Nursing students study health issues in East Africa

Two nursing students had the chance to learn about health issues faced by developing nations when they studied in one of the world's poorest countries this summer.

Ariel DeFrank of Bradford and Alex Miller of Lititz spent five weeks in the East African country of Tanzania. In addition to health issues, they studied Swahili language and culture in the rural city of Iringa, where they lived alongside students at the Primary Health Care Institute.

DeFrank, a junior, said that she had explored some other study abroad programs for examining health care, including one in Austria, but that she wanted to get outside of her comfort zone.

“Oh, I got out of my comfort zone,” she said, “I had to squat over a hole in the ground.”

Toilets were just one of the luxuries she and Miller came to appreciate - along with clean, hot running water, steady electricity, washing machines and fast internet.

Students turned on the water heaters in their apartments only as needed, Miller explained. “Then the water was either freezing or too hot.” She resorted to taking “bucket showers” with the use of a handy water heater like those used in the United States to keep livestock's water from freezing over in winter.

Two days each week, DeFrank, Miller and their fellow students from the Pitt in Tanzania program visited field locations to study aspects of health care. While some of their fellow students were also studying health professions, others were majoring in linguistics, psychology, business and economics, and each could add his or her expertise to the group's experience, DeFrank said.

The students' first field visit was to Neema Crafts where people with physical disabilities work and are able to earn a wage making crafts that are sold locally and on the internet. In the accompanying café, the servers are all deaf. Miller said that on each table in the café were some sign language instructions so that patrons could communicate with those serving them.

She was intrigued by how much she could communicate through sign language. Later, she enjoyed trying to speak her limited Swahili with village children. Playing pickup soccer gave her a chance to be with the children and communicate with them without necessarily having many actual words in common.

“Now I definitely want to learn as many languages as possible,” Miller said. “I really want to learn sign language so I can use it.”

She also learned what it must be like for those coming to a country not knowing the language as she practiced Swahili. “People were so willing to try to understand what I was trying to say and teach me,” she said. “I feel people here (in the United States) are a lot less helpful when there is someone who doesn't speak English.”

Another field visit took the students to an HIV clinic called “Dream.” Because of high HIV rates in Iringa, the doctor at the clinic told the students the clinic treated as many as 70 people a day.

“To us, confidentiality is a big thing,” DeFrank noted, “but there they just line up.” Both students agreed that there was less stigma surrounding HIV/AIDS because it is so prevalent in Tanzania, where 4.7 percent of the population was HIV positive in 2016, according to the United Nations. By contrast, 0.34 percent of Americans are HIV positive.

Later, the group traveled to the village of Kilolo an hour from Iringa where the students spent a few nights at an orphanage for children who had HIV or whose parents had died from AIDS. Instead of living together, the orphans live with families in the village, and the orphanage provides support and supplies. The students had a chance to deliver supplies and socialize with the children.

Another NGO the students visited promoted nutrition by teaching residents how to provide themselves with maximum nutrition in a small space by growing plants in hanging sacks and raising small livestock like rabbits and guinea pigs.

Other health-related agencies the students visited were an education center for young people who did not finish school, a dispensary/clinic in the village of Kilolo, and a clean-water project.

They also learned from guest speakers such as a surgeon who had traveled through Somalia and South Sudan and a traditional healer.

DeFrank said that by studying culture alongside health, she learned how the two can be interrelated. She had learned, for example, that women have a disproportionately high number of upper respiratory infections because they are exposed to a lot of smoke while cooking.

When she spent an afternoon preparing traditional food with a group of women, however, she understood how thick the smoke was and said she could only stay in the room long enough to cut up a single vegetable before stepping out for fresh air.

Each week student had the opportunity to learn more about cultural differences during

conversations held with students at their host university. The two groups of students discussed different topics and had a chance to ask each other questions they might not feel comfortable asking elsewhere.

“Why is there someone shouting on a loudspeaker all day?” the Americans wanted to know. It is a message from a church, the Tanzanians explained. “Why do Americans walk so fast?” the Africans asked. Yes, I guess we do, DeFrank and Miller realized.

In guided discussions, the two groups of students explored cultural differences between the United States and East Africa in gender roles, dating and other topics.

And as interesting as the people and culture were, a highlight of the trip was a two-day safari to Ruaha National Park in Tanzania, where they saw breathtaking scenery and lush mountain forests and plains full of giraffes, elephants, antelope, monkeys, dik dik and exotic birds.

DeFrank said she also loved the long bus ride from the coastal city of Dar es Salaam where they arrived to Iriniga.

“Seeing the changing landscape and animals. It was very humbling,” she said. “There are tons of valleys that look just like home. I was shocked about that.”

DeFrank and Miller studied with the Pitt in Tanzania program.