- I participated in a study abroad program in Iringa, Tanzania called “HIV in Context”. We spent a month in Iringa learning about the history, transmission and public health aspects of HIV in the region, as well as hearing from and visiting clinics, NGOs and professionals in the area.
- Living in Iringa was an eye-opening experience. I lived in a Tanzanian college dorm for a month and ate most of my meals at the cafeteria, which was mostly “wali maharage” (rice and beans). The living conditions and sanitation were also far less safe than those in the United States. Considering the high national prevalence (over 5%) and the regional prevalence of HIV (over 9%), these conditons and nutritional options are considerably dangerous for opportunistic and comorbid infections. Nonetheless, many people had very positive attitudes of success and self-sufficience, free of self-pity. This helped to transform my American perspective of “starving Africa” and the “developing world” into a situation of gray area. Tanzania, and much of Africa, is at a relative disadvantage from the “Western” world in terms of development and access to medicine and technology, but that does make it instiutionally inferior.
- One important part of my experience was learning Swahili. It is very difficult to stay in a foreign country for an extended period of time with little or no understanding of their language. By expanding my knowledge of Swahili, I was able to learn how to communicate directly with local individuals and more precisely communicate. It allowed me to translate for myself certain propaganda and printed or posted statements, rather than rely on the translations of others, sometimes changing the meanings quite signifcantly from the supposed English translations. This helped to create a more authentic experience and direct understanding of my surroundings. It also created a level of ethos on my behalf when conversing with Tanzanians. This allowed me to have more contextual pereptions of NGOs and the work of others’ with HIV and the region. Perhaps the most significant experience of my trip was visiting an HIV support group. The group was created, run by and consisted of all HIV-positive individuals. It was a group meant to provide emotional, moral and financial support to its members. It was extremely well organized, having a president and treasurer, among other roles, and with a regular meeting schedule. The group essentially takes about a USD 2.50 “insurance premium” from each member every month. When a member is having considerable economic difficulty, they then use this money to help pay for the member’s food or medical expenses. The group helps to ensure that everyone regularly attends the HIV clinic and stays with their ARV drugs. They also provide emotional support for an otherwise stigmatized, and often socially ostrocized, group of people. The support group was extremely welcoming to and open with our group. The group all had very positive and proud demeanors, even though they were all in very difficult situations. This experience helped show me that many Tanzanians, even those who are HIV-positive, have a very high sense of credibility, organizaional potential and self-reliance. An experience which similarly helped transform me, but from a different direction, was a meeting with an American environmental NGO. This experience adjusted my view of Western influence on Tanzania. The man in charge was fairly self-righteous and proud of his work, even though it had made little to no difference, so far, for the local population. He expressed quite judgemental attitudes of Tanzanians and their essentially “inability” and “ignorance” of protecting the environment. He was not well versed in the culture and did not even have any basic knowledge of Swahili. It was disturbing that what seemed to be a positive, American-run NGO had such minimal impact and was led by someone who seemed so inconsiderate of the local population. It helped show me that “Western” efforts to “fix” other regions of the world, such as Africa, often have an unstable ground effect and may be “fixing a problem” that cannot be solved in that way, or already has alternative solutions from the local population.
- This program was very significant for my career and life goals. I hope to enter the medical field, where I will be met with people of many different origins and lifestyles. It is important to understand that my perspective is not the only or necessarily correct solution. Western medicine and antibiotics can have stigmas, so it is important to consider and understand local situations and perceptions. I also hope to ultimately work with Doctors without Borders in Africa, where this experience will be especially relevant. I now have a better understanding of how some of this part of the world operates, and how the people think and act, and even of their language. This can help me to be a better doctor and more considerate of people’s beliefs. My new perspective of Tanzania helps build my cultural sensitivity and identity of my own impact.