MEDA Blog - Stories from the Field

Curtis was born and raised in Kincardine, ON.  He graduated from Trent University in Peterborough, ON with a Geography Degree as well as completed a Graduate Certificate at Fleming College in Lindsay, ON for GIS: Application Specialist. He has over 5 years past experience working with Mapping/GIS, databases and programming. In the past, he volunteered with Mission trips to the Village of Hope in Kisumu, Kenya and most recently a few months ago in Harare, Zimbabwe as well as with a group 'Friends of Honduran Children' near Tegucigalpa, Honduras. Past working positions have been with the Ontario Ministry of Natural Resources, City of Brampton and Kawartha Heritage Conservancy. Some of his interests include sports (soccer, hockey, tennis), listening to music and trying new foods. He is looking forward to experience and learn about a new culture and land while assisting MEDA with its TNVS program through distributing ITNs, tracking technology and building new relationships with Tanzanians.

My MEDA Internship Reflection: "It was a great organization"

I decided to apply for a MEDA internship as it was an opportunity to branch out in my career goals. I had previously been working in a provincial government desk job for 5 years and thought it was time for a change to implement my background with mapping GIS/ and international development and it seemed like a great opportunity.

I was most interested in MEDA's wide variety of economic development ideas on how they take grassroots steps in order to help out the people and the countries they are working in. They don't give handouts and instead empower the citizens to reach their highest potential on their own. It was a great organization right from the orientation week to work for, and be a part of. The standards are very high and the organization is well known and respected in developing countries they do work in.

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A Muslim Nikah (wedding)

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I was lucky enough to be able to go to a coworker's Nikah (wedding) ceremony. I had met his wife-to-be a few months before when I travelled across the city by two dala-dalas and a piki-piki to his 'ubaluzi' home. They seemed like the perfect couple, very happy together and caring for one another.Later on in mid-December the day finally arrived – the '19th' was here. It was held on a Thursday before Christmas and a few other co-workers attended with me. Once I got to the area by the mosque where the ceremony was taking place, I was greeted by the man getting married, Matuku. He had brought me a traditional Dashiki (gown) and Kufi (cap) to be worn. I met the official of the ceremony, the Maulvi (priest), and other members before they entered into the mosque.Since I am not of the Islamic faith (Muslim) I was not able to go into the mosque for the pre-ceremony and jioni (afternoon) service where the family of the man getting married gives their permission to have the ceremony afterwards. So I sat with another Christian co-worker while we waited for the ceremony to finish taking place.It was a very large crowd coming and going outside the mosque, plenty of older men with canes and younger children dressed in traditional wear entered. They came by piki-piki (motorbike), dala-dala (bus) panda gari (car passengers) and walking. They all did one thing before entering though, no matter how they arrived at the mosque.They took off their shoes (mostly sandals of all shapes, sizes and colours) at the doorstep and walked in bare feet. After the ceremony was over, I met up again with the man to be married, Matuku, and his brother. A Muslim rafiki (friend) of his managed to bring us some food from the ceremony. We enjoyed traditional Islamic sweets of nuts and jelly called halwa. We got in the car and drove to the next location where the bride to be was waiting.I was again lucky enough to take the hand of my co-worker friend and walk him through the large crowd of guests and into the building where the Nikah ceremony was taking place. Lots of loud and happy people yelling and singing and pushing their way through to piga picha (take a picture) of the groom's entrance.Once we got to the back of the building, there was a small room to enter. It was however crowded by plenty of people who were friends of the bride and family. After finally making it through the door, and into the small room, Matuku was finally able to see his beautiful wife-to-be. The bride was dressed in the traditional outfit with jewels and hijab (head cover) and henna artwork on her hands, while sitting with her sister on the bed. The Maulvi preformed a short sermon on the importance of marriage and declared the two married!Afterwards was the Walima (wedding reception), which ran well into the night. All in all it was a different experience from a Christian wedding, but a unique and exciting experience that I will never forget.
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Afriroots Dar Tour

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Afriroots is a group that is working with local communities first hand in Dar Es Salaam, so traveling with them is direct community benefiting tourism. They are giving back to places they visit. I have had the privilege of taking two different tours they offer. The 'Biking Tour of Tandale, Sinza' (twice) as well as a city centre 'Historical Walking Tour'. On the historic tour we visited government sites, churches, mosques and the memorial for the Askari soldiers who fought in the British Carrier Corps in World War I, as well as the New African Hotel where Malcolm X visited while in Dar, and the Ocean Road Cancer Institute where medical discoveries were made.On the biking tours you visit a formal market area designed by the government to try and clean up the markets, which is barely used and underutilized as it's often in a terrible location or away from the street or main roads. Also you visit an informal market area where it is very busy with people selling every fruit and vegetable imaginable from small stalls bordering the side of the busy roadway. It also has a clothing market area attached to it whereby men have piles of clothing available at their stalls. Some have piles of shoes (sometimes not even in pairs), other may have loads of jeans or t-shirts. They buy the bundles in bulk off of ships from other parts of the world and then distribute the items to whoever will buy them. The market sellers know where the customers are and don't want to move the businesses to an area that isn't busy with passing buyers and foot traffic.Other areas we experienced were a traditional coffee stop where young men were getting ready for the day making Swahili coast coffee, crushing the beans and mixing with boiling water. They have made a contraption that is used to transport coffee around the city while they walk the streets for a few hours selling their coffee. The steel pot keeps the kahawa (coffee) hot and has a holder so it doesn't burn the hand of the carrier. To go along with the kahawa is a sweet brittle type peanut bar, which most people eat with their coffee. You will often see these guys walking around in the morning or at night with their signature steel pots. The tour takes the back roads to these spots with vibrant community and street life keeping the 'Bongo' city in motion.The next location we visited was mama's small chapatti and chai tea shop in the Mwananyamala area. She used to live across the street from her location but was forced out of it years ago. Some friends have since helped her get a small steel shelter area where she has a seating area to serve customers for the morning breakfast of chapatti and chai, a common breakfast staples in the Swahili coast. My own mom even tried to pika (cook) some chapatti herself, flattening it out and heating it up in the pan.We continued biking to a traditional homestead of Tanganyika – this was mainland Tanzania's name before it merged with Zanzibar to become Tan–Zan-ia. Pre-dating independence from colonial rule in 1961, it is a called a wazaramo, from one of the first neighborhoods of Dar and the Bantu people. It had multiple large rooms where a whole family would sleep in.After, we were off to a shop selling homemade remedies, and fixes. It had all kinds of old peanut butter jars full of different mixes and healing powders. A few examples were leaves mixed together to produce a beauty cream formula, and a treatment for mosquito bites. As well as a few bottles, some of which had a love potion.Across the street from this location was a typical kitenge or kanga shop where they were selling the many different colours and patterns of cloth. The difference between a Zanzibar kitenge and a mainland one is by the saying. The Zanzibarian ones are more thrash and talking about revolution. Often women won't even look at the colours of the material or border pattern and will buy the item based on what the saying is. Most are message about good life secrets and religion, almost like a Swahili fortune cookie saying. The kitenge is a larger piece of fabric used for sewing dresses and is either worn like kangas (wrapped around women's hips) or brought to a tailor.The next stop was a small theatre where watoto (children) would frequent on weekends. At this location they can pay a small coin price (a few hundred Tshillings) to see a new movie, DVD, a favourite cartoon or Swahili feature. In a tin shack, a small colour TV is placed in front of multiple benches where lots of kids sit having a good time.We then went through one of the lowest income areas in the city of Dar Es Salaam called Tandale and yet the people are quite humble. This area has informal settlements where they face multiple challenges in areas like sanitation, wastewater management and infrastructure. They live close to a very polluted river that runs through the city. During heavy rainy season, the area where hundreds of people pass every day will often be flooded and impassable. With the help of the AfriRoots tours they were able to replace the makeshift log bridge with a concrete structure to help people, bajaji vehicles, wagons etc. crossing the busy area. However during the recent short rains, the bridge foundations had shifted in the river and the bridge is broken again.More money needs to be invested to build a better more stable bridge with better footings able to withstand the wrath of the river. Next to this area are a few families and groups who are selling recycled items. The one lady has taken old and discarded material scrapes from fabric shops and put them together with a zipper to make a purse, as well as welcome mats made of the same material.Other men had found old wires and fixed them together in a frame to form different animals. Afterwards they would put paper and a mix of mud to cover the wires in a papier-mâché form. They also have their own community garden growing vegetables and plants, which are used to cure different diseases and health problems common to the areas residents. The area has village-based conservation and now sees an increase in sources of income due to the tours. Some very amazing progressive work is going on in here in one of the poorest parts of the city. It is a shame however the area often gets overlooked as inaccessible by the city government for building and health projects.Afterwards we were off to Sinza, a middle-class income area of the city with a rising population in Dar. This area has smaller cheaper hotels and motels along with plenty of small shops and thriving businesses, housing plenty of hard working young Swahili and traditional Tanzania professionals who work in the city centre or other parts of the city. This is a part of Dar where rapid urbanization is taking place.At the end we ended up back at busy Bagamoyo Road. This tour is highly recommended to see parts of the real Dar Es Salaam worth experiencing that are often hard to get to by the average foreigner. The guides are very knowledgeable, spoke great English while they taught us plenty of history and culture of the surrounding areas. On the tour you gain first hand experiences of the social issues facing Dar Es Salaam – living conditions of families, urbanization, infrastructure and the urban environment. You visit markets and meet the people who work and innovate in the informal economy, hearing about the everyday struggles they face.
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Numbers Are Deceiving

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Days out of office with the field staff are a good break from sitting in front of a computer all day. I enjoy seeing new parts of the city of Dar Es Salaam and viewing people going about their daily lives in this ‘Haven of Peace’. On field days with Kapaya and Gabriel the experiences are always unique and differ from the previous drives. I have visited more than a few dukas (shops), kliniki (clinics), and hospitali (hospitals) around Dar in districts of Illala, Kinondoni, and Temeke. I have quickly discovered some of the struggles, and issues with the current voucher system/health care system in place. As well as encountered the deceptive progress reports which are examined and shown to clinic staff. A few trends I have noticed are:1. Overworked staff. After regular kliniki (clinic) hours, only doctors may be working, and they don’t have enough time to hand out the TNVS voucher’s to women so they often write down their names and number and the nurses then have to give them the voucher on their second, or third visit. This translates to a time problem with the nurses, who along with their other duties have to catch up on the paperwork from past patients: fill in the MEDA logbook with the Hati Punguzo net sticker and information, write down the Hati Punguzo number on the Antenatal Card, and check off that it was given to the patient.2. Problems with competing bed net companies.  The two main suppliers of bed nets are A-Z and BestNets. On one occasion, we encountered a situation where the retailer wanted a certain type of net, and ordered it but there was no stock with the original supplier (who had the contract). The other supplier wanted to deliver nets, but a contract was already in place. The duka had already confirmed to receive even though they were not yet delivered. The result of this situation is that TNVS insisted the supplier not to confirm delivery before the duka (retailer) actual received the bed nets. The delivery is still pending.3. Potential for new duka contracts. One observation I noticed on a few occasions was the doctors and nurses at the kliniki (clinic) being helpful in offering new, more reliable, and closer dukas to sell the bed nets to patients. On one occasion we walked with the doctor to a very close duka to see the progress of their start up into the TNVS program. The retailer had been contacted by a supplier to sign a contract for bed nets, but hadn’t received a shipment yet.4. The above situations lead us to the problem of stock. Often times there are more than enough vouchers and e-vouchers being given out to patients but when the customers go to the dukas to purchase the bed nets they are out of stock. With only two suppliers with operations in Tanzania, and a very large country to cover and service, often times there is an issue either getting the bed nets to locations with drivers, or keeping up with the amount needed to service the clients. This creates a problem of a want for more dukas involved in the program, but not enough stock to maintain them. Thus, the need for more suppliers and competition between suppliers, which will bring down the price of the net, and allow stock to be maintained and readily available. As well, a solution might be if stock had to be ordered far in advance, then maybe availability issues could be avoided.5. As well the quality of the bed nets from the suppliers may differ. While all companies bed nets in the program are insecticide treated already, a user may have a preference for a type of net which may be out of stock. Also, most nets aren’t designed to last forever, and instead only last up to five years. At the start of the program the mother may obtain a second bed net for their child as well as herself. If the mother becomes pregnant again she may gain another net for herself as well as her 2nd newborn child and so on.6. Another issue is education of SMS, texting, shortcodes and phones. While most clinics and hospitals have staff that are well-versed in using a cell phone and its functions to report info to suppliers, there are a few holdouts. One kliniki we visited we had to educate the nurse to show her how to use her phone to SMS the supplier on bed net numbers. This is why the pamphlets and paper leaflets given to the duka owners and kliniki staff are a good tool to educate about the program. In some isolated cases repetition of SMS demonstrations is the only way to proceed. You have to have patience, especially with a generational gap with respect to technology, cell phones, and their use. Sometimes, a helping hand is needed to learn.7. Dukas playing their part. Dukas writing the numbers of the nets handed out in the log book (which sometimes doesn’t exist if they haven’t made one) and putting the net sticker in as well for confirmation in the MTUHA (Mfumo wa Taarifa za Uendeshaji Huduma za Afya) (record book). It is important for dukas to keep records, and be educated on the importance of being organized for the program. After all, they are benefiting from the process with profits and need to keep up their end of the bargain.8. Cell phone network issues, and signal problems. Often times different cell phone companies (Airtel, Tigo, Vodacom, Zantel etc.) have different reception problems in rural communities and one might work better than another in an area.  Investment in updating and providing larger cell coverage is key to the success of the e-voucher system. Also it is cheaper to SMS in multiple Hati Punguzo net numbers together in one message. This info could be compiled for a while, and thus reporting numbers may be off if the duka waited too long to report. It is not hard to figure out that if these problems exist in the large urban city of Dar, then they will be highly heightened issues outside in the rural areas.All of this translates to much lower reporting percentages and number for kliniki (clinics) and hospitals for how many vouchers are being sent out to women and children and the redemption rates for them. A large factor is motivation. The workers and field staff at MEDA Tanzania needs to make sure all of the suppliers, duka owners, clinic staff, nurses, doctors etc. know how they are making a difference and helping save lives every day by completing and maintaining their part in Hati Punguzo.An idea of providing a specific phone for each clinic to use has been thought of and mentioned a few times, as whose phone do you use for SMS messages? This is a difficult question, as there may be four plus nurses working on the program. An idea of a specific phone to be used for SMSing voucher codes might make sense, and be affordable for a larger clinic or hospital, but wouldn’t work in smaller cases. Whose talk time minutes do you use? Or, do you use those minutes to SMS a supplier about bed nets or call your family and children? A moral dilemma in some cases.Data shows significant achievements in the fight against malaria in Tanzania after Hati Punguzo was introduced, with the infection of under-five year olds declining to 10% from 18% in 2008. (http://medatanzania.org/) Also, the number of patients attending health facilities to seek treatment has increased since then. In July 2013, in the Dar Es Salaam region most clinics averaged about a 70% redemption rate for vouchers from the kliniki to the dukas and to the user.Even though some of the kliniki, and hospitali redemption rate numbers are low due to several issues explained above, the fact that the MEDA TNVS program is making a difference in pregnant women and children’s lives and helping them from falling ill to malaria is incredible. This is a far more important fact than any number or reporting figure!

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Present Bus System (Dala-Dala’s)

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With the future D.A.R.T. project underway comes the limiting of the Dala-Dala (mini-bus) licenses. These buses can still be used for getting around on the smaller road routes but should stay off the main throughways if the city is going to have a reliable bus system in the future.Being a geographer I wanted to get a look at the dala-dala routes before using this method of public transportation system. This information is hard to come by as I’m pretty sure it doesn’t really exist! These dala-dala drivers have a specific route they take, but the routes have never been mapped and it’s pretty difficult when the streets they take are not named sometimes. The closest thing I have found to a route map was done by Anson Stewart (an American who specializes in engineering and urban studies). While not perfect, this map is a good tool for anyone venturing out in a new city, and trying to make their way around using public transportation. These types of maps should be public knowledge, and distributed. When I showed this map to co-workers and even a dala-dala driver they were intrigued, and wanted a copy for use.For now, the dala-dalas are the main bus transportation system in Dar. However, in the near future the D.A.R.T. bus system will hopefully ease traffic problems. It is a major construction project and in order for it to be completed soon the contractor Strabag needs to pay its workers on the project. The workers are demanding up to two months in back pay. The over 1000 road construction workers if not paid could lay down their tools bringing the Morogoro Highway construction project to a grinding halt. The workers are not only demanding wages owed but are also complaining of ‘poor working conditions’ and are requesting the government to secure them a safe and more humane work environment. Thus, cooperativeness between the Dar Es Salaam Regional Commissioner, Strabag management, Tanzania Mining and Construction Workers Union (TAMICO) along with the construction workers need to happen soon to fix transportation in Dar!

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Urban Planning and D.A.R.T.

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I was lucky enough to get the opportunity to go out with some of the field staff within my first week at the MEDA office in Dar Es Salaam, Tanzania.  On the way to the dukas/clinics I was greeted by the traffic in Dar. It is a city which could benefit from a few changes to its current roadway and highway structure layout. The larger highways (Morogoro road, Mwinyi/Bagamoyo Road) have a smaller side road along it for bikers (boda-boda), walkers, people carrying items, sometimes motorbikes (piki piki), bajajis (3 wheeled vehicles), trolleys etc. Then, there is a large ditch, 2 lanes of traffic, a very large centre area (not often fully used, where you could easily fit in another 1-2 lanes) and the same setup on the opposite side of the road.  This is a city with a traffic problem. There doesn’t appear to be a time during the day when the roads are not clogged. I haven’t yet seen a highway in Dar which has more than two designated lanes in one direction. Adding more lanes would ease congestion in this large city of over 4 million people. A similar case is in Nairobi, Kenya (population of 3 million) where they recently worked on building the Thika Super Highway away from the city. With 4 lanes of traffic (on each side), it works well at dispersing people to and from work within the city centre. This combined with the bypass system for the north, south, and east should further ease congestion.Although I’m not here for Urban Planning, I am very interested in it! The ambitious Dar Es Salaam Rapid Transit (DART) project will first be building a bypass with dual four-lane carriage ways, which seems like a great idea for the city and its transportation future. The project is expected to save billions of shillings lost daily in traffic jams and provide relief to at least 300,000 Dar Es Salaam commuters (I work with many of them!) Completion of the project would result in shorter travel times for motorists, decongestion of surrounding roads, improved security, safety and convenience for pedestrians and cyclists due to construction of footpaths and bicycle lanes. The roads will form major alternative routes bypassing the downtown business area and as such would ease nightmares motorists encounter while navigating through the city.

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