In 1961, I received an invitation from Sargent Shriver to join the newly created Peace Corps. I was a 1959 alumna of the Experiment in International Living that had been directed by Shriver. My husband and I applied and on May 22nd of that year received a congratulatory letter signed by John F. Kennedy. By July 1962, we landed in Mogadishu, Somalia. After teaching in Mogadishu for a year, we were posted to Owerri in southeastern Nigeria.
The following recounts an experience in Nigeria that ultimately led to my return to Africa and the founding of a women and children’s clinic in northern Tanzania 50 years later.
Initially, I had taught English and worked part-time with a clinic in Owerri, but that changed with an incident that sparked everything that has happened since and marked the trail for my subsequent life-long career. This is also, however, about the Peace Corps and its almost eerie power to transform the lives of its volunteers and those with whom they worked. Its cachet has faded some in the public mind these many decades later, but this agency launched by a youthful, inspirational president remains a transformative force that indelibly marked thousands of Americans, from TV political guru Chris Matthews to Netflix founder Reed Hastings, to lawmakers across the nation. I too am one of them.
Owerri and the Motherless Baby Home
Owerri became the last stronghold of Christian Biafra in the civil war of 1966-1968, but was still a small, peaceful town in 1963 when we arrived. There was one tarmac road and a few cement block structures including an abandoned Shell compound where we lived. The road, lined with a couple of hundred tin shacks, was the center of commerce for the local jungle villages.
In addition to teaching English, I chose to work with a well-baby clinic sponsored initially by the Red Cross. It was run-down, if functional, but a new hospital had asked that it be shut down. The mothers needed the care the hospital could provide in contrast to the clinic’s limited capability.
As the demise of the clinic approached, a father bearing a pitifully thin 3-month baby came in begging for help. The baby’s mother had died in childbirth and Chickwem, the child, was severely underweight and malnourished from lack of milk. The father had no means of caring for her and asked us to take the baby to save her life. I took the baby from him promising to help.
Given the Clinic’s minimal resources, I took Chickwem to the new hospital for care. They refused, pointing out sympathetically but firmly that too many mothers died in childbirth for the hospital to accommodate all the babies without becoming an orphanage instead.
It was my first encounter with the dismal arithmetic of the third world’s pragmatism regarding the sanctity of human life. Needless to say, most of the Peace Corps Volunteers, like me, were middle class Americans recently graduated from college. The notion that there might not be enough to go around, while theoretically understandable, had never been even remotely a part of our experience.
When I brought Chickwem home, my husband and I agreed that she needed to be returned to her father at the village. As I later drove there, however, the consequences of that decision sank in. She would surely die of starvation, given that the father had brought her to the clinic as the last resort. I turned around and simply brought her home to stay.
Chickwem’s incidental good fortune wasn’t, however, the fate of most of the multitude of babies deprived of milk by the deaths of their mothers. To get these babies off of death row, they needed a baby care facility, to be fed powdered milk until they were old enough to survive on solid food and returned to their fathers. Anyone could have seen the solution but I happened to be there armed with a twenty two year-old’s sense of invincibility and a license from the Peace Corps to do something to help people. And thus, the Owerri Motherless Baby Home was born.
Whether inadvertent or intentional, the Peace Corps brilliantly left us without an instruction manual to undertake the construction and operation of a baby home or much of anything else, for that matter. No bureaucratic rulebook or oversight, just the mantra to make sure the community was with you– and good luck!
As it happened, the community leaders were solidly behind the idea. The well-baby clinic, now empty, provided the housing for the Baby Home. From Port Harcourt’s companies, I wangled powdered milk from generous Nestles, whitewash, soap, cribs and mattresses and supplies from others. The community and the Red Cross supplied funds to hire local staff. Local carpenters provided furniture. Within a year the Owerri Motherless Baby Home was filled to capacity and, with annual support from the Christian Children’s Fund actually survives to this day!
During all this whirlwind of activity, Chickwem thrived. She returned to her father after a year, now christened at his insistence, Chickwem Diane.
Returning Home
In 1964, after having crossed the chaotic Belgian Congo by car, we blithely spent all our saved funds traveling through Rwanda, Kenya, India and Asia, landing, finally, in New Jersey. My husband, a talented industrial designer, found work quickly. I had been enrolled as a future diplomat in the Maxwell School of Citizenship at Syracuse University prior to being a PCV but Owerri had changed all that. My first employment was as a social worker working for the legendary Dr. Leontine Young[1], a pioneer in child neglect and abuse, in Newark. The slums of Newark were notorious for poverty and crime, truly one of the forgotten inner cities of America.
The children of some single mothers who had succumbed to life of drugs, alcohol and prostitution were not entirely forgotten. The Child Services Association was privately funded to, as best it could, attend to their welfare. The State of New Jersey and the city of Newark did not. My days and many nights were spent tracking down these mothers and their children, supporting them with food, clothing, and occasionally finding foster homes for them. I met remarkable children whose resilience and optimism was nothing short of miraculous.
By the time Newark had exploded in the riots of 1967, we were in California. From a few years of social work in Silicon Valley, I raised two children to school age and returned to graduate school for a PhD in psychology and began private practice as a clinical psychologist in 1983. For those who love this profession, there is nothing more satisfying emotionally and intellectually. My practice and my second husband took us to New York, then Hawaii and finally, northern California again in 2007.
We had returned to East Africa on safaris several times prior to 2009, when I finally decided to go back to see if there was something I could do. This was not a new thought. Some of the red dust of Africa had stuck to me and, I expect, to many of my PCV colleagues. For decades, the notion had remained in my mind that I would return someday to these people whose lives were so tenuous. This self-nagging grew over the years, until at last I knew it was time to do something about it.
Tanzania and the Olmoti Clinic
A friend, Gloria Upchurch, knew the owner of a group of game lodges in Tanzania. Willy Chambulo, who is one of the heroes of this story, also owns a tour guide company called Kibo Guides. Gloria and I arranged our trip with Kibo Guides and went to Tanzania in June of 2009 looking for the inspiration to launch our mission. On the western slopes of Mt. Kilimanjaro near a Kibo Guides lodge, Kambiya Tembo, we were introduced to an influential Maasai midwife, YaYa, and within an hour the mission was clear.
The Maasai of Olmoti
The Maasai are a pastoral, semi-nomadic tribe whose goats and cattle provide their principal means of income and their sustenance, milk and meat. Sale of cattle still provides their principal source of income. Nilotic in origin, they have roamed over the grazing lands of Kenya and northern Tanzania for over 500 years. With the sequestration of major tracts of grazing land to wildlife protection areas and gradual privatization of their traditional lands, however, the Maasai’s exclusion into lands granted in exchange has gradually led them into subsistence agriculture to supplement their diets.[2] Their bomas, collections of huts surrounded by thorn fences to protect their herds, are now becoming semi-permanent dwellings, rather than seasonal accommodations.
The Elerai-Olmoti area where YaYa lives is remote and its people among the poorest in Tanzania, earning around $1 per day.[3]The bomas are distinct from large towns and without public or private transportation. Women of the villages must walk 20 km or more to a hospital for maternal care. Pre-natal care is, therefore, uncommon. Only rarely do trained medical personnel attend births. Sanitation is primitive and running water non-existent.
Maternal mortality in childbirth in Tanzania is one of the highest in the world. In one year for example, more than 13,000 women died in Tanzania whereas in Sweden, having a comparable population, one died. The Tanzanian maternal mortality rate is nearly 100 times that of the U.S.[4]
The problem, common to most sub-Saharan Africa nations, is inadequate health service, both in terms of access to hospitals and the quality of care in rural dispensaries. If a woman has difficulty delivering, more than half will have no access to caesarian sections and death comes through loss of blood. Impending problems are not detected early enough, given the lack of pre-natal care.
Survival under circumstances attending unsanitary birth often brings lifelong suffering from obstetric fistulas. The condition is known as a disease of poverty, caused by lack of pre-natal care, inability to conduct caesarian section, childbirth by immature or undernourished women or even infected episiotomies.
YaYa and the women of the local community had tried to take matters into their own hands. The Tanzanian government, in an attempt to augment its own small budget for rural health, had offered to staff a local clinic, provided the community built the basic structure. When I met her, she showed me the partially built structure that she and the local women tried to build from homemade bricks. They had neither the money nor the skills, only the desire. YaYa asked us for help and Gloria and I said yes. The Olmoti Women and Children’s Clinic was conceived and the gestation period began.
Consent of the Governed and National Policy
The local chiefs designated a plot of land owned by the Maasai near a tiny kindergarten. It had been donated by a generous Swiss visitor who put off replacing her old car to pay for the school. The Longido District Medical officer supplied the basic government plans for rural clinics and agreed to staff and supply the clinic if we could build it.
The offer of staffing and money for medical supplies was consistent with the stated policy of the Tanzanian Health Ministry. Tanzania, a resource-poor country of 45 million people, struggles with the demands of a population growing at 3% per year.[5] Rural Tanzania presents special challenges. Roads, transportation, education, food, health and sanitation, and most importantly water supplies are major issues. Moreover, the Maasai, the most rural of Tanzania’s tribes, are also the least culturally integrated and their pastoral lifestyle has come into conflict with Tanzania’s dependence on wildlife tourism for revenues.
Circumstances are, nevertheless, slowly driving the unwilling integration of the Maasai into the larger community. The loss of grazing land, especially as the Serengeti and other national parks are now set aside for wildlife, concentrates their herds into increasing smaller spaces. Even in June, just after the end of the wet season, Maasai grazing land from Olmoti to Longidoin the north is barren, heralding desertification and its consequent certain loss of the pastoral Maasai life style and the sustenance of the tribe. Formerly, the Maasai’s pastoral practices led them to migrate to other grazing lands while allowing the grass at home to regenerate.
The Tanzanian government has sought to attract Maasai families to rural centers where farming provides a more sustainable lifestyle. Services such as education and healthcare, eventually even trade, are magnets to the formation of these communities but the assurance of food supplies is paramount. Olmoti and Elerai Maasai already dry farm corn and beans and the needs of agriculture now surmount the drive to find alternative grazing for their herds.
The Longido District government’s execution of the federal policies sealed the deal for the Clinic by taking on the responsibility of provision of staff, supplies and staff housing. Without the commitment of Executive Director Julius Chalya, this project would be just another failed, if well intentioned, charitable gesture.
How to Build a Medical Clinic from the Ground Up in Africa
Neither Gloria nor I knew anything about construction or the needs of a medical clinic. We went back to California fired with enthusiasm and not much else. What we did have in Tanzania were people, in particular, Willy Chambulo, the owner of Kibo Guides, who offered to oversee the construction of the clinic. As it happened, we could not have found anyone more capable and committed to be our local representative.
The importance of these connections cannot be overemphasized. Willy is a sophisticated entrepreneur whose network of lodges and guides is Tanzania’s most successful. He is very tall, an imposing mix of Maasai, German and Irish heritage. He grew up in a boma until he went away for his education at age 13. From being a game guide to his first lodge in Arusha took only a few years. Since then he has personally designed and overseen the construction of eight lodges that he now manages in addition to the highly skilled and educated Kibo Guides.
The Kambiya Tembo tented lodge near Olmoti is managed by another key figure, Sylvester John. Olmoti and Kambiya Tembo are two and one half hours drive from Arusha, the nearest city, over roads that, in heavy rains, are nearly impassable. Sylvester oversaw the construction of the clinic from October of 2010 to June of 2011 when it was officially opened. He kept communications with the District officials and the Olmoti Maasai alive and healthy all while expertly managing the lodge.
Extraordinarily, Willy took us at our word that we would raise the funds to build the clinic and, on his own initiative, hired the contractors and began construction. Neither Gloria nor I had the personal resources or even, for that matter, the experience in fund-raising to give Willy that kind of assurance. We simply promised and he said yes. Where else but Africa could this happen and where else but America would anyone have such a naïve certainty of the generosity of their friends?
Funding the Construction and Equipping of the Clinic
Gloria was connected to a charitable fiscal sponsor who handled our donations and we began looking for funds. We held our first fund-raiser in San Francisco, auctioning donated art. At the end, we tallied the results and found, after all our work, that the net receipts were slightly negative.
Neither of us knew anyone with the personal commitment to African health to hand us the check needed to underwrite the costs. Big foundations are concerned with the larger issues of health and education, hoping to have impacts on a scale commensurate with the millions they donate. Local, one-off projects such as a clinic in the backwoods of Tanzania, are usually not on their radar screens.
The key to fund-raising turned out not to be traditional charitable fund drives using professional staff. A friend suggested organizing safaris in Tanzania in which the participants made contributions equal to the cost of the 10-day safari. Kibo Guides agreed to charge only their cost, and the rest of the fee paid by the tourists went to the clinic. Our first safari was launched at the end of May 2010. Gloria is an experienced tour leader and managed a superior safari at Kibo’s lodges. We’ve now done this for 3 years and, adding in the donations of friends, the entire bill for the clinic’s construction has been paid.
We were aware that raising cash for the construction was only part of the equation. Who would pay for equipping a medical facility that needed to provide pre- and post natal care, and perform caesarian sections as well as sanitary conventional deliveries? How would we see to the salary of our local community medical aide, YaYa? We needed to establish connections with hospitalsso that complications beyond the capabilities of a local clinic could be managed successfully.Power, water, solar hot water, all had to be installed. Help, fortunately, was on the way.
We were referred to a not-for-profit, IMEC, an organization that collects and distributes medical equipment to poor countries to see whether they could help equip the clinic. Not only did they agree to do so, IMEC sent Dr. Susan Crawford to see what was needed. As a yardstick of the importance of IMEC to this effort and dozens of other similar ones in developing nations, the value of the equipment and supplies exceeded the actual cost of the construction project! Over $130,000 worth of supplies and equipment was donated.
We were fortunate to find other experienced donors. Vitamin Angels,a charitable non-profitannually donates vitamin A, an essential nutrient for childhood development, and plans this year to expand the donation to include multi-vitamins. One Million Lights, another not-for-profit, donated solar LED lights and a technician to install solar panels for the Clinic’s electricity. The generosity of these organizationswas essential and the outcome, in less than two years, is that the Olmoti Clinic is fully functioning. Two medical professionals—supported and housed by funding from Tanzania’s Longido District Offices—work full-time at the Clinic. YaYa is a medical assistant and community coordinator.
More needs to be done, including upgrading the power and supplying continuous water rather than depending on runoff from the roof. Sanitation, health education, ophthalmologic treatment, and other medical procedures are sorely needed. It is to these areas that I have turned my focus. The Clinic has the makings of a Maasai center of activity. People come on foot from many miles away, even from Kenya across the borderfor help.
The Olmoti Clinic formally belongs to and is managed by the Tanzanian government but it has become the Maasai’s own. YaYa and Olmoti have made it happen through their determination to save the lives of their women. They are fiercely proud of their Olmoti Clinic. It may become a model for more like it in Maasai country.
Conclusion
What started as a blank slate for an idealistic young Peace Corps volunteer has come full circle. Since the ’60s, Africa has been inundated with money and teams of experts from the developed world, all valiantly dealing with issues from water to education to agriculture to disease.The Peace Corps left the bare outline for this epochal public and private philanthropic effort.Such sweeping brush strokes on the vast canvas of Africa’s poverty necessarily, however, leave innumerable opportunities for individuals like you and me to act on their instincts to help others. There are thousands of YaYas determined to save women from an entirely unnecessary death from childbearing, orphanages barely able to survive and millions of children eager for higher education. In the words of a Peace Corps slogan – “Life is calling. How far will you go?”
Acknowledgements
The help of Michael and Susan Merrinan, John and Beth Bredehoeft, and John Beletsis has been exceptional. My husband, Barry, is the essential partner and contributor without whom this story would not have been told.
[1] Young, Leontine, 1979, Wednesday’s Children, Greenwood Press, 195 pages
[2]Taylor, Darren, 2011, Pastoralists of Northern Tanzania face extinction; Voice of America, Online.
[3] Homewood, K., 2006, Maasai pastoralists: Diversification and poverty, in: Pastoralism and Poverty Reduction in East Africa, International Livestock Research Institute. Unpublished, Online
[4] MacLeod, J. and Richard Rhode, 1998, Retrospective follow-up of maternal deaths and their associated risk factors in a rural district of Tanzania; Tropical Medicine and International Health, 3, 130-137.
[5] UN Data, 2012, United Republic of Tanzania, from World Statistics Pocketbook: Online