# Notes on Life in East Africa and Tips for Future Missions --- *I will preface this article by saying that the following is based on my personal experiences traveling and working in East Africa, and I am not an authority on these subjects. I am a seasoned traveler though, having spent more than 450 days living or backpacking through nearly 35 countries in the last 10 years. This will serve as a catch-all article of things I wish I would have had a better handle on before arriving in East Africa.* In no particular order, I’d like to share my thoughts on life and travel in East Africa, in hopes that some of this information will be helpful on future e-NABLE missions to this region. ### Transportation ##### Air Travel  My flight from Dar Es Salaam (Tanzania) to Mwanza (Tanzania) was the only time I’ve ever experienced a plane leaving 20 minutes before its scheduled departure time. After reaching the airport with time to spare, I went to buy a snack before boarding time. Arriving back at the gate, I heard my name being called over the PA system — final call. Confused, I showed my ticket at the gate, walked out onto the tarmac and onto the plane. I was the last one on board! When I got settled in my seat on the little twin engine PrecisionAir plane, I spoke to the flight attendant about the time discrepancy. It turns out that they are a little looser there with boarding process and scheduling. The plane was ready early so they opened up the gate for boarding early. When I got onto the plane, everyone on the manifest was then accounted for. There were no planes ahead of our for takeoff, so they figured: why wait? ##### Bus Travel  ###### Vendors selling their wares at a bus stop in Tanzania. --- Bus travel was cramped and confusing in my experience. I took buses between Mwanza and Musoma (Tanzania), and between Kigali and Nyanza (Rwanda). I know I wasn’t the first westerner to walk around these bus stations trying to figure out how to buy a ticket, but it sure felt like it at the time. There was no shortage of ‘entrepreneurs’ willing to help me buy a bus ticket for 10-times the price. In Tanzania, I paid less than $2.00 USD for the 4-hour bus ride between Mwanza and Musoma on Champion Express. For the first hour, a man with a portable PA system stood at the front of the bus and spoke passionately in Swahili — I thought for sure it was a sermon. I kept my headphones in and watched a movie on my phone to drown out the man talking. It turns out that he was selling skin care products, and his speech was basically a one-hour infomercial. He awkwardly went from seat to seat to see who was interested in buying his wares. At every bus stop, vendors selling anything from food and drink, to electronics, to live chickens, held their wares up above their heads to reach the bus windows. To Americans, this may seem a little odd, but in many places around the world the fast food simply comes to you. How convenient! The bus stops were never long enough to go and find a bathroom. In the 4-hour trip from Mwanza to Musoma, the bus stopped once along the side of the road, right outside of the gates to Serengeti National Park. Half of the bus got off, and I assumed this was another bus stop. Everyone headed for a separate bush — it turned out that this must have been a scheduled bathroom break that no one told the *Muzungu* (Western guy) about. In Rwanda, the bus ticket was was about $1.50 USD for the 3-hour ride from Kigali to Nyanza. The bus was small and cramped. I was one of the first to get on the bus, and the first thing I noticed was there was no place specifically designated for suitcases. There was no storage underneath the vehicle, and no overhead shelves. I had a full-size suitcase, and a 75 liter backpack I’ve taken all over the world with me, and seemingly no place to put them. The bus driver took my suitcase and put it right next to him, and told me to put the backpack on my lap. The bus had a rows of two seats to the left of the aisle, and single seats to the right of the aisle. This seemed perfect — I could sit by the window and stretch my legs out into the aisle at the same time. Within minutes, ever seat was full, but more people kept getting on. I came to find out that there were little seat that fold out from the aisle seat on the left of the bus into the aisle. From back to front, people folded out the seats into the aisle and sat down until the bus was loaded to capacity. To me, this was a very claustrophobic situation. While the bus was cramped and hot, there was also no aisle to stand up in. And in the case of an emergency, there would be no way out of the bus until the passengers in the front exited. * **Do not let anyone ‘help’ you that you did not specifically request help from**. This is my boilerplate advice for doing anything while traveling anywhere you aren’t familiar with. The average person, anywhere, is generally good. But there is an industry of deception targeted at foreigners and tourists everywhere as well. I’ve seen and read about enough scams around the world to know that the likelihood of you getting taken advantage of skyrockets when you engage with someone who ‘chooses you.’ So make sure to only engage with someone that ‘you choose.’ Though this is my default setting, exceptions exist obviously — use your best judgement. * **Ask a vendor or shop owner for help**. In my experience, vendors and shop owners tend to speak a little English, or at least more than the average person on the street. You can expect more accountability from a shop owner as well, because you know where to find them again if they were to give you poor advice. For solid information , make sure to make a purchase. * **In Tanzania - Buy your ticket directly from the bus driver standing outside of the bus**. People will stand next to you to make it appear as though they drove you toward that company and that bus for a commission. I made it clear when I bought bus tickets that I was alone and that no one was helping me. * **In Rwanda - Buy your ticket from the company counter** * **Board early and get a window seat**. I’m a tall guy; on public transportation I tend to opt for an aisle seat so I can stand up, stretch, use the bathroom if there is one, etc. However, these buses were hot, they were packed with people, and they had no air conditioning. If I didn’t have control of the window for fresh, cool air, I’m sure I would have been sick. * **On small buses, get a seat toward the front (exit).**  ### Taxis I had mixed experiences with taxis in Rwanda and Tanzania. First, they are very expensive alternatives to mototaxis and bajajis (discussed below). A taxi ride from the airport in Kigali to a hotel across town (it’s a small city) was around 15,000 FRw (\~$16.20 USD). While the same trip on a motorcycle taxi would run about 1,500 FRw, if you have suitcases you’re out of luck. This very quickly adds up, especially if you are uncomfortable taking an alternate form of public transportation. Taxis there were not metered, riders have to negotiate prices up front. This wasn’t generally a problem for me, but I did have one experience in which the driver changed the price once we reached my destination. The situation became heated. The safest way to get a taxi, albeit the most expensive, is to have a staff member at your accommodation call and negotiate a taxi for you. ### Motorcycles Motorcycle taxis (mototaxis) are very common in the places I visited in Africa, and cost 1/10th what a traditional taxi charges to get from point A to point B. A 15 minute mototaxi ride in Southern Rwanda was about 1,000 FRw (about $1.00 USD). In Musoma, I had a choice between abundant mototaxis and bajajis (discussed below), but in Gatagara, Rwanda, my choices were limited to taking a mototaxi, or walking. Taking a motorcycle taxi is intimidating. I read and heard many stories of frequent motocycle taxi accidents. I learned the word *poli poli!* in Swahili (“slowly, slowly!”) and it came in very handy on the back of many mototaxis. Like anything though, you get used to it, and I developed a few ways to maximize my safety when taking a mototaxi: 1. Mototaxi drivers can be very aggressive when someone looks like they are interested in a ride. I never gave my business to a driver who called out at me or drove up to me. **Always go with a mototaxi you chose yourself, not one that solicited you.** 2. Most mototaxi drivers carry a spare helmet for their passenger, but you wouldn’t believe the condition of a lot of those helmets (cracked, duct taped, scuffed, etc.) The last thing you want it to do is get on the back of a motorcycle with a cracked and scuffed up helmet…what happened to the last passenger? **Always inspect the helmet, and try it on for fit, before proceeding with the negotiation or getting on the back of the motorcycle.** I got so comfortable with choosing mototaxis that if I couldn’t see my face reflected in the helmet’s paint job, I took my business elsewhere. 3. By the same token, **inspect the tires on the motorcycle.** I was in Rwanda during the rainy season, and bald tires are bad news. 4. If you can help it, **don’t take a mototaxi in the rain.** It started raining the very first time I took a mototaxi in Rwanda. 60 km/hr may not seem fast in a car, but it’s terrifying on the back of a mototaxi in the rain with a fogged-up face mask. 5. If you don’t speak the local language, see if the driver speaks a little English. Speaking English is not a pre-requisite for being a good driver (duh), but for a few minutes you are entrusting your life to this person. **Choose a driver you can communicate with.** At bare minimum, you should be able to communicate to the driver that you wish to stop, slow down, or turn. It is also necessary to confirm that you are both on the same page with the negotiated price. *Aside:* It never fails to amaze me how much stuff people can pack onto a motorcycle. In China, I regularly saw families of 5 riding on one motorcycle or moped. In Vietnam I saw bags of recyclables stacked over 10 feet high, precariously strapped down  ###### Have you ever wondered how many ducks you could fit on a motorcycle? ###### Source: https://www.businessinsider.com/people-overloaded-photos-2015-11 --- I never thought I would become this kind of person, but Tanzania forced my hand.  Kyle Reeser, carrying a metal stand on the back of a mototaxi. --- ### Bajaj In Musoma there were no shortage of bajaj auto rickshaws—they were the primary way I got around while working at LVDC. Bajaj auto rickshaws (which I’ll shorten to bajaj(is)) are 3-wheeled vehicles, with a single seat in the front for the driver and a bench seat in the back for passengers. The bajaj controls look like motorcycle handlebars, a little disconcerting when you first see it, but it somehow feels safer than riding on the back of a mototaxi. That is, until the wind hits it — you feel as though one good, swift gust would blow you straight into the lake. Each bajaj reflects the personality of the driver — every bajaj I saw was customized in some way. Curiously (to me, at first), bajaj rides are not private, though you could pay extra for a solo ride. If there is room (and even if there isn’t) a driver will stop for anyone they think they can fit into the bajaj, to maximize their profit. While bajajis are relatively small, drivers really packed passengers in sometimes. I personally experienced a ride with 4 people on the bench seat in the back and another passenger sitting on the lap of the driver in front. Musoma lies along the shore of Lake Victoria, with a single main paved road stretching north-south and dirt side roads leading to adjacent homes, farms, and businesses. By default, bajaj operators drive along the main paved road, between the bus station uptown and the business, shopping, and dock areas downtown. The bajaj ride going downtown cost a flat rate of 1,000 Tsh per person (about $0.44 USD). Any ride going uptown, or diverging from the main paved road costs extra and the price would be bartered for beforehand. If you were travelling with a group, you had the option of bartering a group rate. I never experienced paying more than 3,000 Tsh for any ride in a bajaj.  ### Utilities ##### Electricity The electrical grid was very unstable in my experience both in Rwanda and Tanzania. During my time at HVP-Gatagara, we lot power 15-30 times per day. The power outage would sometimes only last seconds, and at other times could last several hours. When the electricity was on, it was never stable. The lights flickered constantly. The ORTHOLAB at HVP-Gatagara was located in a building adjacent to the metal shop. The most severe instability in our electricity in the ORTHOLAB was when heavy machinery was being used next door, especially the welder. The buzzing of a far-off welder corresponded perfectly to the dimming and brightening of the lights overhead in the ORTHOLAB. Perhaps the most critical piece of machinery in the ORTHOLAB was an uninterruptible power supply (UPS), which clicked on and off constantly as it maintained a steady power source for the 3D printers. I learned the hard way that grounded electrical sockets are not standard in the places that I stayed. One of my big projects in the first week at ORTHOLAB was to assemble and test a Modix3D Big 60 large format 3D printer. Roberto and I were both shocked (literally) multiple times by the Modix3D Big 60 3D printer. We determined that the electrical system in the building that the ORTHOLAB resides in was not grounded. This realization was hindered by the fact that all the outlets had a grounding pin, and also had three wires entering each outlet.  After watching a grounding rod be pounded into the Earth and being told it had been tied into the electrical system, we were heavily shocked again. As it turned out, they had not tied the new ground into the breaker box as we had been told. It took several days to get this issue cleared up.  ###### The electrician at HVP-Gatagara pounds a grounding rod into the soil and attaches a ground wire to tie into the building’s electrical panel. The hole is back-filled with charcoal for drainage. --- In my accommodations at HVP-Gatagara, the outlets were not grounded either. It was a risk to plug anything in. The brushed metal exterior of my laptop must have been lightly charged in the rare occasions I had to plug it into these outlets, because it would hurt my skin to touch akin to touching a 9V battery to your tongue. ##### Water ### Cell Phone and Internet ##### Cell Phone Use ##### WIFI ### Food  Soda comes in both plastic and glass bottles, but soda in a glass bottle costs half of what it costs in plastic. When you go to a shop and buy a soda in a glass bottle, you’re expected to drink it there and return the glass bottle to the shop owner before leaving. If you wanted to take the drink with you, it would cost you more than double. The labels on the Fanta and Coca Cola bottles were often worn way down, an indication of their commitment to reuse of these bottles. In Gatagara, I struck up a friendship with the owner of the local bar, and he let me purchase a few glass bottles of soda to take home with me at the “drink it there” price, under the condition that I bring the empty bottles back to him. I never let him down. ### Weather  ### Daily Life ##### Laundry ##### Muzungu! Mzungu! Mzungu! Mzungu means ‘foreigner’ in Swahili, and Tanzanians were not shy about reminding me that I was a guest and not a resident in their beautiful country. At the market in Mwanza, I would walk by children laughing and playing with bicycle tires and other found objects. When they noticed me, they would smile and wave and say, “bye bye mzungu!” Why it was ‘bye bye’ and not ‘hi’ is a mystery to me, but this greeting is apparently pretty common. From all directions I heard, “Mzungu—fish??” Or “Mzungu—buy cabbage!” ### Accommodations ### Communication ### Safety ##### Rwanda Kigali is one of the cleanest cities in the world, and one of the safest cities in Africa. I felt perfectly comfortable walking the streets of Kigali at night. While I would get the Rwandan “3-o’clock” — the side eye — as I walked past most people, I never felt uncomfortable or in danger. Local women walked alone at all hours as well. In discussion with female employees at the hostels and hotels I stayed at in Kigali, they informed me that in the aftermath of the 1994 genocide, the country has re-invented itself as clean and safe, and that for many young people this *de facto* level of safety is all that they have ever known. For a solo female traveler or volunteer, Kigali is a great option in terms of safety. ### Legal ### Cosmetic Appeal of Devices The cosmetic appeal of prosthetic devices is very important to potential recipients in East Africa, I can’t overstate that fact. Rajab Hamis and the technicians at Lake Victoria Disability Centre, as well as Roberto Postelmans of ORTHOLAB, have treated hundreds of patients in their respective regions. From in-depth conversations with them, and first-hand experience working with patients at LVDC and HVP-Gatagara, it appears that patients will choose cosmetic appeal even over functionality. I’ll give it to you straight: The average recipient in these regions are not going to respond well to the brightly-colored, robotic-looking hands that e-NABLE is known for. That’s okay, e-NABLE has helped and will continue to help thousands of recipients around the world through our current range of devices. Roberto Postelmans has been experimenting recently with applying Ottobock SuperSkin to cosmetic prosthetic devices printed in white Filaflex elastic filament. Ottobock SuperSkin is a pigmented coating used to approximate a recipient’s skin tone, and can flex with the material it is applied to. I found the cosmetic hands printed in Filaflex to  ### Takeaways ### e-NABLE Community Call to Action I learned in Africa that regaining some level of functionality in an amputated limb isn’t necessarily the goal. Often, a persons quality of life can be vastly improved just by giving them an opportunity to feel ‘whole’ again. I would encourage the e-NABLE community to build a repository of scanned hands, both male and female, in a range of sizes and experiment with printing in flexible materials.