By Bob Van Leer

  (DAR ES SALAAM, TANZANIA, EAST AFRICA, Nov. 9, 1993) - The main health problems in Tanzania are infectious diseases, problems solved generations ago in the United States. There is one noticeable exception to this, AIDS. We met today with Ministry of Health officials and the Minister for Communications and Transport. Dr. Fatma Mrisho, assistant chief medical officer in the Ministry of Health, said infectious diseases, especially childhood diseases, are the principal health problems in Tanzania. She listed: malaria, diarrhea, pneumonia, AIDS and cholera and said AIDS is moving up on the list. The degenerative diseases, heart and cancer, that are at the top in the U. S., didn't even make her list. These are diseases of old age and not many people here get to old age.

  Dr. Mrisho said two-thirds to three-quarters of health facilities are now being devoted to pregnancy related treatment and children's health. She said they now have a good system of health service facilities but quality of care is a problem. Three fourths of the people are within walking distance of a health facility. But they define "walking distance" as three - four miles. Emphasis is placed on education, not compulsion. But, still, it doesn't help much to teach someone to boil water before drinking it when the nearest wood for a fire to boil the water is three miles away. Of interest to Rotarians, she said the Rotary Polio Plus program has been beneficial to Tanzania. They are doing well in immunizations, she said, with the vaccination rate below the age of 5 up to 80%. Infant mortality has dropped steadily in Tanzania from 137 per thousand in 1978 to 95 in 1992. But this is still high. For comparison, the infant mortality rate for Oregon in 1991 was 7.2 per thousand according to figures from the Curry county Health Department. On the other end of the scale, the average life span has dropped from 55 years to 53. Dr. Frederick C. Kigadye, assistant chief medical officer of the Ministry of Health, attributed this to AIDS. He said there is a worrisome increase in tuberculosis, also because of AIDS. Dr. Kigadye appealed for help in getting a CAT scan machine. He said there is not one in the whole country. As a comparison, Curry General Hospital and virtually all hospitals larger than Curry General in the U. S. have their own.

  Nalaila L. Kiula, Member of Parliament and minister for works and communications, said one of Tanzania's greatest assets is peace - the country has had only one government since independence. He said the country doesn't have tribal conflicts. Tanzania's neighbors have had political problems and refugees have fled to Tanzania from a number of countries. He said Tanzania gives refuges land to till so they can help themselves. Kiula made a special point of thanking the U. S. taxpayer for help in rural road construction in Tanzania. He said Tanzania has made progress but there is still a long way to go. He said people are still dying because there is no medicine.

  Our final meeting of the day and trip was with the Tanzania Journalists' Association. We were told that seven years ago the country had only four newspapers, two Swahili and two English. After "liberalization" others sprang up and there are now 40 or more and some people think they are too free. The main government control appears to be access to information. Most papers are published in Swahili. Newspapers circulate to the most affluent level of the society. Tanzania is the second poorest country in the world and the 200 shilling, about 50 cents, cost of the paper limits sales. Tanzania is still a socialist country. We talked to one journalist who had spent six years in Russia. Another criticized U. S. policy toward Cuba.

  This evening it is time to pack up for the long, long trip home. We have to leave the hotel at 5:30 a.m. It will be a welcome change to get out of this stifling tropic heat. The air conditioners mostly don't work and last night the temperature in the room probably didn't get as low as 80 degrees. The only news we have read about Oregon since we left was two stories about Sen. Packwood's problems. We don't know how the sales tax vote came out. Tomorrow we fly from Dar es Salaam to London by way of Nairobi, Kenya. Then we change planes for a flight to New York where we will stay overnight before the final leg home. (Nov. 10) - We did get to see Mt. Kilimanjaro. It was a clear day and our British Airways Boeing 747 flew right past and above the mountain and we had an incredible view. The top was snow covered even though it is almost on the Equator and this was the dry season. We landed again at Nairobi where a missionary was brought aboard on a stretcher. He had been shot by bandits at a road block. A corner of a cabin was curtained off for him. Shortly after leaving Nairobi we crossed the equator for the sixth and last time on this trip.