I am so grateful I am having a tough time.

The last month has been harder than usual.

I have osteoarthritis - like so many other people get when they age. For me, that meant a herniated disc and compressed nerves that threatened my long-term mobility. Worst case scenario, if nothing was done and it was allowed to progress further, it could have left me double incontinent and/or paralysed from the waist down. Not a fun prognosis.

Major surgery ahead, taking the bad parts out, fixing those bits that could be fixed, and stabilising the rest with a couple of screws and rods.

I spent 1 week in hospital. I had physio in the hospital from day one - it was not easy, and I may have said a bad word here or there - but I am sure it is the reason I could walk home (even if it was slowly) just 6 days later.

After two weeks, I was back driving, and now 4 weeks later I am back full-time at work.

I still have a lot of rehab to do. Some days it is hard. I have to dig deep to find the strength and the willpower to get on that treadmill or do those exercises. It is hard. I am having a tough time. Yet I am grateful.

Why am I grateful?

Through my work in Tanzania, I see and hear stories about people. I get to meet people in person when I travel across. Some of these people are doing it really tough. They could only wish to have access to medical care like I had. But they don’t.

On my last visit to Tanzania, I met this boy. I took this picture.

Look at his spine. This boy has severe kyphosis caused by spina bifida - a birth defect happening in the uterus. This has caused several issues, amongst others the extreme curve in his spine. The curve is slowly increasing pressure on his lungs… There is no good ending to that.

We see many cases like this where we work in Tanzania. The proportionally higher occurrence is due to a lack of a good nutritious diet for the mother during pregnancy. The deficiencies of vital minerals and vitamins can lead to severe disabilities. Spina Bifida is one of them.

We are working on getting help, not only to this boy but also to the rest of the 35,000 people we are delivering services to.

If you want to help, please donate now.

You can also get your workplace to partner with us on a project. We have a whole catalogue to choose from.

Download it here:

Are you off to a great year like us?

2023 has begun and we have hit the ground running! 

First, I owe you a MASSIVE thank you!

We raised a whooping AUD $8,300 during our Christmas Campaign - well above our $5,000 goal - for our Outreach project.

This means we can buy TWO NEW MOTORBIKES as well as cover all expenses to MEDICINE AND TREATMENTS, and MAINTENANCE AND REPAIRS. All of this is covered for a FULL YEAR. Thank s to you and your amazing support. 

We are beyond grateful for the generosity and trust you have shown us.

Our team has ordered the motorbikes and as soon as they arrive I will send you an update from the field. We can’t wait - and neither can the 35,000 residents of Nyamatongo.

What are we planning for 2023?

Healthcare

With our Outreach Team well supported, we are going to continue to deliver healthcare to residents who are unable to come to the health centre. Many times this is because of disabilities, or simply due to not knowing a condition should or could be treated. A lot of our work consist in sharing knowledge around prevention and treatment of injuries and diseases.

Kamanga Health Centre, our small-scale hospital, is also thriving. It is a busy place tending to more than 1,000 patients every month. Although we do not have a surgical unit only a small number of our patients (less than 3%) needs referral to the larger District Hospital. We are happy we can provide those who need it safe and stable transport in our on-site ambulance.

Ante- and postnatal care as well a safe environment to give birth is also a very important function of Kamanga Health Centre. We generally tend to 100+ pregnant women every month and deliver just short of two babies a day on average. Giving birth in Tanzania can be a deadly event and every day 30 mothers die during childbirth. In most cases, from preventable causes.

Every week we invite families to bring their babies under 5 years old to our ‘baby clinic’. Here we vaccinate children, weigh them and check their general health. We talk to families about nutrition and answer any health concerns they might have. This means we have a very high vaccination rate in our communities and generally we see about 30 children and their families every week.

We couldn’t do this work without our close relationship to the local Community Health Workers. These are locally elected health workers from each village or area and is often the first person to know if anyone in the area is in need of medical care. We provide medical training to our Community Health Workers and in turn they help spread knowledge on family planning, danger signs during pregnancy, and many other health related topics. They visit close to 250 households on a monthly basis.

Entrepreneurship

Last year, we finalised our pilot projet focusing on mushroom farming, entrepreneurship and Climate Change. Mushrooms are a great crop as it climate change resilient and you do not need to own land to be able to grow them.

Our Pilot was a great success. We learned a lot along the way and we are now ready to launch a full 12 month program after which it will be financially sustainable in itself. We are aiming to educate 200 residents every year and assist them to set up their own collaborative small-holder farms. The reason we are encouraging collaborative farms is to benefit from shared overhead costs and shared knowledge and responsibility. 

This project has so many benefits - I have listed a few of the major benefits below:

·       Increase in income for the whole household

·       Increase in income leads to better healthcare and education

·       Increase in self-esteem for women and people with disabilities

·       With self-esteem and independence comes healthier individuals and a higher uptake of birth control

·       A new and affordable nutritious crop available to the whole community

·       Mushrooms can help combat some of the nutritional deficiencies we see daily

·       More children in schools/less drop out caused by economic strain or health issues

·       Innovative low-tech and low-cost driers not needing electricity

·       Any excess production to be dried and access to international export channels

·       Project able to finance itself within 12 months

·       Excess funding and earnings to be used for scaling and other projects within our organisation

Of course, all of this is pending funding. We are actively seeking funding from all corners of the world. The full cost for a 12 month project is AUD $150,000 (approximately USD $100,000). If you want to know more about the Theory of Change, budget and project details please feel free to contact me directly by clicking the button below:

Climate Change and Green Kamanga

As everyone else, we are trying to do our part to combat climate change. In 2021 we planted 600+ trees germinated from seeds. We focused on quick growing timber and fruit trees such as mango, papaya and avocado. We continued this in 2022 and planted an additional 600 trees in Kamanga and surrounds.

But this is just the beginning. 

We are currently developing a 3-year project that will see to plant no less than 100,000 trees! Yes, you heard me right, 100,000 trees in 3 years! 

This 3-year project will build on establishing 100 community self-help groups, as well as provide education on environment and climate change through primary school clubs. Focus will also be on fuel-efficient stoves and the importance of using improved latrines and clean water. 

It is a project with BIG goals and a huge IMPACT or all our 35,000 residents. Of course this also comes with a need for funding with a budget of AUD $65,000 (~USD $45,000) per year for 3 years.

Again, if you want to know more about this project you can contact me below.

We are looking forward to share all our wins and stories with you in 2023.

Do you give meaningful gifts?

Are you, like me, searching for meaningful gifts that won’t have to be returned or sold cheaply on Marketplace first week of January?

Do you end up with gifts that never gets used and gets hidden in the back of a drawer, or in a cupboard for years?

Gifts, that makes no difference and has no significance?

Then I have the perfect solution for you!

a Meaningful Present

From my own experience, sometimes gift giving is hard. It either feels like order-lists are given out (as opposed to wish lists), or gifts are just not quite hitting the mark.

And sometimes you just don’t really need any more stuff to clutter your home.

By giving a gift of a donation you are making a difference in more than one person’s life.

You can donate as little $10 and have a significant impact. Make it a monthly donation and let the receiver receive a thank you note every month. I am sure that will bring a smile to their face remembering what an awesome present you chose.

Each of our Outreach motorbikes enables a medical officer to deliver quality healthcare to patients in our community of 35,000 people every day. For less than $50 you have given the gift of fuel, medicine and maintenance of our motorbikes for a week! $48 to be precise.

An impactful present

Every year we make over 1,000 home visits to people who would otherwise have gone without medical care and support.

We provide training an education to the locally elected Community Health Workers who are visiting another 2,500 households every year. They provide advice on family planning, educate on danger signs on severe medical issues, and encourage families to vaccinate their children.

Our Health Centre sees approximately 1,000 patients every month, and we average 2 births a day.

In total, we provide medical care and advice to more than 15,500 people every year. That is worth having a part in, don’t you think?

We all wish you a Merry Christmas, Happy Holidays, and a joyful time with your families.

Reaching out... For outreach.

Today I am reaching out to you.

We need your help. 

For the past 8 years we have run our outreach program providing quality healthcare to people who otherwise wouldn’t receive any medical care. 

But now we are struggling to deliver this service. The only way we can reach people is on our motorbikes and our old ones are literally falling apart. 

We need new bikes. Can you help?

1 motorbike costs AUD $2,500 and we need 2, so our total need is AUD $5,000

You can read more about how our outreach project is changing lives here:

https://www.australiaforcedartanzania.org/outreach-team-australia-for-cedar-tanzania-changing-lives

Thank you

Nina

P.S.

Please share this with your friends, in a post, in an email.

Hold a bake-sale, charity dinner, or raise money at your office or school.

Please sign up to our newsletter if you have not already.

Neema defies paralysis thanks to Cedar Tanzania

What would you do?

Have you ever imagined what your life would look like if an accident was going to happen to you? Would you have the strength to keep going on?

Neema surely has. Seven years ago, Neema went to one of the larger regional hospitals to get treatment for typhoid. Unfortunately, Neema experienced nerve damage during her treatment and lost most of the mobility in her legs.

Neema is now 31 years old and lives with her parents. She relies on their help for all her basic needs. Neema also has three younger siblings who all still go to school.

Being dependent of her parents has had a huge impact on Neema’s mental health. She has been struggling with depression and feelings of being a burden to her family. As the family already lives in poverty having a member of the family not able to contribute financially is a huge strain. On top of that, there are all Neema’s extra medical bills.

Finding Neema

Our Outreach Team met Neema in 2019 and has since been working in close partnership with her and her family. This free service has provided Neema with a variety of treatment options for both her physical and mental health. 

With the help of our team, Neema has regained some movement in her legs and has literally taken her first few steps towards independence.

It is Neema’s desire to get to a point where she can support herself and contribute to her family. She is grateful to her family, particularly her parents, for the support they have given her through the difficulty times she has encountered. She hopes she one day will be able to return the kindness she has received.

A new beginning

Neema is excited to start our entrepreneurial training.

She says “I have some basic knowledge on sewing. I learnt a while ago before I suffered from paralysis, and I am confident that I can regain some skills if I will get the opportunity to practice again. It is something am interested about and something I am capable of doing”.

According to Neema’s physiotherapist, the tailoring training will help Neema to re-gain her sewing skills and hopefully help her to earn an income. It will empower and strengthen her emotionally, mentally, and physically. Sewing provides an opportunity to rebuild physical strength and this project also provides her with an opportunity to be surrounded by others who are facing similar challenges. 

What is typhoid?

Typhoid is a bacterial disease spread through dirty water and can be life-threatening if not treated. 

The residents of Nyamatongo Ward do not have access to treated water. The only water source is water collected from the lake. With no sewage systems in place, long-drops or open defecation is the norm and is naturally led to the water. Typhoid, and other waterborne diseases are very common in the area.

In fact, diarrhea, which is often caused by typhoid, is the biggest cause of death for children under five.

Can you help Neema and people like her?

Will you give a tax-deductible gift to help Neema and others like her become agents of change in their communities? 

Your gift can pay for training, material and sewing machines to help people with disabilities learn income-generating skills and challenge social stigma.

Changing Lives begins with you. We can’t do it without you.

How a deaf and mute young man learned a trade in 6 months and now supports his mother and 3 siblings.

Today I am going to tell you about Fred and how our Entrepreneur Program has changed his life.

Despite Fred being both deaf and mute from birth, and growing up in a very poor household, he has been determined to learn a trade and become able to provide for his family. 

In this case study I will show you how our Entrepreneur Program makes a real difference for people just like Fred and his family.

Meeting Fred

Fred is a 21-year old young man living in rural Tanzania. Throughout his life Fred has had to rely on his mother for support. Going to school has been particularly hard for Fred as there are not any special education or help available in this poverty-stricken community. Only with the help of his mother he has learned to write and communicate with some simple gestures.

Fred grew up with his single mother and three siblings. It has always been his dream to be able to contribute to the household and to be able to look after his family. Although societies in Tanzania often disregard people with disabilities Fred and his mother never gave up hope.

Reaching Out

Our Outreach Team met Fred and his family on one of their daily rounds in the Nyamatongo Ward where we work. The Outreach Team provide medical healthcare services to people in their own homes for those of the 30,000 residents who are unable to visit our hospital, Kamanga Health Centre. 

Often the team stops and talks to families about life and the problems they are experiencing. They will share knowledge on a variety of healthcare topics such as nutrition, and treatments and services available. Sharing their own stories and speaking to people on a daily basis has made this team a trusted part of our community service.

After meeting Fred and his family our team instantly offered him a spot in our Entrepreneur Program. They couldn’t help but feel Fred’s determination and eagerness to be given a chance to learn a trade and finally give something back to his family and community.

Earning a living

Fred joined our Entrepreneur Program in October 2020 and now 6 months later he is well on his way to opening his own tailoring business. 

The trainer and Fred’s fellow trainees have publicly acknowledged his passion and commitment to the project and his untiring support of others.

With only a limited number of sewing machines available in our program our students must take turns to practice. This means it takes even longer to gain the practical skills needed to finally be able to live independent lives. Fred is now advocating for more support and funding which could allow us to buy more sewing machines so more people with disabilities can join in the future. 

Apart from the practical tailoring skills our program is also teaching the participants simple bookkeeping skills, market research, project planning, and we offer support and help throughout the program.

Living with a disability in Tanzania

In Tanzania, living with a disability has a significant impact on health, education and work possibilities. More than 50% of children suffering from a disability never gets to go to school.

In Tanzania, having a member of the household living with any kind of disability presents a double burden. Just 3% of people with disabilities earn an income from paid employment which means they are extremely vulnerable to abuse and poverty.

This project provides an opportunity for the participants to gain the skills to reach independence and the chance to get a job or to open their own businesses. 

It also demonstrates, both to the people living with a disability themselves and to the community, that a disability is a barrier that can and should be challenged.

It provides people living with a disability with an important and valued role within the society showing they are equal members of their communities.

Tanzania in numbers:

•  There are about 57M people – 68% or nearly 40M people are living in rural areas and most of these are living in poverty. Life expectancy is 65 years.

• In fact, 49% of Tanzanians (26M people) are living on less than $1.90 a day. This is the international definition of severe poverty.

• Most people, 90%, is living on less than $5 a day. That’s about the amount you spent on that take-away coffee earlier today.  
  
  

Can you help people like Fred?

Will you give a tax-deductible gift to help more people like Fred to become agents of change in their communities? 

Your gift can pay for training, material and sewing machines to help people with disabilities learn income-generating skills and challenge social stigma.

The dangers of not knowing

Ayo*, a local fisherman living in Nyamatongo Ward, never knew he had high blood pressure. He recently suffered a stroke that has left him with loss of motor skills on his left side as well as issues with his balance. This means he can no longer work to support his wife and four children. In Tanzania, there are no social services or payments to access when you are unable to work. To avoid the devastating consequences of this family falling further into severe poverty it is of utmost urgency Ayo regains his ability to earn money as quickly as possible.

Life after a stroke is never easy. That becomes even more apparent when you are living in a rural setting without many of the services and aids many of us take for granted.

Cedar Tanzania’s outreach team was introduced to Ayo in April this year, and has since worked closely with both him and the rest of his family. It was only during their initial assessment Ayo found out he has high blood pressure which is likely to have caused his stroke. Ayo now receives treatment in form of regular occupational therapy and medication. To make sure Ayo recovers, it is important everyone in the family understands the importance of the exercises Ayo needs to do as well as the importance of the medication to lower his blood pressure.

Dr Daniel Ndamo, Cedar Tanzania’s Occupational Therapist, has developed a programme for Ayo to follow and regularly checks in on him to see how he is progressing and if any adjustments are needed. Dr Ndamo has also created occupational therapy aids from recycled materials to make sure they are affordable and easily accessible for residents like Ayo.

Living in a rural setting creates many problems in situations like those Ayo is facing. One of them is using the toilet. Only squatting toilets are available throughout the Nyamatongo Ward and Ayo has difficulties using these without assistance and in privacy. Dr Ndamo has been able to provide aids and advice to the family on how best to support Ayo enabling him to perform personal hygiene independently and with decency.

* Name changed for privacy

---

Thinking Outside the (Cardboard) Box

When we talk about our community based rehabilitation outreach programme  for people with disabilities, we often mention the provision of Occupational Therapy services alongside medical services.

But what is Occupational Therapy exactly? In the words of our Occupational Therapist, Daniel: “Occupational Therapy is a client-centred approach which is focused on the promotion of the health and well-being through meaningful and purposeful activities that are age and gender appropriate as well as culturally accepted”.

Even in most Western countries, Occupational Therapy is not something that is widely known. Here in Tanzania, where many people don’t even have access to very basic healthcare services, you hardly find a person who has heard of Occupational Therapy let alone is familiar with the practice.

There is only one university in the whole country that offers studies to become an Occupational Therapist and in 2019, Daniel’s graduation year, there were only 30 students.

Apart from the service and its health benefits being rather unknown, another challenge Tanzanian Occupational Therapists struggle with is the procurement of specialised equipment. Not only is it hard to find, but once sourced, it can also be really expensive.

To bridge this gap, Daniel got creative! It is really impressive what you can do with a little cardboard and a utility knife – but see for yourself what he has crafted!

Occupational Therapist Daniel explains below his innovative use of everyday materials to aid patients regain movement.

The Puzzle

The beloved children’s game can function as OT equipment. Daniel is presenting us a puzzle made out of cardboard for his youngest patients. It improves the children’s shape identification and problem-solving skills and further enhances their motor and coordination skills.

The Range of motion Arc

This interesting looking therapeutic equipment uses a bio-mechanical approach. It promotes and improves the range of motion of the patient’s shoulder, elbow, wrist and joint and is used in all cases where the range of motion of the upper extremities is limited, for example due to a stroke, burn or head injury.

Lid Activity

The lids are used to practice and improve grasping skills, hand-eye coordination and range of motion by opening and closing the lid. It is used for all cases in which the patient shows a limited hand function and, with practice, helps them to perform activities of the daily life such as opening and closing windows and doors or – you guessed it – bottles.

In case you got curious and want to see more of the equipment Daniel and the team have crafted, check out how he created a device for mirror therapy .

Act now to support us further.

Thank you.

Get to know Our Team

This is Daniel Samwel, our Occupational Therapist. Daniel is passionate about his job and we enjoy working with him. The people of Nyamatongo Ward benefits from his creative solutions to provide Occupation therapy that is accessible and affordable.

The Magic of Mirror Therapy

Access to rehabilitation services has not been a priority in Eastern Africa, but things are slowly changing. I have been working with The Cedar Foundation Tanzania in the Community Based Rehabilitation (CBR) project for several months now. Most families cannot afford to buy therapy equipment. So as an occupational therapy practitioner in the villages of Nyamatongo ward, my main challenge is to bring affordable therapy to the village level. One way I do this is by adapting local materials, such as rocks, sand, mirrors and boxes, to make equipment that can be used for therapy. And my vision for the Community Based Rehabilitation project is to promote the use of adapted therapeutic equipment for the benefit of my patients in order to give them the highest chance possible to retain their existing skills and to develop new skills too. In this way the patients will increase their daily activities and therefore enhance their levels of independence in the community.

As part of the outreach program I encountered Issa* - a 59 year old male patient, who had sustained a right hemiplegic stroke in 2016 (paralysis of the muscles of the lower face, arm, and leg on one side of the body), due to hypertension. On our first meeting, I conducted an initial assessment and found that Issa had contracture in his right arm due to being in a flexion pattern for such a long time. The right hand had grade 1 muscle strength and the motor skills were all intact (both fine and gross motor skills). His cognitive and sensory abilities were all fine with the exception of his vestibular system (the sensory system that provides the leading contribution to the sense of balance and spatial orientation for the purpose of coordinating movement with balance.), which was weak and thus affected his balance. My two month objectives with the patient were the following;

• To achieve full passive range of motion to the affected arm

• To increase muscle strength and to activate motor skills to the affected arm

At the end of one month’s therapy, the patient was able to achieve full range of motion passively, without experiencing pain. It was at this stage that we introduced the Mirror Therapy box, for motor activation. I had designed and constructed the mirror box by using local materials. I found that the patient really enjoyed this therapy, and soon began to improve in his fine motor skills in the affected arm.

MIRROR THERAPY EXPLAINED

The mirror therapy theory is the use of a mirror to create a reflective illusion of an affected limb in order to trick the brain into thinking movement has occurred to the affected limb. It involves placing the affected limb behind a mirror, which is sited so the reflection of the opposing limb appears in place of the hidden limb’ says G. Moseley.

A mirror box is a device that gives opportunities to the therapist to easily create this illusion. It is a box with one mirror in the centre where on each side of it, the hands are placed in a manner that the affected limb is kept covered always and the unaffected limb is kept on the other side whose reflection can be seen on the mirror. The activities that are mirrored are those performed by my patients in their daily lives, for example writing, grooming, eating and even catching a ball.  

This theory is based on the neuro-plasticity mechanism/principle. It activates the brain’s mirror neurons, to create a mind illusion that then activates the motor ability of the patient’s missing limb and aids in pain management.

The patients that benefit most from this technique are those who have had amputations. This technique has been found to reduce phantom pain sensations in amputees. Stroke patients also benefit greatly from the mirror technique to reactivate motor skills.

Take Action and be part of the drive to bring occupational therapy to Nyamatongo Ward.

* For privacy, the name Issa has been used but it is not the patients real name.

by Daniel Samwel, Occupational Therapist, Cedar Tanzania.

Jackie and Neema's adventures

Jackie is a Community Based Rehabilitation Field Officer. Together with Neema, the clinical officer, they travel from Kamanga Health Centre to the neighbouring villages of Kamanga on their trusted motor bikes. Watch the latest episode of their adventures!
Watch Jackie and Neema as they do their rounds in the village of Kamanga as part of Cedar Tanzania's Community Based Rehabilitation program, to bring care to people with disabilities.

What Jackie and Neema saw...

When Jackie and Neema, Field Officer and Clinical Officer from our Community Based Rehabilitation outreach programme, first reached Sara and her father in the village, they didn’t know what to expect. One of the Community Health Workers who work closely with Kamanga Health Centre and the outreach team suggested they visit the girl who was newly arrived in the ward as he had heard that the girl had physical impairments. When Jackie and Neema arrived on their motorbikes at a tiny bricked house they encountered an 18-year old girl with feathers on her leg and suspiciously looking mashed green leaves on her head. Sara didn’t speak or smile and her father chased Jackie and Neema away as soon as they had introduced themselves. Seeing the girl in such a bad condition however was really hard on Jackie and Neema who always put all their effort into improving a patient’s condition. They were not willing to give up just like that and returned the next day. Gently, they tried to speak to Mr Raja to find out what happened to his daughter. Though still reluctant, he explained that he was separated from Sara’s mother, who was located in a different ward, and said that as soon as he learned that his daughter was not well, he took her to live with him. Mr Raja assured the outreach team that Sara was bewitched. He explained that she was under treatment from a traditional healer and that there was nothing they could do for her.

Typical housing in Kamanga - the largest village in Nyamatongo Ward

All over Tanzania a widespread belief prevails that people with a disability are bewitched or suffer from an act of God’s will. It is not the first time that our outreach team have encountered resistance to or disbelief in conventional medicine. It took quite some time and several more visits until Mr Raja had built enough trust towards our Clinical Officer and Field Officer to allow them to examine Sara. After being examined by Neema it became apparent that Sara had mental as well as physical disabilities but there was no way of telling what caused her condition. She suffered from spasms on one side, and had severe anxiety and speech impairments. Furthermore, she had a huge burn wound on one leg. This stemmed from a particularly cruel traditional practice whereby the person who is believed to be possessed by a spirit is covered with large cloths and a fire is made at their feet to expel the spirit with the flames.

The outreach team saw an urgent need for treatment and asked Mr Raja for permission, which he finally granted, under the condition that they would not give any injection as this would mess up the traditional medicine. Although the outreach team pointed out that the traditional medicine is not suitable to heal the wound or improve Sara’s overall condition, Mr Raja insisted. Jackie and Neema were not discouraged but kept visiting Sara and her father on a daily basis, continued to dress the wound and started occupational therapy exercises. To support their efforts, a weighted bag which functions as an assistive device was built. This helps Sara to sit more comfortably and independently, reduces the spasms, straightens the spinal cord and improves joint mobility. On top of the medical treatment, the outreach team persistently educated Mr Raja on the benefits of their medical approach, rights and needs of people with disabilities and causes of disabilities.

When Mr Raja saw the rapid improvement of the wound on the leg of his daughter and positive development of her overall condition he finally believed Jackie and Neema. Jackie says: “Baba Sara (Mr Raja) is now very supportive and if we miss going to their house even once he seems to be disappointed”. Seeing his daughter smile again makes him happy and he is very thankful for the good care and quality medical services our CBR outreach team provides. Sara’s father has stopped the local treatment now completely and only relies on the medical service provided by the outreach team.

By the way, the mashed green leaves on top of Sara’s head and the feathers on her wound are traditional medicine prescribed by the local traditional healer. Thankfully, the outreach team managed to convince Mr Raja that this was not adequate treatment for his daughter.

(Patients’ names have been changed to protect their anonymity)

David's smile

David is six years old and is living in a village called Mzizi. The first time I saw David I was riding my CBR pikipiki (motorbike) from Kabagombe. I saw him at the side of the road as he was returning from school with his fellow classmates. I stopped the pikipiki and went over to talk to him because he had a severe case of a cleft nose. He directed me to where his house was located and the following day I went there to talk to his family. He lived only with his Bibi (grandmother).

By chance Sekou Toure hospital, in Mwanza, had sent me a letter, a few weeks previously, about an oversees organisation that was currently in Mwanza offering free operations for cleft lip and cleft nose cases, exactly like that of David’s. This was the best platform and opportunity of helping him. I informed David’s Bibi about this opportunity and she was happy and ready for David to have the operation. I did the necessary registrations with the hospital  and they were soon given a date for surgery, the beginning of April 2019. David was operated on successfully. The CBR outreach team has been visiting him regularly at his home to make sure that he is  healing properly by monitoring the swelling, keeping his wound clean and by providing pain killers to ease his pain.

The family is very happy with The Cedar Foundation and the CBR team for coordinating with Sekou Toure hospital for David’s free operation and for providing his after care. David smiles a lot more now. And what a lovely smile it is!  

(Patient’s name has been changed to protect their anonymity)

Habari Kamanga, Hello Kamanga - Second Article by Katherine Anne Lee

Nearly a month has passed since I arrived back home from my journey to Tanzania, and the last mosquito bites on my arm are finally fading. My mind is still very actively processing my visit to the Kamanga Health Center, however. Maybe you read my previously published story about Peruzi’s light? Today, I would like to tell you my second story about Emanuel Mavuno. I hope you will enjoy the read and feel assured that your generous support is needed more than ever.

EMANUEL’S WALK

By car, we follow Jackie and Neema, who are on their motorbikes. They are from the Outreach Team project. As mentioned in my first story, the Outreach Team is offering quality health services to those unable to reach any form of medical support. The Kamanga Health Centre runs the project, and I cannot stress how impressed I am by their work. Many people in Tanzania don’t have any means of transport, which means they have to walk for hours to reach a larger town. This becomes a very challenging task if they are not well. On top of this, traditional western medical support is only encountered with caution. Tentativeness paired with a difficult journey often leads to health problems being neglected, even when severe. Thanks to the Outreach Team, the ambassadors of the Kamanga Health Centre are in the field and can find people who are in desperate need.

Our small convoy swirls up red dust as we make our way through the remote landscape of the outskirts of Kamanga. Now and then children spot us, wave frantically or run beside the car for as long as their short legs will carry them. Even today I can hear them chanting, “white people, white people”. It’s amazing how happy they are. During the whole journey, I never saw a child cry, let alone get into a temper. Their joy underlines the fact that possessions don’t necessarily mean happiness.  

Emanuel mending shoes

We stop on a grass bank and park our car and the motorbikes. We are out in the middle of nowhere, and I can’t imagine where we are heading. The sun is beating down on my head, I feel thirsty and a first wave of travel tiredness overcomes me. But it feels good to move and use my legs, following Jackie and Neema down a little path. Well, it’s not really a path; it’s actually just some beaten down grass. It reminds me of hiking the rural hills of Church Stretton in England, close to the Welsh border. My grandparents lived there and, every summer, my brothers and I would spend loads of time exploring the hills. The grazing sheep left similar simple paths behind them. It was a great adventure to follow the short-legged animals while picking wild blueberries, and feeling the harsh Welsh wind on our faces. Lost in memories, I reach a platform with a wonderful view of Lake Victoria. Large rocks seam the outer area of a simple clay hut. But my attention is drawn to the view and the peacefulness of the area. It’s a beautiful spot, and its tranquillity distracts me from the real reason for being here. It takes me a minute to realise that we have arrived at Emanuel Mavuno’s house. Actually, I have to admit that I know we are visiting someone, of course, but I’ve somehow missed out on what I should expect. A tall man is sitting on the ground, bent over some old shoes. He carefully gets up as he sees our group. Still admiring the view, I wonder who we are visiting. The tall man has such a happy smile and a calm aura that I don’t immediately make the link between him and medical support. I admire his happiness as he slowly moves closer to our group, but then I notice that he doesn’t walk smoothly. His flip-flops are totally worn under the heel. Well, the rubber shoes don’t actually have heels anymore, just a large hole at the back. Jackie and Neema introduce Emanuel Mavuno to us. He doesn’t really give me the impression of being ill. But as I study him more closely, I realize he is missing large parts of his fingers. Only maybe 30 per cent is left from what must have been once long fingers. While I’m wondering what happened to him, Neema explains that Emanuel suffers from leprosy. Leprosy! A thousand thoughts rush through my mind. Does leprosy still exist? How does leprosy infect you? Is it safe to be so close? What about vaccinations? Did I get a vaccination? How can Emanuel be cured? After inhaling the tranquility of the place, it’s like being slapped in the face.  

Emanuel carefully sits down on a rock and slips his feet out of the remains of his flip-flops, while Neema unpacks some medical supplies.  

Emanuel Mavuno is one of the many people in Tanzania who rely on water supplies from Lake Victoria. The water is used for daily nutrition, and many people also wash themselves on the shore of the lake. The growing population, industrialization and the lack of water and waste cleaning facilities have led to the poisoning of this water lifeline. Lake Victoria is ill, and is infecting the more than 30 million people from Uganda, Kenya and Tanzania who depend on its water. Emanuel Mavuno also washes himself in Lake Victoria. After he became infected with leprosy, his family left him so as not to risk becoming caught by the same destiny. Alone, he was not able to keep up with life. He lost his family, his work and his connection to the community. Before the Outreach Team found him, he was in great pain, hoping for the odd passer-by to show compassion and leave him some water or food. Today, the Outreach Team has been able to stop the infectious disease on his hands. But his feet are still a worry. Ulcers the diameter of an orange cover both his feet.The medical care has luckily been able to stop the further growth, which would have led to losing his feet, and thereby the ability to walk.  

Emanuel Mavuno's hands

Jackie recording today's visit

Neema bandaging up Emanuel's feet

Neema is holding a bottle and signals to Emanuel to lift his foot. While the clear liquid runs over the wound, the giant ulcer turns white. I can remember having pin-size ulcers in my mouth as a child. My father gave me salt to disinfect the wound. Only too well can I remember the burning in my mouth, and the salty taste running down my throat. It was a terrible feeling, and I cannot imagine how this procedure must feel for Emanuel. While his ulcers turn white, he closes his eyes as if to enjoy the sunlight on his face. Only the flinching of his eyebrows now and then reveals the pain he is experiencing. Once both feet have dried, a healing lotion is added and the wounds are covered with a bandage. Emanuel slips his feet back into his flip-flops and stands back up on his heels. I wish we could give him some new shoes – it would be so easy to do. Facing us all, Emanuel expresses his thanks to all of us for visiting and helping him. He expresses his extreme gratitude to the people in Switzerland, who support this project and thereby give him a cure and the hope of a somewhat more ordinary life.  

Back home, I’ve thought about Emanuel Mavuno many times. The terrible disease at such a tranquil place just seemed so surreal to me. Such a kind man with so much happiness to give. Even though his illness shocked me, he was able to give me peace of mind. Even today, in the 21st century, leprosy is a dangerous and discriminating disease. I’m impressed by Emanuel’s capability to face this condition with so much grace.  

Emanuel’s situation has now improved further, and his wounds are still being regularly treated by the Outreach Team. The upper layers of the ulcers are slowly healing, and it appears that his feet will improve with just a little more time and care. What makes me really happy is to hear that he’s making progress with his business of mending shoes and fishermen’s nets. Emanuel is becoming able to manage his life again, and this must be game-changing for such a proud man. He’s also helping some fishermen with their catch, and now and then doing some fishing himself. Lake Victoria’s water is what it is, and I pray that he will be all right. Maybe one day the remediation of Lake Victoria will also be a topic – I would love that moment. Today, I’m just happy that we can celebrate this step of healing and enabling Emanuel Mavuno. Australia for Cedar Tanzania and you, its donors, can be proud. This change matters, and no action is too small! Can you also see Emanuel Mavuno standing by his clay hut, gazing into the distance, feeling the sun and a soft wind touch his cheeks? He is now able to walk towards his own future.

By Kathrine Anne Lee
Katherine Anne Lee is a published author with her first novel "From Dust to Dust and a Lifetime in Between"receiving public acclaim.

Habari Kamanga! Hello Kamanga!

My name is Katherine Anne Lee. I live in the beautiful city of Zug in Switzerland and, a few weeks ago, was given the unique opportunity to visit the Kamanga Health Centre in Tanzania, which was opened by Cedar Tanzania one year ago. My friends and family back home have been very excited to hear about my latest Africa journey, in which I saw many things, some beautiful and some hard to grasp, even painful. They are all stories about everyday life in Tanzania and the wonderful work the Cedar Tanzania team is doing. I’d like to share my first story about my visit to Peruzi, and maybe I can share some more later on. I hope you will enjoy reading this, and see how your support for the project matters.

Peruzi’s light

It’s only a short drive from the Health Centre in Kamanga to a small village nearby. Clay huts line the busy, graveled street. It isn’t a classic street as you would imagine in the western world - the main street of Kamanga is along stretch of dusty gravel that connects remote communities. Sooner or later, everything that is making its way from A to B, has to end up on this street, dodging portholes and stray dogs. Overloaded buses, children who walk for miles to go to school, cattle in search of a new grazing spot and locals on their way to the market or maybe the Health Centre, pass by. It’s a bustle you could watch for a while if you wouldn’t become coated in red dust every time a heavy lorry passes by. But we’re not here to observe the street. We are here to visit Peruzi. Jackie and Neema from the Outreach Team project are showing us their work. The Outreach Team is to offering quality health services to those unable to reach any form of medical support.

It’s only a short jump down the bank from the dusty road and we’re standing in front of a tiny mud house with two simple doors. Both are open, but it’s dark and difficult to guess what’s inside. An elderly lady is nervously sweeping the floor outside, and greets Jackie and Neema. She is missing some front teeth but nevertheless has a happy smile, and points us towards one of the small doors. As we come a little closer, I can see an old, weathered mattress on the floor. There are colourful sheets on top of the mattress, all muddled up. And there, in between the colours, I see a face and part of a leg sticking out between the sheets.So small and fragile, as if it were a child lying there. It’s Peruzi, a 40-year-old woman, marked by her heart-breaking past.

Peruzi is challenged with epilepsy. The illness was more under control in her younger years; she lived within the village and even gave birth to a son. In her twenties, her epileptic outbreaks increased to the point where she was no longer in control of her own destiny. Her mother, a small lady, closely interwoven into the local community and swayed by social stigmas, was unable to cope with her daughter’s deteriorating situation. Embarrassed by the local talk that her daughter was afflicted due to the failure of her mother, she thought the only thing she could do was to tie Peruzi to a rope and lock her into a small dark room. There, Peruzi vegetated for a full twelve years on the bare, cold, clay floor, without any form of comfort, light or proper nutrition. It was a pure coincidence that the Outreach Team found Peruzi. The degeneration of her body left the team with no option other than to transfer Peruzi to the nearby hospital. While Peruzi received care, the team patiently educated her mother to correct her misbelief about disabilities being a consequence of personal failure, and persuaded her to share her old - and only - mattress with her daughter.  

Peruzi’s situation left me feeling ashamed, and reluctant to enter the dark room. I didn’t want to disturb her; maybe she would be afraid or feel uncomfortable at having us all looking down at her. On the other hand, I didn’t want to appear rude by not visiting her. While I waited, I deeply wished I could do more for her. A new mattress, some fresh clothes, sanitary material; this would be easy for us to organise. Having so much, but having nothing in my hands to help gives a feeling of powerlessness. Her big brown eyes gazed up as I entered her room. I wished I could comfort her, tell her it will be better now that Jackie and Neema have found her.

A few weeks later, back home, I was happy to hear that the Outreach Team had been able to improve Peruzi’s situation. They brought her a wheelchair, bedding and sanitary material. I can picture Peruzi sitting outside, enjoying some fresh air and finally feeling the sunlight touch her cheeks again after twelve years in the dark. It must be an exciting moment for her to be part of the community again.  

Only a few days later, I received the terrible news that Peruzi has sadly passed away. Her poor health and missing nutrition had taken its toll. Were we too late? Or could we have made a change? While frustration and deep sadness cloud my heart, I decide to light a candle for Peruzi. Gazing at the flame, I whisper to her and thank her for her time. The candle burns all night in our window. In the morning, the flame flickers one more time before turning to smoke and I realise that Peruzi’s story matters. Peruzi’s light has been seen.

By Kathrine Anne Lee
Katherine Anne Lee is a published author with her first novel "From Dust to Dust and a Lifetime in Between"receiving public acclaim.