Tuesday, December 11, 2012

2 Months in the Vil: Part II

     By the beginning of my second week in the village, I was starting to settle in and get a routine going. My closest Peace Corps neighbor, David, and his girlfriend Colleen who is posted on the other side of our district, came and sought out my hut. This was also the first day that it rained, so I really enjoyed seeing some American volunteers, and sitting with them in my hut watching the lightning and listening to the thunder and rain outside my door. Now, David and I hang out a few times a week, try to coordinate projects together (He is a AgroForestry/Land Conservation Volunteer), and visit each others villages to have meals together. Colleen is moving in with David, so they both come out to my village every Saturday and do tree nurseries while teaching my village, and we have dinner together.

     I began going on evening runs, always around 5 pm because dusk is the golden hour. It's not too hot, and I get to watch the sun begin to set as I'm running through gorgeous terrain. I run on bush paths, which are trails that connect different villages and a small dirt road. A lot of my trails are sand, sometimes the path goes down to a river and is flooded a bit. Sometimes I'm running through grass, sometimes corn, sometimes under a corridor of large trees. I run past massive gardens, rivers and ponds. Goats, pigs, chickens, cows, and children get in my ways. Everyone outside their huts waves and smiles at me and calls my name as I run by. "Yebo!" I reply, which means yes, okay, or fine, according to my language book, but here it is also used as a quick sort of "Hey!" instead of having to stop and shake hands with everyone. Some times the little old grandmas try jogging a few steps to give me a high five and laugh, so I'm often slowing down. As I run by people and they ask me what I'm doing (Zambians don't understand the idea of running for fun or exercise), I say "Chimbira ya ine! Run with me!" and motion them along. They think it's funny, and I enjoy it, especially when I have a tail of 50 children following me. That means I just got those 50 children to run 2 miles.

     On my 10th day in the village, Prince knocked on my door early in the morning. "Pack up all of your things, you have to move out," he said. Then, he ran off. I had just finished unpacking! I tried to find him to ask him to explain, when he popped up out of nowhere and started taking all my things out of my hut. Finally, he told me that people were coming to spray, and as I glanced around my village, I noticed everyone else had moved all of their things out, though their piles were a lot smaller than mine. Even though they saw me move in, I still felt guilty about how much I had. A canter truck pulled up and two men got out, wearing all white hazmat suits, with ghostbuster tanks on their backs. They were here to do IRS- Indoor Residual Spraying, a service that the government provides for free which sprays chemicals in peoples huts to kill mosquitos (and other bugs). They sprayed all of our walls and roofs, but we had to keep the doors closed and stay outside for over an hour before moving back in. I went and grabbed my nail polish, and started painting the babies fingers and toes, and had lunch (sima and potatoes) with the village women.
   
     I've started helping out at my clinic after I observed there a few times. I realize I haven't written much about my job, or what it really entails. The beauty of Peace Corps is that I'm my own boss. I'm the one that's out here, in my village all alone, seeing how the people are living, seeing what they really need. I'm supposed to be the link between the people of my catchment area and the Ministry of Health, which is a segment of the Zambian Government responsible for health. Since I go into the BOMA about once a week, I can relate issues from my clinic to the District Health Office there, or hitch into my provincial capital and meet with the Prov Health Office.
    There are 3-4 main topics that I work under as a PCV. HIV/AIDs Education and Prevention, Malaria Education and Prevention, and Neonatal, Maternal and Child Health. So far, the one I'm doing the most work with is the latter. Every Tuesday and Friday at my clinic are Ante-Natal days. On Tuesdays, we do bookings for new mothers. This means all these pregger women sit on our stoop and I call them into an office one at a time, and fill out their registration card. I butcher their names, village names, and husbands names when I try to write & spell whatever they tell me. Most of them have never been to school or dropped out at a young age (so they could get married and start having babies), so I have to speak to all of them in Tumbuka, and I don't understand half of what they say. When I ask them how to spell their names they look at me like I'm crazy, because there's no way they know how to spell their own name. I ask them when they last had their period, and for some reason, about 90% of them tell me August. So I add 9 months and 7 days to whatever date they give me, and write that as a tentative delivery date. I also have to ask them how many children they currently have, and what years they were born. The women never know the dates, they just tell me how old they think their child is and I subtract the years. It's always astonishing to me when women who are in their 40's are registering with me to have their 7th or 8th baby. No bueno. But it's even more astonishing when I have a 16 year old sitting in front of me telling me this is her 3rd child. Also no bueno. The next question, which is always a difficult one for me to ask because I don't know how to respond, is how many of their children are alive, and how many have died. From that, I have to find out if it was a still birth, or if the child died after being born, and what year that was. Always a tough one. Then I weigh them, hand them a mosquito net to sleep under (which they will probably never do) and send them back out to the porch to wait. Once I've booked all the new mothers, we call them in one-by-one again to do an HIV test, get iron supplements, tetanus shots, and malaria prophylaxis if they're in their 2nd trimester. The HIV test is a simple finger prick, drop of blood onto an RDT, and it gives results within 10 minutes. So far, of the 37 women and 3 men I've tested, no one has tested positive. After I call them in and watch their faces change from anxiety to happiness as I reveal their test results to them, we have them lay down on a bed for a pelvic exam. This is the part where I'm still observing with a midwife. I've been feeling the masses, using only hands and knowledge to determine how far along a woman is and in what position the baby is in. After that, we tell them when they should next come for a visit, and send them on their merry little ways.
    Once a month my clinic does Under 5's, which is a time for all the mothers to bring their children under 5 years old in to the clinic for weighing and tracking, as well as shots. We have a sling which is more or less attached to a hanging grocery veg/fruit scale, and we hang that from a strong branch under a large tree. One by one the babies are placed, screaming and crying, into the sling while I record the weight that I read. I record this on a card that every mother should have, that tracks the childs growth every month, and shows whether they are malnourished or not. The children that are underweight, severely, slightly, or on the decline, I refer their mothers to another clinic worker to learn about proper feeding and nutrition, which I will eventually be lecturing them on. Sometimes, the moms have lost their childs card, so they hand me an empty composition book, which I then have to fill out with the childs name and age. This is the tricky part. 1st off, again, mothers rarely know when their child was born. 2nd of all, they give their children weird ass names. I know a Bornface, Ason (a son...), Alone, Lasson (last one), and other funky things. There are kids named Memory, or Mountain, or Blessing, or even Obama or Barrack. And sometimes I ask a mother their baby's name and all I get is silence and a dumbfounded look. These are the times that, when they don't know their own childs name or I can't understand what the heck they are saying, I write "Emily" or something simple like that :) When I leave, there are going to be so many kids with easy American names.
     Somedays I go into the clinic and all thats going on is medication dispensing. As a PCV, I am not allowed to dispense medication, but I sit with my pharmacist, learn about the different drugs they have and uses, and do pill inventory for them. It seems like my clinics answer to mostly everything is Coartem, which is used to treat Malaria. I know malaria is a huge problem in my area, but there is not really any hard evidence of that. This is what it looks like when I go to my clinic: ~60 men, women, and children sitting on the cement benches right outside the clinic door. My coworker has collected all of their books, and is calling them in one at a time. She calls someone in, they sit in a chair next to their desk. "Suzga vici? What is the problem?" She asks. "Nalwala nthumbo, na mutu. I'm sick in the stomach and head." She writes out the prescription for malaria in their book, and hands them malaria medication. Almost every single person is the same deal. They get different dosages for different ages/weights, but there is never a malaria test done to see if thats what the person is actually suffering from. And they never see a doctor or are examined. They're in, and they're out, and everything is completely free for them. We keep a tally of how much and of what medication we dispence, and that's probably why our clinic reports such high malaria rates. Not only is this a problem because the Zambian government won't always be able to offer free health care if they run out of funding, but also because people aren't learning anything from this process, nor are they bettering their lives. If half of the people that are given mosquito nets actually use them to sleep under, or have their children sleep under them, we would see a huge decline in the incidence of malaria, of child mortality, and we would have more drugs to offer the people who really need them for real reasons. But... it's Zambia.
    So far, that's all that I really do with my clinic. I should be attending more meetings, but I'm either gone or not informed of when they are happening, and in the beginning there's not much I can teach about because I'm still getting the feel of how they do things. This is where I feel like I'm not doing a lot. And to be honest, a lot of the time I really feel like I have nothing to offer them. They are set in their ways, they've got a working routine, and I've never experienced hospitals in a 3rd world country so I don't feel like it's my job to come in and change everything. But it sort of is my job. Either way, I love the people that work at my clinic, and enjoy just going in and sitting with them and watching them work.
     One day I was doing Ante-Natals, and when I finished the booking of new mothers, someone went to cook food. They always provide lunch for us when we're working there the entire day, usually just some sima and a relish such as rape, cabbage, or kapenta. When I had arrived at the clinic that morning to do Ante-Natals, I noticed that there was a government cruiser out front and some people sitting under the tree where we usually hold community meetings. I went and introduced myself to the team that was there from Chipata, they were with the Zambia National Blood Transfusion Service, and said that they were there collecting blood donations. I talked with them for a while (it's always nice when people speak English, plus I'm trying to network with as many people and health organizations here as possible), exchanged numbers, then told them I would find them later as my pregger women were waiting for me. After the booking was finished and I was waiting for lunch, the ZNBTS came and got me to say they were taking off to other villages. They were traveling around to villages in my catchment area, villages that I had not yet visited, so I hopped in the cruiser along with them to go out and meet and greet. In the first village we got to, Samuelli, kids started running after the cruiser once they saw a muzungu in the back seat. We were swarmed with people immediately, a much larger turnout than they probably would have had if I wasn't there with them. Everyone wants to see the white person. There was a woman who wanted me to see her house, so I went off walking with her further into the village, to sit on a couch in her living room for a few minutes with her. Zambians love to have you see the inside of their huts if they have the littlest amount of money to decorate with. I sat there and she brought out a big bowl of groundnuts (peanuts) and handed them to me, then said she wanted me to meet her friend. We ventured further into the village, until I heard loud music coming from some speakers inside a hut at the end of a trail. As I stepped inside, the entire place was filled with women and children dancing, and there was barely any room to maneuver, but they fit me inside. Women fold and tie their chitenges up a certain way around their waist so that when they dance with their hips, it's exaggerated with the extra padding there. They tied one around my waist, and everyone gathered around to watch and laugh at me dancing. I always say "Nili bvina yaya, ndine tuba ya ndine soni! I cannot dance, I am white, and I am shy!" to which they tell me not to be shy. Zambians don't judge you at all, they just think it's great that a white woman is in their house, dancing (or trying to, at least) how they dance. After getting nice and sweaty, I sat on the couch and they served me some munkoyo, which is a village drink that they make out of maize, bark, water, and sugar, that they sometimes let ferment for a few days. I chugged mine down, as it's an acquired taste and I'm now getting used to drinking it (the first time I had it when I had just arrived in Zambia, it tasted like licking a cigarette ash tray). After that, I went back to the tree where we had set up the blood drive, but not without first stopping back at the first womans hut and stuffing all the peanuts from the bowl into my sweat pants pockets. She really wanted me to have them. As I returned, the ZNBTS staff informed me that no one was offering to give blood, and asked if I would as an example. Of course I said sure. Blood is blood and people need it everywhere in the world. If America never takes my blood again because I've served in Africa, then so be it, but it's not going to stop me from helping people where and when I can.
    I sat there on a reed mat under the tree in the dirt, they swabbed off my forearm with alcohol, then slid the needle into my vein. A little of my blood squirted out, which made the Zambians wince. They were also surprised to see how green and visible my veins were through my white skin. As the bag was filling with blood, I thought back to the lunch that I was about to sit down and eat before I jumped in their cruiser, and realized I hadn't eaten anything yet that day. It was 3pm. It took less than 3 minutes to fill up the bag, but as she started sliding the needle out of my arm and giving me cotton to clot the blood, I started feeling light headed. Then my hearing started to get fuzzy, as did my vision, and I told the nurse I needed to lie down for a second. Regardless of my not having eaten, this is a normal reaction anyways. And this isn't the Red Cross, there aren't fancy beds with blankets to lay back in while your blood is being taken, there are no cute little snack areas to hang out in until you're better. I laid back while they got me a softie, and from just laying flat for a few seconds and taking a sip of Fanta, I felt instantly better. However, the Zambians having seen this did not feel better about giving blood. I was supposed to inspire them, and instead I think I hindered it. I sat around making faces with all the children for a good 30 minutes, then people started to finally brave up and donate. We collected about 30 bags of blood between 2 different villages. But that's my experience with giving blood here. No squeeze balls, no gloves, no interviews prior or discrimination or waivers.
Zambia National Blood Transfusion Service

Blood Donations

Making faces at kids making faces at me.

     Other things that have occurred over the last two months are, but are not limited to: teaching sign language to my village kids, learning to cook traditional Zambian food with my village women, playing soccer every day with someone, personally giving shots to my kitten to treat him for worms (the vet in town just gives me the shot and the bottle of medicine to take back to my hut and measure out and administer myself!), visiting the basic school and the community schools around me to observe and teach, getting a new roof for my hut... 3 times, planting a ton of trees all around my hut, growing and then killing herbs because I'm a horrible gardener, attending funerals in many different villages, painting my hut and the kids hands, doing a radio show, staking fish ponds, teaching about hygiene, making mango jam and mango wine, doing fertility dances with women, hitch hiking or biking everywhere, talking about health to anyone who will listen, discovering all the cool things I can cook over a brazier, and reading a crap ton of books. And by crap ton, I mean I've read 14 books in the last 2 months.

(L-R) Jonesi (host brother), Moniqua, Daphu, Alfredi (host brother)
Jones is always in my hut, I dress him in all my clothes and accessories- he's sporting my head lamp in this picture- and him and Moniqua are my little 3 y/o buddies. Moniqua is sick, so she always comes and eats with me, and I make sure she gets enough protein. Once or twice a week I make something for  all my village kids, usually it's popcorn. This was popcorn breakfast day. 

So one day, I took my soccer ball to a village next to mine that has a soccer field. My village kids and I usually play just outside my hut, and use bricks as small goal posts, so I thought it would be cool to go play on a huge field at the school, and that there also might be a few kids there so we could get a good sized game there. I underestimated the "few" kids that we'd find. Before I even got to the field, I had a tail of kids behind me. Then kids started popping up out of everywhere! The village grapevine travels at the speed of light, apparently, and kids were dropping out of trees, coming up out of bushes, and pouring out of little mud buildings running towards me. I quickly had upwards of 100 kids, and only 1 soccer ball. AND I had promised a group of girls we'd be playing soccer, but there were too many boys around to exclude them. I had no idea what to do, and my Tumbuka is definitely not developed enough for this situation, so I let the older kids take the ball to the other end of the field and I stood there surrounded, just staring all of them. A few of them had Zammade soccer balls- sand wrapped in plastic bags tied with bark from a tree, so I started kicking those around and running all over the fields with the kids. Then I tried explaining how to play tag to them, but they just thought I was telling them to run. So they all took off and ran a lap around the track, then back to me. I remembered that Zamkids copy everything I do, so I was like "Okay, perfect time to do some soccer training through running endurance." The kids that had returned from the initial lap stood there panting and coughing up their lungs, which really bothered me. There is no reason for children this young to be that tired from one small lap, which is a result of no physical activity in the schools, and poor lungs from all of the field burning, indoor fires, and inhaling of dust that Zambians do. I'll bet if they were to do a bunch of lung exams in the villages here, they'd find a lot of lung cancer. SO, I started running around the track and sure enough, all of the kids followed behind me. I did side step, karaoke, lunges, jumping jacks, jumping while running, running and touching the ground every few steps, high knees, butt kicks, and backwards running.. and the kids copied everything. They had such a blast doing it, as did I, because I was getting a nice work out and laughing the entire time. 


Oh yea, and this happened.


1 comment:

  1. You are amazing! I love reading about what you're up to. I need to set myself a reminder to read regularly. I hope you had an awesome holiday! Merry Christmas, Happy New Year! And can I write you a letter? Is that a thing? And did you save any of your dreads? If you did you should send me one or two and I will weave them into mine :D Love you! Btw, if you do have an address you can send me it at thirdeyeactivist@gmail.com (I don't have a FB anymore). And my address is 3344 SE 8th Ave Portland OR 97202... If you want to send me a dread or two :D :D :D haha

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