Health Care Hits Home

I eat/cook 95% of meals at home with my 3 roommates because it’s less expensive and because there are very few restaurants in Kilwa (and of those restaurants, they make literally the same food we can make at home so it’s not the same as going out to eat in the states). The communal mealtime provides many opportunities for conversation and has helped us all learn from and get closer to one another.

One of our favorite topics of conversation is the difference between American and Tanzanian culture. Of the many differences that exist, death has been a topic we’ve discussed at some length. Considering roughly 70% of the population of East Africa is under 27 and 45% of the population of Kilwa is under the age of 12, many Tanzanians die, by American standards, tragically young. AIDS definitely plays a role in these stats but there are many reasons people die here. From what my roommates have explained, the high rate of young death contributes to a very matter of fact culture surrounding it. I’ve had a hard time understanding and relating to this because dying in the US before you’re 70 is considered young. And the tragedy of a given death seems highly proportional to one’s age. But young death isn’t necessarily a tragedy here because it’s the norm.

After this past week, I can unfortunately understand the Tanzanian perspective a bit more.

My friend Solim died on Wednesday in one of the health centers I work in. He worked as a bartender for one of the beach hostels down the way from my house. I used to set down my things in front of where he works while I went swimming and chat with him after my workout before heading home. He's one of the few locals that spoke English and my extrovert side had been dying for people to talk to. Lucky for me, on top of actually being able to speak English, he was very warm, intelligent and thoughtful.

Last Saturday I hung out with him for close to an hour after my swim and talked about his family and growing up in Kilwa. He told me that the first time I came into the bar he knew we were going to be brothers because of how he felt around me (people use "brother" here to refer to close friends a lot). He's an artist and I wanted him to paint me some pictures so that he could earn some extra money on the side for his family of 5. We planned to meet the next day (his day off) at my house so that he could show me some sketches to chose from. However, I didn’t hear from him Sunday (which would be odd in the US but locals no showing on plans has been common for me so I didn't think twice about it).

Tuesday after my swim I went to the bar to look for him and the bartender on duty told me Solim was sick. I asked if it was serious and he said he thought he'd be back to work on Thursday. I texted Solim later that night to wish him a safe recovery and ask him if there was anything I could do to help him get better. The next morning (Wednesday) Solim sent his wife to our house to assure me he was OK and let me know he was in the health center getting treatment. Goodluck and I had a car that day for our out reach project so Goodluck called to offer Solim a ride to the district hospital to ensure the best health care. His mother-in-law picked up and said they were fine at the local health center.

Goodluck and I left for work and when we returned home, 5 hours later, our housemate told us Solim had died.

I had meetings at the health center the next morning (where Solim had died the day before) and learned that his cause of death was dehydration from vomiting and diarrhea. A simple IV would have saved his life but they didn't have saline solution at the health center, just at the hospital.

I went to his burial that day and basically the entire town of men came (he was Muslim so women don't participate in the burial process). Everyone helped carry his coffin from his father’s house to the gravesite by lining up in two long lines and passing the coffin down the row. Additionally, at the grave everyone had a chance to shovel some of the dirt on top of his body after it had been placed in the grave. The communal participation and involvement in the burial process occurred with little to no visible grief from those taking part.

It was unsettling to me because of how tragic his death seemed. On the one hand it was an incredible picture of community support and acknowledgement of a loss. But on the other hand there wasn’t the anger or sadness that might have marked a funeral in the US under the same circumstances. The people here didn’t look to blame something. Blame was irrelevant as there’s always a different reason to blame on someone’s death. There’s no age you’re supposed to make it to so the idea of dying too young or dying before your time just doesn’t seem to be a part of the discourse. Solim was dead and there was nothing anyone could do to change that. Life continues without a brother.

I'm still a little rattled by the whole thing but through personal experience I have a better picture of why the culture around death is the way it is. For me, Solim’s death has been a reminder of how life doesn’t have a proper ending time (or a scheduled one for that matter). Living life every day and loving the people around you seem that much more important.

I’ve yet to grieve like I feel like I should but I’ve been laughing a little harder at the jokes Goodluck makes at our roommate dinners each night.