Honey of high quality

This week in my diary: Ticka, the Kenyan boarding school for children with a disability where we are starting up an orthopaedic workshop. However, unfortunately all the equipment is still stuck at customs and the mission has been postponed until September.

That’s why I decided to go to Mwanza, where we started a House of Hope together with FoCC in January 2018. FoCC stands for Friends of Children with Cancer, spina bifida and hydrocephaly. In the neurosurgical wards, where children are treated for brain tumors, there are many who suffer from hydrocephaly and spina bifida. 
For this reason, FoCC has incorporated our children in their target group.Afbeelding
FoCC Montessori school in Dar es Salaam

FoCC has started a day centre and small school in Dar es Salaam which I visited last year. I have invited Walter and Janet from FoCC to attend the Child-Help / IF-workshop in Mombasa in 2017, where we gather every two years with all our partners. I saw FoCC as an example as they undertake fantastic initiatives to find local funding, within Tanzania. This in contrast with a lot of our parent groups and Houses of Hope, who look at us when it comes to finances. This complete dependency on one donor is not good for our projects. This is the reason why Child-Help encourages its partners to find other donors as well.

Janet of FoCC at the educative play ground 

In November 2017, in Mombasa on the Indian Ocean, I asked FoCC to start a House of Hope in Mwanza as a lot of our children are treated in the Bugando hospital there. Three months later there is a House of Hope that is running at full speed. What an achievement!!!

Mwanza rock formations
Mwanza is located at the Victoria Lake, about a two hour flight from the Kilimanjaro. The surrounding area of Victoria Lake is dotted with beautiful rock formations. It looks like they have been stacked there by the children of giants and that they can topple over any minute.

As the Bugando hospital places shunts in 600 children in this region every year, a House of Hope in Mwanza is not a luxury. Together with FoCC and the Bugando hospital, I want to see if we can organise a CIC training here with two German trainers. 
Besides this I want to start a bee project for the parents, who because of the care for their child with a disability are housebound, to give them an income.

The mission in Mwanza is short as in three days I have to go to Dar Es Salaam to attend a ceremony where I may hand over an ETV/CPC machine to MOI, the government hospital, in the name of Child-Help Netherlands.

Later this year we want to organise a Tanzanian Network meeting to better coordinate the care and initiatives for our children. I am wondering if it would not be better to organise this on a regional level. Tanzania is such a big country that networking is better started per region. Walter and Janet of FoCC both confirm this.

On the plane I read reports and check contracts and find a bilingual document (in Swahili and English) which users of the House of Hope need to sign. A well thought through and good document that calls on parents to actively participate in cleaning and cooking, but also contains rules that capture the rules of living together. 
I would like to share this with the other houses.
The House of Hope in Mwanza

The House of Hope in Mwanza lies 6 kilometres away from the centre and the Bugando hospital. On the way Walter stops so that Janet can pick up free bread at a friend’s (she does this every other day) for the mothers in the House of Hope.

The House of Hope is an Indian looking, relatively new building with decorated columns and marble floors, four big bedrooms and a big fenced garden. Janet wanted the house to be at a certain distance from the centre and the hospital, its own island, an oasis of calm.

Twelve mothers with their children welcome me, and Sipha who previously worked for the parent group ASBATH in Dar Es Salaam, introduces everybody by name and story.

All these children have the right to stay here, for them this house is a solution and sometimes even a rescue. Dorothy works for FoCC in the Bugando hospital and has a bridge function between the hospital and the House of Hope. 

The cooperation with Bugando is built on 5 years of cooperation for children with cancer of FoCC and is formalised in a cooperation agreement.
Lake Victoria
Once a month the House of Hope invites the doctors for a barbecue. They have put money together for a goat which I first get to eat in soup with bones and later roasted. It becomes a warm and interesting conversation about politics, ETV and shunts. 

Last year, Maria, a Portuguese neurosurgeon performed ETVs for six months with a rigid endoscope, but the doctors are not convinced that this was successful. They keep believing that ETV is out of the question for babies and quote the German neurosurgeon who confirmed this.

Elias and Fatuma from the local ASBATH association are also present and will organise a meeting of the parent group tomorrow. 
The two-year-old son of Elias is blind and spastic and doesn’t speak yet. 
Fatuma’s little daughter has epilepsy that they can’t get under control, even though they have recently performed a shunt revision. A lot has gone wrong for them. Elias’ son received an ETV by Dr. Maria because the shunt got infected. One cannot blame her for the complications. I am going to try and get in touch with this Portuguese doctor.

About 30 parents are present for the parent meeting. From the Bugando hospital a five head strong delegation arrives including the director of the surgery department and the neurosurgeon. They address the parents warmly and praise FoCC, ASBATH and Child-Help. And rightly so as here we see an example for the rest of the world. Our target group needs a network of care. A hospital can’t provide this on its own. The House of Hope functions as a cornerstone that holds everything together.

Elias and Fatuma talk to the parents at the ASBATH meeting
After everybody left, I meet with FoCC and Sipha and Dorothy to report about the first three months of our cooperation. The numbers are impressive, and also the registration system is professional.

Every parent that arrives here is invited for a consultation, a form is filled in with all the important details of the child. The house rules are explained and information about the disability is provided. The Ship passport is completed and given to the parents. In a log book every passport that has been given out receives a serial number and today that number is a 100. Parents are encouraged to join the national health insurance. Together with ASBATH they strive to also get our children admitted into the health care system as a lot of our children are not accepted.

Sipha tells us how they cooperate with district hospitals to get them involved in the care for our children. For the removal of the stitches for example, it’s not necessary to go to the Bugando hospital.

Dorothy takes over the reporting. She works in the Bugando hospital and is recognised there as an employee of the House of Hope who can have access to the file and the computer system. This cooperation has been captured in an MOU with Bugando. She follows up on all the children and introduces the House of Hope where necessary. She participates in the visits around the wards and hands out Ship passports to parents.
Parents cook and eat together

The House of Hope came just in time, as the ward has been reduced from 20 to 10 beds. Before the House of Hope existed, all these children were in different wards. Now, there is a separate ward for children with spina bifida and hydrocephaly which makes things a lot easier. Although now there are sometimes two children to a bed. The House of Hope will therefore become more important. Children and parents can wait there for their appointment in Bugando and are sure that they will receive their treatment in time.
Dorothy already handed out 232 Ship passports. Since the end of February already 63 children have received the necessary surgery.

The House of Hope can be reached with two small buses at 40 minutes distance from Bugando. The housekeeper is a key figure in the House of Hope. She is a single mother with a spastic daughter who has been going to the daycentre of FoCC in Dar Es Salaam. There she took on more and more responsibility and also received training sessions in physiotherapy for her child. She lives and sleeps with her daughter together with the other parents and runs the household in the House.

Badge of Dorothy in Bugando
The ASBATH representatives in Mwanza tell us that their region is too large, as the national board of ASBATH can’t divide the region of the big lakes even more. The distances are too big and the means at their disposal too small. They thank Child-Help for the House of Hope and for the shunt donations but ask for training sessions in CIC. They have a plan for an income generating project for milk production. A cow costs one and a half million shilling here. I haven’t seen their e-mail concerning this project from two months ago, and they have sent it once again. I immediately forwarded it to RBU in Sweden who have taken ASBATH under their wings. I promise to discuss their problems with the ASBATH board in Dar Es Salaam and with RBU.

I suggest that FoCC tries honey production as an income generating project. As they can’t start this straight away themselves, they want to start by buying honey from farmers, who are also parents who have been helped by FoCC. 
They want to explore the market and also buy some beehives for the House of Hope with the help of these parents.
Jennifer the house attendant at the HoH

The network of care that is developing here is an ingenious beehive and produces honey of high quality. What happens here, is exceptional and educational for all our other projects. High quality honey asks for an ingenious system and cooperation of different kinds of bees. The House of Hope together with the people of FoCC have achieved that here. Child-Help can prove here that coordinated care is possible.
After arriving in Bugando we pass the consultation rooms where children are waiting to see a doctor. It’s a real beehive of activity. The triage is done by Bugando. The registration worker selects 32 children today who are eligible for neurosurgery. The doctor works together with Dorothy, Sipha and Elias. In this room it’s the staff that queues and not the parents.
After medical check-ups, the parents move on to Dorothy who hands out a Ship passport and who teaches the parents how to measure a head circumference. She introduces them to Elias who immediately receives 3000 shilling as membership for ASBAHT. Sipha introduces the House of Hope.

Sister Massenga is the head of surgery. Yesterday she visited the House of Hope. She wants to become a paediatric surgeon and for this purpose has stayed in Kijabe for a year. She hands me the contact details of a surgeon in Brussels who comes here on mission every year.
The meeting with the management takes place in very good spirits. Unfortunately, the general manager is in Dar Es Salaam but will organise a Skype meeting with me after he has been briefed.
ASBATH Mwanza with Pierre Mertens
After the customary words of thanks, I put 3 proposals on the table suggesting where we can cooperate:
-       An ultrasound for neurosurgery to avoid scans where possible
-       A CIC training by our new German team at the end of October with a certificate for the participants
-       An ETV/CPC training session for the hospital to avoid shunting

Bugando added two more proposals:
-        Prevention of NTDs with folic acid for the mothers who already have a child with spina bifida
-       Streamlining the registration of children with spina bifida and hydrocephaly in cooperation with the registration board of the hospital IFV research and publications. 

The day is over and I am a happy man. It is possible after all. Walter and Janet take me with them to their office in the hospital. They talk with everybody that we meet on the way. They know the cleaning staff as well as the director. They share their office with the only neurosurgeon in the hospital. Both Walter and Dorothy have a key to the office. How unusual is that?

FoCC gets some take away meals and both its own team as the doctors enjoy it.
Ship Pasport
That’s a sign of appreciation. 

At sunset on our way to the airport, Walter, Janet and myself dream of a closer cooperation. Janet could work for Child-Help and be our African representative. Part of our administration could move here. Child-Help has been translated into Swahili as SAIDI MTOTO and has immediately bought at Conversal the url www.saidiamtoto.org. Now we have to adapt the logo to this name. Child-Help is getting wings here.

Dar es Salaam
In the name of Child-Help, I participate in a political ceremony for a donation from Kuwait to the MOI hospital. While heavy rains are tormenting the region I am there as requested at 08.00. I am witness to the slow build-up of a very theatrical occasion. The neurosurgeon Dr. Shabani wanted to combine this with the donation of an ETV machine by Child-Help The Netherlands. However, protocol doesn’t allow this.  So after too short a night I am here seated in the public really for nothing. Hakim who made the donation from Kuwait possible has not been able to give his speech. The consul of Kuwait was to take over a part of the speech. It is a staged puppet show which reminds me more of North Korea than of real solidarity. This is a political statement between countries. Blandina asks me if I am disillusioned and Shabani apologises. No, I am not disillusioned and I understand that protocol has its rules. Our donors don’t ask for this puppet show and neither do I. The deputy of the ministry of health invites us to talk more tomorrow. He would call the next day one hour beforehand to tell us when we could come. He obviously didn’t call.
Dorothy teach the mother how to measure the head of her child
Sister Massenga
Five families live in the House of Hope in Dar at the moment. The new matron is marrying a Zambian preacher and will leave her job in June. Jeremiah is building a physiotherapy centre on top of the House of Hope and is looking for activities to strengthen the mothers during their stay.
When I visit the ward of the MOI the next day there is no double occupancy of any bed and some are even empty which means that surgery is on schedule.

Many of the children on the ward received ETV and are doing well. The nurses are also more actively involved than before. A new wind blows through the hospital. In a month’s time they will have a new operating theatre and operations will be possible on a daily basis. The operation camps on Saturday can then be abolished and one can operate every day. MOI wants to train the doctors of the local hospitals so they can ensure the basic care for our children and refer in time for surgery. Many children still arrive too late.
Blandina works for Cure and visits the wards every day. Kilumba and Hidaya from ASBATH work here as outsiders inside the hospital although they don’t have the same authorizations as FoCC has in Mwanza.

Kilumba, (ASBATH), Blandina (Cure) Dr Shabani (Moi)  en Pierre Mertens (C-H I) look at ETV  Child-Help donated 

Together with Dr Shabani I check the goods that Child-Help The Netherlands has donated. It’s a complete ETV/CPC installation of the brand Storz. Over the years a lot has changed at MOI. The new president of the country tackles the corruption seriously, users of government services can put in claims. This has an impact. We have a meeting with the medical director who really appreciates and supports our work. The new ETV installation opens up new possibilities. Shabani dreams of becoming a training centre like the one in Mbale while a second neurosurgeon is leaving for Mbale for training.

The House of Hope in Dar es Salaam gets a unit for physiotherapy as neigbour 

I visit the FoCC daycentre and the small school with two inclusive Montessori classes for children with a disability. Last year still in scaffolding, now operational. Beautifully painted murals and work corners where children can choose themselves and grow. The teachers have made most of the educational material themselves, and show me around. With recycled material a whole educational playground has been created. 

To be recognized by the government, a new stock room is being built as well as a kitchen. It’s bustling with initiatives here, and everything has been achieved with locally sourced money. 
Although of course, some things go wrong here as well. It’s a beehive taken over completely by ants. 

However even before I leave, a new beehive is hung up, up full with buzzing honey makers.


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