The Global Implications of Poverty

During my recent volunteer excursion to Tanzania, Africa, I engaged in occasional discussions with the District Medical Officer of the Bagamoyo District Hospital where I worked. He could not contain his frustration at the problems faced by him and his staff in running the small, dilapidated, rural hospital, the oldest in East Africa still standing, and often disclosed some of these concerns to me. As we walked past the maternity ward of the hospital, he pointed to a shattered window at the front of the building, jagged pieces of glass emerging from above the grayed white-washed building. “Do you see that glass?” he asked, “It has been broken for months. In order to get it fixed, I would have to write ten letters requesting the government for money to repair it, have them passed through four departments of the hospital before they are sent to the appropriate government office, where they will be reviewed for a few weeks or a few months, and then a return letter will be sent back denying my request. Then we will repeat the process. This is only the beginning of what we have to go through to get even the smallest amount of funding.”

The health issues faced in Tanzania alone are staggering – Malaria remains the number one killer, its primary targets children under the age of six and pregnant women, both of whom have lowered immunity during these vulnerable phases of their lives. Every individual in Tanzania contracts Malaria at least a few times a year, and though easily cured with anti-malarial medication, not everyone can afford the 10,000 shilling price tag which is roughly $8 US dollars. The Bagamoyo District Hospital recently opened a Malaria Vaccine Research Clinic with international funding – the clinic is state-of-the-art with its own generator – however, the rest of the hospital comes to a standstill for several hours a few times a week when the electricity goes out, the idea of a $100,000 US generator completely out of the question.

HIV/AIDS and TB follow closely behind Malaria, with seven out of every one hundred Tanzanians infected by HIV/AIDS, and TB accounting for a third of AIDS deaths. In the HIV/AIDS clinic of the hospital where I worked, by 8:00 am the benches outside the clinic were full of men, women, and children on days the clinic was open, waiting either to be tested for HIV/AIDS, or to follow-up on their current HIV/AIDS status. The woman I worked with in the clinic, Awlina, did not arrive one morning. Assuming she was just running late, I tried to get the computer started to update the patient database, but the electricity was down. I sat on the clinic steps instead, and played peek-a-boo with a small boy waiting to be seen by the clinic. I had begun to be able to tell the difference between an HIV+ child and a child with full-blown AIDS, despite the obvious physical signs – the AIDS children did not play. They did not even look at you. One little boy’s head was being held up his mother. Every time she let go, his head would fall face-down onto the concrete floor – he did not have enough strength to hold it up. His eyes were entirely a blue-tinged white from blindness, and he registered nothing.

Awlina arrived a few hours later, her eyes bloodshot and drooping, sweat pouring from her face. “I’m sorry I’m late!” She rubbed her face and laughed a short burst of laughter. She looked around for a chair and collapsed on it, exhausted. “I was at the doctor’s clinic getting medicine….I have Malaria.” I was rather shocked and asked her why she insisted on coming into the clinic when she was so ill, surely she should go home and rest? “Ha!” She laughed again. “These documents were supposed to be finished last week! They must be sent out by the end of this week latest, there is too much work for me to go home!” Awlina’s working hours are supposed to be Monday, Wednesday, and Friday, the days the clinic is open, from 8 am until 4 pm – she works Monday to Saturday, often until 8 pm at night. “You know, there is only me working in this office, no one else.” Her head was drooping over the keyboard as she typed on one of the hospital’s only computers, and I finally managed to convince her to lie down and sleep on an unused bed in the corner, normally piled with patient files, while I resumed her work.

The rise of HIV/AIDS in Tanzania means the rise of AIDS orphans. There are approximately 11 million children in sub-Saharan Africa that have lost one or both parents to AIDS, according to the World Health Organization. I passed by a small orphanage on my way home from the hospital each day. I walked up the dusty path and peaked through the open door of what I was beginning to think was an abandoned orphanage, when I little boy in blue shorts appeared and giggled at me. I greeted him and tried to explain myself in broken Swahili, but he only laughed more. I was grateful that he had at least not screamed, “Mzungu!” (Swahili for ‘white person’, but often used for any non-African foreigner) at me and run off in fear, as the other children occasionally did, but instead pulled the Swahili-English dictionary out of my hands and looked through it bemused. A slightly older girl appeared, and she shyly pointed at my camera, so I showed it to her and then took a picture of them both before I left. Later, I asked the volunteer director of my program why there were no volunteers at the Tumaini Orphan Care Centre, and she told me the centre had refused volunteer help because the volunteers would have nothing to do. With no money, no clothes, no food, and no school supplies, the orphanage did not house any orphans.

The words of the District Medical Officer at the hospital were recalled to me: “Money is only the beginning. What we really need are people with management skills who know how to improve the way things work. Maybe the hospital will get more doctors and more money, but if we keep doing things the same way they are now, things will not change.”

Nabia Majeed is a member of a Calgary-based organization called The Orphan Sponsorship Program, which seeks to raise awareness and funds for orphans living lives of destitution and hardship worldwide.

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