June 24th - The Real Dar Es Salaam

Today at Pasada, we spent the day with the Home Based Care team, who regularly drive out to people's homes when they do not have the ability or health to travel to one of the clinics. We piled into the back of a Land Rover and drove about 40 minutes to see our first patient. This was the first time that we had really driven off-road and the first time seeing the 'typical' Tanzanian community.

I don't want to call it squalor, because the people deserve more respect than that word expresses, but these communities are collections of dusty and tired shacks built with concrete  or brick if the family was lucky or mud with scrap-metal roofs if they were less so. The roads are pitted and would probably be impassable in anything other than dirt bikes or trucks. Shops hawking wares lined many of the narrow roads, with bunches of bananas, oranges and papaya on display next to khangas and seemstresses: the colours of each seeming to compete for our attention as we drove by. We got many stares driving through these neighbourhoods, and many children, as soon as they saw us, would immediately scream "Mzungu" and run towards us excitedly, braking off from whatever game they were playing. The kids were typically dressed in dirty old clothes that were probably second hand from Europe or North America in the 80s or 90s, but many of the adults are dressed smartly, in khangas (colourful fabric that can be used as a skirt or shawl) or dress pants and button-up shirts.  

Despite their conditions, every family who we called in on were incredibly gracious and seemed proud to have us in their home. They greeted us all with a warm "Karibu sana" and went to great lengths to make sure we were seated comfortably, even if it meant sitting on the floor while we took their chair (it felt a little awkward). They seemed interested and understanding of what we were doing there and comfortable enough to allow the medical assistant who was with us to translate their health histories for us. We saw AIDS patients with opportunistic infections, space occupying lesions in their brains, neuropathies and even called in a one person's home to find that he had passed away one month previous. It was tough to see. Many of these people would never progress to their stage if in Canada, but the lack of resources here is a death sentence to many victims of the virus.

I don't think I could ask for a better exposure to Tanzanian life in one day and I'm sorry that I cannot fully express the reality here in words or pictures. I had my camera and snapped some photos from the window of the car, but I felt wrong bringing it out on the street, as if I were a tourist. We got to see some beautiful countryside though, and I've tried to include some representative shots