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Read about Project Tanzania 2009 » |
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©2009 The Phil Simon Clinic |
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2006 Field Journal archiveAuthor - kim shriner There really are no words to describe the last thirteen days…hopeful, heartfelt, challenging, surprising, awe inspiring, tearful,joyous. We’re heading home (currently somewhere over Greenland) after a sometimes frenetic but very fruitful time in Arusha. This has been a trip of hope. The antiretrovirals (ARVs) have finally reached sub Saharan Africa and our now being used; saving lives, restoring futures and families. It seems a time of cautious optimism. But there is still so much to do. We all have a much better overview of the healthcare system in Arusha and Northern Tanzania-thanks in large part to the many meetings and visits with the main testing and treatment centers in the region. Volunteer testing and counseling is well established but had not been much utilized because of the stigma of HIV/AIDS. The presence of the antiretrovirals, though still not widely distributed, seem to be changing that. Eight to ten percent of the population of Arusha-some 20,000 people, are thought to be infected with HIV/AIDS. Treatment centers such as Mount Meru Regional Hospital, St. Elizabeth Hospital and Selian Hospital in Arusha and Kilimanjaro Christian Medical College (the primary referral center for Northern Tanzania, also known as “KCMC”) in Moshi are providing antiretroviral therapy for some 2,000 individuals-perhaps a drop in the bucket, but a drop all the same. Tanzania has a limited arsenal of ARVs-primarily four drugs compared to the twenty two available in the U.S. But it is making a difference. We learned that Peter-one of the HIV infected individuals who welcomed us into his modest hut in a local squatter’s village last year, who was at that time barely skin and bones is now on the medications and back to supporting his family. Several of the members of Ann Kleeger’s and Jody Casserly’s HIV women’s group at Upone Clinic are also enrolled in HIV treatment programs and doing well. With a small number of available drugs, there is some concern about the development of resistant virus-a subject much discussed at our second annual HIV/AIDS symposium held at the end of the week. Learning from the mistakes of the developed world, the Tanzanian government has taken simple, yet effective steps to discourage improper use of the HIV medications. Taking the profit out of the drugs, distributing them without charge only through designated treatment centers and closely following clinic visits and compliance at home have seemingly produced a very high adherence rate. More individuals are testing and HIV prevention is being discussed freely now in many support centers around town. Mount Meru Hospital and Upone Clinic are interested in an oral fluid testing project sponsored through The Phil Simon Clinic. Team member and laboratory clinician, Cheryl Arteaga has trained several members of Mount Meru’s staff on oral fluid testing techniques and we hope a larger project will be launched soon. One of the shining moments was when Cheryl’s oral testing program discovered a patient who had been misdiagnosed and was really HIV negative. Certainly an enormous relief for the patient and another example of how even small projects can really make a difference. Cheryl has been offered many jobs at the various medical centers-so if she ever wants to move to Tanzania… This trip, like much of Africa is a marvelous mixture of technology and tradition. It seems that each of the past trips have built upon themselves. Ann Kleeger’s HIV positive support group is still meeting and was awaiting her when she returned to Upone Clinic-a testament to Ann’s perseverance and compassion. Jody Casserly’s camera project and the return of her Tumaini women’s group shows the depth of her bond and commitment to the people of Arusha. Jody had the opportunity to show previous camera project photos to the group members-the cackles and chirps of joy are not to be forgotten. We have had just a glimpse of this year’s Children’s Camera Project and, suffice it to say, they are amazing photos. Tom Warren, our veteran nurse, triaged the Upone patients with aplomb and had several opportunities to exchange stories and expertise with fellow Tanzanian nurses. Tom’s clinical expertise continues to impress all who work with him and his obvious love for the people of Arusha really represents what this project is all about. Suzie Icaza and Gyongver Sovago had their first taste of Tanzania as well. Suzie spent several hours reviewing patient care and interviewing HIV positive individuals at Upone Clinic. Her expertise in sand tray therapy may play a role in future projects and it was a delight to see Suzie carefully and compassionately explore the mental health aspects of HIV in Africa. Gyongver, our videographer did a marvelous job recording the entire trip and clearly was moved by the emotion and beauty of Tanzania. A real moment occurred when she met a fellow Romanian physician in the female ward of Mount Meru Hospital. The world is indeed a very small place. We are all anxiously awaiting the images she has captured so thoughtfully. Finally, Lyn Smillie has once again gotten everyone and everything to Africa and back again. No small task given the thirty hour plane flights, one thousand pounds of luggage, dietary dilemmas and ten different personalities. And that doesn’t even count the bumps in Moivaro Road, enormous African spiders, Serengeti dust, cranky lions, slippery showers and of course, the occasional bouts of Tanzanian Two Step. Thank you, Lyn. As we fly across the Atlantic, so many images and sounds and smells come to mind…the phenol odor of almost all the Tanzanian medical facilities, the soft fragrance of honeysuckle in the morning, the sweet voices of the children of the orphanage and their cheers to their colleagues at Holy Family School, the loud “twats” of the resident hornbills of Moivaro Lodge, the bustling and dusty streets of Arusha, but most of all, the grace of the African people who have so willingly and warmly welcomed us into their lives. We are honored to be part of their community and we say, Asante sana Arusha.
Author - Jody Casserly, LCSW Back from our safari safe and sound. More than I can say for the cape bufallo and the zebra being enjoyed by the lions of the Serengeti and Ngorongoro Crater, however! We're saying goodbye (kwaheri) to Arusha today. Everyone's a bit quiet, and, for some, the tears have already started (well, that would be me. My brother and sister always used to taunt me with the chant "Jody is a crybaby." Not much has changed!). As much as we all miss home, it is so hard to leave here after all we've experienced. This morning we met Dr. Solomon and his staff at Upone Clinic. They wanted to say goodbye and present us with gifts. All the women on the team received beautiful Katangas (sp?), and Jim and Tom shirts from brightly colored African fabric. It was a touching send off, and Dr. Solomon let us all know how much our work at Upone and in Arusha has meant to them, and each year improves the morale of the staff and the patients. As we left Upone, I was again greeted by the women of the Tumiani group who came to say goodbye, safe journey, and to express their "upendo" - love. There were also 18 of the 20 disposable cameras waiting for me at Upone, which are at the Arusha one hour photo as I type this. Dr. Shriner is currently meeting with the Mayor of Arusha - a tremendous honor ("If I had known I was going to meet the mayor, I would have worn my GOOD safari pants!") The rest of the gang is out shopping for small trinkets to remember their time in Arusha. But really, I don't think anyone will need help remembering the people we've met, the relationships we've built. So many memorable moments -- some shared by the whole group, and some experienced privately by each team member. I think many of us may be adding to this journal in the next few weeks as we have time to process everything. In addition, I believe some of the people we've met in Arusha will also be contributing to this journal soon. So keep checking for new entries. Tonight at 10:30pm Arusha time (11:30am Friday California time) we start our VERY LONG journey home to Pasadena. We'll be home around 1:30pm Saturday afternoon. I'll try to get some pictures from the trip into the photo gallery on Sunday.
Author - Lyn Smillie Hello Everyone, One again I find myself back in Arusha, East Africa. This has actually been my fourth trip and I have to say that I am very happy to say that there has been such a huge change in the care of patients living with HIV/AIDS. We have met many of our old friends and have made many new ones and it has all been a positive experience. On this trip it was a welcome change to visit Mt. Meru Hospital which is a Government run facility and to see that there inpatient population has now dropped due to the actual ARV treatment of HIV/AIDS patients and to see that they have an outpatient clinic that they can do there follow up. It was very encouraging to see that there clinical lab has expanded and there growth is continueing. The is excellant news for the people of Arusha. One of the stongest memories on this trip for me will be the day Cheryl Arteaga went to Mount Meru to do the testing on patients and they actually had a female who tested negative and they double checked there results and the lady actually was not HIV positive. I wish we could have all been there to see that lady receive that wonderful news. On this trip we have visited a few other facilities and have been very impressed to see that they are all working on problems to help there people understand the problems related with HIV/AIDS. One of the main hurdles now is getting proper nutrition to the people. There is now a very strong presence of Hope in the people and it is so wonderful to see. Our team's presence here in Arusha with there HIV/AIDS has been well received by all we have met. Our Medical Symposium was a huge success and it was great seeing those buses full of medical people arriving at the conference room. Today our team leaves for Safari and it will be hard for us to get internet access but we will post pictures as soon as we can. See you all back in the States.
Author - Jody Casserly We all talk about the people and the hope and the spirit. In addition to the amazing people of Arusha, I have been facinated with how American pop culture is alive and well throughout the town. So many bars with American names (The Hollywood Bar, Moonlight Bar, Las Vegas Bar). Then there's the Dalla Dalla's - kind of like American buses, I guess. They are about the size of a minivan, but usually have about 15-20 people riding at one time. My friend, Lesikar, explained that there is a lot of competition for business, so each owner tries to make his Dalla Dalla "flashy" so people will choose his over another. Brightly painted in wild colors, they also have some very interesting names: White Snow, Love Situation, Baby Girl, First Justice and Then Peace, Unique Sister (there are lots of these - this owner is quite the entrepeneur!), Marco Polo, Heart Light, Tony Montana, Ruff Ryder, Spider, KK one, Bone, Mr. Johnson, With God All Things are Possible, Max, Injection Pipe, Golden Eagle, Hot Stepper, Red Devil, Life is Life, I love this Game, Led Zepplin, B52, Absolute Power, Sea Never Dry, Tortoise (don't think I would take this one if I was in a hurry!), Gecko, Def Jam, I Believe in God, Liverpool, Jerusalem, Bulldog, Respect, Poison, Responsibility, Hard Rock, Pappilon, Chameleon, Horse Race, Bad Card, Makiavelli (their spelling, not mine!), God's Lucky, Superman, Passion of Christ, Scorpion, Jesus Will Answer, Star Wars, Air Jessica, Lord is My Fort, Baby Boy, Bam Bam and finally, Sean Puffy Combs. One day we saw Tsunami, and tried to chase it down for a picture, as that's the name of Gyongyver's swim team in San Marino. These kids sent letters and a donation with Gyongyver for the orphanage we visited, so we really wanted to get a picture of their Dalla Dalla. He was too fast for us. Then one day while some of the team was out in the town, they finally spotted Tsunami again -- Lesikar, step on it!!! After a chase, Jim snapped a picture for Gyongyver to bring back to her team. My favorite was the Dalla Dalla called Tracy Chapman. I asked Lesikar if he knew who Tracy Chapman was, and he hadn't heard of her (his favorite music is Country Western and his favorite artist, Dolly Parton!). With the magic of Susie's IPod, Lesikar was able to put a voice with this Dalla Dalla namesake.
Author - Susie Icaza I sit on the porch of my thatched roof bungalow, close my eyes and listen. The sounds are distinct and yet they seem to merge into one harmonious sympohony. I hear a multitude of bird calls, shrill whistles, small chirps, loud caws, and deep throaty gurgles. Nearby cattle are lowing and a rooster, crowing since dawn is still at it. An axe is striking wood and hammers strike nails repetitively. Somewhere in the distance Afro pop plays on the radio and many voices shout to one another in that beautiful melodic language that is Swahili. When I was invited to join the 2006 Phil Simon Clinic Tanzania Project nearly a year ago I was excited and empowered by the notion that I might, in some small way, make a difference in the fight against the pandemic of HIV/AIDS in Tanzania. As our departure date neared and the reality of the trip began to sink in, I was increasingly occupied by feelings of anxiety and even fear. Fear of the devestation brought about by the disease that is HIV/AIDS. Instead what I have encountered again and again in the events of the past week is a message of comittment and hope. Comittment on the part of Tanzanians serving those who are infected and ill and hope brought about by the advent of antiretroviral therapy. With treatment comes hope and a lessening of the feeling of shame brought about by this brutal disease. Nowhere have the messages of comittment and hope been more evident than on Friday where we visited St. Elizabeth's Hospital and an orphanage caring for well over 250 children. There is no doubt about the devistation wrought by disease throughout Africa. HIV/AIDS, TB, Malaria, and poor nutrition are just a few of the contibutors. It would be easy enough to lose hope, and simply give up in the face of such devestation. Nonetheless, we have had the honor to meet many caring and remarkable human beings who are devoting their lives to taking care of those who cannot. I was brought to tears by both the doctors, nurses and social workers we met who are giving their lives in the service of caring for others. My life has been changed by their beauty and strength, heart and soul.
Author - Jody Casserly, LCSW So, my entry the other day got cut short! Not used to being limited to my time on the computer, when my 30 minutes was up, IT WAS REALLY UP! Anyway, I just wanted to add that seeing the Tumiani group return to Upone was one of the highlights of my week! The connection we have made with the people we have met here over the years is really what stands out to me - they remember us and appreciate not only any help we can provide, but the relationship. I had a wonderful afternoon with these ladies! Luckily, Dr. Shriner had the pictures from TROUGH AFRICAN EYES on her computer, and I was able to show them a slide show of the pictures they took with the disposable cameras two years ago. We had so much fun looking at the pictures -- "that's my mother," "that's my husband." An infant in the pictures is now two years old and was there to see the pictures too. What a gift to be able to share this with them. It's really been amazing to see the changes that have occurred here over the past three years - especially in the last year since antiretroviral therapy is now becoming available. I'm impressed with how far they've come here in establishing support services such as groups, home based care, etc. Don't have time to get into it all now. Sorry we haven't been able to download any pictures. I tried again today, but wasn't able too. As soon as we return I will put some pictures up.
Author - Jim Avedikian This is my first trip to Africa with this group. So far it has been an amazing adventure. The plane ride over was never-ending for me as I was in the middle of a head cold. Fortunately all our flights were on time, connections were flawless, lay-overs were minimal and we arrived 30 minutes ahead of schedule. Once we arrived at Kilamanjaro airport our processing through passport control and baggage went smoothly. As soon as we arrived at Moivaro Lodge they greated us warmly with glasses of mango and watermellon juice (delicious)!! We got our room keys and I flopped into bed and was asleep immediately. Upon awakening I was able to see how beautiful Moivaro Lodge really is. After breakfast we began our scheduled appointments. Our day and a half at Upone Clinic was amazing. The first day I re-organized the medicine cabinet with help from my able assistants, Lyn, Raffee and Cheryl. The next day we saw 36 patients in 6 1/2 hours. I was able to sit in with Dr. Shriner and dispense the prescribed drugs for each patient. The Tanzanian people are truly inspiring. They all waited patiently to be seen without any complaints. They are a beautiful and proud people and quite shy. even the sickest among them rarely complain outwardly. The children are the most amazing. Wehn you look into their eyes and they begin to smile, your heart simply melts. We had brought many gifts for the children--the most popular being a talking banana named Bobby. When you push on his stomach he begins to sing a snappy jingle and the children are totatlly amazed. Even the sickest ones responded with huge smiles. Several patient stories caused me to cry, I swear I could actually feel my heart breaking. You want to do something for them, but all you can do is offer support and a hug. Treatment with anti-retrovirals are becomming available now, and that has changed the lives of hundreds, just as when they were introduced in the USA. People are able to return to work and care for their families, and many are now coming to get tested. But now a severe drought is affecting the country. There is no power for most of the day and animals and crops are dying. So the Tanzanian people have yet another disaster to face. But with our help, and their spirit, they will survive.
Author - Gyongver Sovago Friday, February 3 I am the eye behind the camera, having a chance to see everybody in action, our team and the Tanzanians. What eyes see through the lens is remarkable. What I feel being here is remarkable. The main thing is the feeling of just to be. Nothing else matters. No material world matters, just the human connection. The human connection has built up in the last four years by the team, and I am fortunate to witness the results of their work and the work of the newcomers like Raffee, Cheryl, Susie, Jim, and myself. Watching Dr. Shriner, Jody, Tom, Ann, and Lyn just being here is like for them coming home and being home. Tanzanians in the lodge, in the hospital, and the patients all welcome them as family members. There are no words to describe the insant results of the team's work, in the children's smile, in the mothers' gratefullness, and the doctors' appreciation of sharing professional knowledge. The philosophy of the Phil Simon Clinic and Dr. Shriner is validated every day and every place we go, and by everybody we meet. I want to thank my swimmers who sent their notes to Tanzania, and to the parents who supported me in my journey. I hope I can bring back a very usefull message.
Author - Raffee Reyes Thursday 2/2/06 Hello, America. It's our fourth day here in Arusha. So far so good. Today we are on our way to Moshi to visit KCMC (Kilimonjoro Christian Medical Center). KCMC is a teaching hospital. They have a bed capacity of 450, but they have a daily census of 600 patients. They accept private and nonprivate patients, and unfortunately you will see the difference in their amenity services. We had the opportunity to visit the different departments of the hospital. For me, the most fascinating is the food and nutrition department. I was able to see the different practices they had, and it is a total difference from the way I am accustomed to. In a nutshell, our visit was very enlightening, and I have great admiration for the African spirit, their tenacity, and endurance. If you have the opportunity to visit Africa, do it. It will change your life. Asante sana (thank you).
Author - Jody Casserly, LCSW Last January, when we returned to the Upone clinic, I saw very few familiar faces from the year before. Each day I hoped to see Twalibu sitting in the waiting room with his aunt. They never came. Neither did Gerald, the little 6 year old HIV+ boy whose picture we have used on the Phil Simon Clinic Tanzania Project brochure. Neither did Joseph and his daughter, both HIV+, who so graciously allowed me to interview them on video about their experiences living with HIV, the stigma of HIV, and their hope that the antiretroviral drugs would come to Africa before it was too late for them. And my women's group, the Tumiani Group I wrote about in this journal in 2004 -- Jenny and Hadija and Eliza and Tatu and the rest -- the ones who told me "don't cry, teacher" when I got emotional that they had been so inspired by my Spanish speaking women's group in Pasadena -- did not return to Upone in 2005. Last year I wondered about all these folks. What happend to them? I was afraid to ask Dr. Solomon, preferring to imagine stories about their just moving too far away to come back to the clinic, not something worse. But the truth is that I think I know what happened to most of those people we came to know in 2004. There was no treatment for HIV, and HIV kills. Since we returned to Arusha this year, and to Upone yesterday, I have been struck by how different things are in just this short year. When we drove through the Upone gate, I saw many, many, familiar faces from last year. I came to know them during our time at Upone last year, but have memorized their faces looking at the pictures they took last year with the disposable cameras for my Through African Eyes project. In all of our visits in the past few days to Mt. Meru Hospital, Angaza testing center, Selian Lutheran Hospital, and Upone, we have heard stories about the beginnings of antiretroviral treatment programs that have FINALLY reached Arusha. With the medications, it seems that there has also been a return of hope to the people of Tanzania. Many more are being tested knowing that treatment is available. People have seen the effects of these medications -- those who were bedbound are returning to work. There's obviously a long way to go. Out of about 20,000 people infected in Arusha, only about 1000 are actually getting treatment. But what a difference from last year! I never did find out for sure what happened to Twalibu and Gerald and Joseph and Rose (his daughter), but this afternoon, the women of the Tumaini group returned to Upone to see their "teacher."
Author - Cheryl Arteaga February 1, 2006 A very busy and productive day today. Jody, Gyongver, and I went to Mount Meru Hospital and clinic to test the Orasure oral swab HIV test kit. We tested many HIV-positive patients as well as HIV-negative patients, and found the test to be easy to use and well received by the Tanzania patients. We were actually able to one patient good news, as she was previously tested at another hospital and was told she was positive for HIV; however, when we tested her, the results were negative. Repeat testing showed negative as well, which was then confirmed by two different blood HIV tests (using two different kinds of tests). We wish we could have been there to see her when the counselor told her she was HIV negative after all. We did several interviews and learned a great deal about the patients and their experiences living with HIV. Although there is a long way to go, the Tanzanian people have made great strides in just the last couple of years with education on HIV, testing, medical treatment, overcoming social stigma, and living their lives with HIV. After we finished at Mount Meru, we joined the rest of our group at Upone Clinic, where Dr. Shriner and Tom saw 25 patients today. On the side, we had art projects going with the children, group interviews with adults, and individual interviews. It's been a long but satisfying day. It feels like we are making some progress with our work and we feel good about it.
Author - Ann Kleeger ("News of Work!") January 31, 2006 We are seeing changes since the first year of our visits in 2002 and note the scaling up of the Tanzania government for the VCT (Voluntary Counseling and Testing) and ARV (Anti retroviral) treatments. Decreasing stigmatization is possible as more social support services are offered to people. People are becoming more knowledgeable about VCT and now have more hope for treatment. They are becoming more knowledgeable about how to take care of others safely as well as themselves, which is major factor as well. Today we visited one of the VCT centers where we learned about their expanding services in the community for VCT. We were allowed to meet with thirty of the sixty members of the post-test club that showed up. They gather together for hope, help with problem solving, and to exchange ideas. By afternoon,we arrived at our sister facility, Upone Charitable Medical Clinic. Dr. Shriner,Tom our nurse,social workers Jody and Susie and the new Medical Officer of the clinic Joseph met with each of the patients. Cheryl,Lyn,Jim and Raffee worked to organize the medication closet. Gyongver worked hard all day filming our activities. Eleven of the "living positive" support group, started in 2004,showed up to meet. The group has grown this year from the 11 last year to a total of 31 members. They expressed a great deal of thanks for the medications they have been receiving throughout the year from the Phil Simon Tanzania Project donations. Thanks to all who offer support and donations back home. Many of the members note this group as one of their primary supports. We are looking forward to meeting again with all members tomorrow.
Author - tom Hello to one and All, We survived our 30 hour flight ordeal and have arrived safely in Arusha. We had very litle time between flights so it all went smooth and the trip seemed a little shorter than usual. We arrived at Moivaro Lodge Sunday evening about 8:30pm and we greeted by many friendly and familiar faces--oh it is so good to be "home" again. The distinct smell of the wood fires made us know we were back in Arusha. We got some fast sleep and then were up and at em for breakfast Monday. Afterward we piled into the landrovers and were off to the Arusha Municipal clinic to meet some political fellas---they were out of town :) So we went to Mount Meru Hospital and met up with Dr. Chandy, Dr. Makule and sat for about an hour and an half discussing a potential educational exhange for the future between their hospital and ours in Pasadena. It was heartening to hear that the anti-retroviral medications have finally arrived here and they have about 600 people enrolled in the program so far!! We got of the hospital--it is like our County hospitals--very poor--ours look rich in comparison. We saw some of the wards---patients have to bring their own linens and family members must bring them food as none is served by the staff. Can you imagine that at Huntington?? It was truly an eye-opener to see all the people--they have about 300 in-patients and see about 200-250 outpatients each day. And people back home think they have a long wait. The exhange of information between our medical staff and that of Mount Meru seems very encouraging for the future. We hope to be able to set up an exhange program so that our doctors can come here and some of theirs will come to Huntington for sharing of information and learning how to deal with HIV in particular, but all medical aspects of care in the future. So this ends the entry--hope you are all doing well and realizing each day how fortunate we are in our country. Here, even though it is poor, the people are rich in color, human emotion and friendliness.
Author - kim shriner January 27, 2006 It's hard to believe more than a year has gone by since our last visit to Arusha, Tanzania. Once again, we are packed and ready for another trip to East Africa to continue our work in HIV/AIDS and our very special associations with the Tanzanian people and healthcare workers. Ten duffel bags are packed with medical supplies, educational material and toys for the children we meet. Ten dedicated members of The Phil Simon Team are ready to make the thirty hour journey across the Atlantic, over Europe and the Mediterranean and then down the vast African continent, landing at Kilimanjaro International Airport under the African moon. Many things have happened over the last year in Africa. In spite of the oft cited calamities on this continent, there is much to celebrate and congratulate. Democracy continues to emerge, albeit sometimes tenuously. Tanzania celebrated a peaceful presidential transition from Mr. Mkape to Mr. Kikwete. Women have become prominent on the African horizon with the election of Liberia's president, Ellen Johnson-Sirleaf and Wangari Maathai, Kenya's prominent environmentalist won the Nobel Peace Prize. The world has begun to take notice of just how important it is to address the political, economic and medical problems of Africa. All of us know how small the globe has become and how important it is to reach out to the entire community of humanity. Every individual can make a difference. I am reminded of this by the extraordinary activities of Ms. Ricci's fifth grade class at Holy Family School in South Pasadena. Over the last two days and under the patient tutelage of Mr. Louis Longi, a very talented artist, the children have created fantastic wax sculptures which will soon be transformed into bronze beauties and sold at our next fundraiser. The proceeds will help supply medications and medical care for Tanzanian children. In addition to the wonderful bronzes, the children have sent along a prayer chain filled with greetings and best wishes to some of the Tanzanian children we will meet on this trip. I can't think of any greater gift than one made by hand from the hearts of such generous individuals. We will have a busy schedule, meeting healthcare workers, social workers, adults, children and families affected by HIV. There will be much to do and I am sure many extraordiary moments. Over the ensuing days, you can read about the various activities and impressions of the team members as we proceed with this very special project. We thank all the extraordinary people who make this project real every day and say, Asante sana (thank you). Jambo Africa, Jambo Tanzania! Kimberly Shriner |