Epilogue

Epilogue-A

It is fitting that Zanzibar’s architectural icon is its doors.  They are imposing and unique. Many even have spikes to ward off  attack. The doors we passed casually were often closed, but if they were open, we were warmly invited inside.

Like the doors, the Zanzibaris we met were initially closed. Their pride served as armour, and we were awed by their presence. Once they got to know us, even a little bit, their doors flew open wide and we were shown remarkable hospitality and affection.

One mom who brought her child for evaluation was a medical resident at the hospital. She invited us to visit her at home, which we did. We chatted honestly about the challenges of caring for a sick child while building a career. She was warm and her adoration of her daughter clearly shows.

Epilogue-D

Interviewing patients and their families was fascinating. Questions that seemed simple to us were difficult for Zanzibaris to answer. Until explained why we were asking them personal questions, like how family life changed post-surgery, or what they thought of Israel and SACH, they either answered with one vague word, or just smiled. Once they understood we were evaluating their experience to ensure Save a Child’s Heart was doing the best job possible, in a style which Zanzibaris were comfortable, they opened up. Some moms admitted they had been scared to travel to Israel because of the threats they perceived until they were actually there. Some moms told us they had no idea what to imagine since they had never left Zanzibar. Many explained that the only thing they knew was that getting their child to Save a Child’s Heart in Israel for treatment was their only chance to live. Quietly, a few added that they feared their child would not survive to make it home.

Epilogue-E

The common threads in all answers were the appreciation parents felt for their children’s exceptional treatment, positivity about their time in Israel and the follow up care they still receive. Moms said they felt “free” in the SACH house, and for some, it was the first time in several years that they were not alienated due to their child’s illness.

The fabric of community we felt was as vibrant as the clothing patterns we saw everywhere. At the core, the Save a Child’s Heart team is a tightly woven family. The families from around the globe who lived together in the SACH house now see themselves as cousins. The Zanzibaris who see each other monthly at Dr. Omar Suleiman’s clinic form a club and support system. Many, who before travelling viewed Israel skeptically now praise it generously.

Once Save a Child’s Heart opens a door for a patient, it never closes it. SACH is rigorous in its commitment to follow-up, and that in itself is extremely reassuring for patients and their families. We met several young adults in their 20’s and a few in their 30’s who had surgery as children. Many are now parents themselves, something impossible if they had not received treatment in their youth!

We returned to Canada this weekend with friends we never imagined meeting and the knowledge Save a Child’s Heart holds the keys to open doors for families around the world. We are committed to do our part to ensure SACH can continue their work, and ask you to do the same.

Epilogue-I

 

Day 4 Zanzibar

The mission had a grand total of 318 stories…. The SACH team screened 318 patients in    3 ½ days. Each day was busier and hotter than the day before. Families lined the hospital hallways patiently waiting to be seen. There was no rudeness, no one demanding service or trying to push ahead. As chaotic as it appeared, the scene was incredibly well organized. Every single child who came to there hospital for assessment was seen. No one was turned away.

Day4A

We met so many friendly, gracious people. Everyone greeted us with a smile and appreciated our interest in their children.

Day4B

We leave Zanzibar tomorrow with new friends – some Israeli, many Zanzibarians – from Layla, who jumped off the bed to dance with Jason after her examination, to Buthayna’s family who received us in their home when we went to visit. They insisted we leave with a gift of mangoes and bananas from their garden.  In clinic the next day they greeted us as friends.

Day4C

The Israeli team worked with nurses from the hospital. Many of them have traveled to Israel. They worked hand-in-hand to update files and adjust medication prescriptions.

Day4D

There is a special bond with Dr. Omar Suleiman, the pediatric cardiologist. He works tirelessly to provide the best care possible with limited resources for the children of the island’s 1.25 million people.

Day4E

The team was visited by Hamad Rashid Mohammed, Zanzibar’s Minister of Health. He is determined to improve health care infrastructure on the Island for cardiac care and looks forward to working with Save a Child’s Heart to do it properly. The Minister is such a fan, he invited the team to lunch on the way to the airport and insisted on escorting them to the airport to be sure they made their flight on time. That kind of hospitality seems natural here. Mr. Mohammed has a special connection to Canada – he attended St. Francis Xavier University in Nova Scotia in the 1980’s.

Day4F

The people we met this week will stay close to our hearts. They are warm, friendly and generous of spirit. We cannot talk about people without mentioning the former patients who worked the entire time as volunteers. They helped register people, assisted the nurses, and so very importantly, translated between Swahili and English. We became true friends with the de-facto leader of the volunteers, Tamima. We had heard how helpful she was on past missions, but were thoroughly impressed with her commitment and willingness to help. The days were brutally hot and very long, but she sat with us to translate follow-up interviews right until the last minute. Tamima even took Jason and the SACH photographer Nati to the market for a quick shopping trip to stock the Israeli team with fresh vanilla beans to take home. In her absence she found another few past patients to help translate for the interviews. Tamima plans to become an epidemiologist, and we are confident she can do anything she sets her mind to!

Day4G

We leave Zanzibar knowing SACH is viewed as a beacon of hope. Parents expressed profound gratitude. They credit Save a Child’s Heart with giving their children life, and offered blessings in gratitude.

Day 3 Zanzibar = 97 + 50

97 screenings and 50 follow-up interviews. That is a huge day. Here’s a peek at the hallway of people waiting.

The examination room buzzed at a level that was superhuman.  The SACH team doesn’t even need to speak to each other to communicate…a quick glance translates to… “I’m ready for the next one” or “Where’s the file” or even “The Minister of Health is here with a TV crew, but let’s just finish this patient”

Tomorrow the team leaves at 1 p.m., but they still plan to screen 45 kids!

More than 50 of today’s screenings were follow-ups for SACH patients who had surgery performed in Israel. The “kids” ranged from 18 months old to over 30! Surgeries date back to 1999, and yet, they are still seen here. These follow-up visits are so important. Not only are the patients monitored, but they know that care does not stop when they leave Israel. After their examinations, we conducted interviews with the kids and if they are still young, their mothers or fathers. The interviews provided a glimpse into life before and after surgery. When asked what activities the kids could not do before surgery but can now do, answers ranged from running and playing to going to school, to helping with household chores and even to carrying water for the family. The impact of healthy children affects families deeply. Healthy children mean parents can work to provide for their families. Healthy children are not seen as a burden.

Past patients and parents recalled fond memories of their time in Israel. They very often included building relationships with other people from different places who most often spoke different languages! They mentioned that at the SACH house, they learned to speak “kid”. Every single patient expressed profound gratitude for the opportunity for better lives thanks to SACH and its supporters. Many many blessings have been sent.

Here are some of the people we interviewed today:

There are so many more photos. Smiling faces shining energy and hope is the common thread. We will post more images tomorrow since we didn’t even get to talk about the very special home visit we did yesterday. There’s one very special photo that we aren’t posting. It is of the prenatal ultrasound taken today for a 25 year old patient who had surgery several years ago. The fact that she is carrying her 3rd child is proof of what a difference surgery makes. It was a bonus treat for her and the team to hear her child’s healthy heartbeat the same day she had a perfect check up.

Until tomorrow, goodnight from Zanzibar.

Day 2 – Zanzibar

Yesterday the SACH team examined Ali,  a handsome 24 year old who had surgery In Israel when he was 6. He’s now studying to be a medical lab technician, and his follow up was perfect. He sees his annual appointments as routine, and is very grateful for the care he received. Since he was so young, he doesn’t remember a lot, but Ali was one of Dr. Ami Cohen’s patients.

Day 2

Tomorrow is the big day for follow-ups post surgery, but we saw 10 today, and completed follow-up questionnaires with the indispensable translation help of Tamima, a past patient who volunteers when the team is in Zanzibar. We have learned how to spot the follow-up kids. They are for the most part much more animated and comfortable with strangers. These kids did, after all, make the huge voyage both geographically and culturally from Zanzibar to Israel for treatment.

The cultural nuances cannot be underestimated. Speaking to the parents of the kids who have had surgery, it has become clear that there is stigma about heart disease. Parents were very reluctant to talk about life before surgery. They were much more focused on how grateful they are to SACH for offering their children a chance at a healthier future.

The reality that surgery fixes more than hearts hit hard when interviewing a mom this morning. It became clear the child does not attend school. Keyhrat is a 6 year old girl who is bubbling with life. She charmed her way into a full stock of balloons, activities and lollipops. She danced and giggled and ran after bubbles. When pressed about why Keyhrat wasn’t in school, her mom, a teacher, explained that she was waiting to go back to Israel for more surgery. It turns out that one day in the future, Keyhrat may need another surgery, but for now just needs regular follow-up care and can absolutely go to school. Once clarified, mom said that she would arrange for school. That is big – surgery gave Keyhrat the chance to live a healthy life, and this follow-up gave her the chance to live a normal one.

Day 2B

Daoudi was another special little guy, whose enthusiasm for life lit up the room. Apparently he had the same effect in the SACH house. His energy is unmistakable and unforgettable.

Day2C

Witnessing the rhythm of the screenings is really a privilege. Every team member has a job that they do with efficiency, expertise, and patience.

Day 2D

The days are grueling and very very hot. We thought the fact the team screened 89 kids yesterday was monumental, until they did 97 today! Today’s break time offered a real treat however. No juice boxes here…

Day2E

Tomorrow we will meet more kids for screening and follow-up, and we will tell you about the incredibly special home visit we did today. Goodnight from Zanzibar.

Day 1 – Zanzibar

Malaria can save lives. That is a strange reality in Zanzibar. Many of the kids we saw this morning had only been seen by a doctor because they needed treatment for malaria. Heart murmurs and other signs were noticed. Those who survived infection were able to be screened and hopefully treated for serious cardiac conditions.

image003

 

We were greeted early this morning by Dr Omar Suleiman, the head of pediatric cardiology at the Mnazi Mmoja hospital. His nurses greeted the Israeli team as old friends. They have worked together several times, and most of the nurses have travelled to Israel with the kids from Zanzibar.

image004

The hallway was full of waiting children and mothers… and THEN we were taken upstairs where there were MOBS of kids. The temperature rapidly rose. The only air conditioned room, the examination room, was full of people all day – patients and parents, medical scribes, nurses and a few curious doctors. The air conditioner just can’t keep up and has been sputtering.

image005

Colouring pages, markers, balloons, toy cars, stickers and pipe cleaner finger puppets helped occupy the kids, but many of them waited hours. A few of the older kids acted as “agents”, taking toys to the younger ones.

The team is a smoothly oiled machine. They screened kids as efficiently as possible, given language barriers and the difficulty in examining young, squirming children.

It is 5:30 pm and kids keep coming. The line is not getting much shorter.

We just took a short field trip to the home of one of the patients screened this morning. Her mom is a doctor in the hospital, and knew one night when her daughter was 6 weeks old that something was wrong. The doctor who examined her thought she had just choked on saliva, but mom knew something didn’t feel right. Indeed, her intuition was correct, and sweet Gadija will be travelling to Israel shortly for surgery.

We heard a lot about Moms sensing something was wrong with their children. The “normal” fevers our kids have at home can be lethal here, and often the damage goes undetected.

One fact to leave you with since it’s time for us to do the rounds of keeping the kids somewhat entertained… The rate of mortality in Canada for kids under 5 is .5%  in Tanzania, it is 7%

The Israelis have received so many blessings today… those blessings provide the fuel to keep going a few more hours.

We’ve fallen in love with some of these kids… they are sweet and beautiful, and deserve a chance.

Getting ready to start our adventure!

We are so excited to join a screening mission in Zanzibar this month!

A bit about us as travelers – We travel. A lot. We do most of our bookings directly, but have learned the hard way that using an agent can be very helpful for trips that aren’t straightforward. After years of searching, we have found a great travel agent who booked our trip. If you are interested in speaking to her, You can reach Genevieve Stachtchenko  at Genevieve@visionvoyages.ca    Her phone number is  (514) 488-8685 and cell (514) 575-2251 (texting from the airport is always good in case of problems to get a quick response).

Zanzibar is far. From everywhere. Let’s be clear…you will need to make some stops on your way. Our advice: consider where they should be. We decided that flying through Zurich was the best option. We tacked on a side-trip to Italy to see an art show, but essentially are using that time to get over some of the jet-lag. Depending on your timing you can fly into Zanzibar without a stop in Dar Es Salaam. Try to make that happen if possible. The small airlines that service the short flight are not known for their timeliness. If you do have to fly that way (we did one way) try to book the company flying the largest equipment. That wisdom comes from our travel agent and people who have posted on the topic. There is a ferry option, but arrival seems to be a chaotic experience. So we are doing Montreal-Zurich-Zanzibar on the way there, and Zanzibar-Dar Es Salaam – Zurich – Montreal on the way back.

We visited our local travel-medicine clinic and left with sore arms and lighter wallets… Recommended immunizations vary a bit by province. Yellow fever is a “thing”. While Tanzania does not apparently require it, several people, including friends who visited recently, report that if you enter without it, you are given a choice to get immunized at the airport, or not be allowed entry. We decided to get vaccinated in Canada, even though it may not 100% be required, and since there is a current shortage, our fractional dose only vaccinates for 2 years. Since we are connecting through Nairobi, which is in the endemic zone, we would likely be targeted for a shot at the airport. We were quite surprised to learn that polio is still an issue in the area, and decided to get the recommended boosters.

In addition to our vaccinations and prophylactic malaria medication, we have a small medicine kit including: emergency antibiotics, pepto bismol to use to pre-empt stomach problems (it has been shown to work – in questionable situations, take 2 tablets before eating) individually packed antibacterial wipes, mosquito repellant (30% Deet minimum) and a small first aid kit. Sleeping pills or melatonin are also a good idea since the jet-lag is considerable.

Most of our luggage is packed with activities for the kids- colouring books, markers, crayons, stickers, cars, balloons, a few “doctor kits” for the kids getting examined, and lollipops! We have also packed small gifts – for interpreters, nurses, any families who we meet and spend time with.

We’ve also packed a dry-erase board to use to identify each child when we take a photo of them for their files, and photos of what Canada looks like (yup, all the clichés), as well as a map of where it is, and where Israel will be to get people prepared if they are to travel.

Our clothes are quick-dry washable light-weight and modest. Zanzibar is a Muslim country and modest attire is appreciated. Beach wear is ok…on the beach. It is recommended to stay covered for sun protection during the day and mosquito protection at night, but repellant is a must.

Our personal items include sleeping bag liners, as suggested by previous participants, and flip flops for the hotel room/shower.  We have packed protein bars to have for lunch while at the hospital. We’ve been told that lunch is offered to the volunteers, but mystery meat didn’t sound tempting. The rule for food is…”If you can’t boil it, bake it, or peel it, forget it”. All drinks need to be bottled or in cans, and please be the one to crack the seals. Plan to use bottled water for everything including brushing your teeth.

For currency, USD is well liked. Apparently dollar bills are appreciated. We have learned however, that US currency older than 2009 is not accepted.  I went back to the bank to exchange old bills – they were not surprised. Apparently, old counterfeit US currency is an issue in that part of the world. It was a challenge to get Tanzanian shillings. Order them from an exchange office or bank well in advance of travel. 1 CAD is 1780 shillings, so there will be a lot of division figuring out prices!

…And we are off. We will see if our preparation was anywhere near what it should be. Stay tuned for news and photos!

 

Rachel and Jason