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Culture and Health Care

The culture is Tanzania has developed greatly over the last 5 years. Although men still dominate the culture, there has been a significant decline in arranged marriages, mainly amoung educated women. That being said, marriages under 18 still exist, however few of those marriages are forced. It has also been noted to me that women should not wear pants or cross their legs when sitting since it challenges a man’s authority. I asked how women partake is sports then and it was noted women wear leggings under their dresses and skirts. This being said, I have seen a handful, but only a handful of women in pants, again, it is more commonly found amoung women in higher education like universities. So although Tanzania has come a long way with women equality, it still has a long way to go.

After meeting with a medical doctor from St. Joseph’s Hospital in Moshi, Tanzania, one of the largest health concerns is depression among women. Divorce does not exist in the Tanzanian culture, so many women sit in silence after being beaten or cheated on. And since the culture doesn’t acknowledge mental health problems, several of these women attempt suicide, keeping Tanzania’s suicide rate high, and making it one the largest health problems the country faces. If a person is treated at a hospital for depression, medication is not given, and the person is advised to come back monthly for ‘talk’ sessions with a doctor. Thus, in low income communities where people cannot afford monthly doctors visits, depression is usually left untreated.

In regards to other medical issues, malaria and HIV/AIDs are both less than 10%, and continuing to decline over the past 5 years. This has been as a result of government campaigns where children under the age of 5 years old are all given free mosquito nets to sleep under, and the government does regular chemical spraying in areas that contain still water, since still water has heavy mosquito populations. Also, death rates related to malaria are becoming less common due to education; if you have flu like symptoms it’s probably malaria and you can go to a local clinic for testing and treatment. Clinics are found easily since there is about one clinic for every 20-30 households; however, there is only one hospital per province and those hospitals serve around 300,000-700,000 people.

HIV/AIDs has been heavily reduced due to the acceptance of birth control. Additionally, all people getting married are mandated by law to get a HIV/AIDs test, which is shared with the partner.

Other interesting facts:

-Healthcare is free for all pregnant women, resulting in a decrease of at birth deaths. However, infant death rates are still high (this is a concern). I asked how women can deliver at hospitals when some live 3 hours away; they may not make it in time before delivery. The doctor said that women are asked to come to the hospital a few weeks before their delivery date; the entire multi- week hospital stay is free.

-Medical care for children under the age of 5 is free, and all children have to be vaccinated to go to school. However, there’s an issue of clinics signing off on the mandated vaccine forms for schools, without the children actually having the vaccines.

-If a person is employed, they have insurance (both private and public sector jobs). The insured person is allowed to add five family members to their insurance plan. I asked what if someone has 7 children (not uncommon); the answer, only five people can be put on the insurance, so they must pick 5 of the 7 children to insure.

– Hospital visits (not clinic visits) cost around 50,000 shillings or $25 USD, which results in people only going to the doctor’s in emergency case situations, which usually results in a more expensive visit. This problem is not uncommon in the United States either.

– Clinics provide basic healthcare: malaria testing, basic prescriptions for antibiotics or over the counter pain medicine, blood testing, immunizations.

Although soccer is considered a ‘man’s sport,’ women are starting to play. After three days of playing soccer with my kids, two girls joined us! And they are really good!! They play with a lot of passion, much like I did when I was young. Growing up in Germany in the early 1990s, I was never allowed to play soccer with the boys. Once I came to the U.S. and was allowed to play soccer, I played with all my heart, much like these two girls. It’s always the small things one takes for granted.

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