Author Archives: yvettetz2013

Headed Home…

Mitch and I return home tomorrow. We fly out tonight (Friday) at 10pm and arrive into D.C. tomorrow (Saturday) at 3:30pm

Mitch joined me for a two week period in which I happily hosted him in a country that I have comfortably been able to call home for four months. I hope to send pictures soon!

What have the past four months meant personally? What answer do I have for those of you who will ask “how was Tanzania?”, “what did you do?”…

Can I decline to answer and instead invite you over as I share my 5000 pictures to tell my story? 🙂 While many of you will lovingly humor me and allow me the opportunity to share through visual reflection, I still need to find the short answer for those of who I may only have a few minutes with… but, is there a short answer…?

If you ask me if I enjoyed the food… I will tell you about the 10lbs I gained (ugh!!)

If you ask me if I enjoyed the country… I will tell you that I am already planning to return

If you ask me if I enjoyed the people… I will tell you about the friendships that will last a lifetime

If you ask me if I missed home… I will tell you that hugging a computer screen during a skype session with the kids is just not the same

If you ask me if it was hard being away… I will tell you about the friends that made sacrifices along side my own family to support Mitch and the kids, and that it could not have happened without each one of them… I love you, and I thank you!!!

If you ask if I would do it again… I would say… in a heartbeat…


All Good Things…

(My last official blog on Pfizer intranet)

“All good things must come to an end…” Well, hopefully not completely…

While it is true that my 4-month fellowship in Tanzania “has come to an end” it is with the greatest of hope that the foundations in which accomplishments were achieved are sustainable and will continue to foster even greater successes in the months and years to come.

Supporting PSI the last few months has been one of the most life changing and rewarding experiences. PSI has established a new Health Services department that will focus primarily on supporting the franchise clinics with additional services to assist the people and communities of Tanzania. Health Services will work to educate, train, and develop providers in clinics to offer high quality health services; and will continue to work to insure those high quality standards are maintained.

Previously, PSI was supporting Family Planning services. During my tenure here, we have launched cervical cancer prevention and treatment programs, as well as programs for prevention of childhood illnesses. Near the end of my fellowship, PSI began launching a third additional service to provide safe Post Abortion Care. Implemented programs will heavily impact morbidity and mortality in women and in children under the age of five.

As I return home to the United States, I search my memories and experiences to define what the past four months have meant. All the superlatives come to mind “life changing”, “unbelievable”, “amazing”, “eye opening”, but what do those terms mean? For me, they serve as a springboard to advocate the need for improved health services in underdeveloped communities. To drive home this point, I go back to a heart wrenching fact I learned while I was here and I posted in an earlier blog. Tanzania is a country of 43 MILLION PEOPLE. It is twice the size of California, yet the country has ONE HOSPITAL that provides chemotherapy treatments… and this is merely just one example of the need to improve access to life saving medical care; unfortunately, there are so many more.

I want to thank Pfizer for the opportunity to become a part of the Global Health Fellows program. Without corporations who are truly dedicated to social responsibility, the path to identifying the tremendous need for support would be much more difficult to navigate. As Pfizer continues to develop medications and develop its people who can develop innovative strategies, there will be continued hope for UNDERdeveloped nations.

Whales AND Sharks!! …and Co-pilot!!!

So my previous blog’s question was “do I swim with whale sharks?”– Got to do BOTH! …”Both?’ you ask?

On Mafia Island, got to swim with Whales and Sharks! Got to swim with mama humpback whale and her baby.. AND… later…whale shark!!

The good news is… it was the experience of a lifetime… to experience these amazing massive creatures in their natural habitat… amazing!! …and not scary at all!

The “bad news” is that I do have some video and some pictures but probably needs a little explanation as to what you are seeing as the moving water, etc makes it a bit challenging…


Zanzibar was amazing, as well.  Standing face to face with the red colobus monkeys (indigenous only to Zanzibar), visiting spice farms, seeing the ruins of the Sultans palace, the gorgeous sunsets, learning about the history,… mostly Arabic history… very interesting… and I could understand many of the people speaking Arabic…

DSCN9032Red Colobus Monkey. Only in Zanzibar



I had three flights to take… Dar es Salaam to Zanzibar, Zanz to Mafia, and Mafia back to Dar… Two planes were 13-passenger, one was a 9-passenger… I requested to sit next to the pilot on each… I want to be a bird in my next life! :):)






… So many pictures to share…

Whale Sharks!! Swim or stay in the boat? What would you do?

Long weekend in Tanzania!! Headed to Zanzibar and walk around Stone Town, and then… … fly to Mafia island and see whale sharks!!! 

Do I swim, or stay in the boat? Is that on anyone’s bucket list?… to say you swam with the largest creature in the world!!?? …. …20-40 feet long and weighing 10-20 tons!! (google “swimming with whale sharks on Mafia Island”)

(P.S. they are not people-eaters… mostly plankton…  at least that’s what I was told… 🙂  )

I hope to have some great stories, and even greater pictures to share soon…


Is it time for me to go home? (funny)


You know it may be time to go home when….
You get a call from home saying that the two female pet rabbits just had 6 babies! ….hmmmm??…. does that mean one WAS NOT a girl rabbit? (Anyone interested in adopting rabbits, contact Mitch….. immediately!!! LOL!!)
(Just before I left for Tanzania, Alex, our 11 year old daughter gave a full 30 minute presentation justifying why she should be able to have pet rabbits. She researched EVERY aspect including living environment, medical needs, dietary needs, breed/species requirements, local veterinarians and their hours of operation, cost commitments and how she is going to earn the money to keep them, AND she put together a plan as to how she would be responsible for finding care for them if she was unavailable due to school related activities. She practiced her presentation on the neighbor (adult) before she presented to Mitch and I. (We received a phone call from the neighbor in support of letting Alex have pet rabbits…LOL!!) We tried to challenge and discourage her with EVERY difficult question we could think of… she even researched and justified why she should be able to keep them indoors because of their body temperature). 
You know it may be time to go home when….
You have this Skype conversation…
Mitch:     “Kids made me so mad this morning. I was supposed to take them to toy stores but they kept fighting.Then, they wouldn’t help around the house by picking up their stuff. I had had enough. Told them I wasn’t going to take them to the toy stores or to the new Wegmann’s for dinner.”
Yvette:   “So sorry to hear. What did you guys end up doing?”
Mitch:   “Told them they would have to stay home and eat whatever I cooked.”
Yvette;   “What did you end up cooking for dinner?”
Mitch:   “I grilled”
Yvette: “Oh, what did you grill?”
Mitch:   “Filet Mignon”
Yvette:   “Great punishment! You showed them!”
(Gotta love it when dad is on his own with the kids!)

Comparing Cultures

I have 2 1/2 months to go to complete my time here. I have to thank everyone who has commented on the blogs… I really love reading your comments!!! They are motivating, inspiring, and lift me up. I am missing you all tremendously (and my family even more, if possible) and your words give me the strength I need for the next two months without all of you.

So, many of you have had similar questions about culture differences so I wanted to share with everyone. I know some of you are wondering the same thing, but maybe didn’t want to ask (especially about toilets… — I will leave that till last 🙂  ) Most of the other stuff I think you will find humorous and interesting; a couple of serious things, too. If you don’t get a chance to finish reading in one sitting, PLEASE come back… funny stuff later.

Some Serious Stuff: (this is why I am here… and why others need to come)

Malaria: The average person growing up in Tanzania gets Malaria AT LEAST once a year; they get it so much, that by the time they are young adults (and have had repeated treatments), the symptoms are a fever and maybe runny nose, and many will not have to be treated with medication, but can get better on their own. THE CONCERN: Millions of children a year are untreated and die before the age of 5! (THIS IS A TOTALLY TREATABLE DISEASE!)

Adverse Events: I was asked to help develop an information sheet for adverse events. PLEASE, take your time and walk through this scenario with me…

Let’s say you had a minor procedure done (same day surgery). You go home, and later have an adverse event/complication occur. What do you do?

No, you can’t call 911 because it does not exist… … … now what?  No, you can’t call family… they don’t own a car… … Maybe go back to the doctor’s office? Hopefully it is a “short distance” away because you had to take the overcrowded public bus then walk there, and now you have to take the overcrowded public bus then walk back… (sorry, you don’t own a car, either)

You see the provider (who is not an M.D.) and she must report the event and consult with the medical representative of the products used during the procedure. The medical rep determines that a “referring doctor” (specialist, M.D.) must also be consulted. Between the two of them, it is determined that you should be admitted to the one regional hospital available … … miles away.

How do you get there? Oh, you have to wait for the medical representative to come and get you, to take you to the hospital that is miles away over very bumpy dirt roads….

The medical representative is in another part of her territory… … … four hours away…

Welcome to accessible healthcare in a developing country…

(I was thinking it may be inappropriate to put “Humorous and Interesting Stuff” just after a sobering scenario… but this is reality… this is life here… I kind of hope it did effect you… it was not meant to get you down… just the opposite… this scenario hopefully lights a fire and wills someone to want to find solutions…)

The Humorous and Interesting Stuff:  


I have 16 channels; 3 channels play American movies and TV series- I toggle thru those… a lot; regardless of the show or movie I watch (comedy, drama, etc…, the word “God” is bleeped out– remember, I am in a country of about 50/50 Christian/Muslim… also bleeped out are bad words and what I tell my kids are “inappropriate” words (ie,.. stupid, idiot,…— sorry, kids)

One channel plays non stop Rugby (I still don”t get that sport???); I get CNN, but the European edition, BBC, and Al-Jazeer (news, sports, and weather); I get Indian soap operas and African soap operas– both have captioning 🙂

Public Education:

Primary school (elementary) is 7 years; girls start at age 6, boys start at age 7… it’s a maturity thing (no kidding);

Secondary school (middle school) starts at age 13 or 14, and that is for four years; so you finish at age 17-18

High School starts at age 18-19 and is two years; if you fail at any level (which apparently there is a high rate of multiple failure) you have to repeat the entire year, there is no summer school. If you have done the math, there are thirteen grades.

You start University at age 22 (assuming you did not have to repeat), and is for three years, and you receive a certificate; if you want a diploma, you have to apply and get accepted to attend post graduate university for one year (my colleague found out he was accepted today! Go Edwin!!!) Hence, the discussion on education…

–If you share this with your kids, maybe they won’t complain about going to school so much :)… or you can just threaten to send them to school in a foreign country (FYI– Haiti also has thirteen grades)

(From here on… keep track of the “big bucket of water”)

Eating Out:

Almost all local places to eat out are literally outside. It is the culture to always wash hands before eating. It’s not bad… most places have a big bucket of water in the vicinity of the eating area with a spigot attached to it to wash your hands. My colleague commented that the water we are washing with is probably dirtier than what is already on our hands… :/ In some “restaurants” they will actually come to your table with a jug of water and big bowl and will hold both for you as you wash. This is very common.

Meals are usually pretty standard: beef or chicken (each can be cooked two or three ways); veggies (usually spinach and beans); ugali (made of maize and cassava; think of very thick tasteless cream of wheat), and “chips” (french fries). “Tasteless” is not an offense when describing ugali, that is how the locals describe it. It takes on the flavor of whatever you dip it in. It is very filling. The next day for lunch and dinner, switch it around… and the next… switch it around again… Oh, there is no silverware, sometimes you may get a spoon, but you have to ask. Or, you can shape the ugali and use as an edible spoon (which is actually the purpose)… and the meat… pull and eat with the right hand, not appropriate to eat with your left (yeah… I haven’t mastered that one yet….) Besides, you will need your left hand to shoo away the many flies that are landing on your food 🙂 After eating, you wash hands again, from that big bucket of water, but this time you can use powdered soap (I think it is detergent)

As you leave the eating area, you notice the staff washing dishes… dishes that your food was served on… being washed in a big bucket of water… brown… ready and “clean” for the next person…

DSCN5851    The bucket of water to wash hands.

DSCN5848 DSCN5855


Hotel Stays: (Mitch and all my Marriott friend’s… you will want to steal some of these ideas 🙂 )

I have been doing a lot of traveling as we visit the regions to recruit facilities into the social franchise network. It is all driving, regardless of the distance. It is usually myself, my colleague, the PSI regional representative. and the driver (we never do the driving– trust me… these roads require an expert)),

My colleague always reserves the first class hotels for him and me, mostly for safety than anything else… and maybe some for comfort.  The PSI regional rep and the driver find alternate accommodations or a local’s hotel.

Average room rate for first class hotel per night: 30,000 – 50,000 shillings ($18-$30); breakfast included; local’s hotel is 15,000 ($9), no breakfast included (we had to stay at a local hotel one night); both will have mosquito nets over the bed.

When I go out for the evening, I leave my room key (room key, not room card) with the front desk; but it’s okay… I packed my computer and valuables in my backpack, …which I also left behind the front desk, as well… (I know my Risk Manager husband is probably having a heart attack!!)

Showering and Towels: only one bath towel, used throughout your stay (no other towels of any kind available) If at an even nicer hotel, you may get a second tattered and stained towel used as a bathmat in front of the bathroom door. You will have flip flops provided to wear for when you enter the bathroom or take a shower, but please leave for the next guest. No flip flops at the local hotel.

Make sure you remove the toilet paper roll and place away from the toilet during showering. The shower head is on the wall, next to the toilet; Also, you may need to notify hotel staff that you DO want hot water so they turn the hot water on in the morning for you… but you may have to remind them again in the morning, and then run water for a few minutes. You don’t have to use the shower. You can bathe…. just use the big bucket of water next to the toilet. Use the scoop in the bucket to pour the water over you. Yes, really! At a local’s hotel, if you have to have hot water, they will boil water for you (if they remember– but, they didn’t) in the morning and bring for you to mix with the cold water in the big bucket. There is always a big bucket of water…

DSCN6139                         DSCN6138

If there is anything that does not meet your standard and you decide to complain, be aware… it could get worse for you the next day (so I was told). My colleague and I shared stories… I told him if you complained in the states that you would get upgraded to a suite, get your room free for the night, and in addition to the free breakfast, you would get dinner for two in the hotel restaurant! LOL!! …He also laughed at the concept of turn down service 🙂

Rest Stops:

There are none. It usually consisted of the driver pulling over to a series of shanty built fruit stands on the side of the road and paying someone 100 shillings (6 cents) to let me use the “community toilet” 50 yards from the road. The outdoor outhouse is associated with the group of mud homes and shops that make up the community… As I “use the facilities” I consider how lucky it was that I brought all dresses to wear… long pants would have been more challenging to keep from dragging the wet floor of the “restroom” …what’s a girl to do… i really tried to drink less water… and I learned the hard way that i needed to pack my own “tissue” because there is none… nowhere… not for ANY purpose… get it? …oh, but there is that big bucket of water…

Below is a bathroom in one of the clinics. That let me use the “staff” restroom. This is very fancy with tiled walls and flooring. Replace tiles with wet, muddy floors and wooden walls and that is the majority of “public” restrooms… notice the big bucket of water…


I am having fun sharing all my experiences with you. This lifestyle doesn’t bother me. It keeps life back in the US in perspective. It makes me appreciate what I have… and what I need… and gives a much better realization of what I don’t need. I know I am blessed with an amazing family… an incredible husband who seems to be getting along well without me (ummm… too well!)… and the best group of friends ever who are willing to keep track of me for a while :):)

Don’t worry… I have not gotten sick or contracted anything weird… despite the bugs, the flies, the used flip flops, the mosquitos, the washing with dirty water…

Besides, I have a big bucket of water… :):)


Getting to know Tanzania

Getting involved is more than showing up and demonstrating what skills you can bring to the table. Of course, that is important… but what good are the skills if there is not an understanding and an appreciation of the culture and environment in which those skills are necessary. As we travel to the different regions, I am learning and living among those we are trying to help… and as I mentioned when I asked you to follow my blog, I want to share that with you. So, I hope you enjoy the next few pictures as I share some aspects of Tanzania with you.

I visited a third region in Tanzania where we recruited additional facilities in support of providing cervical cancer screenings and prevention of childhood illnesses. It has been very exciting to see how motivated the facilities are to bring these additional services to their communities.

In each of the three regions I have visited so far, I have tried to expose myself to the distinguishing attribute of that region..

In Iringa and Njombe, south central Tanzania, I watched as ladies picked tea leaves; and  visited a clinic that was at a tea plantation… tea plants as far as the eye can see… a teaspoon of freshly ground tea leaves can make 4-5 cups of hot tea… I think I inadvertently bought enough tea to last a few years 🙂ImageImage

In Tanga, northeast Tanzania, I saw miles and miles of sisal plants. The plant looks like a giant pineapple in the ground. Sisal leaves are fibrous and are used to make rope, mats, and a beautiful handbag I use for work 🙂


In Morogoro, central Tanzania, I was humbled with the labouring of the people as they made bricks and harvested and processed rice… manually.

Bricks made of mud are shaped and laid out to dry.



Once the bricks are dry, they are stacked either in pyramid or rectangular structures. The structures are packed in every crevasse with wood and straw and then set fire. The edifice burns for about 48 hours.


Once the bricks have been “baked”, they turn red and are ready to sell. One brick sells for 100 shillings… about 6 cents… talk about a hard day’s work…


ImageAs we continued our journey, we came upon the “rice ladies”. Rice is harvested manually and then eventually makes it to the processing mill… but there is a labour intensive process in between…

I saw beautifully dressed ladies shaking “something” (rice) out of flat baskets. We stopped to see and understand what they were doing. They were separating the rice, still in its outer shell, from straw and grass. As they shake, the rice remains in the basket and the straw falls to the ground. The rice is then laid out on large blanket to dry.



One of the ladies crushed the rice  between her hands to demonstrate how the mill separates the grain from its outer shell.


They were so proud to demonstrate their work and excited that I wanted to take their picture that they sang a special song welcoming me.


I am visiting a couple more regions in the next few weeks. Looking forward to sharing!