Scrubs

One of our team members offered to order scrub tops (and bottoms) for those of us who were interested.

 His daughter designed the logo, which promotes CACHA and is a great way to show team spirit!

I think we ended up paying about $8 CND for each scrub top. The plan was for everyone to order one for themselves and then order (and pay for) a second one that would  be donated to the Kilema Hospital.

More About the Medical Bins

The medical bins are actually large, blue Tupperware containers with several holes drilled around the lids for securing with plastic tie straps. They are stored in CACHA's warehouse in downtown Ottawa; a few blocks away from the their office.

In an effort to bring as many medical supplies as possible at a low cost, CACHA requires each participant to claim 2 medical bins as their personal, checked luggage. All group members are expected to help pack the bins and write out a detailed content list for each bin. From these lists, the mission lead will create a manifest list of all bin contents.

Participants can take the bins with them or have them delivered to the bus pickup point just before the flight.

Once the bins have cleared Canadian customs, they are then secured shut with the tie straps.

For the trip back home, participants are asked to bring the empty bins back with them, again as checked luggage.  The bins take a beating during the caravans, so many don't make it back.

If you're travelling light (i.e. carry on /back pack only) then the bin(s) you bring home will provide a way to cart home any souvenirs that you purchased.

Pre-Mission Meeting

In preparing for our mission, we attended a Pre-Mission meeting here in Ottawa at the CACHA Office, Saturday Sept. 11 from 10:00am to 05:00pm. This meeting is setup for participants so they may ask outstanding questions, raise any concerns, and help with bin preparation. (Bins are the containers we use to ship the medical supplies)

The meeting started with an introduction to one of CACHA’s founders Dr. Don Kilby who was there to address the medical side of the mission with the doctors and nurses who were volunteering. Having no medical background ourselves, I still found this part of the meeting very interesting and helpful overall.

Dr. Kilby explained that this mission is actually an outreach program of the Kilema Hospital so we are in fact representatives of the hospital while we are there. He went on to describe the hierarchy of health care facilities in Tanzania. Apparently there are three levels that we could be interacting with:

• Dispensaries—located in the rural villages of Tanzania, these locations only provide basic care, observation for 48 hours, midwive service and dispense medication
• District hospitals (of which Kilema Hospital is one) provide limited surgeries and an out patient department
• Regional hospitals—the closest for us would be in Moshi which is the Kilimanjaro Christian Medical Centre (KCMC)

Cost for care in the district and regional hospitals is $3/day for hospitalization, yet most residents cannot afford this. If given the money directly, many will end up using it for more urgent things like food.

The most common problems we will see are:

• Musculoskeletal (MSK) problems
• Goiters
• Large tumors
• Low hemoglobin count (apparently a low count of 4-5 is common)
• Many incidents of osteomyelitis (particularly in children) which may lead to amputations
• Malaria, Pneumonia, Urinary Tract Infection (UTI), Diarrhea, Worms, Tuberculoses, HIV/AIDS
• C- Sections

Rapid testing kits will be available for syphilis and malaria. All people who come to the caravans will be invited to take an AIDS test. Many fear that if they accept the test in public, they will be ostracized by their peers. Because of this, we have been instructed to also ask the question in a moment of privacy so that each person has an option to reconsider.

Our caravans will dispense the same amount of medication in 2 weeks that the local district hospitals dispense in 3 months.

Next was an overview of what the logistics team will be doing, presented by the mission lead, Lise Turpin.
Logistics participants (that's us !) will be trained to perform triage (among other things).
First step in triage is to take temperature, heart rate, and blood pressure.
Questions that need to be asked are:

• Are you pregnant?
• How many children have you had? How many are still alive?
• What is their main concern for this visit (try to limit to one)
• Invite them to have an HIV test

Translators are hired to accompany us on the caravans so they will be asking the questions (whew).

There is a common misconception amongst the villages that Gynecological exams are performed on both sexes; anything below the waist is considered gynecological! The Gyne team was warned not to be surprised if men showed up wanting an exam…they should (obviously) direct the patient to another doctor.

The emphasis from both Don and Lise was teamwork across the board; it's what makes these missions work.

We all broke for lunch and dined at a nearby restaurant—another good opportunity to get to know the people we will be on the mission with.

After lunch, we headed to a storage unit where the bins of medical supplies were located. These bins were pre-packed by other volunteers. Some bins contained logistics supplies, some medical and some a bit of both. Seeing that we, as volunteers, are traveling with these bins (they are essentially our luggage), we should know what’s in them. This is why it is important to participate in this pre-mission task. We spent some time counting and verifying the supplies based on pre-made lists. We ensured that the bin numbers matched with the identified items within. Bins are labeled and weighed to ensure they were under the maximum allowed weight (23 kg). Later a hard copy manifest of each bin will be created for the volunteers to take with them during their flights.

UGH...Paper Work

Besides a valid passport, CACHA requires that you fill in and submit the following:

1. Mission Sign-up form (available online through CACHA's web site)
   You first need to be accepted into the mission by CACHA. Filling out and submitting this form is the first step. If you are approved, then you'll probably be contacted by email. All necessary documents will either be included with the emaiL or contain instructions on how to get them.


2. Membership form
   If you are not a CACHA member already, you will need to purchase a membership $40 CND per person for one year.


3. CACHA Waiver form and Code of Conduct
   Obviously you are representing CACHA when you are in Africa so there are some waiver and conduct items that need to be understood and acknowledged.


4. Mission Volunteer Agreement form


5. Photocopy of your passport


6. Photocopy of your Travel Health Insurance


7. Copies of any professional licenses


8. Working Permit/Exemption form
   This is a work permit that will allow you to volunteer in Tanzania. You need to fill this out and submit to CACHA who will the handle the submission process for all the mission members.
   
   You need to submit 3 copies of this form to CACHA along with 5 passport size photos that have a blue background, plus photocopies of any professional certifications/licenses/diplomas for reference.
   NOTE: This form is different form the Tanzanian Visa which you, yourself are responsible for attaining. Submit your application at least one month before departure. The working permit must be processed before you can apply for your visa.


9. Entry Visa (obtain from the Tanzanian embassy in Ottawa)
   You will need to submit a passport picture with this application. The cost for a visa is $75 Canadian; cash only (no credit card or cheques). As well you will need a "letter of Invitation" showing that you have permission to be working in the country. The letter of invitation will be sent directly to the embassy by CACHA, who will inform you as soon as the letter is sent.
   
   About the visa application process:
   
   -the embassy requires that you leave your password with them! They have it for about a week (kinda stressful) and they "add a page" with your visa info.
   
   - when filling out the visa form, item #11-Purpose of Visit, should be checked off as Mission. If you are staying for travel afterward, also check off Travel, Leisure, Holiday. Be prepared to include all addresses of the places that you will be staying at during your visit (for both mission and travel).

A couple of notes regarding the pictures: The 5 passport size photos with the blue background are used by CACHA to accompany your paperwork. They don't need to be passport quality. You can get them taken at a photo booth as long as a blue background is available. We tried that route but found that the blue background came out grey, so we threw a blue sheet on a door, took some digital pics and printed them out ourselves.

There are tons of places for you to get your Visa passport picture.
A few we checked out in Ottawa...
for a set of two pics:
Blacks Photography (Bayshore S.C.) ~$23
Shopper's Drug mart ~$10
Costco $6.99 (if you can wait the 30 minutes without buying anything else in the store!)

Canada-Africa Community Health Alliance (CACHA)

Our plan is to volunteer with an organization called Canada-Africa Community Health Alliance (CACHA). We will be participating in CACHA's medical caravan mission in the Kilema district of Tanzania. This is a well established mission therefore a lot of the "kinks" of the mission have been worked out over time, so we are expecting smooth sailing (for the most part). 

Neither of us have a medical background so we will be participating as logistic members. What does that mean? Well for now what we believe it to be is: packing, unpacking, pharmacy inventory, counting pills, talking to residents, logging some of their personal information for medical stats, setting up reception areas, and generally entertaining the locals while they wait to see the doctors. More to come on what we actually do in later blogs. 

This particular mission lasts for 14 days. During that time we will staying at the Kilema Hospital which is built on the slopes of Mount Kilimanjaro. 

According to the web site InterCare-Medical Aid for Africa Kilema Hospital http://www.intercare.org.uk/health-centre/tanzania/kilema-hospital 

"...is run by the Sisters of Our Lady of Kilimanjaro and has a catchment of around 228,000. This was the very first hospital in this area to be set up by the European missionaries. They chose this site – high up on a hill – because the place was too high for the mosquitoes so there is virtually no malaria caught in the area. The place is beautiful, and pine trees (planted by the missionaries to remind them of home) grow alongside lemon and orange trees. To reach the hospital it is necessary to travel on very poor roads up the slope of the mountain and in the rainy season this is virtually but not quite impossible. " 

 Every day we will be driving out to the surrounding villages with our "caravan" of supplies and people. Hope the rainy season is over by the time we get there.