Thursday, August 23, 2012

David's reflections

Much has already been written our day-to-day activities so I'll just share a few thoughts from my journal.

Playing with the kids after the last day of work in Mwanza (videos below) was a big moment for me. For the first time on the trip, I feel like I completely saw past the color of their skin. I forgot everything about albinism and poor vision. On the field, we were all people, just playing, singing, and dancing. No doctor or student, American or African, yellow or black or white. And there was something so profound and beautiful in that. I felt ashamed at my subtle discrimination, how I identified children by their condition even though I should know better.

In that moment, I could clearly see their dignity as human beings made in God’s image. That is what the country needs to see for themselves, though their prejudices are deeply engrained and reinforced by lies. Part of the problem is that PWAs surely believe they are inherently inferior because that’s how they have been treated their whole lives. Now I better understand what UTSS is trying to accomplish and how hard it will be. I'm reminded of the people with illnesses in the Bible who were thought to be unclean. Through physical healing, Jesus also gave them spiritual and social healing.

I went on the trip expecting to understand the full gravity of the situation in Tanzania. Back at home, I could see pictures, watch videos, and read articles about the terrible things that happened to children with albinism, but it always seemed a world away. An unexpected reality check came during the morning of departure when I saw the news of the shooting in Colorado. It reminded me that life is precious and time is fleeting.

Even after working with the children, however, it was easy to forget why UTSS has to place them in protected schools. And that's the point - the threat of mutilation and murder has been removed. I did not witness the fear of a gang with machetes coming in the middle of the night. Nor did I see discrimination against PWAs, who are considered the lowest members of society. I knew these things existed in my mind, but what I experienced first-hand did not match. Only when I came across the few students with machete scars or missing limbs did the danger become tangible. Then I could more deeply connect with UTSS's mission and understand how essential each component of their program is.

Their scholarship fund takes PWAs through school so they can become educated, working members of society. Healthcare supports this endeavor by removing barriers to learning. There is also the task of educating the public and correcting widely held myths through literature and other media. In the end, I had mixed emotions about where our team and I fit into the bigger picture. I felt indispensable at times as a highly educated doctor-to-be from the States.  Sometimes I swayed to the other end of the spectrum and felt overwhelmed and useless when I thought about how much time and work it would take to change, in some sense, a whole country. I'm trying to maintain a balanced perspective instead of these extreme. I may play a small role in the grand scheme of things, but that role is important and necessary. I should not and cannot do nothing just because I can't do everything.

Tuesday, August 7, 2012

Some final thoughts

Our final day of clinic at Under The Same Sun (UTSS) began like any other.  We were told that we would see one, maybe two kids with albinism, but were greeted by five (there were always more) patients, waiting patiently in plastic chairs.  The first few kids came upstairs and we (me, David and Michelle) each had our "final exams" with Dr. Kammer checking our cover tests and retinoscopy findings and wrapping up with trial frame refractions.  I went downstairs to check on the remaining patient, when Anna pulled me aside.  There was one kid waiting, donning sunglasses, with skin noticeably singed by the sun in several prominent spots.  Underneath the sunglasses, the boy had a tumor that started near his eye, but had now completely overcome his lower right lid margin and the globe of his eye.  There wasn't much that we could do for him other than pray for him and connect him with the local public hospital.  I spent the rest of the day in a fog, unable to shake my sad and helpless state.

Anna actually told me just recently that she was praying every morning to see miracles and this episode was just such a miracle.  The boy had worked for months (years?) in the field, in all likelihood completely unshielded by the sun's rays.  He had visited a local clinic where they provided him with an ointment, but the medicine did nothing and he continued to pick at the wound and work the fields until he could no longer ignore the situation.  By the time he started his journey to the big city (Dar Es Salaam), his vision in his right eye was long gone and he had no idea of his final destination.  At the bus station, he asked around, pleading for assistance.  Another man felt compassion and took him to UTSS where Dr. Kammer and our team would also soon arrive.  Becky told me that initially the UTSS staff was going to send the boy on his way.  The cancer hospital would cost a minimum of $1,700 a day and there was no budget for such a situation (to be perfectly honest, my mind also constantly drifted to the cost).  But after some debate and expert consultation, they decided that they would cover any living and travel expenses necessary to send the child to the local public hospital, where he was eventually admitted.  The fact that we and, in particular, Dr. Kammer (an eye doctor!) were there at that exact, providential moment was completely lost upon me until Anna brought all of this to light.

I recall reading Psalm 121 that evening and these verses struck me deeply:

"5 The Lord watches over you—
    the Lord is your shade at your right hand;
the sun will not harm you by day,
    nor the moon by night.
The Lord will keep you from all harm —
    he will watch over your life"

And I know from Hebrews 11 that faith is "confidence in what we hope for and assurance about what we do not see."

So what I ask for is continued prayer over this boy, for miraculous healing of his cancer and good discernment from his treatment team.  Please ask for doors to be opened, for hearts to be stirred into action and resources made available for his treatment and recovery.  Pray for unwavering hope in his heart and increasing faith, both for him and for us.


On our final afternoon in Dar Es Salaam, UTSS's Tanzania Executive Director, Vicky Ntetema, reported on her meeting with the Ministry of Health and Social Welfare.  I was just in awe of all that God is doing through UTSS in supporting people with albinism and making known their plight and their needs.  High ranking officials agreed to regularly distribute sunblock to people with albinism, to mobilize liquid nitrogen (?) tanks for treatment of skin cancer and to increase healthcare staffing at schools where kids with albinism are being housed.  We also heard news that the prime minister adopted three children with albinism and has been learning firsthand about the vision needs and cancer risks faced by people with albinism.  His adopted daughter recently came home from school with a sizable skin lesion, and he took immediate action to find care for her and find out what was going on at the school that a child could develop such a condition and not be treated with the parents not even notified.

In so many ways, awareness is growing and the situation is getting better and better for people with albinism in Tanzania, but there seems to be so much more work yet to be done.  The prime minister himself said that he was learning more everyday about his children with albinism, their needs and their gifts.


I've shared in other forums about the song, "God of this City".  It was written as it was being performed by Bluetree, an Irish Christian band, as they played in a brothel in Pattaya, Thailand.

The lyrics read,

"You're the God of this City
You're the King of these people
You're the Lord of this nation
You are

You're the Light in this darkness
You're the Hope to the hopeless
You're the Peace to the restless
You are

There is no one like our God
There is no one like our God

For greater things have yet to come
And greater things are still to be done in this City
Greater thing have yet to come
And greater things are still to be done in this City "

There were nights where I played this song as I prepared for bed and Anna shared with me recently that she also played it once (for Hope) during our trip.  I could imagine these words stirring the hearts of people in Tanzania, just as easily as they have for people in Thailand or throughout the world in churches, concert halls and even in bars and brothels already.  During our short visit, we experienced so much darkness.  But we also saw glimmers of hope, even emanating from the eyes of those most affected by the violence.  Anna told me about a girl with both arms amputated who nonetheless greeted everyone with a hug.  And we experienced even in the shyest, most introverted and damaged children, smiles peeking out of unclenched mouths upon these kids examining their newly white teeth or donning a stylish pair of sunglasses.  God is truly at work in this place, but there are so many greater things yet to come.  Please pray that those things would come to pass.

Personally, I'm not sure what the next steps for me and Anna will be.  We've learned that we could go pretty much anywhere that God leads us.  To be honest, Tanzania was not all that different than rural Thailand.  And the people who we met were so warm and so inviting and so desiring to share their culture, their language and (most importantly) their food with us.  In an interview that I did on one of the final days, I was asked about my long term commitment and I did respond that I see myself being committed to the mission of UTSS long-term.  Whether this means that I will go back or that I will support the organization from afar is difficult to say.  But I am open.

Some final images

The sun greeting us upon landing in Dar Es Salaam
The daily commute to a school in Mwanza
The dentists in their makeshift dental clinic
Anna in the waiting room
UTSS staff teaching dental hygiene to the kids

UTSS staff sharing about their recent meeting with the government
A final group shot with our security

A beautiful moment (previously described)

Sometimes seeing an event is so much more effective than reading about it. In the first clip, Anna has already approached and started chatting with the boy who so often stood by himself and the two kids (one pigmented and one with albinism) are well into their game. By the second clip, the crowd has formed and everyone's looking on at this beautiful, but simple scene.

And here is the blooper reel of us trying to follow suit...

Not sure how Anna avoided the embarrassment!

Sunday, July 29, 2012

Some reflections on completing our mission

The kids above are without a doubt some of the favorite ones who we served within the span of the past six days. I'd like to say that I recall each and every child who we served, but, in all honesty, the entire experience has passed by like a whirlwind, with few moments of true rest and reflection. Even when we sit down to process, we are pouring over paper charts that need to be transposed into Excel charts that need to be cross checked with order forms and converted into new spreadsheets to check test/retest reliability. All in all, we saw about 200 kids in five full working days. Tomorrow is officially our last day of work, as we'll be seeing one final kid who was bussed in over the weekend and all of the staff of Under the Same Sun. But there still will be so much more to be done in terms of sorting through the massive "paper trail" of vision records, dental records, health histories, order forms and spreadsheets; consolidating it all to make sense for the staff at UTSS who will then be responsible for providing for the follow-up care to the kids; and setting up next steps as much as possible for future teams and our local partner optometrists. Please do pray for that entire process, for focused time, organized efforts and good discernment.

I do want to share that on our final two days of serving scholarship children, we met dozens of older students with albinism who were already making inroads in secondary school, college and graduate studies. Some of them were studying social work, others working towards becoming educators and still others well on their way to becoming practicing lawyers. Education is one of the main vehicles that UTSS uses to transform the culture of Tanzania and we were able to catch these small glimpses of the near future leaders of this society. Praise God for that! In a related story, last night we were invited to an art show and concert headlined by a band featuring a very talented drummer who happened to have albinism. It took the crowd a little bit of time to get warmed up, but, before long, it seemed like the entire room (full of local Tanzanians, Europeans and Americans--i.e., us) had morphed into a giant conga-line, led by the infectious beats of the drummer.

But there are two sides to every story. I recall the feeling of unease that came upon me one of the mornings as we drove towards the UTSS office, seeing an older, disheveled man with albinism stumbling through traffic towards our car, begging for money. And in addition to all the older kids and young adults with high aspirations, already living out their promise in so many ways, we saw more than ever people with albinism with missing limbs, chopped off and sold to witch doctors, sometimes by their own family members. There is still so much that needs to be done in this place, so much darkness tied to wrong ideas, beliefs and attitudes towards people with albinism. My prayer is simple: that God would reclaim this city, this people and this nation as His own, that He would wipe away the lies and deceit, and overthrow the powers and principalities of the enemy in this place.

Finally, I want to leave you with a picture of something beautiful, of some of the kids in the playground who we met during our journey up north. One of the dentists decided that she wanted to pull out her camera and snap a few pictures, and then the game was on as the kids rushed forward, waving and dancing and wanting to get into every frame. A few seconds later, the dentists decided that they had to jump in, too!

Thursday, July 26, 2012

Back in Dar

Hi all,

We are back in the big city (Dar es Salaam) after 4 days in Mwanza.  Today was mostly a day of rest, with a little bit of time devoted to catching up on charting and more than a little bit of time catching up on sleep.  We are still recuperating after seeing nearly 120 kids over the course of three days.  To put this in perspective, most optometrists see about 8 patients or so a day!  Many of the kids had to be bussed in from far away schools, some from nearly three hours (200 km) away.  Praise the Lord that we were able to see so many!!

There are so many sad and wonderful stories to share, but here are just a few:
  • There was a girl who was a recent victim of an attack.  Several men approached her and ordered her to stick out her hands so that they could chop them off.  She adamantly refused and pulled her hands from their grasps.  In response, they viciously beat her, only slowing to look for a machete to complete the act.  In the confusion that followed (none of the attacked could find a machete), she rushed away.  Despite all the hostility and hatred directed at her, I just remember this girl being such a beautiful, kind and gentle soul.  I couldn't imagine anyone wanting to hurt her.
  • On the second day, one of the Under The Same Sun staff members helped me in the dispensing station, training the kids on using their brand new telescopes.  I remember the joy and confidence he expressed in showing them how to focus the telescopes, testing their abilities on a visual acuity chart and tying straps on the telescopes so that the kids wouldn't lose them.  This was the picture of one of these kids, fully grown, educated, employed, accepted by his peers and empowering the next generation.
  • Towards the end of one day, we sat at the edge of the school and watched the kids (with albinism and without) playing.  Hope, Cheryl and Anna had noticed one boy with albinism who would stand day-after-day by himself hugging a tree.  Anna finally got up the courage to walk up to him, give him a bag of trail mix and talk openly with him in front of a growing crowd of other kids.  She wasn't sure what he said, but I think that little encounter may linger with him for awhile.  We also saw one little girl (with albinism) playing a game with a typically pigmented kid.  There just seemed to be such a childlike, playful innocence about the encounter, untainted by any hint of prejudice or animosity.  A moment later, another girl with albinism led a whole group of kids (again, some pigmented and some not) in singing and dancing--we'll definitely post this up!  The girl had the loudest voice and definitely the most rhythm.  I got a kick out of seeing David try to follow along.
These are just a few of the moments that I could recall.  I've also attached a brief update from Anna below.  Now that we're back in the city, we'll post more frequently, including some pictures and videos!

Thank you so much for your continued prayers!

Much love,

"Hi everyone,

Thank you so much for your prayers!  We can truly feel it here!  We are now in Dar Es Salaam at a hotel with Internet!  Yay!  Back to civilization!  We spent the last 3 days in Mwanza (about 1hr 20 min plane ride from here) to treat about 120 kids that have been bused in from different schools.  Some kids traveled 3 hours to come see us!  On the dental side, we set up a clinic in their library and did cleanings and screenings.  They were very long days and our backs were killing by the end of them since we didn't have any type of reclining chair to use.  We all also miss our dental assistants sooooo much because we had to do everything ourselves from set up to clean up to sterilization!!  Although they were tough days, to be able to love on and interact with these kids made it all worth it!  We will try to put a video of the kids singing on our blog.  Steve has been busy learning the optometry side.  It's been really great to serve with him and watch him use his skills during this trip.  We both are staying in different rooms for the entire time because it would be awkward for David and Michelle to stay together.  This is the first time since we've been married that we are sleeping apart.  It's kind of like when we were dating again!

We have met some of the bravest, most amazing children.  Today, we treated a 10 year old girl who was attacked and had her arm cut off.  I don't exactly know how she managed to escape but she did!   Another little boy had his finger cut off but escaped by biting his attacker.  Please continue to pray for our trip and also for these children. There are some schools where the teachers really take care of the children and then there are others where the kids are more neglected.  In those school, I saw a lot of kids with sunburn and different skin lesions that could be the precursor to cancer.  It really broke my heart...

That is my update so far...getting really late...have to get sleep!  I miss you guys!

Anna & Steve"

Thursday, July 19, 2012

Meet the team

Becky Kammer is the ringleader of team. She first learned about the plight of people with albinism in Tanzania while watching a documentary produced by Under The Same Sun. She is an O.D. and an expert in low-vision, which is particularly useful in working with people with albinism.

David Nguyen is an optometry student who leads the Fellowship of Christian Optometrists at the Southern California College of Optometry. He is the baby of the team and has a fan club of adoring (female) colleagues.


Michelle Lee is also an optometry student at SCCO. She was recently elected American Optometric Student Association Trustee, which is kind of a big deal. She has a season pass to Disneyland and likes men who wear suspenders well.


Hope Ann Nguyen is a pediatric dentist and mother to an adorable dog named Shelby. Her favorite restaurant is Cafe Chloe and for some reason she has a chandelier that hangs over her bathtub.


Cheryl Estiva works alongside Hope as a pediatric dentist. She really enjoys finger puppets and has a surprising depth of sports knowledge, especially as it relates to the Bay Area teams.


Steve Wang and Anna Chandsawangbhuwana are husband and wife, optometry student and pediatric dentist, respectively. They really like to travel and eat, and never in their wildest dreams expected to be going to Africa this summer. Yes, Anna has a very long last name and, no, nobody has ever told her that before.

Thank you for taking the time to get to know all our amazing team members. We are excited, frightened and expectantly awaiting amazing things on our journey to Tanzania. So many things still need to be done, such as packing the rest of our supplies, learning a bit of Swahili, making sure that we are 100% malaria resistant, completing the homework assignment that Dr. Kammer gave us all and just really preparing our hearts to go on this voyage together. By God's grace we have the good fortune of being able to provide something of value to the people we will be serving. So many of you have already contributed an exceedingly generous amount in financial support, but we ask you now to also partner with us in these upcoming weeks with your thoughts and prayers. We'll send out a complete list of prayers within the next couple of days and we will try to update you as much as possible with our experiences along the way.

God bless,