Yesterday, I traveled 120km through the rocky roads of NW Tanzania. On this one road, I had a close and clear view of both Rwanda and Uganda-it was amazing. We were making our way to an orphanage out in the isolated village of Bugamora. Sister Pendo, a catholic nun, began taking in orphans 15 years ago. As people heard of her kindness, they began to bring her children who were stranded, asking if she could take them in. She of course never turned any away which made it incredibly hard to remain stable. Today, she takes care of 13 children from the ages 1-16.

She invited us into her dark house and began to tell us her past and present story. They have no belongings, no electricity, little food, and rely on the rain for their water supply. Fortunately, she has a large plot of land where they grow pineapples, groundnuts, papayas, maize, and raise chickens and pigs. All of these are used for personal consumption first and the rest are sold to purchase soap, salt, sugar, flour, etc. But the children were a pathetic group-malnourished and filthy. A few had scabs on their scalps from shaving their heads with dirty knives and razors, which are cleaned with dirty water, spreading and intensifying infection. Sister Pendo says the first thing she concentrates on in survival-how can I make sure these children survive? Therefore, food, shelter, and water are her first prioities. This explained the childrens lack of shoes and tattered clothing. Sister Pendo says over the past 15 years, she has NEVER had anyone visit and give any sort of donation or financial help. Everyone in the community knows of her and the orphanage, but has never stopped by.

As our visit came to an end, I mentioned I had a few gifts to give her. The first were about 40 or so small tubes of toothpaste and an equal amount of toothbrushes. Her smile grew so large when she saw these and so did mine. She said the children have never had either of these items. The find small sticks and knaw on the ends until they are frayed and use that as a toothbrush. Well now, thanks to my dentist, Dr. Mann, they will have these supplies for a while. Next I brought out about 15 coloring books, 3 boxes of crayons, 2 boxes of markers, 2 boxes of colored pencils, and a box of regular pencils. The chidren could not believe what I was placing in their hands. They have never had ANY of these items, and I could not think of anyone better to give them to. There were a few more small toys-cars, bouncy balls, stickers-and their hands were full. But then, I asked what color socks they have to wear to school? Their response was white, but they don't have any so they go barefoot. Out of my bag I pulled 15 pairs of white socks and everyone cheered.

It was a better visit than I could have ever imagined.

Joakimu Gideon

At the end of my visit with the orphan support group, a woman who volunteers with the kids approached me holding the hand of a young boy, who looked about 8 or 9. Wearing a “Hello Kitty” sweater and a pair of swim trunks he stood rather limp next to the woman as she told to me his story.

“His name is Joakimu Gideon, he lives with his mother and two younger siblings but his father is dead. You see his eyes? They are bad, he cannot see well. He is not going to school because he cannot see the board or books well enough to read and the teachers refuse to give him extra help. So he stays at home all day with his mother.” she said.
“Do you think he needs glasses?” I asked.
“We do not know because he has never been to the doctor. His mother cannot afford to take him to get his eyes checked-it is too expensive.”
“How much is it for an appointment at the hospital?”
“About 10,000 or 15,000 shillings ($ 8-12 USD),” she replied.

I was so saddened by the fact that a child is forced to quit school because of poor eyesight and furious at the teachers for not even attempting to help him. So I arranged to take Joakimu to the hospital later that week with his mother to get him checked out. When the woman announced this to the group, they cheered with joy as Joakimu gave a huge smile. They are missing their friend at school and are anxious for him to return.

Wednesday morning, I arrived at a local NGO in Karagwe, which has assisted the orphan support group, where I was going to meet Joakimu and his mother. But I was given a big shock as they approached. A few days earlier, while at the orphan support group, I had not seen Joakimu running around playing with the other kids or participating in the dancing but there were so many children, I did not think twice about it. However, as he walked towards me I realized his problems extend far past his poor eyesight. His mother held his arm as he walked my way with a limp, dragging the left side of his body behind him. He grabbed his left hand with his right and struggled to pull them together up in the air to give me the respectful Tanzanian greeting. What was this? Why was he walking like this? Maybe there was an accident over the past few days? No, I just had not ever seen him walk or move around before but this was him.

Joakimu’s story…

Since birth, the left side of Joakimu’s body has been almost completely paralyzed; he has barely any strength is his left arm, leg, hand and foot. I wrote in the beginning of this story that I thought he looked about 8 or 9, but Joakimu is actually 12 but living in a slightly underdeveloped body because of its lack of use. The entire left side of his body is significantly smaller than his right as a result of his paralysis. His head is very disfigured and oversized and his eyes slightly crooked. His toes and toenails and torn apart and mangled because he cannot clearly see the ground when he walks to he is constantly hitting them with rocks and stones. His mother says his memory is not strong he cannot be trusted to walk anywhere alone, even a path they walk together everyday he will forget. She enrolled him in Primary school at the age of 7 but he was soon sent away because of his condition and has never been back since. He does not have the strength or ability to help his mother with the daily work-fetching firewood and water, harvesting crops-so he sits at home, all day long completely idle.

When we arrived at the hospital, I walked a bit behind Joakimu and his mother so I could see how he walked. She always held onto his arm because if she let go, his body would start to veer off to the left. After checking in, we had to walk through a narrow maze sort of path (the ones designed for long lines) that curved right and left and right and left. I had to take Joakimu by the shoulders and direct him at each turn because he was very disoriented if walking on his own (the one time I let go, he walked straight into the metal railing). Unfortunately, every Wednesday the eye doctors are out doing surgeries, but we made an appointment with a regular doctor anyway. We sat down for what I knew would be a long wait but it gave me a good chance to learn more about Joakimu. I asked him how old he was and he cheerfully replied that he did not remember and I should ask his mother. I took his left hand, and asked him to squeeze my fingers as hard as he could. His grip changed a little but it only felt as if he was lightly holding my hand but when I took his right hand, he could fully squeeze mine back. Each time he wanted to move his left arm or leg, he had to pick it up with the right hand and move it. His small body clearly showed the signs of malnutrition and a lack of movement/use. After 2 hours, it was our turn to see the doctor. He was a very nice man, well-spoken and interacted well with children. He asked Joakimu a few questions to check his alertness, checked his reflexes, breathing and range of motion with his limbs. The doctor prescribed him a B vitamin complex but unfortunately did not report anything I couldn’t already see but he did refer him to a ward to be admitted. In the Tanzanian hospitals, it is not possible to say,
“I want you to come back in 2 days and you will meet with this doctor.”
If you need further examination, as in Joakimu’s case, you are admitted into a hospital ward where you will stay as many days and nights as are needed. Usually, people come prepared to stay, with bags of clothes, soap, pots/pans and food because the hospital provides nothing bed sheets and a blanket. But we were not expecting Joakimu to be admitted so his mother came with nothing. She had no way of telling her 2 young children or neighbors back at her village that they would be staying because there was no phone. I was very confused by the entire process-I did not understand how admitting Joakimu would help. This was a condition he was born with so what could they possibly do to help? All I wanted was to check his eyes and possibly find a solution for that because his eyes are what are holding him back more than anything. But it was sort of out of my hands, so I just went with it. I told them I would come back in 2 days to check on him.

Over the next week, Joakimu and his mother stayed in the hospital. I visited every 2 days to see if the doctors had made any progress on tests or anything so he could be discharged, and also to bring he and his mother a little food or small amounts of money to buy food. Every time I visited and came to his bed, Joakimu gave me the respectful Tanzanian greeting, “Shikamoo” and with a huge smile said “Asante (Thank you).” That alone made my entire day brighter. I would spend a few minutes with him, asking how the hospital was, how the doctors were and how he was feeling. I was very frustrated by the management of the hospital: too many people and very few doctors. I can now see why Joakimu’s mother had never taken him to the hospital before. She would never be able to afford it. Unfortunately, this is a problem that many people face and end up suffering from. Joakimu’s head and left side of his body were x-rayed and he was given a few blood tests but everything came back negative.

Finally, one week later, they checked his eyes. That is all I ever wanted, my single goal, to get his eyes examined. They found a prescription of glasses that will benefit him, but of course, yet another obstacle got in the way. Those type of glasses, or ANY children’s glasses for that matter, are not found at that hospital. The closest hospital they can be found at is Bukoba, a town about 2 hours away. The doctor I spoke with wanted him to go to Bukoba not only for glasses but also to see the pediatrician there. They can give Joakimu and his mother a referral to the Bukoba Hospital, but I do not know if she can manage the journey. Round trip transportation will be about 15,000 TSH ($13) plus she will have to get food and in the case the appointment runs late, she must find a place to stay. She is an incredibly vulnerable woman, especially in an unfamiliar city like Bukoba. However, there is a pediatrician coming in August to the hospital he has been staying at the past week, so we first decided to make an appointment with him to examine his physical condition and then, if he is satisfied, they can possibly make a day trip to Bukoba to retrieve only the glasses. For now, he will return to his village and continue on like he did before he came to the hospital. Without a single change.

I have been incredibly frustrated, saddened and confused throughout this whole ordeal. All I wanted to do was take him to get his eyes examined and possibly get glasses only so he could return to school. However, the situation I was supporting was quickly taken out of my hands. I understand Joakimu has a serious problem far past his eye sight that he has struggled with since birth but that problem is too big to tackle all at once. Instead, I wanted to focus on what can be fixed easily and make a huge change in this Joakimu’s life-his eyes. But no one else saw the same as I did. Even the doctor said,

“You cannot just look at one problem with this boy, you must look at everything. You cannot only try to fix his eyes and set aside everything else. His problem is much bigger than that.”

I understand that, but people in rural Tanzania cannot afford to look at the whole picture with the health care they are facing! Even the Joakimu’s hospital stay this past week could not have been possible if I was not financially supporting it. And in Joakimu’s case, he cannot attend school with bad eyes and a weak body. But he can go to school with good eyes and a weak body. So why not give him glasses, knocking out part of the problem and giving him the opportunity of education, and try to tackle the rest of his problems at a later time? I am feeling incredibly disheartened and angry now that it is finished.