October 9th: Ndanda

October 9, 2008: Ndanda
I ran into the director of the hospital today while I was buying eggs at the mission kitchen. Peter is from the Netherlands; even after numerous stints around the third-world he is shocked and dismayed by Tanzania’s health care system. Lindi and Mtwara districts, the “Deep South,” have a bad reputation across the rest of the country. My headmaster himself told me of the myth of the “undeveloped south” when he explained the teacher shortages the school was facing. The economics teacher, who has since left for greener pastures, explained the people’s laziness, “But we are Tanzanians, while the Arab influence has corrupted these people.” With underdevelopment comes poor health care and often the (foreign) doctors across the street wonder at the other surrounding hospitals; no electricity or clean water, critical shortages of sanitary equipment, absent doctors, incompetent nurses, and corrupt staff are the most common complaints.
Even before I arrived in Ndanda I had expected to hear about all these problems, which have their parallels in the school system. Peter has a new target, Bush’s PEPFAR (President’s Emergency Plan For AIDS Relief) which has invested several hundred million dollars in Tanzania. I myself must fill out PEPFAR report forms twice a year and in fact I completed my second one today, writing zeroes in every single box. The problem with PEPFAR is that such a vast amount of foreign money co-opts the local health care system. The budget of any PEPFAR program is astronomical compared to any Tanzanian scheme, so these programs have their pick of the best and brightest in country. Talented doctors will not work in the rural areas; even in cities they rarely care for patients and instead fill out the ranks of foreign aid. I believe Ndanda hospital pays somewhat better than the nearby government hospitals but Peter tells me they’ve also had a hard time keeping staff recently.
Peter also conveys a more general ambivalence about foreign aid schemes, an ambivalence which every foreigner in this country has expressed at one point or another. My new Peace Corps sitemate came to visit on Monday and wondered whether we were not just engaged in some new form of imperialism. A German dentist, who has been working on and off in Ndanda for some twenty years, believes that his presence may have been good for a few select people, but it was bad for the nation. The refrain is always the same; African problems need African solutions, development in Tanzania will take place on the country’s own terms.
The power has been out for a while and my computer is almost dead, so no more ranting.