Thursday, November 28, 2013

Q&A Session

So my friend Eilene (bff4life! since the third grade when I wrote on an assignment that she was my favorite new kid. We have spent many summers at camp sleeping in the same twin bed, every weekend at each other’s houses in grade school, and have managed to stay in touch in our adult life. I am so happy to call her my friend.) has asked me about one million questions about my life now. She may be actually interested or she may not know what to say to her freak friend living in a village in Africa. Either way I have convinced myself that maybe other people actually want to know how I am living now. Since she has covered about everything I thought I would do a Q&A blog with just her questions. Be prepared there are a lot!
Here we are at one of the many times at camp.

What is your house like?
My house is two rooms, one room that is supposed to be a living room and then a bedroom behind it. It has concrete floors, and glass windows. Very basic but works. I also have a yard with my “kitchen” and “bathroom”.

What is your toilet like?
My toilet is a drop hole. It is a pit that has been dug and a building has been constructed over it. In that building is a hole about the size and shape of a brick, that is my toilet.
Do you have electricity or plumbing?
No. I have had a solar panel installed and it allows me to charge my phone, laptop, and camera battery. I am supposed to have lights, but the battery to the solar panel is so bad that they do not work. My battery also makes this terrible noise the whole time it is on so I have to cover it with a blanket. But I am happy being able to charge my stuff. Also when I did have lights for one night it attracted so many bugs. Using a head torch works just fine. There is no plumbing. I have a woman bring me water in buckets every day. I treat one bucket with a lid and a spout for drinking. I use the rest for cooking and cleaning.
Where do you get your food?
Most of my food I can get in town. There are two close by; Balaka and Ntechu. Both have some grocery stores and markets for vegetables. I can also get some small items at little stands in the village or just from people willing to sell from their gardens. When I get more settled I am going to attempt to have my own little garden and some chickens for the eggs.
Do you always boil your water before using it?
Boiling is a lot of work plus takes a lot of wood. So I am using a solution called water guard. When I followed the directions on the package my water tasted like a swimming pool. It made me very grumpy and I barely drank any water. Mary told me to use about half the amount and it would be better. I have done that and it is at least drinkable. I would prefer a filter though, I do not feel like chlorine is really appropriate for drinking.
Where will you get furniture and what will you get?
I have ordered furniture from a local carpenter. I am getting a dresser, cabinet type thing for kitchen things, and a book shelf. I think eventually I will also get a small table, chairs, and a toy box made for the kids.
Where do you sleep?
I have a twin bed and a mattress that was provided for me
How do you use that toilet?
Squatting. I am working on my aim, it is not easy to pee into such a small hole while squatting.
How are you supposed to use it when you are drunk?
I will probably not be drunk here, drinking warm drinks alone does not sound fun. Plus I do not have time with all of the things I need to do, and having a bedtime of about nine. But I am sure it would not be much different, I would still pee all over the damn thing as usual. I think the risk of slipping in it would increase drastically.
How do you keep from tripping and breaking your ankle in it?
That is the only reason it is a good thing the hole is so small. I think it would be very hard to fit my foot in it.
How does a shower room work?
It is just a building with a drain (hopefully) where I am able to take a bucket shower. This way I will not have to stand naked in my yard while a crowd gathers.
What have you learned about the clinic?
I have learned that it is barely running and needs to. The building has been there for ten years and nothing has been done by the government to make it a functioning clinic. This needs to change.
Does it have established staff and equipment?
No and no. There are two non-medically trained volunteers. The main staff member was a traditional birth attendant years ago. The only thing the clinic has is aspirin and Tylenol.
How often is it utilized now?
It is used daily by many people. Due to lack of supplies it seems (from my one hour observation) that it is much like a school nurse office. Everyone comes in with a headache and stomach ache. One man said sometimes his stomach makes funny noises and he has loose stools, after further questioning he revealed this happens after drinking lots of beer. I said, “Well duh, we call it the beer shits. My professional nursing opinion is less beer more water.” Same problems as being the school nurse (just kidding, they would never tell me they drank).
How do the people in the village feel about you?
They seem very excited. It is nice being the only volunteer in a wide radius. They have had previous volunteers in the community but never a medical person. They are very excited about all of the work I want to do. And they are also eager to learn. They are also just fascinated, I am often asked questions about life in America.
Do you know everyone around you?
I am beginning to know quite a few people. Paul is my next door neighbor, he is a teacher at the primary school. Mary’s mother, not sure her name, I call her Agogo (means grandmother in Chichwea) and her brother Davey live close as well. Davey speaks English well and he was the one that invited me to play soccer with them. Mary and her daughters; Linda (9) and Clara (7) also live close. Nobody else speaks English that live close, but I am starting to learn where people live and their names.
What are they like?
Mary is great, she is friendly and I am pretty sure knows every person everywhere we go. She is kind and helpful, and a great mother. Her husband is working in South Africa so she is raising the girls, along with one of her sister’s children alone. Linda is a sweet and smart girl, she is always helpful and understands quite a bit of English, she is always a joy to be around. Clara is a pistol, she is loud, bossy, so loving, and a bit crazy. I learned tonight that she gets in trouble in school and then she will not listen to any punishments. I asked Mary if she ever spanked her, apparently Clara sings and dances to taunt her mother when she tries to spank her. As we were discussing this Clara came running across to my house and threw her arms around Mary and then me. It is hard to stay mad at her. Mary thought her issues were because she had meningitis a few years ago, I laughed and said no, you just have one strong willed kid. Agogo is the sweetest and happiest woman ever. From the first day I have arrived she has come to my door and speaks Chichwea to me, I do not understand a word she says, but it is cute and friendly anyway. Davey seems like a great guy, he is always friendly and helpful. He is also the best soccer player on the team. Paul is very friendly, every time I am outside and see him I know that I will be spending an hour talking with him. He has let me know a lot about the culture and the problems in the school as far as health. Both Paul and Davey are potential running partners as well. Everyone else is extremely friendly. Malawians are just welcoming and happy people. While sitting outside and cooking I hear groups of people walking by always laughing loudly. They are also extremely kind and generous. I never do anything alone here, my bags are carried, my floors swept without me asking for it, and I am offered food every single day.
Do you have a plan for after Africa?
That is a hard one. Until this point I have seen myself returning back to work at Children’s Mercy. Already being in the village I have a hard time thinking I will be leaving a job that involves global health care. I am not sure I could live here forever. But I also know that Africa is now a part of me, and I have a feeling I will pursue a career that allows that to be part of my life. But we will see what opportunities come up.
What type of produce can you get?
Tomatoes, onions, potatoes, carrots, eggplant, zucchini, garlic, green pepper, and green beans.
Does it have to be fairly local stuff?
Yes, I do not believe anything is imported. Everything is grown in gardens here.
What about fruits, meats, bread, milk, and cheese?
I do not like much fruit, but I can get apples when I want them. There are pineapples, bananas, watermelon, strawberries (sometimes) and a few others. Meat, it can be bought in town and I am sure from people in the village, but I do not have a refrigerator, so the easiest thing to do is not eat it. I do eat meat when I go into towns or to lodges for the weekend. I ate meat at every meal at home, I really do not miss it anymore here, I never thought I would say that I could be vegetarian. Bread can be bought in town, I am sure people in the village make it too. I may ask somebody to make me a loaf every week. Milk is pretty much non-existent. There is instant milk powder that I use for cooking. But I have not had a glass of milk in six months. Cheese is only available in large cities. So I also only eat it over the weekends when I am not at home. I was told about an amazing pizza place in Balaka, it was finally a decent pizza. So I think when I need to go into town I will be choosing Balaka over Ntcheu, yes cheese has that much a deciding factor here, they also had mushrooms!!
Do you have a lot of books?
Yeah I brought about 7 with me. I also read some from the library at RIPPLE.
Do you read much there?
I have read 7 books since being here, so more than home but still not a ton. Having my laptop and internet on my phone still gets in the way of reading. Long bus journeys increase the number of books I read though. I once read an entire book in a day, because of a bus journey.
Is there a library?
Yes, it is mainly for kids though. There are a lot of books donated by unicef to help with beginner readers.
What are literacy levels like?
This is hard to tell, I would guess very low. There is not much to read here and I would bet that a lot of people never went to school. Also many may be able to read in Chichwea but there is a lack of material available. Most of the material is available in English.
Do people care about art and pop culture?
There are a lot of talented artists in Malawi, but I think they mainly use their talents to sell things to tourists. I am not sure they really appreciate the art, I could be wrong though. They love music. There is a lot of American music here; 50 cent, Enrique, Rhianna, and many more. They are very quick to know the artist and words to every song. I think if they had access to more pop culture they would be all over it.
Is the toilet in one of your rooms? How do you keep it from smelling?
The toilet is in the back of my yard. It does not smell. I think because only I am using it, the waste is able to decompose rather quickly and it has not been a problem. Unless I just don’t think my shit stinks. Either way it works.
THERE ARE BATS IN IT???
Yes, I looked down one night and a bat was flying below me as I was peeing. A bat also almost hit me in the face while trying to fly at my light.
Can you easily get a rabies shot if a bat bites you in the ass?
I think so. I have been told yes and seen something given at a hospital before. I am not sure it is the best stuff though. I really do not know a lot about rabies. I have done some research, and bats rarely carry rabies, they also have only bitten people usually because they are down from being ill and people think they look harmless and handle them. They are great at flying without hitting things, and I do not think they have it out for me. I am allowing them to live in my house, so they should be grateful and eat all of the mosquitos for me.
Do people stand naked in their yards to bathe?
No. They have grass structures or something built for privacy. Cute babies do sit in their basins naked though.  When I lived on the lake people would be naked bathing, well women would be topless but always have some sort of bottoms on. Boobs are not a big deal here, women constantly have a boob flopped out most of the time there is a kid attached. But their thighs and butts are very risque. Here in the village I have to wear a chintenge (thin colorful cloth) wrapped around my waist over my dresses and skirts.
Does Mary have running water?
No, nobody in probably a 3 mile or more radius has running water. It is more likely that there is electricity, which here there is also not. The clinic that is about 3 miles away does have running water, hopefully ours will too!
What about real medical emergencies?
Well people probably just die. There is no way they can get to the hospital in time, and even if they did, the lack of supplies and technology in this country are insane. Even when the clinic opens this will still be the case. That is why prevention and early intervention are so important. Hopefully with a clinic available and good health education people will become proactive in their well-being.
Is it a small enough place that people know why you are there?
Yes, I am convinced all of Malawi is. People do not have much form of entertainment in the village, therefor anything that changes is exciting. I am confident that most people know my name, profession, where I come from, and where I live. I am sure that by the time I leave I will also be gossiping about my neighbors and be asking tons of questions if any new person comes. And if they are a white person I may just lose my shit!
Are people’s accents hard to understand?
Sometimes, I think they have a hard time understanding me more than I do them. I have been told to speak more slowly. But I have also noticed that here they love to mumble and shorten everything. So when I am greeted in Chichwea I often have to ask them to repeat it so I am sure I give the correct response.
Are you lonely ever?
No, currently I feel very far from lonely. I am always busy and never alone. I was so worried about feeling isolated here, at RIPPLE I was surrounded by other volunteers all the time. As much as I love all of them, I think that was harder for me. I am used to living alone and spending a lot of time alone, although I do not get much of that here. It was also very stupid of me to think that just because I am with people different from me does not mean I cannot develop relationships with the people here. I feel I am doing that. Also working and trying to figure out how to cook and clean without power are busy! I am also lucky to have facebook, imessaging, skype, email, and what’s app on my phone. I feel very connected to everyone. And I am enjoying any alone time I can get.
What are people’s day to day lives like?
For men it depends on if they are working or not. If they do not work they typically do not do much. The women however are busy every single day. They carry water, firewood, cook nsimia (this is a lot of work!), garden, care for animals and children. Running a household here is a lot of work. I am learning it is a bit difficult to manage with work.
What do people do about fires and house fires?
Despite the fact that they build fires everyday they never get out of control. The lack of grass keeps fires from ever traveling into the house.

      Ok, this wraps up the one million questions. If you have any other questions (not sure what else there is to ask) feel free to send them to me. I am more than happy to answer. Also if you made it through all of that, I am impressed, if you got bored feel free to lie to me and say how interesting my life is. I am exhausted and should go to bed. Tomorrow is Thanksgiving! I am going to pass out supplies to HIV positive children’s guardians and then head to the capitol to meet some friends from RIPPLE. Hopefully we can find somewhere serving a Thanksgiving meal. I plan on returning home on Saturday. I am going to spend this weekend hopefully painting my house. I have already decided I will need about a million paint brushes for all of my helpers and some paint thinner for all of the pain they are going to spill on my floors.
                Have a great Thanksgiving! Remember to be thankful for things like indoor plumbing, ice cubes, and most importantly health and access to healthcare.



I'm back!

               I’m back! Sorry for the long hiatus, there have been a lot of changes happening here. I have moved to a new charity and a new part of the country. After several months at RIPPLE I realized it was not the experience I had wanted. It was however an amazing 5 months, I had a great introduction to Malawi and met some people I know will be life-long friends. I am now volunteering under an organization called Consol Homes, it focuses on the care of orphans and vulnerable children. I am living in a remote village on my own, and I am loving it! Some things are not easy, but I am learning to cope.
                I have now been in the village for almost two weeks. It has been quite a crazy two weeks. I arrived to the village on a Friday, while having my solar panels installed I played with the kids all day. I learned where the boreholes were, and attempted to carry my own bucket of water on my head. Yeah let’s just say it was the last time I have done that. I was not about to give up in front of all of the women and children who carry much larger buckets every single day, but I did not hesitate when a woman insisted I give her the bucket. I have now hired a woman (Ester) to bring me buckets of water every day. I am happy I can give her a small income every month and even happier I do not have to do that shit again, it hurts! Saturday was spent moving things into my home, then Sunday I became sick. It first starting with vomiting, since I have a small hole for a toilet I was throwing up in my yard and then kicking dirt over it. I was laughing at how ridiculous it was, after the 5th time it was not funny anymore. I also felt so hot and weak, I kept trying to cool down by putting my hands and feet into my bucket; it was not working. Then the diarrhea started (sorry for all of the details, I just want you to know how sick I was!). I was losing fluids so fast. I have never felt so sick in my life. Every time I would take a sip of water I would immediately throw up. I no longer had the strength to squat over my toilet or stand to vomit. I just lied on my porch or sat on the ground while vomiting. I had went to get Mary (founder’s sister in law, basically helps me with everything in life) at her home when I started to feel very ill, of course she was not home. While sitting on my porch a group of kids were just starting at me. I asked them to get my neighbor (by asking I mean I pointed to his house and said, “English?” They responded, “yes” so I made a knocking gesture). Paul came out and asked what was wrong, I told him and that I needed help. They went to go find Mary. I lied on my porch and all of my neighbors (none of which speak English) came to help. Mary finally came, I told her that I have never felt so sick and I was afraid I was becoming dehydrated so quickly, being about 15 miles from a hospital and having no transportation I was worried. I asked her if I could go to the hospital. They knew of somebody driving through the village and called him to come pick me up. While lying on the porch waiting, Mary’s mother put blankets down for me, her daughters arranged my things trying to make me feel comfortable, and they were cleaning my house. The truck came very quickly and we were on our way to the hospital. Mary went with me. We got to the hospital the driver would not let me pay him anything, which was so kind, being from one of the poorest countries in the world and knowing I was desperate he could have said any number. I quickly saw a clinical officer, he agreed that I should be tested for malaria (I think he would have agreed with anything I said). Because I am on anti-malarials I have to be tested with a microscope, I cannot use the rapid test. They called the lab technician at home, and said he would come in. Mary went to get me a cold drink, it was all I had wanted, popsicles or ice chips would have brought me to tears I think. The lab technician came and he said, who ordered this? I told him, he said, “I am not testing this, we only do that during business hours.” I said, “Is that not something you could have said over the phone instead of coming in?” I was a bit angry. So we went back to the clinical officer, I said he refused to test me and I will have to wait until tomorrow. I told them I have no way to get home for the night and cannot come back in the morning for testing unless I stay the night. They agreed to admit me and put me on IV fluids per my request.
 I used to say I would rather die than be in a public hospital here in Malawi. This illness gave me a reality check. Not only when you are sick do you want any medical attention, but also what makes me better than anyone else here? These people have welcomed me into their village and everyday lives so openly. They love me and take care of me on a daily basis. This is where any person in my village would have to seek medical care, so why shouldn't I do the same? I felt ashamed for my previous attitude about the situation, so I climbed into my bed next to the other 30 something women in the ward and felt beyond grateful for the caring community I now belong to.
Well the result was not malaria, which I was hoping it was, that way I would have a definitive answer and not have to worry about things like water and food. I am assuming it was contaminated water. I have not treated my water anywhere in Africa so I am not convinced it was the water itself, it may have been a contaminated bottle or bucket. But since I do not want to feel like I am dying again I am sticking with my water guard and have informed my family that a filter water bottle is at the top of my Christmas wish list.
So other than being sick the last couple of weeks have been full of learning my new role and figuring out what work can be done. The main project I have is to get the clinic going. A building was constructed 10 years ago, that is about the extent of what has been done. There are two medical volunteers, they have no official training, and they give out Tylenol. Other than sick people having to walk a long way to get to a clinic, for some up to 6 miles, women also have to walk this far to give birth. In Malawi one in 36 women dies during childbirth or pregnancy, this number can be drastically decreased by a midwife or medically trained professional is present during the birth. So the clinic needs to open and start running! Today I have met with some people about how to make this happen. They were both surprised this clinic existed and is not running. I have been told to write a letter of why it is needed and what I think is important in the clinic (ummm everything! I will have to be realistic though). I have a meeting again on Tuesday to see what can be done. It feels good to at least have somebody give me a job to help get things going. The goal is in 2014 we will have a running clinic and our first baby will be born safely there!
I have also had a meeting with community volunteers. There are three sections of volunteers; early childhood development (they work with preschools), orphans and vulnerable children (not exactly sure what they do), and home based care (visit sick people and children with chronic illness in their home). At this meeting I felt like some great leader giving a speech, every time what I said was translated the room erupted with applause. Then after I was done speaking there was singing and dancing. It was so touching! Then I thought, I guess I better get my ass in gear and get some work done. One thing the volunteers have requested is training sessions. The home based care volunteers have no medical training or background, they seem so open and eager to learn. I asked what topics they would want to cover, they have given me a very long list. On Monday I am doing a training session on malaria. I have invited anyone and everyone to come. I have been told they are going to bring even the chiefs of the villages, they are all so eager to learn. I am excited to see how many people turn up, and turn up on time. I have said I do not wait for people and if you come to a meeting with me it will start on time! This is a very different culture from theirs.
I have also learned many things about the community and the culture within it. They say they have a culture of eating meat, drinking, and having sex. There are many alcoholics in the community and apparently they do not believe HIV/AIDS exists in this community. This suggests the number of people that have been tested is extremely low. I have learned quite a bit about HIV over these past few months. If a person is on ARVs and their viral load is low, it is 92% less likely they will pass the virus onto their partner, this number even suggests so during unprotected sex. So having the virus is really not a dangerous or even that bad of a thing, we have great drugs now! But the idea that it is a fatal disease and passed onto everyone so easily is what makes it so taboo. One of my goals is going to be to talk a lot about this, make it more open and discussed, encourage people to get tested, know their status, and take their ARVs. This will be quite a difficult attitude to change, but I think the more knowledge and facts people have the better!

I am so excited about all of the possibilities in this community. It is nice to be in a place where I feel so needed every day. I also love living right in the community. My house always has people especially kids around, when I pull out my laptop or camera they come in swarms. I attended soccer practice last week; many people came to watch the white girl play with the boys. They loved when I got aggressive. I am excited for all of the new ways I can begin to fit in with my new community. It is already feeling like home.