Furah na Amani!
Greetings from Bukoba! As we prepare to celebrate Christ’s Resurrection, it is with great joy that I announce that the Orthodox Resurrection Hospital is now officially registered with the Tanzanian government as a Health Centre! Glory to God!
As many of you know, the “hospital” was built long before I arrived in Tanzania, through the generosity of an NGO in Greece. In 2010, just as my fellow missionaries arrived here in Bukoba, the hospital was closed by the government because it did not meet the requirements to be registered as a hospital—it did not staff enough physicians, nurses, and other medical professionals to be considered a hospital. We knew that it would take time and effort to re-register as a Health Centre, but we also knew that this ministry was important to the Archdiocese of Mwanza in Tanzania and Metropolitan JERONYMOS, and that the services the Health Centre could provide were much needed and appreciated by the people in Bukoba. It has been a much more complicated process than I think either the Greek NGO or OCMC and our missionaries had expected. I can say with certainty that His Eminence has been just as eager for things to move forward as we have.
As thrilled as we are to have registration, there is still much work to be done before the Centre will officially open and we will be treating patients. There are government guidelines as to staffing requirements we must meet, and finding and hiring qualified people may take some time. We also have to design a budget to cover staff salaries, the cost of supplies and medications, etc. There are certain pieces of equipment we need to purchase, too, such as sterilizers and machines to run laboratory tests. We need to create a simple yet effective method to inventory medications and supplies, and to be able to tell when we need to reorder those things. There is also the question of designing some system of medical records for patients. Finally, we are also trying to understand how to set up a system where patients contribute to the cost of their care, in a way which does not undermine other healthcare facilities in the area, but which allows the underserved to still have access to care.
When I applied to be a missionary with OCMC, and when I was speaking at parishes and raising support, I envisioned myself going to Africa to work as a nurse in a hospital. I knew that I’d always felt called by God to use my talents and blessings to serve others, particularly in healthcare ministry. Particularly, I’d always felt a desire to combine my nursing skills and my love of caring for people with my desire to share Christ and the gospel with people who hadn’t had the chance to know God. Even more specifically, I had always known that maternal-child health statistics in Africa were poor and my passion for providing holistic, safe maternity care seemed to make Africa the perfect place for me to make a difference. I thought I’d be helping to deliver babies here. I was wrong.
It might not always be so, but for now my ministry is much less focused on direct patient care and much more focused on administrative work for the Centre. I’m afraid I don’t enjoy it very much. In fact, when I worked as a labor and delivery nurse in Washington DC, the Chief Nursing Officer of the hospital where I worked used to say to me (frequently), “Someday you’ll be in my shoes!” I used to think to myself, “Not if I have anything to say about it!” I remember those words and realize that I don’t have anything to say about this. This is not the work I would choose for myself, but it’s the work the Church, the Metropolitan, and OCMC have asked me to do for the time being. I am learning more about obedience than I could ever have imagined, and that’s a blessing.
When I think about the administrative work I'm doing at the present, it doesn’t really excite me professionally. I miss taking care of women in labor more than I ever imagined. On the other hand, in the past year I have come to learn a lot about healthcare in Tanzania and about the struggles people face in obtaining basic medical services. I’ve accepted that although my ministry here does not look at all like what I’d envisioned it would, that doesn’t mean that it’s not valuable. I’m learning that there are many nurses and even midwives here in Tanzania—the government here is not in as desperate need for them (in cities such as Bukoba) as I had imagined. However, there is a great need for people with healthcare administration skills and experience, and that is particularly true within the Orthodox Church. The people in the Church here who have education and experience with administration are already committed to working for the Archdiocese in many different positions, and none of those people have medical training. The physicians we have hired to work at the centre are either Roman Catholic or Lutheran. There’s nothing wrong with that, of course, but it means that there is nobody who fully understands both the logistics of running a Health Centre and also the relationships within the Church. For now, my fellow missionary Felice and I seem to be a link in a chain between our Metropolitan, the staff at the Health Centre, and the representative of the NGO in Greece. We’re also frequently the point of contact for mission teams from the US and other countries, which is a big responsibility. I enjoy being a coordinator and hostess of teams and using my communication skills to serve the Church and especially to encourage others in their calling to missions; but it’s a lot to manage.
It’s challenging to be involved in the health centre as an administrator instead of as a staff nurse, not because I don’t know how to organize or delegate, but because I don’t have familiarity with the larger health care system here in Tanzania. I don’t know the rules and regulations, but I do know that they exist. I think one of the most common misperceptions non-Africans have of life here is that “anything goes,” or that because it’s a developing country that means that there aren’t guidelines which must be followed. I myself have been surprised at how careful the government is about foreign healthcare teams and individuals coming into the country to volunteer. In many ways it can be frustrating for people who think, “Why is it so difficult? I just want to help!” I still feel that way sometimes, but I also understand the other perspective, that the government here has a responsibility to ensure that the care provided by the missions is safe and appropriate, and that it doesn’t undermine the work already being done by healthcare workers who live and work here and understand far more than outsiders do.
For now I am trying day by day to learn as much as I can and to respect and appreciate everyone I work with, from the local physicians and government experts to the volunteer doctors and nurses from Greece and America. Most days I feel like I know and understand so little, but I also recognize that it’s better for me to ask people questions than to assume that I understand something. It’s also kind of fun to realize that at least I know more than I did a year ago! I pray that God uses me to help build relationships and to support the health centre and its ministry, and in the meantime I’m trying to be patient about wanting to 'catch babies'. Maybe, if I help with Health Centre administration now, someday the outpatient Health Centre will grow to be able to accommodate a maternity ward!
I wish you all a very blessed and joyful Pascha and Easter, and thank you as always for supporting me to be here in Tanzania.
Kristo Amefufukka! Kweli Amefufukka!
Christ is Risen! Indeed He is