I'm lovin' it.

For as little food as they have, most Tanzanians are keen to eat what’s healthy. Starch in the form of maize flour or rice is the staple diet. Protein is added through beans and local spinach is a tasty source of vitamins. So if enough food were available, I suspect Tanzania would be a healthy country.

A bench of old ladies, draped in every colour of kanga, waited toothless and patiently to be seen by the doctor. As I bent my head round the door and smiled at the long tired line, they grinned as one, beckoning, “Karibu”. Celina called me through, ignoring my awkwardness. I had come to see this dispensary for myself, as I had heard so much about it since I arrived two years ago. It was created by the Sisters of the Holy Redeemer and one energetic German nun in particular, serving a poorer district of this already poor swahili coastal town.  A large white block tucked behind the enormous white block which is the Catholic Church at Majengo, the dispensary is clinic, pharmacy and emergency feeding station in one. Built in robust German style, full of high quality polished wood and spotlessly clean floors with incongruously lurid paintings, and random Swahili paintings and Makonde carvings, it’s unlike any Tanzanian health centre I’ve ever visited.

The centre treats more patients in a day than any other clinic, partly, because of the district it serves, but mainly because of the prices it charges for treatment. At TSH1000 for a consultation and perhaps TSH1000 for treatment, it’s one of the cheapest around but still unaffordable for many. Celina is a large cheery woman, the daughter of a Polish woman and a Tanzanian man, who speaks English like a European, with a touch of Polish impatience in her voice, as I quiz her as to the way the clinic functions. I had gone to see the emergency food given to the hungry and as we talked, three old ladies approached us, holding their stomachs. They were hungry and had come for maize flour and beans. A carefully kept register listed their names in blue ink and confirmed that they had each come here for food four weeks ago. They would each be given enough for a few days.

“Could you use more flour and beans?”, I asked naively.

“The more we have, the more we would give. There is no limit. The need is here. Every day, it’s the same.”

Sunday Mass is usually an uplifting experience and this week we were graced with the dancing girls in papal gold and white, performing a graceful line dance on the altar steps and then shimmying the length of the church ahead of the offertory procession. Elf-like in size and stature, they provoked spontaneous ululations from around the congregation. And yet, perhaps the heat is getting to all of us. A whispered conversation behind Caroline, led to the cheery old man next to her, leaning forward and pointing out to the lady in front, that her bra strap was showing. As she tucked it away, she turned and thanked him demurely and then yanked the arm of the small boy to her side. After communion, a man in front of me, clearly tired as well as prayerful, knelt too long and the creaky old man with glasses many sizes too large, sitting in front of him remonstrated with him to move away. For a few moments we were offered relief from the tedium of the reading out of offertory collection figures, as the prayerful man insisted on kneeling and the wizened old grump waved him away in theatrical whispers.

In Maebras’ modest living room Philibert, Maebras, Doctor Mrope and I met to discuss community health insurance. At present, if you work for any arm of the state – teacher, doctor, nurse, policeman or soldier – a health insurance premium is deducted from your salary. Many complain of the inefficiency of the service and resent the charges, but for those in employment, it at least guarantees consultation and treatment. If you’re poor, work on the land or in your own business, you pay as you go and it can be expensive. If you’re poor and you get malaria, you to have to hope that a friend or a member of your family will lend you the money. So a community scheme, led by the local Council, offering insurance for a whole family for as little as TSH10,000 seemed too good to be true. It yet might prove to be so, and we are awaiting confirmation from a local dispensary before we agree to pay for the twenty poorest families in Kiangu B to join the scheme.

Today, after two weeks of disrupted lessons, while a lengthy sporting tournament ran its course, and just as we thought we could squeeze one week of undisrupted teaching in before lessons are suspended next week for terminal examinations, two hours were taken from us as representatives from the government health insurance scheme addressed all 700 students in a packed hall; so packed many of us found shade and rest under a nearby tree. They had details of a scheme costing TSH27,000 a year, a figure few here can afford.

“Why have they come?” asked Janet.

“To sell us insurance we can’t afford, ” said Vaileth.  There was a hubbub of disgruntlement near me. Students were cynical and suspicious, resentful of time taken from studies and annoyed at what they saw as well paid civil servants intruding. If Dr Mrope’s plans come to fruition, we will be able to offer students a plan, costing them little more than TSH2000 a year. I explained as much to Moshi who as Dean of Students will meet Mrope to discuss the scheme.

Moshi’s a fit man, proud of his physique and trains often to stay healthy. He was wearing a smart, beige shirt this afternoon, with a small yellow ‘M’ on the breast pocket.

“So you chose the shirt for the letter ‘M’, Moshi?” He didn’t.

“Have you ever been to a Macdonald’s?” He had never heard of them.

“They sell burgers and are perhaps the biggest burger chain in the world.”

His face, usually a permanent smile, fell almost imperceptibly.

“What’s a burger Adrian?”