Thursday, October 23, 2014

The Great Travel Debacle of 2014

I know I have been on a lengthy blog hiatus lately and for those of you that don’t know I have a new job which is entirely irrelevant to this story.  Suffice it to say, I took a new position in March of this year at University of Washington (UW) at I-TECH (http://www.go2itech.org/).  I am now the Research and Evaluation Advisor supporting the Tanzania country program and I promise my next post will be much more about my ew(ish) job and much less about the Great Travel Debacle of 2014.

I am writing this story for two reasons:

1.  I cannot deny I have always had a flair for the melodramatic.  At 38, I can finally admit to this to all of you.  It is time.

2.  I do not EVER want this situation to happen to you and if I can save one (ok), two (better), 50 (feeling even better) or 1000 (maybe I will ever consider the phrase “maybe worth it”) I will be really happy.

Let’s go back in Liz Blanton’s travel story so you can have proper prospective before I launch in.
  • In 2007, while in Nigeria, I decide to go on a weekend trip to Benin to get away from the sheer chaos of Lagos when I realize upon reentry to Nigeria that I only had a single-entry visa and was stamped out of Benin and not yet stamped into Nigeria and was in “no man’s land.”  This required a few hours of (scary) interrogation from Nigerian officials and a call to a high up diplomat to bail me out.
  • In April 2008 I contracted Dengue fever in Indonesia.  This still remains to this day the greatest travel debacle of my career.  After a painful illness I make a full recovery.
  •  Somewhere in 2009 I had an epic trip across West Africa traveling to East Africa due to a flight cancellation and rerouting that went ATL to Senegal (arriving at 2am, leaving at 7am), followed by a flight to Mali that sat on the runway for hours in over 100 degree heat, then to Kenya.  During the sort-of overnight in Senegal I had the pleasure of sleeping in the airport hotel full of prostitutes and over-pushy West African dudes.  The whole trip took 30 some-odd hours and I had to go straight to work when I arrived in Kenya at 8am.

The story I am about to tell falls somewhere between the Nigeria and West African travel journey and is the story of the great travel debacle of 2014.

Day 1 – Oct 18, 2014
I am unusually happy on the way to the airport 2.5 hours before my flight from Seattle to Amsterdam.  I had a leisurely day packing the day before and felt ultra-prepared and well rested.  I even conceptualized the perfect travel outfit, yoga pants and sneakers and one over-priced wool tunic that would cover my ass from Athleta (http://www.athleta.com/).  I made a special trip to U village (god I hate that place) to purchase this tunic.  Had I known that I would literally live in said tunic for five straight days I may have felt slightly less guilty making the purchase.  I get to the airport and meet up with my new beloved colleagues – boss Shelia and Lauren. 

I am pretty excited to travel with both of them. I not only get along with them really well but I have an immense amount of respect for the type of heart and soul they pour into the work that we do.  Lauren and I go to the lounge and run into two of my previous coworkers from PATH; including an all-time favorite Dunia and one of my old WASH colleagues, Andy, who will both unexpectedly be on my flight to AMS from Seattle.  So, there I am on the flight surrounded by 4 or my current or previous coworkers and I feel pretty happy and connected to my small global health world surrounded by good people who do good work.  I don’t sleep a wink on that flight, but that is ok…..I am a pro, right?!  We arrive Amsterdam around 8am.

Day 2- Oct 19, 2014
I say my goodbyes to Dunia and Andy and wish them luck on their leg to South Africa then I split up from Lauren and Shelia and go to walk around the airport for a bit.  At approximately 9am (one hour before my flight) I go to the gate and hand my ticket to the KLM agent checking people in to the boarding area and I realize he is holding my passport, counting on his hands, and deep in thought.  Then he brings to my attention that my passport expires on 02 Mar 2015, which means I am less than six months from it expiring (~5.5 months), which means…..little did I fucking know….I cannot travel on to Tanzania.  Apparently Tanzania and many other African countries require that you have at least six months left on your passport to enter their country leaving me to wonder what is the point of the expiration date.

I would like to pause here for a moment and say two things:

1.  The use of explicit language is an absolute necessity the rest of this post.  Mom and Dad, I am sorry but it is a must. I was in a desperate situation that cannot be described justly without cussing like a sailor.

2.  I fully recognize that a good number of global health folks are on my blog list.  You know who you are.  If you are thinking to yourself right now, “OMG, of course, I can’t believe Liz didn’t know that?” I strongly urge you to keep your mouth shut!  Sorry, but it is a sensitive topic and I have heard way too many similar sentiments over the last few days that if I hear it again I may react violently and out of character.  If however, you are thinking to yourself, “OMG, I had no idea either!” please feel free and at absolute liberty to tell me that in your sympathetic reply to my blog post.

The astute mathematician KLM agent then proceeds to tell me there is no way I can proceed to Tanzania and directs me to a similarly curt check in agent lady thing that informs me that I will not be getting on the flight and they will be offloading my bag immediately, as if I committed a crime!  I keep repeating in awe that I had no idea of this rule and can they please page my boss Shelia so I can inform her I won’t be on that flight?!  They page Shelia.  She comes and exclaims that she too had never heard of this rule (didn’t I say she is nice and awesome) and we proceed to say our goodbyes.  Shelia and Lauren board the flight and there I am in the AMS airport with no clue what to do now.  Curt agent lady thing directs me to the transfer desk for assistance. 

At the transfer desk, a somewhat nicer KLM lady actually helps me (a little) and tells me I will need to go into Amsterdam and try to work something out with the US consulate.  She prints out their address and business hours for me and tells me I should go into AMS for the night and get a hotel close to the consulate and try to visit when they open first thing in the morning.  It is Sunday and they don’t open until Monday at 8:30am.  She says to go to the tourist booth outside of baggage claim and they will help me fine the hotel.  Her parting words are, “Honestly, there are much worse places than Amsterdam to get stuck for the night.”  I completely agree and at this point I feel a false sense of hope that this can be easily worked out without too much stress. I manage to collect my missing bag after 3 hours of them looking for it during which time was the only time in the whole 72 hour experience I almost cried staring blindly at an empty baggage carrousel for hours.

The nice tourist lady directs me to a 3-star, budget, twin-bed room for 160 euros a night approximately 1.5 miles from the US consulate.  She tells me I can take a bus 197 for 5 Euros that is a straight shot into town and then a 10 minute walk to the hotel.  Super!  I get on the bus and the driver tells me there is not one but several marathons in town that day (like 5, um, who has 5 marathons in one day?) and he will need to divert the route but is still going to the center of town.  I decide to go for it and think to myself I can get a taxi or some other form of transportation once I get there if necessary.  Mind you I am pulling two roller bags of approximately 70 lbs. of luggage.  When he gets to the stop in town I realize my hotel is on the main road through town and that at least one of the marathons is also on that road and it is completely block off to any through traffic.  GPS at this point says I am 2.5 miles away and I will have to literally pull the 70 lbs. of luggage through a festival size swarm of people to reach the hotel.  No other options…gotta do it.  And then it starts raining.  Did I bring rain gear or cold weather gear?  Nope sure didn’t!  Just the overpriced Athleta tunic which thankfully is hooded.  I get soaked on the way to the hotel and so does my 70 lbs. luggage.  And little to my knowledge, this is the first of many soakings in the cold rain over the next 48 hours.

White bean ravioli with roasted pork shoulder
I check in to my room roughly the size of our bathroom in Seattle and realize I have about 30 emails to write notifying people of my situation at which point I start to feel the effects of not having slept in about 40 hours.  I take a hot shower and treat myself to my first indulgent meal of Amsterdam at a high in crowded pasta place called Pekelharring (http://www.pekelhaaring.nl/).  I can’t lie, this place was fantastic probably even for the non-delirious traveler.  I had the white bean ravioli with roasted pork shoulder and two glasses of wine.  I never crave/order pasta, but trust me, I needed it.  This is my first happy moment of the day.  I go back to the hotel and pass out for ~7 hours.

Day 3 – Oct 20, 2014:
Gorgeous morning in Amsterdam
Wake up at 7am and head to straight to the consulate.  The website says that all passport services are by appointment only (I have a scheduled apt the next morning) but it never hurts to just go beg in person.  It is lovely day in Amsterdam and the consulate is in Museumplein which is close in proximity to the newly reopened Reiksmuseum and Van Gogh Museum.  The last time I visited Amsterdam (aside from the airport) was when I was in undergrad over 15 years ago and sad to say my priorities in visiting were slightly different back then.  ; ) I walk over several picturesque canals and decide to try to make the best of my otherwise crap ass situation and try to take this opportunity to revisit Amsterdam and possibly even take in a museum because I am staying so close.

Rijksmuseum
I am staying in the lovely bohemian neighborhood of De Pijp (http://en.wikipedia.org/wiki/De_Pijp), which used to be home to much of Amsterdam’s working class and artists but now is a much more affluent part of town.  It still retains an artsy character with cute outdoor cafés and boutique shops and vintage stores.

I locate the consulate and there is a substantial line.  I approach the security guard outside who is checking folks in and tell him I have got somewhat of an emergency passport situation and have an appointment tomorrow morning (Tuesday) and ask him if there is any point in me standing in line and waiting.  He says no, it has to be tomorrow morning.  Ok great.   Then I tell him briefly about my situation and ask him what the minimal amount of time will be to resolve my situation.  He confidently says, “Oh it can be taken care of in one day.  You will probably drop off your passport tomorrow morning and pick it up in the afternoon.”  Hmmm, this is unexpected and great news; however, I acknowledge he is the security guard checking people in and not a customs officer. I am cautiously optimistic.  I head back to the hotel and extend my stay another night and start investigating flight times and seeing how full the flights look to Dar.  There is one Tuesday night that routes through Kenya and another one on Wednesday morning that is identical to the flight I was supposed to be on Sunday.

I write to update my team and the country office that I will likely be in Tanzania by Wednesday night.  After several hours of work in the early afternoon I decide to go on a city walk.  Keep in mind that Tuesday was the only dry, nice weather day that I was there.   I consult my friend Katherine, who had recently been to Amsterdam a few weeks ago and she tells me to go to the ‘nine little street’ section of town where 3 famous canals separate nine street and it is full of boutiques, cafes, storefronts, etc.  It is a couple of miles from my hotel so I head out on foot and successfully locate the area.  The area is really cute and I am struck by how fashionable and expensive the clothes are.  I think even more so than in previous years of my life, living in Seattle the last 4 years is really taking a tool on my opinion of buying expensive clothing items, expect the tunic that I have on (of course if you are going to buy something expensive it best be outdoorsy).  After walking around for an hour or so I head back to De Dijp and settle on a panini at Meme’s Café which is a really cute artsy café with fantastic paninis which I wash down with a stellar latte.  Feeling pretty happy about all of that I head back to the hotel to do some work and have a lengthy call with boss Shelia. 



Fancy number two dinner that night was classic French food at L’Entrecote les Dames (http://www.entrecote-et-les-dames.nl/).  The reviews I read about this place said that they only have two options on the menu (fish or meat) but they do both very well.  It is a price fix menu of bread and butter, salad, and fish or meat.  The salad was delicious, fresh baby lettuce with a mustard vinaigrette dressing and walnuts.  I chose the fish which was a lemon sautéed filet of sole served with pomme frites and mayo.  ;)  This place lived up to its reviews and was delicious.  Day 3 was definitely the best day I had during the great travel debacle of 2014.

Day 4 – Oct 21, 2104
Day 4 would receive a 1/5 stars from me and rivaled day 2 for worst day in Amsterdam.  I woke up at 4am and couldn’t go back to sleep, jet lag fully setting in.  It has been storming all night which continued at that rate for the next 24-hours.  I set out for the consulate in my standard uniform – jeans, tunic, lattice toms, and a purple scarf that I found in my bag.  Imagine the beginning of Homeland where Carrie is running through the streets of wherever she was in the Middle East looking sketched out and followed.  That is what I looked like!  Tunic hood on, scarf wrapped around my head, head down, walking at a fast clip through the pouring rain (cue Borne Identity sirens in the background).  Mind you, I would have stopped to buy an umbrella but in no way wanted to be late to the consulate. 

I get to the consulate and huddle with a mass of people under a pretty useless little 6/6 foot tarp they strung up which wasn’t all that helpful seeing at the wind was so strong and the rain was coming in at a hard downward tilt.  There I stood at 8:20am shivering like a wet cold dog. The security guard comes out and asks who has an 8:30am appointment.  About half of us raise our hand.  Then he asks who has a cell phone and about 5 of us do (including me).  He asks that we line up – non-cell phone people on the right and cell-phone people on the right.  Let me pause here.  

I was well aware that the website requests that you do not carry any electronic devices (laptop, cameras, or cell phones) to the Consulate or “your entry could be delayed.”  However, in my defense, I had very good reasons to carry my cell phone. 

1. My hotel was 1.5 miles from the Consulate and it was pouring fucking rain.
2.  Boss Shelia wanted to be updated as soon as I got out of my appointment.
3.  I would need to try to reach KLM by Skype and possibly rebook my flight for that evening if I figured out I would, in fact, receive a new passport that day.  Time was of the essence.
4.  I needed to call KLM to determine if I needed to tell the hotel I needed another night (check out time was 11am).
5.  Skype calling did not work very well from my hotel room, it was pouring rain, and my best bet of reaching KLM by Skype was calling from a coffee shop, one of which was conveniently located by the consulate rather than having to sketch walk back to the hotel in the pouring rain, get phone or computer, go back in the pouring rain and walk to coffee shop.

I mean for fucks sake, I did not just blatently ignore the website and instructions; I had legitimate reasons for having my cell phone.

So the punishment for bringing a cell phone was letting everyone else in for about 45 minute, including admitting non cell phone people who had appointment at 9:15, 9:30 and 9:45.  My appointment was at 8:30 and I am just standing there shivering like a dog.  Are you fucking kidding me?!  The guard even told people with a car nearby to go ahead and put their call phone in the car and he would and did admit them.  The woman behind me started raising hell and asked how long this was going to go on and he replied, as long as there are people walking up without cell phones.  Prick! 

Finally the cell phone line devises a plan to give all of our cell phones to one person.  This really nice African woman at the end of the line offers to hold all of our phones so that we could take turns going in and alternately holding one another’s cell phones until another person cycled through.  That is right I just turned over my I- Phone over to a random stranger in line who I didn’t ever know her name and then got in the right hand line.  Then the guard asked me if I had a cell phone.  I replied, “I obviously just handed my phone to a random stranger to hold and don’t have a cell phone on me anymore.”  She smiled and said “Great!”  Asshole!!!!!!!!!!!

Sigh…I finally get checked in to the consulate.  An overly exuberant customs officer listens to my story inside and says “Yeah, you really need to have 6 months of time left on your passport.”  It’s a good thing that glass he is speaking behind is really thick.  Yes got it.  Expiration dates on passports don’t mean shit and are arbitrary dates put on there to fuck with you.  Lesson learned.  Don’t need to hear it again…..EVER!

Then he says, “What we can do for you today is issue you limited validity Emergency Passport but there is no guarantee that the Tanzania government will let you in on such passport.”  In other words, what he was saying is that I will just simply have to fly there on this emergency passport and try it out at custom in Tanzania and no guarantee that they will let me enter the country.  OMfuckingGod, are you serious?!  I get to stress about this the next two days.  Yep.  Sure do.  They tell me to come back and collect possibly useless $110 emergency passport at 2:30pm.  I go outside and get the stack of cell phones from the sad looking line of cell phone carriers and then proceed to wait another 30 minutes for the next person to come out of which to pass off the shamed cell phone stack.  Honestly, this portion of the story had to be by far the most ridiculous and just plain unnecessary practice by the US consulate.  Come on!!!  Is insult to injury really necessary?!  Is it possible that every other consulate in the world has a cell phone check in when you go through security?  I don’t think I need to belabor this point any further.  I think I have adequately described how I felt about this particular situation.

Leave and go to coffee shop nearby and order a latte.  Call KLM and a very nice gentleman rebooks me on the morning flight at no additional charge (because of involuntary rebooking) in my aisle economy comfort seat.  Finally, something is going my way.  All this gets worked out for me to extend my hotel room again for one more night by 11am.  Do some work….update my boss.
Dutch Sausage Sandwich

There is a slight lull in the rain (equivalent to a Seattle misting rain) and I decided to head to Kingfisher Café (http://www.kingfishercafe.nl/) for lunch.  I want to order this traditional Dutch Sausage sandwich and the waiter warns me it is an acquired taste.  He explains that it is raw ground sausage, that is smoked (so not raw), but maintains the consistency and color of raw ground sausage.  I am intrigued and decide to go for it.  It was really good.  Nice bun, fresh veggies and basil mayo.  Practically nothing is served without mayo in Amsterdam which really speaks to my heart.  ; )

Back to the hotel in the rain.  More work until 2:15.  Back to the Consulate in the pouring rain, soaked, without a cell phone, back to the hotel in the pouring rain to get my cell phone and or computer.  Decide to just stay there and work.  The weather is too miserable to go outside.  Decide to get pizza and set out in the rain looking for a pizza place, get lost in the rain and can’t find it.  Give up all hope for the day and get a take-out burger at Geflipt (http://bysam.nl/getest-geflipt-nieuwe-burgerbar-de-pijp-amsterdam/) and get totally soaked in the pouring rain on the way back to the hotel.

Did I really eat a raw sausage sandwich followed by a burger for dinner?  I sure did!

Day 5 – Oct 22, 2014
Despite a million canceled and delayed flights mine takes off right on time and I get to Dar 10 hours later and fly through customs with my two passports (one emergency with 6 stupid months before expiry and one with 5.5 months with an active Tanzania visa.

11:30pm – crash in my hotel room in preparation for an early morning call today.  That is right…..after 5 very long days I finally arrived Tanzania!

A summary of lessons learned and afterthoughts (I believe they call these ‘post-mortems at PATH – ha!):
  • ALWAYS….ALWAYS read the visa page before traveling to the country.
  • Travel confidence can be the kiss of death.  I pretty much thought I knew it everything about international travel and it got me into trouble this time.
  • Never and I mean never take your phone to the US consulate – you will regret it!  Stash it in the bushes or give it to a random stranger in line or just don’t bring it ever.  Or you can opt to just throw in the middle of a busy street, which is what I almost did that day.
  • As amazing as Amsterdam is, it is cold and fucking rainy in October.  If at all possible go ahead and pack that rain jacket, even if you think you are visiting a sunny tropical climate.
  • The expiration date on a passport can mean nearly nothing.  Just to be safe always renew 6-months in advance.  No shit.  Lesson learned.
  • Amsterdam is killing it in the culinary scene.  Plenty of awesome food around there to drown your sorrows in when stranded for 4 days.
  •   I fully acknowledge and understand there are much worse things that can happen to a person while traveling (i.e. you can contact Ebola).  My experience was simply a slight nuisance rather than a life threatening condition which is precisely why it was ranked down on the travel debacle index.

I think this post is more of a short story than a blog post.  Oh well, I think it was cathartic for me to put the whole experience behind me.  If the story was not entertaining, I hope it was at least informative and keeps 1, 2, 50 or 1000 of you out there from going through the same experience.  ; )





Tuesday, November 5, 2013

Family Planning Matters!!

Sign on the wall at a health center in Mayuge District
Hello from Uganda!  I am here again in the warm sunshine just narrowly missing the start of the cold rain in Seattle.  Sometimes trip timing has its benefits.  I am in Uganda for the next 7 days on the way to the International Conference of Family Planning happening in Addis Ababa, Ethiopia next week.  Believe it or not, it was more cost effective for me to come to Uganda first than to go straight from Seattle to Addis.  Fine by me, there is plenty of work to do here in Uganda.

As you may know from my previous posts, PATH is responsible for the introduction and evaluation of Sayana Press (http://sites.path.org/rh/recent-reproductive-health-projects/sayanapress/) in the four countries of Senegal, Uganda, Burkina Faso and Niger.  The product is intended to be delivered to woman by lower level community health workers to inject.  Theoretically, this could help women access family planning in their communities rather than having to travel  to a health facility and  see a trained medical professional for their family planning injection.

So, you may be asking yourself at this point, why does that matter?  This photo may help to illustrate.

New mother to triplets at a heath center in Mayuge
We met this woman yesterday at a maternity ward at a health center III in Mayuge District. Two days prior she had given birth to triplets, which were her 7th, 8th and 9th child at the age of 32.  The story was rather remarkable.  She is from rural Uganda and never had a prenatal appointment during this pregnancy.  When she went into labor she went to her TBA (traditional birth attendant) in her community to give birth.  She thought she was only having one child.  After hours in labor, the woman was weak and in trouble, and the baby was breached.  The TBA recommended she go to the health center, but they had no money for her to get there.  So, while she was struggling through this difficult labor the family begged from the kindness of strangers to help her get to the health center.  Luckily, help came through and she was transported to the maternity ward of this health center.  After the first baby was delivered, her stomach was still very large and they realize another one (or two!) were still in there. The midwife at the health facility said, “She is lucky she made it there and there were plenty of us around to help” deliver her babies.  She only brought one dress to change into and has no money for clothes for the children.  She was accompanied by her husband in the maternity ward, where they are trying to keep her and the babies there for another couple of days because they are so small and as the midwife stated, “They only have a dirt floor and it is not safe for the babies with sensitive immune systems.”  It goes without saying we offered money to help with the babies and their basic needs.

The gravity of a mother with nine children at the age of 32 weighs heavily on me.  This is not uncommon in rural Uganda, where access to family planning services is limited.  I hope that Sayana Press can help make a difference in hard to reach areas and gives some women more choice and control over their reproductive health.

Wednesday, August 28, 2013

You know you are in Uganda and not in Seattle when.....

Truck going to the market
1.  Your driver throws all his trash directly out the window, including 1 Liter plastic water bottles (every time!).

2. The truck carrying people to the market looks like the photo instead of the Seattle city bus.

3.  Large 4WDs are not only popular, but absolutely necessary.

4.  You spent most of your time the last two weeks on unpaved dirt roads that are TERRIBLE.

5.  There are grass huts throughout the neighborhoods as opposed to Craftsman Bungalows.

6.  You have suddenly gone vegetarian the past two weeks because you don't like the taste of boiled meat.


7. The bigger the vehicle the more right-a-way you have on the road.  Bicycles...look out!

Current banana surplus



8.  You are expected to eat at least 4 or 5 mini-bananas a day and if you do or don't, people will keep buying them for you and you will have a banana surplus.

9.  Big IS beautiful for women.  If you are thin, something is wrong with you or you must be sick.

10.  There large beautiful mango trees everywhere.
Mango Tree

Friday, August 23, 2013

Sayana Press

Maternal mortality rates are alarmingly high in sub-Saharan Africa with over 800 women dying a day from preventable causes related to pregnancy and childbirth.  Almost all these women are among the rural poor in developing countries.  A landmark announcement was made at the 2012 London Summit on Family Planning where donors and leaders around the world pledged their commitment to ensure that 120 million women gain access to voluntary family planning services by 2020.  Read more in the press release here: http://www.londonfamilyplanningsummit.co.uk/1530%20FINAL%20press%20release.pdf

At this summit the Ugandan President, H.E Yoweri Kaguta Museveni, said In developing countries like Uganda, women continue to die so needlessly during pregnancy and childbirth. Yet the causes of these deaths are well known and so are the solutions. The causes are largely preventable. Use of relatively cheap technologies, including family planning can lead to rapid improvements in conditions of women.”
Sayana Press

At this meeting a donor consortium made up of The Bill and Melinda Gates Foundation, DIFD, USAID, UNFPA, and Pfizer, Inc. agreed upon the purchase of 12 million doses of Sayana® Press to help reach some of the 120 million women pledged by the Family Planning 2020 goal.  Sayana Press is a form of the injectable birth control, very similar to the method Depo Provera.  Depo, as many of you know, is a shot that women get to prevent pregnancy protecting them for 3 months.  In its current form, Depo Provera must be administered in a clinic by a trained practitioner intramuscularly with a one inch long needle.  The new product, Sayana Press, is the same medicine (Depo) but in a different injection system.  This system, called Uniject, is a technology that was developed by PATH, and is an all in one injection device, with a small needle that can be injected subcutaneously.  The Uniject system allows for the same drug, Depo Provera, to be delivered to women outside the clinic setting.  Therefore unskilled community health workers can take the injection to women in the most rural of areas and administer it without them having to come to a clinic.  The donor consortium and PATH have a strong hunch that this will greatly increase access to family planning for the women who need it most. 

PATH won a grant to coordinate the introduction and evaluation effort for Sayana Press.  Within our grant we will be introducing the product in four to six countries and conducting a large outcome evaluation in 3 countries between 2013-2016.  I was hired on the Reproductive Health, Sayana Press team, to provide technical support of the evaluation. 

Plans are well underway to introduce in Senegal, Uganda, Burkina Faso, and Niger.  We will be evaluating in Senegal, Uganda, and a third country yet to be determined.  I am currently in Uganda conducting district visits in 22 selected districts that the Ministry of Health would like to introduce. The purpose of my trip is to visit with government district health teams and discuss the project and get some information from them that will help with introduction.  In addition, I am visiting a health care center in each district where women receive family planning services.
Community health worker in Uganda with Sayana Press


More about our project here:  http://www.path.org/projects/uniject-dmpa.php


I feel honored to be a part of this team and excited about the next 3 years.

Monday, August 19, 2013

Update - New Beginnings

In February, I made the difficult decision to switch teams at PATH from the WASH team to the Reproductive Health team.  The decision was precipitated by a number of uncertainties and difficulties within the WASH team, not the least of which was the lack of funding.  With the help of my super supportive supervisor, I was able to identify two promising options for teams at PATH which could potentially benefit from my skill set and expertise.  After carefully considering both options and consulting a number of old colleagues and friends, I decided to pursue the opportunity with the Reproductive Health team.   The Reproductive Health Global Program at PATH is solid and well-established.  The work ranges from the cervical cancer prevention, to breast cancer research, to the development of new, more acceptable methods of family planning, to advocacy for safe abortion.  After working 100% with team for the last 6 months I am happy to report it was a really good switch for me. 


I think my biggest concern/hesitation of making a topical switch was wondering if I would be as passionate about Reproductive Health issues as I am about water and sanitation.  After spending nearly a decade in WASH and pouring a good amount of my heart and soul into that work, would I be as excited within this new position?!  As I debated this, I thought about how lucky I am to have spent nearly the last 20 years of my life avoiding unintended pregnancy by having easy and cost-effective access to a variety of family planning options at more or less the drop of a hat AND in the near absence of oppressive stigma.  And then I thought about women in developing countries that I have worked in and I thought about how their choice, options, and means of obtaining contraception must be severely constrained.  Not to mention access to preventative cancer screening such as the ye ol’ dreaded pap smear that I now feel we TOTALLY take for granted.  Needless, to say the new team has opened up my eyes to a wide-array of public health issues in global reproductive health.  I feel happy and reinvigorated in the new position and am happy to report the team dynamics have also improved dramatically.  Suffice it to say, Liz Blanton is much happier in the RH group and you know when I say it in the 3rd person I really mean it.    More about the current trip soon...

Saturday, November 24, 2012

Starbucks Community Needs Assessment


Jai and Mtemi (the Starbucks Agronomist)
PATH recently received funding from Starbucks Foundation for the purpose of strengthening safe water and sanitation in coffee growing communities they buy from as part of their cooperate responsibility.  Jai and I are here to start this project by conducting a rapid community needs assessment in their areas of interest.  The premise of our proposal to Starbucks was to work with communities to identify the needs and gaps that need to be filled in water and sanitation and then work with them to design the appropriate intervention and then implement that intervention.  That may sound like a logical chain of events to people reading this blog, but actually, in my opinion, it is rarely done in global health.  Sadly, more often than not, we decide on an intervention and then go into a community without first consulting the community to see if they think the intervention is appropriate.  Personally, I have been a part of a number of these interventions in the past 10 years and I think this is a bit of a backwards approach.  All that aside, let’s faces it, who doesn’t want to work with coffee growing communities in Southeastern Tanzania?!   Jai and I are pumped to be here.  ; )

Closeup coffee plant
So, how do you conduct a community needs assessment?  Good question!  I had no clue before consulting a few people at PATH much more experienced in these assessments than I am.  They offered a plethora of suggestions and then we came up with our own design of participatory learning approaches (PLAs) to make up our assessment.  While here, we will be conducting 4 different data exercises in 6 communities that the local Starbucks Farmer Support Center (SFSC) selected. 

 Those data collection activities are:
·         Focus group discussions among farmers and non-farmers from each community
·         In-depth interviews with community stakeholders
·         Water testing
·         Asset mapping (visually verifying a checklist of assets while walking through a community)
Water sampling from a spring used for drinking water
We started water testing and asset mapping today while waiting for local ethical approval to start the community discussions and interviews.

As an aside, Starbucks has been buying coffee from the Arusha (Northern) area of Tanzania for quite a while but they are only now starting programs in this Southeaster region.  Personally, I think it is pretty cool that they are already starting a water and sanitation intervention in communities they are only yet thinking of buying from.   Don’t get me wrong, I still enjoy the hell out of a Seattle independent coffee shop but good for Starbucks for doing something worthwhile in areas of the less developed world that they purchase coffee beans from.


Monday, November 19, 2012

Southern Highlands

Mambo from the Southern Highlands of Tanzania!  After 34 hours of travel time sans layovers we have arrived in Mbeya, Tanzania.  I am traveling with my coworker extraordinaire, Jai Sutherland.  I am lucky to have such an awesome, bright, and fun traveling companion.

Travel time breakdown:
  • Seattle --->Amsterdam = 10 hour flight
  • Amsterdam ----> Kilimanjaro = 8 hour flight
  • Kilimanjaro ----> Dar = 1 hour flight
  • Dar ---> Mbeya = 15 hour drive
I think these US to Africa travels seem much longer to me than they used to.  Well they are longer from Seattle.  Haha!  I can say it was totally worth it.  It is absolutely beautiful here.  As in...I LOVE IT!!!  No big surprises there.  This is Tanzania. 

The travels have not been without their hiccups - thus far we have encountered a seemingly corrupt and hostile immigration situation, customs red tape to relinquish water testing equipment, nearly hitting a cow in the road, hitting and killing a LARGE African bird, stopping to pee at a brothel, and nearly getting killed by a bus.  All that being said, I couldn't be happier to be here.  I love me some Africa.

On the drive from Dar to Mbeya we were lucky enough to drive through Mikumi National Park where we saw elephants, giraffe, water buffalo, gazelles, warthogs, and monkeys.
                                            



We are now in Mbeya staying at the "Peace of Mind" rest house.  It is colorful and nice.  The ceiling inside is even painted in a turquoise giraffe pattern.  The bed is large and comfy and I would say I am about 90% recovered from jet lag.
                                                        
The Southern Highlands are considered the "food basket" of Tanzania.  This is the major agricultural center of the county.  The region is dominated by volcanic soil which is rich in nutrients ideal for producing bananas, maize, beans, tea, and coffee.


We have been in Mbeya for the last two nights and head to Mbozi tomorrow where we will be conducting our project.  The town of Mbeya is very close to the border of Zambia and Malawi and Lake Nyasa, which I recently learned is the same as Lake Malawi.  As you may have guess a lake spanning two countries comes into dispute often and could be called two names by each respective country.


Tomorrow we travel to Mbozi, the final destination on our tour of Southeastern Tanzania where we will be doing our project.  What project you say?!  Stay tuned for the next post!