While walking to class or sipping coffee in the Courtyard Café, the rural Tanzanian village of Tungamalenga may not occupy the daily thoughts of many Gustavus students. For the group of students that will accompany Professor of Nursing Paula Swiggum on her January Interim Experience course to Tanzania, it is a place that she says will leave an impression.
While Gustavus Adolphus College and Tungamalenga, Tanzania may seem worlds apart, these two communities are linked by what is steadily becoming a lasting relationship. This is due, in large part, to Barnabus Kahwage, who is the healthcare provider in his Tungamalenga. Recently Kahwage even made a trip to visit Minnesota and the Gustavus campus.
Gustavus and St. Olaf nursing students have taken two January Interim Experience courses to Kahwage’s clinic in 2006 and 2008 and are about to embark upon their third trip this January.
Kahwage is the sole clinic officer for the village of Tungamalenga, Tanzania, and its surrounding villages. He and his support staff of two nurses serve a community of approximately 10,000 people from a facility that only recently gained the advantage of solar electricity.
“Every patient that comes I must face,” said Kahwage. He stays at the clinic each day “until he’s served everyone,” said Professor of Nursing Paula Swiggum. “But I don’t get tired,” said Kahwage. “In the medical profession time is not a factor for us … I have had a call upon me since … I was a child—I wanted to serve people. As I work, I always see it [as] my call.”
The idea for the January Interim Experience course began to form in 2004 during a conversation between Swiggum and her pastor at the Shepherd of the Valley Lutheran Church in Apple Valley.
This church is a sister congregation to another in Kahwage’s village of Tungamalenga, Tanzania. They are part of a network of over 50 Twin Cities churches that have partnered with sister congregations in the Iringa region of Tanzania.
When Swiggum introduced the idea of taking a group of students to Tungamalenga to volunteer their time and knowledge while gaining experience at Kahwage’s clinic, Swiggum said Kahwage was very welcoming, calling her offer an answer to his prayers.
Over the following year and a half, Swiggum and St. Olaf Nursing Professor Diana Neel worked to organize the program to, “give students an opportunity to experience and provide healthcare in a third world country,” said Swiggum. With a relationship already established through their church, it did not take long to put the idea into action.
Gustavus nursing students arrived in Tungamalenga each bearing one personal suitcase and another full of free medical supplies provided by Global Health Ministries. Some accompanied Kahwage to appointments with ailing patients, others carried out treatments ordered by Kahwage and many worked in the ward, performing injections and IV infusions.
Kahwage said that children are the most vulnerable members of the population, due to their “low levels of immunities.” They often are victims of a very common disease—malaria. AIDS and HIV are also rampant in Tanzania, and Kahwege developed a home-based care program in order to address these diseases.
Gustavus students accompanied Kahwege on house calls in the village to victims of HIV and AIDS. “When visiting homes of people very poor and ill, it’s easy to go in and look sad,” said Swiggum, but Kahwage reminded us that “our job is to give hope.”
Swiggum said that her students have been challenged by what they have experienced in past trips to Tanzania. They are placed in an atmosphere that is different than what Gustavus nursing students may face in their clinical experiences. Maintaining a positive attitude in the face of tragic circumstances can be difficult, according to Swiggum.
“Probably the hardest thing for us is that malaria is so preventable,” said Swiggum. For the cost of a meal at a fast food restaurant in the United States, many of the Malaria cases Kahwage treats could be prevented. Medicated bed nets, costing between $2 and $3, could save the lives of “innocent people,” said Kahwage.
While it may seem like pocket change in the U.S., for many Tanzanian families it is a hardship to take these preventative measures. Many families simply can’t afford them.
Facing these eye-opening realities motivated some students who have gone on the trip to take personal initiative. “Two students gave money to the clinic to buy bed nets when they returned to the United States,” Swiggum said.
Others contributed what they could to pay for emergency medical transportation to the hospital, which is five hours away, for a mother with severe liver failure.
Kahwage must be proactive and independent when confronting these issues, as he cannot depend on national support. “We receive no help from the government,” said Kahwage, “and all resources of the clinic are bought by our own dispensary or donated by the church.”
Kahwage has become very resourceful in treating patients with limited resources. Therefore, students learn a great deal about “how to diagnose and treat without technology,” said Kahwage.
“We must be experts in clinical diagnosis rather than rely on equipment—70 percent of what we do is clinical, 30 percent technical,” Kahwage said. Senior Nursing Major Ashlee Oldani was amazed at what “careful diagnosis” Kahwage was capable of with “practically no medical equipment.…He would know exactly the right questions to ask to diagnose his patients,” she said.
For Kahwage, the educational process works in both directions. “I learned a lot, too,” said Kahwage, “including things [the nursing students] do to take care of themselves and prevent transmission of diseases through cleanliness.”
After a month of working with Kahwage in Tanzania, many participants returned to Gustavus with a new outlook. Swiggum witnessed what a transformative experience her January Interim Experience class can be.
“When you strip away all the stuff, what you have left is human interaction and caring,” said Swiggum. For Oldani, the trip made her recognize the importance of “forming trusting relationships with patients” as she watched Kahwage work; “Everything [he] did was focused around people.”
Swiggum has also been impacted by Kahwage. “In spite of the tremendous difference of material wealth in the U.S. and the lack thereof in Tanzania, people, including Barnabus and his wife, Alice, demonstrated such joy, faith, generosity, and a spirit of welcoming, that we felt totally loved and appreciated right away,” said Swiggum.
Although the course has only been available to nursing students in the past, this January it will be available to any student with an interest in healthcare, and will also have a new emphasis on the healing power of music. “Everyone should probably go on this trip,” said Oldani. “I would love to go back.”