Category Archives: Health and Wellness

A Home Reflection

Jan 28, 2019

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To be honest, I’m still reflecting on my emotions towards being back home. It’s only been a week and I need more time to process it all.

My last day at work was the sweetest! The teachers I worked with threw me a small party. The three teachers gathered their classes and made a circle, placing me in the middle. They danced around me and expressed their gratitude. I explained to them that I was forever grateful for having been apart of such a beautiful community. These teachers were beyond ordinary and I made sure to let them know. They gifted me with a large photo of them with their classes and individual drawings from the students with an address attached to stay in contact. As I said my good-byes, I had one of my little children in my arms. She dug her face into my shoulder. I asked if she was okay and when she looked at me, she had tears coming down her face! My heart broke. I know it’s part of the journey but walking out of a child’s life is not easy. I’m going to stay in contact with the teachers via e-mail but I still wish I could have stayed with my little babies forever! I can’t wait to hear from them!

Now, my arrival into J.F.K was not as bad as I expected it to be with the government shut down. I made it through customs in less that 15 minutes. I filled out a quick questionnaire on a computer, the guard asked me, “Are you declaring anything?”, I said no and went on my merry way. I walked out of customs and broke down in tears when I saw my dad smiling at me near the entrance. I missed my people! I have thoroughly enjoyed being around my family. I love being in their presence and being able to hug them. I cannot begin to explain how tired I grew of Facetime. On a scale of one to ten for connectedness, one for low and ten for high, I give Facetime a big fat three. I prefer to “talk to ya when I see ya,” when it comes to long conversations. In the states, I typically use Facetime for silly, short conversations. However, I checked in on family on a weekly basis and sometimes daily. It was bitter-sweet to say the least. All-in-all, I am taking advantage of the time I have back at home.

Aside from working, I spent majority of my time in Spain applying to graduate schools. Thankfully, I completed all of that work before coming home but Uncle Sam still found a list of things for me to take care of. Welcome home! Jokes aside, I do enjoy staying busy, but I would enjoy it more in Valencia, where the sun is always shining, the coffee is 1.50 euro, and everyone takes a siesta. That’s the one thing I would definitely bring back from Spain if I could. If dying and taxes are inevitable, why not throw a siesta in the mix to make it more bearable? Ah, one can dream.

Overall, I am extremely excited to see what 2019 brings. By February, I will find out my status for graduate school! I’m honestly at peace with whatever the outcome is. I just have this feeling that everything will play out the way it is meant to. Spain helped me focus on my strengths as an individual and it assured me that I am on the right path. 2019 is my year to further engage in activities and conversations surround topics that I am passionate about, i.e. mental health, mental illness, child-care and development, social issues etc. I dedicated myself to my undergraduate work and received wonderful opportunities because of it. Now, I am prepared to take it to the next level.

This scholarship helped me immerse myself into work that I care about dearly, but it also allowed me to hit the reset button. I know that I earned my awards and opportunities because of the work I put into it all. However, it put a strain on my mental health, and I know this is an issue for millions of students across the world. That’s why I am beyond thankful for this scholarship. I needed it more than I realized at the time. Now, I am prepared for what’s to come.

Talk soon,

Rachel Beihl

Unraveling My Purpose

Dec 3, 2018

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In the dream of heaven, you completely surrender to life, knowing that everything is just the way it is. And because you accept everything as it is, you no longer worry about anything. Your life becomes exciting because there’s no more fear. You know that you are doing exactly what you are supposed to be doing, and that everything that has happened was meant to happen because they have led you to greater awareness. Even the worst thing that can happen to you is meant to happen because it’s going to push you to grow. – Don Miguel Ruiz

Adjusting to Spain has been easy, but I can’t the same say in regard to having no local support system. While I enjoy the presence of my fellow volunteers, it is exhausting to constantly be around individuals with journeys that do not align with mine. I mean, I’m a 23 year-old who is ready for a more serious part of her life, while the other volunteers are 18 years-old and dying to finally have some control over their own lives. This is 100% natural! I’m only mentioning it because I want all future travelers to know that it is okay to feel like the outsider of a group, to realize that who you are may not fit into the group’s agenda. Raising our awareness and respect for others is the best thing we can do for ourselves in these situations. Be social when you can but also honor the moments when your body tells you you’ve had enough for the day. Your mind, body, and soul will thank you. I promise.

On a different note, Spain has been treating me extremely well. From time to time I reflect on the Lumos catch phrase, “Travel with a purpose.” My purpose has unraveled little by little each week, but I’ll wait till the end to share that with you. I will say that my Spanish has improved significantly. I’ve let the children I work with correct my Spanish. For 5-7 year-olds, they are pretty intelligent. Mind you, some of them are from different countries and have to learn Spanish, Valenciana, Castellano, and English! These little sponges are way smarter than I was at their age! After 23 years, I can finally hold a conversation with my Abuela (grandmother) back home and it warms my heart. Common now!

I’m impressed with the way the teachers work with the children. In my experience, I have never seen so many teachers treat their “wild” students with so much love and patience. I love it! I’m so use to watching teachers get frustrated with these types of students. I have the utmost respect for these kinds of teachers because they volunteer the best parts of them. I first heard this idea from a college professor of mine in NY. He said, “I get paid to teach you. It doesn’t matter how I teach you because I still get a pay check. But if I expect you to learn, that means I have to volunteer my best self.” He then went on expressing how fed up he was with teachers who don’t get personal with their students; but I digress.

As I’ve mentioned in my previous posts, these children come from all over the world and they are all from lower income families. Additionally, the teachers in this school all have fair skin, while the students vary from tan, to brown, to black. Now, I am only mentioning this because I have observed the teacher-student relationships. I have yet to see one teacher pick on a student for their race or ethnicity, or looks for that matter. Not one teacher favors one group of students more than the other. This may not be true for all of the schools in Spain, but I recognize the genuine love and respect that these teachers have for each of their students. I’ve watched some of the children struggle with accepting that not everyone looks like them. Little fights break out here and there, but the teachers are always there to set a good example. They always tell the kids, “It doesn’t matter what you look like. I’m no better than anyone here. We are all a team and we have to respect one another and love one another equally.” It’s beautiful, necessary, and powerful because there are plenty of schools in the world that don’t adhere to this belief. Also, this is a crucial developmental stage in a child’s life. I comforted and honored to work in an environment that takes their role seriously. My mind screams, “Family!” every time I think about it.

Oh, and speaking of family – my soul sister and her fiance came to visit me in Spain! What? Do y’all understand how excited I was to see a familiar face? This is a woman that I look up to. We are about 9 years apart, she is a Licensed Mental Health Counselor (the profession I am going into), and she is one of the individuals who sparked my new life journey back in 2015. Needless to say, she is very special to me.

We took tourism to a whole other level. I spent a day and a half with them in Valencia just catching up on life! I then spent another day and a half meeting them in Barcelona, where we saw about 6 amazing sights within 5 hours. Crazy, I know but it was amazing. I wouldn’t trade those memories for anything!

*Side note* Spain’s trains are not cheap and the U.S. dollar does not work in our favor here, at least not right now.

Okay, back to it!

I purposely spent a day in a half in Barcelona because I knew I’ll be returning during Christmas time, which is three weeks away. Again, what? Where is the time going? Soon I’ll be meeting family that I’ve only ever known through social media. Am I blessed? Yes. Oh, and then my boyfriend is coming to visit for the remainder of the break! When I signed up for this trip I thought I was going to be solo. Thankful is an understatement! It’s a peace of mind to know I have these events to look forward to, especially after the emotional and physical fiasco my body went through prior to the GRE, which I am so glad is over by the way!

I went m.i.a. the day before the test. I did not have the energy to talk to anyone. I was overwhelmed and had knots in my stomach. I can’t express enough my dislike for these types of tests; a test that measures absolutely nothing about who I am and what I am capable of doing. I process things at a slower pace and I need time to grasp concepts. I learn better through writing and discussing the material rather than memorizing it for the sake of getting a good grade. It doesn’t align well with who I am. Nevertheless, I still gave my best on test day, and luckily I don’t get nervous once a test is in front of me. I accept the moment, I breathe, and I do what I can.

When the day of the test arrived, I had to travel three hours on train from Valencia, Spain to Madrid. During that time I had journaled to myself. In that journal entry I wrote:

...You did your best. You will do your best. You challenged yourself. You rose to the occasion. Be proud. Smile. Feel love. Be love. Be.

After writing, I let go of all the pressure I had placed on myself. Once I arrived in Madrid, I spent an hour in a coffee shop catching up on some reading. As I drank my delicious mocha coffee and ate my cinnamon bun soaked in Nutella, I came across the passage in the beginning of this blog. I had chills, y’all! I felt at such peace with myself. My world aligned again and I was ready for whatever was to come.

Taking the GRE in a different country was probably the best decision for me. It felt more relaxing to be amongst individuals from different parts of the world. I can’t explain it, it just felt good. At the end of it all, I can honestly say I am content and EXTREMELY thankful for the experience. Oh, I’m also thankful that it’s over! Out of sight and out of mind!

I called everything post-GRE “The journey back to myself.” Between being sick and stressed out about the test, I definitely fell out of touch with myself. I needed to socialize, start working out, and do more sight seeing. This was my new mission. To hold myself accountable, I began writing a list titled, “What do I want to accomplish today?” I would even list something as simple as waking up, which is a great accomplishment for anyone. As someone who is active in the mental health community, I find it extremely beneficial to notice all the “small” things. This type of mindfulness is powerful because things such as waking up can be a difficult task, especially for those like myself who battle depression. It helps reprogram the brain in more ways than one. For me, it sends a message to my brain that everything I do matters. It reminds me to be impeccable with my words and my actions, especially towards myself. It’s a reminder to never feel less than or shrink at the presence of challenging situations.

So, yeah. All is well my friends. I am learning, growing, and embracing this journey that I am on. I wouldn’t change a thing about this experience.

Talk to you soon,

Rachel

Life Beyond the Vines

P.S. Enjoy the pics! There are some things that don’t need to be put into words. A picture can say it all.

Expect the Unexpected

Nov 13, 2018

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*Leaves the U.S. with a week old cold and no medicine.*

Me: I’m fine. It’s just my body re-adjusting to this Northern weather.

*Arrives in Spain with flat mates who are also sick.*

It’s fine. I’ll just clean, eat really healthy, and drink some tea.

*Has Bronchitis during second week in Spain.*

“I’m so tired. I’m dyinnnggggg. I can’t sleep. Ahhhh!”

*Goes to a doctor in Spain – Begins 3^rd week in Spain.*

See, I knew it’d pass. (Meanwhile I’m on steroids and antibiotics and two other prescriptions).

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I am overwhelmed at the pace of life right now. On the 19^th of November I’ll be on my way to Madrid to take the GRE. A part of me is anxious because I’ve been extremely sick and unproductive these last two weeks (at least in my eyes). Yet, I’ve given my best along the way and the other half of me is a bit more understanding. Nevertheless, I am still trying to jump into a healthy routine and it’s already my 3^rd week here. Trying to reach my normal energy level has been a challenge. I can’t wait to finally feel 100%!

Anyways, let me fill you in on my two-week journey thus far.

As my mini-dialogue expressed, I’ve been sick since the week before I left for Spain. This made my departure from the U.S. quite interesting. My flight from Newark, NJ to Charlotte, NC was just fine. At this point I could deal with my sniffles. However, traveling grew more painful as the day went on. On my eight-hour flight to Madrid, I was lucky enough to have an entire row to myself. Yes, I sprawled out across four seats during the entire flight. I wish my body would have let me fall asleep on that flight, but instead it kept reminding me of how sick I felt. By the time I reached Madrid the next morning, I was EXHAUSTED. Oh, how I wished I could have been in Valencia already. Instead, I spent seven hours in the Madrid airport. The “best” part of it all was getting lost and having to check back in with customs. Ha! I was a walking zombie. I could not even process what was going on. I remember facetiming my boyfriend and tearing up because I was past the point of exhaustion. I did my best to stretch, read, play music, and keep my mind busy. Unfortunately, my immune system said, “Sorry girl. I’m clocking out,” and it did.

I was beyond grateful to have finally reached Valencia, Spain. Sleep was the number one thing on my mind, but it was not the first thing that I was able to do. Instead, I bonded with my flat-mates and fellow volunteers. They have been such a sweet, fun, and lively group of individuals. A few of them are from Germany, one is from Switzerland, another from Poland, and another is from Washington State. I was surprised to find out that I was the oldest in the group. I expected to volunteer with a variety of ages. Instead, they’re all 18 years-old, straight out of high school, ready to drink and party. Then there’s me, your 23-year-old nanny and college graduate, who’s ready for bed by 11:00 p.m. I suppose our priorities are just a tad different, but that’s okay! I’ve enjoyed working and growing with them these past two weeks.

However, in regard to my health, these past two weeks have been a fiasco. The medicine I picked up from the pharmacy was 100% ineffective. My body was not having it but I still tried to stay active during my first week in Spain. From bicycle rides to the beach, to joining the other volunteers on early afternoon excursions, I pushed through it all. I even joined them on Halloween night.

Side note: the night I learned that Valencia parties until 7:00 a.m. Can you imagine my face when I was told this? My jaw dropped and I shook my head. I was used to my own family parties lasting until 3:00 a.m. in the morning, but 7:00 a.m. Excuse me, what? New York City, you are not the only city that never sleeps. I can’t hang and I’m not ashamed!

I digress. Anyways, my cold escalated and turned into bronchitis. I grew miserable. My energy and moral was low. I was coughing so much that my sweet elderly neighbor Keke knocked on my door to make sure I was okay. I cried. I was so tired of being sick and I missed having my loved ones around. I’ve also been anxious about the GRE and my college applications. My body needed time to relax and I was not giving it what it needed. It took me until the end of my second week here to finally go to the doctors. Four medications later and I’m slowly getting back to feeling like myself again.

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Now, I’m sure you’re wondering how the volunteer work has been. It’s been an amazing learning experience. In the two weeks I have been here, I have journaled endlessly about all the things I have learned, the things that I’d like to do, and the things I never knew. For example, I came across a video one day discussing the cons about certain volunteer trips. I was a bit disappointed at myself for not thinking twice about the matter. This was my response after watching the video:

It’s interesting to watch this now that I’m already on my “Travel with a Purpose,” scholarship. I’m glad that I came across this video because it raised a perspective that went unrecognized in my mind. If I’m being honest yes, I feel a built guilty after watching this video. However, I believe that video has added on and changed how I will spend my time here for that same reason. How can I give back in a way that will actually be helpful to the children I work with? That’s the question I’ll be asking myself everyday. If nothing else, I want to be a role model and help these children use their minds and embrace the process of learning and thinking for themselves. I wish I had the money to help the organizations here, but I can’t change their situation at the moment. But I can give them the tools they need to grow. The next couple of months will be filled with learning. I’m still thrilled to have this opportunity but even more thrilled to learn how to be a better advocate for the children here.Volunteer Tourism

The children I work with range from six to seven years old. Majority of them have come from different parts of the world, some from Africa, Pakistan, and South America. In the time that I’ve spent with them so far, I can tell that these children need structure, consistency, and better examples of of how to interact with different cultures work as a team. However, it’s been a challenge for me to maintain order in the class room while the teacher is gone. The children aren’t difficult to be around. What’s been difficult is trying to tell them to be quiet and sit down when all they want to do is hug, talk, and smile with me. It’s unfortunate that I’ve been sick for the first two weeks, but I am so grateful to have 3 months with these children. Week by week I’ll be learning more and hopefully adding to their activities and helping open their minds. Next week, I’ll be playing the ukulele for them!

Hopefully my blog post improve from here on out now that I am starting to feel better! Enjoy the photos! (If you click on the images they will automatically rotate themselves.) Technology can be weird sometimes.

I love you all.

Xoxo!

Wish me luck on my last week of reviewing for the GRE. Been studying since May (on and off) will I ever feel ready?

OR Day

Aug 31, 2017

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August 21st

My experience in the OR was absolutely amazing!!!

It was a nice break to get away from my second week in the ED. We got to go to the theatre at 8am and stayed in the OR until 5:20pm. There was one surgery right after another with no breaks. By the end of the day I was very hungry! I had the chance to see five different operations.

CAUTION: if you don’t like reading about gross things like details of surgeries you may not want to read any further!

Without giving out patient information I’ll summarize everything I saw! The first surgery was a laparotomy. It was crazy watching the surgeon pull out all of the organs. I was able to see how the liver was black due to the illness and see the small intestines and large intestines out of the body. I’ve seen two operations back in the United States but none of them dealt with the abdomen.

The second surgery was a radical mastectomy where they removed an entire breast. This was very interesting to watch and observe! You could see the muscles once they removed all of the adipose tissue. It was very insightful! It’s so important for a woman who’s had a mastectomy to not have her blood pressure taken on that arm because of the removal of the lymph-nodes on that arm. During the surgery I was able to see how much of the breast they actually remove. It almost goes into the woman’s armpit which is where the lymphatic system runs.

After that surgery I was going to see a proctoscopy and biopsy. However, due to the patients condition once he got on the operating table they canceled the surgery.

The fourth surgery was an insertion of a GFT. The patient had dysphasia due to severe tongue cancer. I was able to see the surgeon take out the stomach and place the tubing in. Since the patient can’t swallow properly the insertion of the tube will allow them to feed her through the tube and bypass the throat and go directly into the stomach. They wanted to try this first before they looked into radiation.

Now... the last surgery was UNBELIEVABLE. I had never seen anything like it before. The patient had KS, Kaposi sarcoma. People were also saying elephantiasis. The surgeon said that what this patient had was a rare tropical disease! His leg was 20 times the size of the other one and he also had a fungal infection on top of it. The surgeon said I could take a photo and the patient gave me his permission but unfortunately I’m not sure if I can share it on social media. The patient began having this condition 7 years ago but he couldn’t afford medical help so it progressed to this state. They had to do a AKA: above knee amputation on that leg. I had never seen an amputation take place. I always had wanted to but I never thought I would be able to stomach it. With it being the last surgery of the day as well I was starving and really wanted some food on my stomach because I had a headache and was a little light headed. All of those things aren’t a good combination when you’re about to see a lot of blood and an intense surgery. However, I made it through the surgery without getting queasy or anything! It was absolutely amazing. Just watching the surgery take place was unbelievable. The patient wasn’t put under anesthesia so he was awake for the entire surgery; which blew my mind! He had a sheet dividing the lower half of his body and his face. This is similar to what they do when a woman has a c-section. They gave him a spinal tap so he couldn’t feel anything below his abdomen. However, he could hear everything going on. When it comes to patients I just really put myself in their shoes and imagine how I would be feeling if I were them. For this patient I kept thinking of all the sounds he was hearing and smells he was smelling. Sorry if I’m going into too much detail but during operations they have to burn through the flesh to stop the bleeding. Especially in a leg where there are a lot of veins and arteries they would have to stop the bleeding by burning off the vein in a sense. The smell that comes with that isn’t the best thing in the world. Also, you can hear the sound of flesh being cut. Having to hear the sound of my leg being cut off and smelling my skin burning would not be okay. I just couldn’t imagine what he must have been thinking. As I’m still working on my Swahili I’m able to carry out a conversation in greetings, goodbyes, and introduction. However, for more in depth in conversations I’m still learning. So I could just small talk with him. The biggest surprise with this surgery was when it came down to the bone, literally. So the appliance they had to saw the bone kept breaking and they weren’t able to cut it. So they improvised. They ended up pulling up the leg and bending it backwards manually breaking the femur. There was a loud pop and the bone was officially broken. When in Africa you see things like this. I couldn’t believe it had happened! Remember that the patient is AWAKE. So he heard his own bone crack! Can you believe that?!?! CRAZY! Furthermore, the doctors and nurses were laughing about it.

Overall, I was very happy about the clinical practice that goes on in the OR/theatre. They have a “Time Out” session right before the surgery just like we do in the US to make sure they’re operating on the right patient in the right place. They did their best to obtain and retain a sterile field. I still saw some not so good things like re-sticking the patient with the same needle or beginning the surgery as the nurse was going over the time out sheet.

Though it was a long day it was a bomba, bomba day! Bomba means fantastic in Swahili. I had only ever seen 2 surgeries in the OR in the US but here I saw 5 in one day!

My Experience in the ED

Aug 31, 2017

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August 19, 2017 Saturday

I’m currently writing this in the pitch dark. It’s night time in Tanzania and all of the electricity just went off. A few nights ago after tossing and turning all night because of hearing various sounds throughout the night I woke up in the morning at 5:30am to the sound of heavy rain, electricity no longer working, and a leak in the room. All of the electricity goes out periodically here; both at the house and hospital. There are a lot of things that I’ve experienced here on a regular basis that I wouldn’t typically experience at home.

Sometimes the water goes out when you need to wash your hands or even while you’re in the shower. The toilet will stop working, sometimes the toilet is an actual hole in the ground,

having to hand wash clothes, not having any toilet tissue in any of the public restrooms, constantly having to have bug spray on because misquotes are everywhere at all times, no AC anywhere, etc. However, I can’t even complain. There are so many people here who don’t even have a proper toilet. I’ve seen people washing their clothes in puddles of water and in the ocean. A lot of people in Africa don’t even have electricity. I am very fortunate both here and at home.

When I look back on this week I’m not gonna lie, it has been a really hard one. I’ve just really had my ups and downs. Especially with seeing so many painful and tragic things in the ED. Today as I reached my half way mark I had a mix of emotions. At first I was excited to be halfway done but the more I thought about it, it made me very sad. Of course I miss my dear family, boyfriend, friends, and the little things that America has like oatmeal chocolate chip cookies or AC but I’ve finally made some really great friends with the Tanzanians and feel like I’ve got a good bearing of this city. The people at the Work the World house have been amazing and I’ve been great friends with everyone since day one! However, it’s just different with making friends with the native people. A lot of people come and go at the Work the World house. Everyone that was here when I arrived has left now. The two girls from Belgium that arrived the same day I did just left an hour ago. It’s been so hard saying goodbye to everyone. There’s been people from all around the world: England, Belgium, Netherlands, and Australia. So far I’ve been the only American which has been hard. But everyone has taught me so much about their healthcare systems and cultures.

When I met with the Lumos committee I will never forget what one of the people on the committee told me. He said to be sure to

really make an effort to get to know the local people.

I couldn’t express how it has been the best and most rewarding thing I have done since I’ve been here. The people and culture are literally my ultimate favorite. I’ve never met people as kind as I have here. If you show them a little interest they will pour into you times a million and give you four fold. Everyday is literally a new adventure. I never know what’s in store. Of course I know I’ll be waking up at 5am to get ready for the hospital and it’ll be an hour commute. I may or may not have a seat on the dala dala. But, the hospital is always a surprise. Which nurses or doctors will I see today? What patients will come in? What new friends will I make? What will my evening be like? I hardly ever leave the hospital at the same time in the afternoon/evening. It may be 3:00p or it may be 6:00p. Sometimes a nurse will take me to her home or student nurses will make me dinner and let me come into their hostel. Everyday is literally a new adventure!

My first full week in the ED was extremely eye opening. Everyday felt like I was in an episode of Grey’s Anatomy. I won’t go into too big of detail because I know how some people don’t have super strong stomachs and because of patient confidentiality but I would see patients all over the spectrum: SEVERE motor vehicle accidents, SEVERE burns, accidents with bombs, gun shot wounds, several head hemorrhages, tetanus, TB, malaria, many cardiac arrests, machete accidents, and so much more.

I’ve seen tragic things at the same time. There was a patient who’s blood pressure was 300/200 and was having a stroke. She didn’t have the money to afford a CT scan which is about 170,000 Tanzanian shillings which is about $60 US Dollars so they wouldn’t let her have one. When I asked what’s going to happen to her they said she’ll remain there until her condition improves or worsens. If it worsens she’ll be sent to palliative care. It was midnight and she had arrived early afternoon. Her condition was only worsening. She was struggling for each breath, she was bleeding out blood, and her blood pressure wasn’t dropping. The only thing they were giving her in the IV was dextrose. I was so confused and upset on the inside but I simply had to remind myself of this phrase, “It is what it is.”

I’ve faced a lot of ethical dilemmas while I’ve been in the hospital. There are so many ethical decisions being made that I don’t always agree with or understand but I’ve learned to just observe everything going around and accept what is happening. For instance, my last day in ED there was a patient with 3 wounds to his head. We believe they were gun shot wounds. He started going into cardiac arrest so we began CPR. However, when we would do rescue breathing for him the air would come up through his head and more blood would gurgle out. Eventually he went back to a normal sinus rhythm but shortly after he was somewhat stable his B/P dropped and he went into cardiac arrest once again. Right then and there all of the nurses and doctors began talking about whether they should do CPR again. They stated his pulse was gone and asked if anyone had any issue with leaving him as is. No one advocated to continue so they just left him. My insides flipped over in that moment. I had just never seen that happen before. From what I’ve seen in the US the doctors and nurses will try everything in their power to keep the patient alive unless they have stated they’re a DNR. This patient was probably in his late 30’s. I honestly haven’t seen anywhere on any patients charts if they’re a full code or DNR so I’m not sure if they have that here but I’ll have to ask. This is an example of just one of the many situations I’ve seen where ethics go into play. I could see where the healthcare team didn’t see a purpose in continuing CPR because of the overall outcome of this patient. However, it was just hard to see people giving up on someone to live.
There are two other patients that I would like to talk about that really stood out to me during my time in the ED. I had both of these patients on the same day. Let’s call the first one Rob and the second one Jim. I won’t be able to go into too much detail due to patient confidentiality.

Rob was an older man who has been suffering from various health conditions one of which was cancer. He came into the hospital with a chief complaint of overall malaise and weakness. He didn’t seem 100% orientated and he was struggling to breath. We put a non-rebreather mask on him to increase his 02 level. However, he kept trying to pull it off. The doctors and nurses ended up restraining his hands to the bed so he would keep his mask on. When I was in the SICU at Vanderbilt a patient was so delirious because of the lack of oxygen that he kept trying to pull off the mask, just like the patient was doing here, so the doctors and nurses gave him a light sedative to keep him calm. I thought it was the best thing they could do since they didn’t have the sedatives available. However, he was really having a hard time breathing. It’s always so important to observe your patient and listen to what they’re saying. A teacher at Belmont once taught me that a nurse is nothing without their assessment. However, they kind of just left this man in the corner of the room. About an hour later his breathing stopped all together as they were attempting to intubate him. Due to his various health conditions they didn’t feel it would be a good overall outcome if they attempted CPR. Almost an hour after his death various doctors were still practicing how to intubate. They had the device in his mouth and one after another doctor would practice and clean up their technique. This made my stomach sick and made me so sad. With patients I always try to think of them as an actual family member. This man was just a few years older than my Dad. I wouldn’t want anyone doing that to my father! No way could I do it on this man. Some of the doctors asked if I wanted to practice but I said no. I understand their reasoning so they’d know how to do it on future patients (some American intern doctors were teaching them how to properly do it). But I still didn’t feel right about it. After they all practiced intubating him they just left the room leaving him there. My mind immediately went to what I had learned in my Adult Health 2 class about postmortem care. During my SICU clinical experience back in the US I had experienced my first death of a patient and that was the first time I had done postmortem care. I was incredibly thankful for that experience because it helped me in that moment. Although the postmortem care was a bit different here I was able to do it. One of the hardest things here in the hospital is not being able to speak Swahili fluently. From context clues and simply observing the situation I was able to identify who his daughter was. I wanted to so badly be able to speak with her in her language but all I could say in Swahili was that I was very sorry. It was so interesting to watch how the healthcare professionals treated her. It’s just not what I’m used to seeing in the US. I just kept putting myself in her shoes. If my father had just died I would be a basket case. She called her mother on the phone to let her know. It was all so heartbreaking. To make the situation even worse I was watching what the nurse was doing on the computer screen. She was JUST NOW PUTTING IN HIS TRIAGE INFO and how he presented upon being admitted. She wasn’t even the nurse in the room that saw him once he got there so she was making up a lot of it. It was over an hour after his death and she was just now putting in all of this info that had happened upon his initial admission which was about 4 hours ago. This just surprised me so much. She was documenting on a dead man from when he was alive hours ago because it wasn’t done yet. The situation with this patient really made me sad. What if I had just listened to him when he was taking off the mask. Maybe he was just trying to show us he wasn’t breathing properly with it on and that’s why he was trying to take it off and we should’ve intubated sooner. I’ve faced a lot of situations in the ED that made me question how good my nursing skills are. I don’t have that many clinical skills under my belt since I’m a recent graduate but I just can’t help but think if I maybe had more experience I would’ve been able to save more patients lives.

Later on in the day the second patient that I would like to talk about came in, Jim. He was about my age and was a very fit young man. Looked like someone that nothing could hurt. He was very muscular and healthy looking. Just full of life. However, like many of the patients he was involved in a motorcycle accident and was laying on the bed lifeless. The doctors put me in charge of suctioning and manually bagging him. I did this for about an hour before we transferred him. As we were transferring him I was still bagging him. We took him all the from the ED to the surgical intensive care unit. Which was a good 10 minutes walking distance. They were strolling him and I was bagging him while I tried to dodge running into people. Once we got to the SICU we were able to get him hooked up to the ventilator. However, the SICU was the most eerie place ever. I felt like I was on an episode of The Twilight Zone. The windows were tented with this dark pink/purple tone so you couldn’t see out of them and there were all of these constant noises that would come on every few seconds and play in harmony with one another. It was pure white on the inside and all the patients were lying across from one another in the ward not moving or talking since they were mostly all on ventilators. It was just a very creepy feeling I got. And all the doctors were dressed in a different outfit with white shoes on. The facility seemed great though. It seemed like they had a lot of money going towards that ward which was nice to see.

The teachers at Belmont have taught me SO much! I hold onto everything I learned while at school like a treasure. It’s really helped me while I’ve been here.

Pediatric Oncology August 28-September 8

Aug 28, 2017

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August 28-September 8

My experience in Pediatric Oncology these last two weeks was absolutely unbelievable despite me having strange things going on with my health.

My first week was a weird week for me because I was having some serious GI complications. It made me miss 2 days at the hospital. It makes me really upset with myself when I miss work but you can’t take care of other people until you take care of yourself. Luckily, I’m all better now. However, this last week I actually had to go to the hospital for a minor operation. I’ll write about that in my next post. In this post I’ll talk about the Oncology Ward.

My first day on the Pediatric Oncology Unit was unbelievable. I absolutely fell in love with all of the children!

I’ve always heard people say how hard Oncology can be, especially Pediatric Oncology; however, I love it. Of course the children are very sick and it can break your heart. But, children have such a special place in my heart. So even though these children are sick and sometimes lifeless which is the exact opposite of how children should be, it’s when they need you the most. I’m so honored that so many parents and children knew me by my name! On Monday I was beside the medicine closest and a lady walked passed me. I remembered her face but couldn’t really remember anything else. I said hello and how was her morning and then she said both my first and last name! I probably met her once last week but she remembered my name and everything. There are two units in the Oncology Ward. There’s upendo and tumaini. Upendo means love and that’s where the really critical patients are. The Tumaini Ward means hope and that’s where the less critical patients go to or where patients from Updeno transfer to when they are improving. I spent most of my time in the Upendo Ward.

The children honestly make your heart grow 20 times bigger. Being with the children really made me want to know more Swahili so I could communicate with them and play with them more. Most children don’t understand you can’t speak Swahili. They’ll keep speaking to you. I realized though during a lot of the play time with children you don’t need words to communicate. It was so interesting getting to play with African children. For instance, there’s a playroom you can go in where the children have different things to play with. When you walk in all of the children smile ear to ear and just run up to you yelling, “Mzungu!!!!!” We were using clay and they were making food to eat like chipati’s or ugali. It was funny to me because that’s exactly what children would do in America except it’s just different foods. They’d also play doctor with me. They’d pretend to put an IV cannula in me and would tell me to not cry and shh. Since they’ve been in the hospital so much that’s what they’ve been exposed to so they were reenacting what they’ve had to do.

Handsome Uma! My first kiddo friend! He loved wearing my name tag everyday!

Her little smile could literally light up the world!

This is the play room where all the fun games happen! Mzungu alert!

PHOTO 1- There was never a day where I wasn’t holding at least 2 children’s hands.

PHOTO 2- They always wanted to take me somewhere

PHOTO 3- And we are off again!

Sometimes the kids would also hurt you. Since I’m white they find me very interesting! They’ll get my hair out of my bun and just pull and pull on it trying to get it to come out. This one little girl kept jumping up and popping me in the eye. She would pull my arm hairs and all the children kept pinching my skin. No matter how much I would say no, hapana, they would literally mock me and just laugh. I had to hide in the nurses room so they would stop hurting me. But for the most part they were very sweet and loving. It was very interesting to see how they do some of the things in the ward compared to what I’m used to seeing in America. I was able to understand why we do a lot of the things we do in the states. For instance, there’s this big bottle of liquid morphine that just sits in the unlocked cupboard in the middle of all of the patients.

The parent will simply bring a cap size clear container to you which means there child is in pain and they need the morphine for them. Without documenting or anything you simply fill the cap to the top and that’s it. You don’t go assess the child or follow the parent with the medication to make sure the child actually takes it. In addition, the nurses typically give the parents the medications to administer to the children. No documenting is done (or at least any that I’ve seen). Of course the nurses administer IV medications and IV flushes and will put a check mark beside the action in the patients file but other than that the parents are in control of the actual pills.

I saw a situation where this went very bad due to miscommunication on various ends of the spectrum. Me and a doctor from Ireland named Rincy were looking at a patients lab values over the course of a week and documenting them on a chart so you could see a trend. However, the child’s K+ level was 2.4 two days ago... The lab value hadn’t been rechecked since then and the child was taking a potassium tablet. However, upon further investigation and talking with the Mom we discovered that the child had ran out of the tablets a few days ago. The mother simply didn’t understand. It was the mothers responsibility to tell the nurse or doctor that she ran out of the medication so they could order a new prescription. However, if it was properly documented and the nurse distributed the medication then this problem wouldn’t have occurred. The scary thing to think about is what would have happened if we hadn’t of caught that? Who would have? And when? A low potassium is critical and needs first priority.

This situation taught me the importance of patient advocacy. If you don’t advocate for your patient and truly know their chart then who else will? That responsibility falls on you. We are so lucky in America to have almost an entirely paperless system. There are far less accidents that occur. Another example is having to read the doctors orders on each patients chart. It’s very interesting how they do their orders. The doctor will write it inside each patients chart and then a nurse will go through all the charts and write all the orders in a notebook where all the orders are together in one spot rather than various folders. I did this job one day. Writing down all the orders literally almost took me all day.

Moreover, reading the doctors handwriting was absolutely horrendous sometimes! I could easily see how someone could write the orders down wrong. I would have to ask various nurses sometimes what the doctor was trying to say because the handwriting was quite horrific.

As far as infection goes I could see how easily a child could be infected due to germs of other children. The unit was a ward so there would typically be 6 children in one room. Now add family members and brothers and sisters and that’s a lot of people in one room that can transmit germs. One little boy was being tested for TB and he was still around all of the other children. Infection control was something I constantly worried about. Furthermore, all the patients share the same bathroom and toilet. Inside the ward there’s just the room and the communal showers are in a different room. The hospital cooked food for families that lived too far away and couldn’t bring food from home. However, if they did live close to the hospital they were expected to bring their own food from home.

On EID Day there was hardly anyone at the hospital. I didn’t even realize that Friday was a holiday. It’s a huge Muslim holiday. How people explained it to me is that it’s kind of like Easter to Christian’s. There was only one nurse on the Upendo Ward taking care of the patients. I found this to be my golden opportunity and I basically became this nurses side kick all day. Since there were very little hands and so much to do I was able to get a lot of experience that day. I helped prepare all of the IV flush medications. In America typically all the medications are already mixed for you. However, you prepare the entire medication. In the bottle it starts out as powder. You have to draw up a certain percentage of sterile saline (depending on which medication you have to dilute) and mix it with the powder. You even have to do normal saline flushes this way. They do not come pre-made. This is something I never even thought about having to do. We are so blessed in the US to have all of these things already made for us.

EID weekend was a very interesting weekend and we had to take extra precautions. There were lots of parties going on and the Work the World team warned us not to be out late because a lot of thieves are out and about during the holiday. There was a huge party at Coco Beach which is just down the street from where I live. I was meeting up with someone near by and as I left the house there were stampedes of people on the side of the road walking. It was evening time and they were all leaving the big celebration at Coco Beach. Most were all dressed in hijabs and typical Muslim clothing. There were probably 100 people walking down the street in the same direction I was trying to get to. I ended up walking on the road. About 2 minutes had passed by as I was walking and I just felt someone hit my arm. I turned around to find a Muslim woman glaring at me. She asked me why is it that American women (how she knew I was American I have no idea. Most people think I look either Greek or Italian here maybe due to the curly hair) think they can just walk so fast in front of everyone else? She spoke very good English but she was being very passive aggressive towards me and I actually got extremely worried because I was not in a safe environment. Of course I was wearing respectful clothes for the culture and I had done nothing wrong. I was walking on the road so I didn’t even push my way through people. It was a clear opening. People in Tanzania do tend to be very hakuna matata (no worries) and don’t typically rush. I’m just a fast walker in general. I explained as nice as I could that that’s not why I was walking fast. I was walking fast because I was late meeting a friend (which was true). In that moment I saw the friend out of the corner of my eye. I began to walk towards him and she just glared at me as if I owed it to her to continue having a conversation with her when she was practically yelling at me. I explained this is my friend right here. She just rolled her eyes and continued walking with her friends. That has honestly been the only bad encounter I’ve had with a Muslim person here. All of them are so sweet and kind. This situation just really caught me off guard and reminded me to always be cautious and safe with my surroundings.

The last thing I’d like to talk about are two little boys from Muhimbili. One is 15 (almost my little brothers age) and the other is 11. Both of them loved to draw. This reminded me exactly of my little brother, Grantley. He loves to draw as well and I could see the same passion Grantley has in these little boys eyes. They had their drawings on loose printer paper. That day after work I decided I’d run by the little grocery store and get them a sketch book and some art pencils. I honestly can’t not put into the words the feeling I got when the boys saw what I had got them. It humbled me so much. Their eyes lit up as if it was Christmas morning and they kept saying God Bless You. My last day at the hospital I got those boys each a football. They had asked me for one weeks ago but I didn’t know the place to get them. I asked Faraja (one of the staff members of Work the World) if he could get me some if I gave him the money and he said of course! As I pulled the footballs out of the bag (red and white for Simba colors of course) their eyes were even bigger than before when I gave them the art supplies. They grabbed the balls and they were off to go and play with them. That’s the last time I saw the two boys. Best moment ever.

I’m definitely going to miss all of those children.

And I’ll always remember the special moments like a child just running up to you to hold your hand and walk around the unit with you. Or when I had seven children just clinging to me for about 10 minutes. One of the grandparents had to tell them to let go of me so I could go to the nurses station.

My favorite painting in the hospital. There is beautiful artwork all around the children's hopsital.

My favorite painting in the hospital. There is beautiful artwork all around the children’s hospital.

Mukumi National Park and Maasai 25/08/2017-27/08/2017

Aug 28, 2017

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The Safari Journey

On the Way to Safari
25/08/2017

I literally can not contain my excitement to be going on the safari! Today is finally the day! My favorite animal in the entire world is an elephant or in Swahili tembo.

Two female elephants and one of their babies

I’m going to actually be able to see them in their natural habitat and home! It’s a 7 to 8 hour drive to the national park! Therefore, I have a lot of time to just think and write about everything I’m feeling. I’m really happy I’m able to get out of Dar and see the more rural area of Tanzania. Though a lot of people live in Dar (which is a huge city and Capitol of Tanzania) a lot more live outside of the city and the rural areas are more representative with how the majority of people live in Africa. The last 2 hours I’ve just been mesmerized with simply staring out the window and observing my surroundings away from Dar. It took forever to get out due to so much traffic. It’s so different to see so many people take local transportation to get to work. There are so many bus options you can take. There’s this thing in the city (the name of it isn’t coming to mind) which is where people get on the bus and there’s no traffic. There’s a lane made just for that bus in between the two main car lanes on the road and it never has to sit in traffic. There’s a specific lane just for those buses (kind of like a subway). Just like the dala dala the people were PACKED on it. The people on the buses here literally looks like sardines in a can. All you see is a big blob of people because everyone is squished together. I love taking the buses because that’s how the people here travel and you feel more like a local. I like to call the dala dala bus rides dala dala yoga. This is the main transportation I take every day to and from the hospital. You just never know which body part is going to be stretched.

Here is a link that discusses what the bus system is like: http://www.eastafricatravelguide.com/tanzania/get-around.html

When you look out and see the shops/road side stands and homes it can be kind of hard to take in. Imagine a big, black metal pot of boiling water over a fire where a beautiful mom dressed in a colorful, bright dress and kanga is cooking food over. Right beside her are 10 people both standing and sitting eating food and conversing. There’s dirt and trash all around them. Behind them you see a row of run down shops which kind of look like mini road side stands/markets where people are selling various goods like oranges, corn on the cob, nuts, etc. All around them are people commuting to work. They’re either waiting for bus’ or waiting to cross the road. Right behind the road side stands and all the people commuting and cooking you see these little shanty shacks/homes. They are all piled together. Some are completely closed in but others you can see where there’s an opening.

Something that’s really been on my mind lately is how can I accurately convey what I see? No matter how many photos I take or how much I describe what I see it’s just not the same and can’t do it justice. You just have to experience it for yourself in order to truly understand the experience. This makes me so sad because I know a lot of people in my life who will probably never come to Africa. It’s so sad because Africa teaches you SO much and exposes you to a new way of seeing life. The people here are unlike any other people I have ever met. Knowing that some people will go their entire lives without seeing this side of the world is heartbreaking. We can learn so much from one another. How can I bring this world and life to my other world and life in America? How can I help further Africa develop as far as healthcare and educating people goes?

As you progressively get more and more out of the city you begin to go through villages. There are hardly any shops. You see Maasai herding cow and oxon. It was so eye opening to be able to see this side of Tanzania rather than just the city. It makes me quite sad because most people who have recently been born and live in Dar weren’t brought up by a tribe. Since Dar is the biggest city in East Africa it has a lot of Western influence. Therefore, the younger generation that live their tend to lose some of the ways of their people. That’s apart of Africa that makes the culture so rich. I am saddened when I see a lot of western influence here. Rather than a woman wearing a bright colored, long dress you may find her in a pair of jeans. So plain and stereotypical of where I am from. The majority of people I have met in Dar seem to have an admiration for how we do things in the western region. They try to mimic how we dress, act, and do things. To an extent, it is a good thing.

There are some great things that they can learn from our infrastructure and mold into their own social infrastructure as they see fit. The main two I think they could learn from is taking a look at our foundations that could help the growth of their economic capital and social justice. On my connecting flight from Istanbul to Tanzania I met two gentleman who worked for the Tanzanian Constitution Forum. I have been able to be in contact with them throughout my journey so far. They travel all over the world in hopes to learn from other countries and change their constitution so that they can help their country grow to its fullest. They do a lot of civic education and public engagements to educate people in Tanzania to take a stand and fight the government to implement and reform their constitution. This is an amazing thing to be apart of and I was so blessed and humble to talk with them for hours in the airport waiting for our flight. However, I just don’t want the people of Africa to ever lose their heritage and culture. Being able to travel somewhere different than what I am use to seeing is like finding a gold gem in a cave of brown granite. Every place is unique and beautiful in the world. We can definitely learn from one another but we must remember to hold onto what makes us, us.

Now back to transportation. A lot of my nursing friends explained to me that buses are their way of transportation to get home (the ones that weren’t born in Dar). It’s the cheapest form of transportation. Although it would be quicker to fly it’s best on the wallet to take the bus. The bus is not air conditioned and it probably fits about 60 people on it. There are so many different kinds of buses that people take depending on which region they’re going to. Mikumi National Park is in the Morogoro region. Bear is in the south and that’s a 14 hour bus ride. But the bus is the most common mode of transportation I would have to say.

As I’m staring out my window and seeing everything of course the wheels in my head start spinning. I keep thinking of everything from a health perspective. What type of healthcare and treatment do the people in rural areas have? How close is the nearest hospital and what are their resources like? Muhimbili National Hospital in Dar is a government run, regional hospital. So the most severe and sickest people are typically seen here. People in the rural areas who can’t get the resources they need in their region are sent to Dar to get treatment. However, they have to take the bus because that’s all they can afford. Imagine if you’re severely sick and you need treatment as soon as possible but you have to get on a bus that could take 8, 14, 16 hours. I honestly can not even fathom that. That’s so scary to think of. There were so many accidents we passed by where big semi trucks were in ditches and completely flipped over. I just kept wondering if the people survived those accidents. It’s so heartbreaking to come to the realization that so many people simply die due to lack of resources and poverty. If you can’t pay for treatment then you simply don’t get treated. Moreover, we would pass by SOO many people riding motorcycles extremely fast without helmets. At one time I saw three gentleman riding a motorcycle with no helmet on. They were all in flip flops and t-shirts around my age maybe a bit older. They would just weave in and out of the lanes. Overtaking is such a big thing here and everyone does it continuously. When we went to the village and were actually on one of the buses I honestly couldn’t tell you how many times I saw the bus overtake cars when there was a car coming in the next lane. Maybe 20 times at least?

In addition, this was the first time I’ve seen actual speed limits and police pulling people over. They even pulled over our safari vehicle once for overtaking someone. When I asked our safari guide, Rama, why is that In Dar there’s no speed limits or anything he explained that since Dar has so much traffic there’s no need to have speed limits whereas compared to the rural areas you could easily go 100 because there’s hardly any congestion once you’re out of the city. Rama taught us a lot. He explained in habitation areas the speed limit is always 50 kilometers per hour. These are areas like schools, zebra crossings, etc. However, once you’re out of those zones you’re allowed to go up to 80. However, when we were on the bus going to the village I caught the bus going 120.

Overall, I would absolutely love to do research to see the percentage of health habits as in smoking, food intake, and so on. In addition, to studying infectious diseases and how the government of Tanzania can have certain grants that go towards vaccinations as well as pass legislation that will help hone in on these problems. How can I be apart of that? Sometimes I feel like a little green pea just sitting at the bottom of the Indian Ocean. How can I be apart of helping their health system? Where do I even begin?

Mikumi National Park Part 2: Safari and Maasai
26/08/17

My safari rafikis!

This weekend was an absolute dream come true. We got to see every kind of animal you could imagine: elephants, giraffes, lions/lioness, zebras, baboons, pumas, etc.

Antelope are known as the McDonald’s of the savannah because there are so easily eaten as prey because of how many there are. Do you see the “M” on their back end near their bottom?

There were literally everywhere!

Such big antlers

Mommy and baby baboon!

One of my new favorite animals. They are so smart. We got the chance to feed them fruit before we got into the park.

A class that took a field trip to the park!

There’s a highway that runs right through the national park! Semi trucks go SO fast on it. We got the chance to see some giraffe’s crossing. This is so common to the local people. It is like seeing a deer for us crossing the road. I was constantly in awe!

Even rare ones that I never even dreamed of living like the colored plum thrush or the lilac breasted rola which is a type of starling.

It took everything I had in me to not leap out of the safari jeep and hug the elephants.

Some of the quick fun facts that I learned: 6% of a giraffes body weight is made up of their heart because their heart has to pump so much blood all the way up to the head and down to their legs. Giraffes also just have seven vertebras. Giraffes live to be up to 30-35 years old. Elephants spend about 16 hours a day on feeding and consume around 250 kilos a day. Rama then went on to explain how elephant poop is actually used for quite a bit of things. Their poop can treat epilepsy and is also used as insect repellent. He also said that some people even smoke elephant poop. Rama would also tell us all of the different legends and stories of some of the animals and trees. One of my favorite stories was the story of the baobab tree. This tree is literally upside down! I’ve attached an article that tells all about it because it is just so fascinating!

http://nature-explored.com/baobab-info.htm

The roots are the branches. The belief is that the trees were drinking all of the water in the land so God punished them by turning them upside down. Some of the other trees that were very interesting to encounter were the tamadrina tree and this one tree used for brushing teeth! Ukalia divenorma (brush teeth with tree) and you can use the leaves as lipstick. It makes your lips yellow.

The Baobab Tree! We actually got to get out of the jeep in the middle of the Savannah and climb this magnificent tree!

Moreover, it was so fascinating seeing all of the symbiotic relationships among the animals in the savannah. An example of this are the zebras and the giraffes. Typically anytime you see one you see another near by. Giraffes are able to see things far in the distance and protect the zebras in this way; whereas the zebras have wonderful hearing and see things closer to the ground. Therefore, they work together in not being prey. There is a similar relationship with the birds and the buffalo. Everything really does work in harmony. Seeing it from the aspect of animals was so mesmerizing.

Furthermore, I was able to get up close and personal with the lions and lionesses. I had no idea how lazy the male lions were. The lionesses typically do all of the hunting. Anytime you see a lioness you know her cubs are nearby. Right when we got into the park zone we saw a lioness run across the road to get to the other side where her half eaten carcass lay under the brush. The adrenal I got was amazing!

The lioness and her prey! First thing we saw to begin our safari journey!

This lion literally slept here all day long! It was crazy being so close to the King of the Jungle being completely nonchalant with everything around him.

Even though this a beautiful beast of the wild that could easily eat us all just laid a foot away from me. Rama taught us how they see objects as a whole. Since we were in a jeep much bigger than she was she didn’t even pay us any attention. It was so fascinating! He also told us stories of people who had been eaten by them because they simply weren’t being smart. For instance, one driver of a semi-truck stopped because his engine was over heating. Instead of waiting for a car to pass by and help him (because power in numbers) he stepped out of the car to fix it himself). For a few days people drove by this truck that was still running. Once the vehicle finally died someone noticed the driver was missing. A few days later near the vehicle his clothes were found covered in blood and ripped. On our way to the park we actually stopped on the road to help fix another vehicle. Rama did not know him but stopped because if there is more than 1 person they are less likely to be attacked. The male lions also mate up to 6-10 hours a day when the females are in heat!

Another interesting fact is that hippos can only breath for 5 minutes underneath water. They stay underneath the water all day because their skin can easily be burned and is very sensitive to the sun. There eyesight is also very bad. They travel in a signal line and if you get in the way of one of the hippos and make it lose its path from the others it will get very aggressive and attack you. So you always want to stand clear from the hippos when they are on the move. When the hippos mate and the baby is born they separate. The female wont bring it back to the male because he will kill it so he stays the top dog. Hippos live for around 35 years and can send a message to one another up to 8 kilometers away! As for some other creatures that live near the water, like the crocodiles, I learned that they live up to 45 years old.

Right by the hippo pool! They come out at sunset.

This is actually a hippo on top of another hippo. It was such a beautiful thing being able to see the animals in their natural habit just doing natural things like pro-creating.

One of the many hippos in the water on this sunny day!

Rama telling one of his amazing stories! He was telling me the legend of the hippos and why the people believe they were cursed of having easily burned skin.

After a full day of being on the safari and looking at animals we then got invited to go to a nearby village and

meet the tribe that lived there, the Maasai.

I was extremely ecstatic to get the chance to visit them! Maasai typically live in the outskirts of the national parks! They herd cows mainly and are known as nomads.

Here’s a picture of the tribe we got to meet!

The elders of the village

As we were walking to meet the tribe we ran across some children. Being out in the country it is very common for people to never see a white person. There were 2 girls one around 7 and the other around 3. The 7 year old was carrying her baby brother. The 3 year old was carrying a giant machete. When the 3 year old saw us she just burst into tears because our appearance scared her. She had never seen a white person! They don’t have access to things like TV, newspapers, magazines, etc. out in the country aka: the bush. She hid behind her big sister until we walked by.

I was looking down around me admiring all of the bugs that I had never seen before and then I saw an ant pile. Rama saw me looking and asked if I knew what the people use ants for. I had no idea. He went on to tell me that the people use the ants to test for diabetes. He said that if the person is positive when they pee on the ground the ants will be attracted to it because of the sugar. I was so amazed at the ways people test for things here compared to back home. I mean, it was absolute brilliant since high blood sugar equates to DM but just how they use their resources is wonderful!

After our 25 minute walk we finally arrived to our destination! I got the chance to be fully engulfed in the culture of the tribe. We were greeted by the women upon our arrival. They began handing us clothes and helping us put it on in addition to jewelry. We danced with them and got to hear them sing. We got to tour their home and see where they kept their live stock. We got the chance to ask them any questions we had.

We got the chance to hold some of their live stock before they went up for the evening.

Herding time for them to go in for the night

This is the home the family lives in. It was the size of probably a garage. Maybe smaller.

Inside their kitchen. To the left is one of the bedrooms which is where Simone is coming out of and to the right of me is the other bedroom. That’s their home.

I was able to see how the culture was inside of this tribe. They literally lived in their own little world. They hardly ever leave their little region and land. Maybe once a month the man of the household will go into town to get supplies but they mainly use everything they have right in their own home. The little 8 year child carried a giant knife to protect him from any wild animals that may come.

Remember, they live right outside the national park! I couldn’t imagine having to defend myself against a lion or hyena! Especially at that young of an age. He looked so confident and like a mini man. The Maasai believe the look of their wealth come from their live stock. If they need money for medical purposes they will never look at one of their cows to sale. That is their wealth. They hold on to their animals and land for dear life. No matter how in need of money they may be in.

The women do all the house work (lugulu) and the men have all of the leadership roles. They are trying to balance out gender now and now both males and females go to school. Moreover, some controversies were brought up. The main one was female genitalia mutilation (FGM). This is something that I had read about in my world religions class at Belmont with the Maasai tribe. However, I was actually getting to see it in real life and talk with the people who actually practice it. I was trying to get a better understanding and grasp of why the people do it. Supposedly they feel that if they make it unpleasable for women to have sex then they wont cheat on their husbands. A big problem in the past were women working for prostitution but now that education and schooling is in place it’s not as big as it used to be but there is still a lot of it. I actually went to a place close to where I live in Dar where prostitution was going on all around me. I was shocked and so uncomfortable. There was a hotel attached to where I was and you would see the girls take the men upstairs where they would do their service. A lot of the men were actually older, white business men. I was so sad to see this going on. Furthermore, a lot of things we take for granted knowing is not common knowledge in this village. For instance, polygamy is a common thing in Tanzania and in this village the elder had 10 wives. If his friend were to come and visit it is understood and common courtesy to let the friend sleep in your room with one of your wives. Education on STD’s, most importantly HIV and AIDS, is not understood in many of the villages. Getting to visit the village was an amazing, eye opening experience!

You can’t even imagine how many questions I kept asking during this safari journey. When everyone would be sleeping in the jeep (since it was an 8 car ride) I was constantly in Rama’s ear asking questions. Just getting a better grasp on the culture and society. In Mikumi which is apart of Morogoro, the region, there are 4 main tribes that commonly live there: Lugulu, Sagala, Vdundone, and Pogoro. On the drive to and from Mikumi you pass by Ew Lugulu Mountain which is so big and absolutely stunning! The sulu reserve goes though the mountain. There is also a sizo plantation which runs below the mountain and the plant is used to make rope.

Rama also taught me many phrases in Swahili! The common theme of our trip would be him saying, “Twende? (lets go?)” and our response, “Ndio (yes)!” Everytime we would stop to look animals before we could move on to the next spot he would say “Twende?” and we couldn’t move on until we all said, “Ndio!” I loved it! Some of the other phrases he taught are listed below (and please excuse if I mis-spelled anything. I wrote it out by how I would say it):

Habari awko (how are you? Can ask to someone your own age)
Habari zah sai easy (say to anyone anytime)

Nikoo sa e d a nini (how can I help you?)

Eww may ah mmm ka jaye (how did you sleep)?

Ew si ku mway muh (good night)
Lala salama (sleep well)

Uhm may choka (r u tired?)

He also told me why greetings are so long in Swahili. Literally anytime you greet someone it always takes a few minutes. Words from Rama, “We have formal long greeting when we ask how one another are doing simply out of respect. You respect them like you respect your mom.”

Lastly, as we were driving back to Dar we went through a village that was selling these beautifully colored woven baskets, in Swahili: Ketunga. I got the chance to get three of them.

Selfie with the best tour guide ever! Rama!

The Circle of Life- I felt like I was in the Lion King during my time on the Safari

Mental Health Ward

Aug 15, 2017

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August 15th

I’m sitting outside with the sun shining on me as it begins to set. This Saturday is coming to an end and as it’s ending I’m reflecting on these last 2 weeks that I had at the hospital. I have been in the Mental Health Ward and it has been such an eye opening experience!!! At first I was really worried because I didn’t know what to expect. I had heard how it was very different in some aspects. However, I absolutely loved it.

I spent my first few days in the male acute ward and fell in love with the patients. In the psych ward they have an acute ward for males, a general ward for both females and males, PPI which are private rooms for people with private insurance, Occupational therapy unit for groups, a day clinic for pediatric and adolescent patients, and a methadone clinic. I had a chance to go to each of these units; however, I spent most of my time in the male, acute ward because I was able to see and learn a lot there!

This is the outside of one of the acute male rooms. It looked a lot like a prison and you had to use a key to unlock the gate to get in

When patients first arrive they are immediately admitted into the acute ward (if they are males) and then when they calm down they’re admitted into the general ward generally after being in the acute ward for 24 hours (sometimes longer). A lot of the male patients upon admission are aggressive. I witnessed quite a few. The family members that bring them in as well as the staff hold them down to the bed and restrain both arms and legs. At first I had a hard time dealing with this. In America, restraining patients is a last ditch effort. We go from least invasive to most invasive. Once they get the patients tied down they then administer medications. Both through the vein and an IM (intramuscular). However, when they administer the medication through the vein they don’t insert an IV cannula. They do it strictly with the needle into the vein. It’s quite a big needle and sometimes the patient is thrashing around on the bed. Typically the needle is jerked out and the nurse re-inserts it several times until they’re able to get it all in. In America we never restick the patient with a needle. This was quite different to see. I’ve never seen medication injected directly into the vein without the use of an IV cannula. It also made me nervous for a needle stick injury. It would be very easy to accidentally stick yourself with the needle with the patient is trying to fight you putting the needle in.

A lot of the patients were admitted with psychosis due to drug use. The most common drug of choice was cannibus. Patients were also admitted because they weren’t being compliant with their medications. Therefore, the patient may come in because they’re being manic from their bipolar disorder. There were also patients there who had schizophrenia, grandiose due to psychosis, aggressive/agitated patients, major depressive disorder, etc. A lot of the patients were highly educated and had a college level education. A lot could speak English as well. In the acute ward there are two rooms. Each room has 6 patients so a total of 12 patients. However, the rooms didn’t really look like rooms. They looked a lot like a jail cell. The male patients wore blue scrubs and the female patients wore red.

Inside the acute ward there was one patient that absolutely broke my heart. He was found on the street (they think his family just dropped him off and left him) and brought to the mental health ward. He is mute and seems to have some sort of mental disability. A lot of patients with mental disabilities are seen as someone who has a mental health problem. They tried sending him to an orphanage but things didn’t work out there so he has been in the acute ward for 2 years now. T W O Y E A R S. I just couldn’t believe it. The rooms aren’t that big and there’s nothing to do inside the room. Every now and then the patients are able to leave for OT but that’s not that often. Since he is mute he’s unable to tell anyone his name. In addition, he’s not able to write so he can’t write his name. He’s literally known as Unknown. They don’t have a name for him. They’ve tried putting his picture in the newspaper, on the news, and on radio broadcastings to try and let his family know he’s at the hospital because he’s unable to give the staff any information about his family and where he’s from. However, know one has shown up. In one regard it’s wonderful that the government pays for him to be there and that he’s not left out on the street but it’s very sad that he’s been there for so long. They’re trying to get him a permanent home but it’s still in the making. I’ve learned that you can’t change things in the hospital but you can have an open mind and just understand that’s the way it is. Before I came here a native had told me to

Be compassionate but not emotional.

That’s the one phrase that I’ve kept in mind over and over again. I’m not here to compare and contrast how we (America) do things compared to how people in Africa do things. I’m here to see how they’re able to manage and use the resources they have here. Countries can learn a lot from one another. Whether that be a developed or undeveloped country.

The man in charge of the acute male ward is named Clemence.

He is SUCH a sweet man and taught me so much!

He’s been there for 10 years and went to college at Muhimbili. He’s such a sweet man with a huge heart and shows compassion to all of the patients. He was so good at explaining how a lot of people in Africa aren’t educated on mental health conditions and people may think the patients are bewitched and such. He also explained how the police force aren’t educated on mental illnesses. A lot of the times the police officers will see a person acting out. Maybe the person is being overly manic and destroying things or acting out in public and the police officers will beat the person and then bring them into the hospital. There was one patient who would scream in pain any time you would touch him and his upper lip was extremely swollen, bruised, and bleeding. When I asked what happened to his lip Clemence explained that he was acting out in public so a police officer bit (yes... bit) him on the lip and they beat him before they brought him in. They did this simply because they weren’t aware that he couldn’t help what he was doing due to his condition.

Moreover, a professor and clinical instructor invited me to a class presentation that his students had where they presented a case of a patient. This was very eye opening! I learned a lot by getting the chance to attend the class. They use a lot of the same terms we use in America for their patients and they also use NANDA! Which is North American Nursing Diagnoses. So a lot of the same nursing diagnoses we use in America they also use in the mental health ward.

Getting to go to the Methadone clinic was a very unique experience. A lot of the patients who have addiction problems to drugs and/or alcohol will go to the clinic to get methadone which is a type of opioid. It is bright green and they drink it at the clinic. It’s in liquid form so the patients can’t try and sell it which they could if it were in pill form. The patients who are seen here have to want to get help and have to no longer use the substances they have been using. Each and every day the patients come to the clinic to get the methadone and then leave.

A lot of the patients who suffer from addiction and have risky behaviors tend to also have risky behaviors sexually. Therefore, a lot of the patients being treated at the methadone clinic also are being treated for HIV. Since they HIV and their immune system is lowered they tend to also have TB. Almost all patients with HIV also have TB. Before the patients can get their methadone they have to come and get their TB and HIV medications. Since the patients really want their methadone, it helps increase the compliance of them taking their other medications first so they can get their methadone. I know back in America it is extremely important for patients with TB to take all of their medications each time. Patients are typically on TB meds for an entire year and take up to 6 pills. At the health department if patients don’t come to take their meds then staff members will call them and even go to their home. It’s so crucial to be compliment with the medication regiment. I thought it was very smart for them to put all 3 medications (methadone, HIV, and TB) in the same clinic. Since there is methadone in the clinic there is a risk for people coming in with guns to try and get the methadone. They said that it’s happened in the past where people have come with guns. So I was extra cautious. However, nothing like that happened while I was there. I also got the chance to see a patient in the clinic get reassessed with how he’s doing with his addiction and no longer using drugs. During the interview there was one thing that really stood out to me. When he was asked what his annual income was he said 350,000 Tanzanian shillings. This is less than $200 US dollars. I just couldn’t believe it. On a typical week here I usually take out 200,000 which is $89 US dollars for food and commuting each day on the bus and tuk tuks. I just couldn’t fathom it.

The methadone clinic was different then any other clinic I’ve been to in America. The experience I’ve had in my mental health rotation and my senior practicum which was in a child and adolescent psych unit back home in America was quite different compared to here. There aren’t rehab programs here or a place for children to stay in patient. The day clinic for children and adolescents doesn’t admit children for overnight. In addition, there is not a problem with self mutilation among pediatric patients here. The most common issue with children and adolescents are drugs. This was a great thing to here! I had to explain to the doctor and nurses how children in America do self mutilate and will sometimes try to kill them selves. It was the first time they had ever heard of self mutilation. However, one of the nurses did tell me that on the adult unit a patient would bite at his fingers and literally chewed them off. Other than that, the patients don’t tend to harm themselves as often as I’ve seen in America. Furthermore, there was also a difference with not having a geriatric unit. The older patients tend to stay in the acute ward and aren’t put in the general ward because the other patients are too intense there and there isn’t as much observation in the general ward. There are about 30-40 patients in the general ward and they all share one room. So the older patients just stay in the acute ward until they are discharged.

Overall, I was able to see a lot of admissions, discharges, and transfers. During my time in mental health I learned a lot! The biggest issue I see is the need for educating others on mental health and imploring more time for the patients to have in OT and getting out of the room on a day to day basis. There are some things they can’t help like being understaffed and not having as many psychotropic drug options as we do in America. However, I was able to learn a lot here from the patients, nurses, and doctors. I’m excited to see what my next two weeks will be like in the Emergency Department! I did a night shift once in the ED already and it was a very interesting experience.

Who Run the World?

Aug 7, 2016

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Early on into my program, I promised a post detailing the role of women I observed here in Morocco. And it’s really only fitting, seeing as the genesis of this project is centered around women’s empowerment after all. But before I share those insights, I’d like to take a second to talk about why and how women’s empowerment makes a difference... And not just for women!

While working at the US Department of State, my office’s research was wholly centered on development strategies, both domestic and abroad. However, regardless of the region in question, there were some recurring themes in these strategies. Of all of these themes, the one that surprised me most was women’s empowerment. Naturally it is advantageous to help women to contribute to society, but it is so much more than just that. This article from the Brookings Institution explains it best, so give it a quick look before continuing!

From skimming this article, it is clear that the positive correlation between supported, hardworking women and overall improved society is unquestionable. This is not only part of a feminist movement advocating for more women’s rights, this is a valuable insight about what women as a gender contribute to society when they are equipped with the skills, support, and tools necessary to succeed.

Having explained that, let’s turn back to women in Morocco. As you may remember from previous posts, the Kingdom of Morocco was established in 1956, and the country has enjoyed marked stability under the monarchy ever since. It is an Islamist country with strong Berber and colonial European influences, and as a result the Moroccan people are a unique balance of many modern and traditional cultural values. In 2004, the Moudawana code established a Moroccan woman’s right to sign her own marriage certificate, file for divorce from her husband, and to be protected from child marriages by the state. Women currently make up 17% of the Moroccan Parliament and are excelling in higher education, particularly in STEM fields. These are all examples of good improvements made to the lives of Moroccan women. Good, but to be quite frank, not good enough.

Though Moudawana has done a great deal to protect women from abusive marriages, there are still some holes. Domestic abuse and rape, for example, is still something that is very difficult for a woman to prove and be protected from. (I’ll just leave this here. Note that this article could be a trigger for sexual assault survivors.) As for Parliament, the only reason that 17% are women is because it is the mandated representation of women in the body, a law often made in developing countries that is quite controversial. When it comes to college education, these women still struggle to compete against their male counterparts for the already scarce amount of jobs available. Needless to say, we can do better.

Before going to Morocco, I was asked many questions by American women and men about my project. I’ve chosen three of the most popular questions and asked real Moroccan women to respond in hopes of us better understanding their culture, society, and how they see their future. Below are the questions that address our some of our foremost cross cultural differences in the context of women’s empowerment. My responses are crafted with direct assistance from local Moroccan women of all ages to paint as vivid a picture as possible.

Is living in an Islamist country oppressive of women?

In the US, there is a lot of confusion about Islam and whether or not it oppresses women. This is the first point I’d like to address, because it is by far one of the most sensitive no matter where you go in the world. After extensive discussions with both devout and non-religious Moroccan women, I have come to the conclusion that while Islam itself is not oppressive, some of the cultural and societal norms it facilitates in an Islamist country like Morocco are. Take for example the hijab, the headscarf a devout Muslim woman wears. She can choose when she wants to start wearing it, but she is obligated by the Quran to commit to wearing it at some point in her life. The hijab represents a woman’s commitment to her relationship with God, somewhat akin to wearing a crucifix or a Star of David on a necklace. The hijab itself is not oppressive: it is a religious choice that women are given the freedom to make at any point in their life. Furthermore, Islam as a religion is not particularly disciplinarian. If a woman never wears a hijab, that is simply between her and God, and not for anyone else to judge.

The problem, then, arises when that choice is taken away... Such as a parent deciding for their daughter when they will wear the hijab despite their daughter’s objections to save face, or a husband demanding that his new wife start wearing a hijab to honor her new marriage, despite never mentioning it before. Or, even more dismal, a woman who only chooses to begin wearing the hijab because she knows it will superficially protect her from the unsettling and incessant jeers she gets from men whenever she is out by herself. All three of these scenarios (all true stories from Moroccan women) demonstrate societal pressures that circumvent the beauty of what the hijab is supposed to symbolize in a way that manipulates the woman’s choice into questions of honor, loyalty, fidelity, and demand for respect. But that’s not all.

In a country that enjoys the luxury of close proximity to Europe, the hijab can also pose a problem in reverse. For example, a devout woman who has committed to wearing the hijab is asked to remove it as a condition of her being hired to be seen as “more modern”. With unemployment as it is, the woman can’t afford to turn down the job. But why must it come at the cost of her religion? The woman who experienced this did take the job, but confessed to feeling so ashamed whenever she saw her friends and family. It is one thing to never wear the hijab, but it is quite another to remove it after wearing it, which is why she felt so humiliated by the choice her job forced her to make.

Nonetheless, it is clear that Islam itself is no more oppressive than Christianity, Judaism, or any other faith that entreats women to dress, behave, or live a certain way. It is only when religion is manipulated that such oppression occurs.

How does dating work?

In Morocco, it is a very big deal if you are known to be dating someone. It is expected that you intend to marry that person if you acknowledge that you are indeed dating them, so it is more like an unofficial engagement for the duration of time before you become engaged, and eventually marry. As a result, the whole family is a big part of the relationship, and unanimous approval is usually necessary. This is vastly different from the Western concept of casual dating, which is more about enjoying each other’s company than pursuing long term commitment. For that reason, it is important to be aware of how dating is defined differently to understand the cultural implications of introducing a significant other.

Beyond that, any time spent with your significant other is spent in a public place, like a cafe or park. You usually meet through family members, at school, or at work. And while arranged marriages do still happen in some villages, it is much more common to marry for love. Interestingly, the age at which Moroccans get married has been getting increasingly older, just like in the US and many other countries around the world. The reason for this has a lot to do with women seeking more education and better opportunities for employment instead of just a husband.

Within the context of marriage, my sources agree that every relationship is different. When a couple sits down to write their marriage contract, (yes, they do write it together) they specifically articulate the roles that they commit to play for each other. Typically, the man agrees to be the primary breadwinner, accepting sole responsibility to provide for the family. So if his wife also has a job, she has the liberty to keep all of the money she earns in a separate bank account from her husband, unless it is stipulated in the marriage contract that she will also contribute. Her responsibility is typically childcare, but many of the women I have encountered have put their children in daycare to take on work or more schooling themselves. Because the marriage contract delegates that responsibility to her, she is free to decide as she pleases about daycare. I found this to be a particularly interesting play on traditional gender roles in marriage, because while these traditional gender roles still exist, they have certainly been tweaked to allow more flexibility and freedoms for women in particular.

What do Moroccan women want for their future?

The same thing most women around the world want... To not be seen as any less or any more than who they are. To have the chance to earn the same opportunities in education, work, and life overall that a man can. To not have their competence judged based on how they look or how they dress. To have the freedom to be independent, self-sufficient, and powerful influences on society! Regardless of religion and culture, women can and should unite around making all of these goals a reality. It has been such a comfort during my conversations with these women to share in their frustrations, triumphs, and dreams in imagining a world where women are just as able to make a difference as men. This kind of rhetoric may make some uncomfortable, especially those who are wary of the many definitions feminism has taken on in recent years. And that’s okay. But remember the Brookings article... An empowered woman is an empowered society. And that’s something we can surely all get on board with! (Salma certainly agrees in the photo below!)

To conclude this post, I’d like to introduce some insights about Morocco’s current status of gender equality using international comparative research. As previously discussed, Morocco is a country whose gender equality usually looks quite good compared to its counterparts. But for this last part, I am going to remove the rose colored glasses. It is my hope that this will clarify and challenge the way we track progress in women’s empowerment as a tenet of overall societal development.

Fair warning: From this point on, I’m putting on my social science analyst cap on... This means I’ll be discussing variables, data, metrics/measurement, and all sorts of things that one who does not particularly enjoy social science may find a bit dull. However, this is aimed to be a *BRIEF* substantive analysis, which will synthesize a lot of the research I’ve been doing behind the scenes as part of this project. So I promise, if you keep reading I’ll make it worth your while!

Ranked at 139 out of 145 in the World Economic Forum Global Gender Gap Report of 2015, Morocco is a country whose gender equality often looks a lot better on paper than in practice. As discussed earlier, Morocco has one of the highest percentages of women in Parliament and is often thought of as one of the best Islamist countries for women. So what is it about this report that contradicts those accolades? Well, to put it simply, a more comprehensive metric.

The report evaluates gender equality using four basic categories: economic participation and opportunity, educational attainment, health and survival, and political empowerment. Each of these categories is further broken down into empirical variables that are measured using a variety of primary sources such as the UNESCO Institute for Statistics, the International Labor Organization, the World Health Organization, and more.

According to this data, no country in the world has successfully closed the gender gap yet. However Iceland, Norway, Finland, Sweden, and Ireland have all closed over 80% of their gender gap. That is a wide discrepancy from the lowest scoring country, Yemen, which has only closed 48% of their gender gap. At 139, Morocco has closed just under 60% of its gender gap. That is about 15% less than the USA, which ranked at 28 with 74% of the gap closed.

Though Morocco’s cumulative ranking is 139, it also received a ranking in each of the four categories that generated the final ranking. Those rankings were as follows: Economic Participation and Opportunity: 140 Educational Attainment: 123, Health and Survival: 95 and Political Empowerment: 97. From this breakdown, it is clear that the areas most in need of improvement are economic participation/opportunity and educational attainment. Which makes sense, given the continued struggle of unemployment in Morocco as well as the 67% literacy rate, (90% of which are women) as reported by the World Bank. Furthermore, this is why I have spent the last three months in a classroom working as a cross-cultural mentor teaching a lucrative language skill.

Though gender equality is different from women’s empowerment, I found that the two concepts inform each other quite well in creating and executing my project. I hope that through reading this post, albeit lengthy and (at times) complex, you too can see how my work has targeted the needs of my selected demographic. I also hope that you are taking away a better understanding about the culture and society that has shaped these women whom I’ve come to love so dearly. I am privileged to share their stories, but I know they’re not quite over yet! Speaking of which, be sure to check back later this week for another post that will tell the very special story of one of my dearest friends here in Rabat. You won’t want to miss it!

P. S. I will be revisiting this post to insert proper citations as soon as I get my hands on a laptop! Any questions about any of this information, don’t hesitate to ask!

Ramadan Mubarak!

Jun 13, 2016

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Last week, I shared my decision to participate in the month-long fast of Ramadan as a means of more fully immersing in my environment abroad. But what does it mean for a non-Muslim to participate in Ramadan? What’s the point? Is it difficult? When (and what) do you eat to stay healthy? But before we get into that, here’s a quick summary of what my typical day during Ramadan looks like:

I wake up around 2:30 AM to share a light breakfast with my fellow fasting volunteers. We snack until around 3:30, when the call to prayer rings out, indicating the sunrise. Some people choose to sleep through the night instead of waking up, but regardless of what one chooses, from sunrise to sunset, we fast. So no food or water from about 3:30 AM until about 7:40 PM. Because the whole country is participating, schedules change universally to allow for extra sleep in the mornings. My class now begins at 10:30 AM and ends at 12:30 PM. I get back to the house around 1:00 PM, and around 1:30 PM I have either Arabic lessons, a lecture, or cooking lessons. (As you can probably imagine, the cooking lessons are admittedly rough!) For me, this is the hardest part of the day. The only scheduled activity is to prepare my lessons for the next day, which usually only takes me 30 minutes to an hour since I like to do the majority of my lesson planning over the weekend. Many volunteers opt for a nap around this time to pass the day a little faster. Naps make me feel lazy, so I usually try not to. (Though I’ve certainly conceded once or twice!) I usually read for the last few hours, up until around 5:30 PM when the others start to wake up from their naps. We hang out and chat until around 7:00 PM, when we start to prepare the food for iftar, the breaking of the fast. A lot of the traditional Ramadan dishes are extremely sweet, (and delicious!) such as chebakia and sohor. This is to up your blood sugar after 15 hours of fasting! After enjoying a delicious and highly anticipated meal that lasts at least an hour or two, we start to get ready for bed around 10:00 PM. And then the cycle begins again!

Though it may sound intimidating, I haven’t found adjusting to the fast too difficult at all. It’s important to know your body and its limitations, so taking it easy is crucial, especially at first. (No running marathons on day one!) But you’d be amazed at how quickly the body adjusts to a different feeding schedule. To make sure that I’m staying healthy, I try to stay active by regularly going on walks around the neighborhood or to the medina. I also make sure to drink a lot of water throughout the break of the fast to stay hydrated. It’s also important not to eat too much too fast once iftar hits, because you don’t want to overwhelm your body with too much all at once. But these are all pretty straightforward guidelines, so perhaps you’re starting to see why the fast itself isn’t all that intimidating after all!

In my (very limited) experience, the hard part is the commitment. Right now, all of my fellow volunteers are participating in the fast. But next weekend, eight more volunteers will come who likely will not participate, meaning they will be eating at a normal schedule while living with us. This will be like a next level test of willpower for those of us here now, but I imagine this is just another day in the life for any Muslim not living/celebrating in a Muslim country... And for that, I salute them!

As a non-Muslim, Ramadan holds a different significance for me than my students. But the unending support and sense of respect I have earned in their eyes for participating in Ramadan as a foreigner has already made it so worth it. By doing this, I make myself a lot less of a foreigner and much more a part of the community. One of my students who describes himself as not particularly religious wrote a wonderful essay on the importance of the principle of Ramadan for class, and it’s all too appropriate to share an excerpt of his interpretation as part of my own justification for participating in Ramadan:

Because I am hungry and thirsty, I remember my brothers in humanity in Somalia, Djibouti, and everywhere else in the world. I invoke the suffering of these people with my fast. Ramadan is not just a principle of the Islamic religion. Ramadan is like a school to teach the great values of humanity: patience, tolerance, empathy, solidarity, kinship, respect, and forgiveness for our false assumptions about the lives of others.

No pun intended, but how’s that for some food for thought?