arrived here that power outages are scheduled for during the day on Thursdays, and during the evenings on Fridays. I wasn’t told that there would be random power outages of varying durations at other times. Usually the outage is from 3-4 hours in the evening to 6-8 hours in the day. On a couple of occasions it has taken 14 to 16 hours before the power came back on, and on one of those occasions it was less than two hours before it went off again for another 6 or so hours.

My partner back home asked me if I was angry or frustrated with the power outages, limited internet access, etc. My reply to her was that I came here not only to work in the hospital but also to experience the different culture and lifestyle first hand. Yes, the power outages are frustrating, but it is what most Tanzanians are experiencing, or at least, those who have a power supply. If I was here as a tourist I would most likely be ensconced in a Western-style hotel with it’s own generator for use during power outages, air-conditioning, and 24-hour in-room internet access.  I would also likely be observing the “local culture” through the window of an air-conditioned bus.

Instead of just looking out of the bus at the roadside stalls that sell a variety of produce, crafts, cheap jewellery, and the like I am there buying some of my food from these stalls and have learnt a little of the art of bartering, another aspect of the local culture. The souvenir stores mostly have fixed prices, depriving many tourists of a different shopping experience. Buying from the same stores the locals use I have had to learn the barter system. I now can feel pleased that I have beaten the price down to nearly half of what was asked, although I have no doubt that the vendor is also pleased that I have paid nearly double what a local person would have. 

I still do some of the tourist things, of course, such as a “cultural tour” of a Maasai village or “boma” but looking inside a “demonstration” mud hut was not the same as making a house call to someone who lived with her family in such a hut.

Coming to work in the developing world one must be prepared to experience at least some of the local culture. It is possible to limit one’s degree of exposure, but I don’t see the point – it’s part of being here.

For example, one can choose to pay the standard 4,000 Tanzanian shillings (/-; about $3.00) and take a reasonably comfortable and speedy taxi, or pay 250/- (less than 25c) to ride with the locals in a much less comfortable and much slower dalla dalla or minibus.  This has about 15 seats, but each dalla dalla is packed tight and on one trip I counted 26 adults (me included) as well as a number of small children crammed in. Not surprisingly it is cramped and hot and it’s a good idea to have your fare in your hand when you get on – you’ll never get your hand into your pocket once you are wedged in with everyone else.  

The less optional experiences are the climate (back home in Canada we have weather, but here they have a climate), and the insect bites – malaria prevention pills and mosquito nets are essential as well as insect repellant and sunscreen.  Does anyone know if the latter two interact if applied together?

I have to stop now – the power is still out and my computer battery is getting very low.

Mervyn Dean is a palliative care physician recently retired from his post in Corner Brook, NL, Canada. He has come on a voluntary basis to the Kilimanjaro Christian Medical Centre (KCMC) in Moshi, northeastern Tanzania, to help provide and teach palliative care.