Friday, January 23, 2009

My First Experience with Homebased Care Visits (1/23)

Yesterday I accompanied my colleague Especiosa on my first round of home-based care visits. From what I gather, home-based care visits are one of the principal ways that local communities are dealing with the HIV and AIDs crisis. It goes something like this: either a health worker, AIDs activist, or community member regularly makes house calls to the sick to see how they are doing. They sometimes prescribe medications and bring food, and always check that the caretaker is meeting the special needs of the patient. Prayers and singing are often an integral part of the visit. I think this is a personal way to provide support and help to the afflicted and a welcome contrast to how institutionalized health care has become in the States (not denying how lucky we have it with access to health services).

My first home visit was particularly sad, an experience I'll never forget. Especiosa told me before we entered that there were multiple family members living with HIV, but no other details. Upon our arrival a straw mat was laid out for us to sit on so we could visit with the family outside. As we were settling on the mat, eight children ran past laughing and squealing except one little boy who was devoid of energy and sullen. I assumed by his size that he was 6 or 7 at first glance, but my eyes rested on the size of the skull. His skull was much larger and more developed than that of a small child. Especiosa informed me he was 13. I was in disbelief. This boy and two other adult family members (his grandmother and father) were HIV+ on ARV treatment, but he seemed in the worst condition of the three. They contracted HIV through blood transfusions at the hospital. Long before this boy had become HIV+, life had been hard on him. His mother abandoned him when he was only months old to marry another man in a different village, so he had been malnourished since infancy.

From different sides of the world, I from the first world and he from the third, life brought us together briefly yesterday. There I sat, the picture of health. A product of being well-nourished, well-educated, with loving parents who continue to support me 110%. I consider myself fairly petite, but next to him I looked like a giant. We sat side by side with our legs extended in front of us, his entire leg measuring only the distance from my knee to foot. (Think about the average size of a 13-year-old in the States. I pictured Molly who has bigger feet than I do at age 13. This boy had the feet of a 6-year-old.) There he sat, bare bones and pinched skin. A living skeleton. It was eerie how much his skull protruded from beneath his skin. As a pair, we made a stark contrast. The inequalities of this world bluntly placed before my eyes in physical form. I was born into a privileged life. I am healthy and happy. All he has ever known is sickness and hunger. Seems pretty unfair, doesn't it? I have resolved that trying to answer why is futile, so I'm trying to ask myself instead, "What can I do about it? How can I help?" Often I feel helpless, but at least presence is something. Before leaving we gave him money to buy cookies and I squeezed his hand. He smiled for the first time since we'd been there. I smiled back, linked simultaneously by this simple universal gesture and our humanity.

Monday, January 19, 2009

Some things that made me smile, laugh, want to cry, and think hard last week (1/19)

Smile

On Sunday afternoon I was playing guitar on the front porch, just relaxing and catching a breeze. I had out my classical guitar books just playing random pieces when kids started peering through the fence. I ignored them and continued playing until a few asked to enter. I decided "why not?" because I love kids, so I let in three. Little did I know, 20 more came out of the woodwork, and so I performed my first solo classical guitar recital in front of African kids all under age 10. Spontaneously. The children made a good audience. The kicker is when I started strumming the worship song Sanctuary at the end they all stood up cheering loudly and began booty dancing. It was wild. Really wish I had it on camera, but I can guarantee it put a smile on my face.

Laugh

I took a 1.5-hour-long bus ride only 7 km into the African bush. On the slow-going way, first I spotted a cement house with the rapper Eminem's name spray-painted all over it. This prompted a small internal laugh. Continuing on, we passed a bamboo hut with the rapper 50 Cent's name spray-painted on multiple times. A trend. This prompted a laugh out loud. It also generated disbelief because although the houses had no electricity they were using solar panels and generating enough power to blare stereo systems with American rap music. Smile

Upon arrival, I met 15 ladies who I will be working with to build a community center. One woman was modeling her patterned lenco (headscarf) and capulana with faux-pearls. Remembering my love for the south and pearls, I smiled.

Laugh

My dad asked if it was roosters he heard crowing in the background when we were on the phone. I laughed because it did not even register that in my other life that's out of the ordinary.

Cry

Abby is doing home-care visits, which means making house calls to HIV+ people to help care for them when thy are sick and bring them to the hospital for treatment. On her first day she came home and cried because on one of her visits, both the mom and her young baby were HIV+. Abby described how the baby could not be more than 6-months-old but how it's skin looked like that of an 80-year-old woman. Moreover, it was all skin and bones. The baby was covered in scabs, too sick to even cry or move, and rapidly losing still more weight. The mom had transmitted HIV to the baby during pregnancy. (97% of HIV transmission occurs from sexual intercourse in Southern Africa so under 3% is due to vertical transmission from mother to child. Nevertheless, it is tragic, especially since steps can be taken that nearly eliminate it.)


When Abby returned the following week to check on the baby, the baby had died. I wanted to cry for the child's life – for the pain and the suffering.


Reflect

I'm not really fond of the words religious and evangelical because they are too often tied with close-minded and forceful behaviors. Morevoer, it seems to me that historically the "religious" and evangelicals have regularly perverted Christianity so far from what it truly is meant to be. Yet my Christian faith has played an important part in shaping my life and by default I guess that classifies me as religious.


On Saturday I was meeting with all the leaders and activists to discuss the community center project. As usual, the setting was under the tree and took place in the local dialect. After the opening prayer and song, my mind wandered because I could not understand the words. I look around at the nature – I saw luscious, green trees, butterflies flitting everywhere, and colorful wildflowers peeking out amongst weeds. I felt thankful because it's been so long since I've actually sat and been amazed by the quiet beauty nature offers. By this time I was in full contemplative mood. My eyes fell on a young woman seated below me with her legs extended forward. A small sleeping baby rested on her legs, positioned with its arms extended. For some reason, it reminded me of Jesus on the cross. I suppose because it was positioned similarity and because of its vulnerability. I recalled a challenge a speaker posed at a youth conference long ago that has stuck with me, "What if we saw everybody through Jesus' eyes?"


I have to remind myself to try to do this multiple times daily, and even then I often forget. I was thinking how the world would be more full of faith, hope, and love—some good things he gave us—if we could see each person we encounter through Jesus' eyes. The world could certainly use more grace and people trying to model the virtues of the fruits of the spirit. This doesn't mean giving up fun and being super rigid about it, just an effort in that direction. As I stared at the sleeping baby, I also remember Jesus' words, "Let the little children come to me." For me, all these teachings hold wisdom and a way of living that makes me feel very alive and that life is worth living in spite of all the heartache and suffering that exists. It leaves the promise of something good, and gives me the freedom to really laugh, smile, cry, and love…

Thursday, January 15, 2009

Life Stories 1/15

Everyone's got a story to tell, and if you take the time to listen I often find that the ordinary people I'm surrounded by each day have stories that are far more interesting than I would have imagined. I can't believe some of the tough times they've been through, how heavily some seemingly inconsequential event from their past impacted their lives in a profound way, or how much more they're capable of than it first appeared to me. We humans are indeed complex creatures.

My own life story is filled with awesome role models who helped guide me through the challenges of growing up and led me down a clear pathway to give me the brightest options for my future. I had it easy compared to most – my parents, coaches, extended family members, and youth advisors all played active, visible roles in my life so I could easily imitate their successes and learn from their mistakes.

All the extended "breaks" in my work have provided an excellent opportunity to listen to my colleagues' life stories. Isabel, the lady responsible for cooking and cleaning at my organization told me the story of how she ended up where she is today. It's telling of many young girls in Mozambique. Isabel bore her first child at age 14 and for the first four months of pregnancy had no idea about her state. She recounted how she felt; she was getting fat but did not know why. Then she got sick and lost weight, but her stomach continued to stick out. Her professor began continually reprimanding her for getting bigger. At this point, she interjected that she was still just a kid and did not know any better. She also added that her professor really liked the girl students, but began telling her that her clothes were becoming too tight and short. (My eyebrows raised because a pressing problem in Moz is that the teachers commonly sleep with their students.) When Isabel was really sick one day, she finally went to the hospital and found out she was pregnant. Isabel was so embarrassed she did not like leaving the house. It was then she stopped her studies, she continued, her voice filled with regret. I reminded her she received the blessing of her son. From what I gather, the father of her son was not very involved and moved to South Africa. He sadly passed away a few years later. Isabel also has a young daughter with a different man who has not played an active role either. The lack of a father figure in many families is another common reality in Moz. This petite, "Kristi-sized" woman (that's for you, Cameron!) bravely shared this story with me and then broached the subject of wanting to go back to school. The next day, true to her word, she marched to the school to enroll in night classes. I have great admiration for her resiliency and will to persevere even though she's been dealt a tough hand.

The stories continued. Over lunch with my co-worker yesterday, I learned Sandra's story. The cuisine was a fish head over rice; she asked me why I didn't eat the skin/scales. (You gotta be kidding me, right?) The conversation turned to boys. Typical. We compared the average age girls usually have their first boyfriends and settle on anywhere from 12 to 18. The age range was the same, but the level of sex education is different. It is practically non-existent here (efforts are being made to change this). In the US, we at least all get sex education in school, even though some might argue that the methods are not effective.

Same story I've heard a million times here – my co-workers had her first boyfriend at age 15 and they had unprotected sex because she did not know any better. In no time, she was pregnant. She dished to me, "Girl, I was so pretty at that age I could get any guy!" But those carefree days ended prematurely and the responsibility of her child set in. 21 years later Sandra is currently four months pregnant with her sixth child, also originally an unwanted pregnancy. Sandra's husband leaves for work in South Africa for months at a time so she stops taking birth control pills until he returns. What no one explained to her is that birth control is not effective unless you take it constantly to regulate the hormones. Sandra did not realize these sporadic three month breaks were probably the cause of her third unwanted pregnancy. I explained this to her, marveling at how crucial it is that we are all educated about our own bodies and how our body systems work. It is also vital to teach people how to take medications correctly!

Sunday, January 11, 2009

Abby and me – my new wifey (1/11)

[Editor's note: I have been deluged with emails from would-be male suitors of Gracey all over the world, lamenting that their hopes appear to be dashed by the news herein about Gracey and her "wifey." I have been adding all the names to the screening database that Gracey's five other uncles and I maintain of suitors for our nieces - the one that does the FBI checks, orders ammo for our shotguns, and completes the psychiatric testing. For those of you who have inquired: the fact that you don't clearly see Gracey's ironic sense of humor in what follows reveals that you clearly don't "get" Gracey; hence her uncles have unanimously agreed that all such inquiries are ipso facto disqualifying and will be reflected as such in our database....]

I am so blessed to have a roommate to be able to share this experience with – we have already laughed much together, learned from one another, and cried to one another when we saw something difficult during the workday. I am happy to have someone I can relate to and who will always listen. We joke about how she is my wifey for the next two years because we play house in Mozambique together. This is serious business.

We tackle the bugs together. We have a compromise . Abby has never lived anywhere with cockroaches, but I am a Southerner, synonymous for expert. The first week our outhouse was crawling with cockroaches so wouldn't you know that I took a bottle of Baygone bug spray to exterminate them. Thirty minutes later at least 20 dying cockroaches were making a mass exodus out of our outhouse. Abby came outside to find me killing them with a broom so they would suffer no longer, as she squealed in terror. (I swear we don't violently kill off all bugs – I am learning to live in harmony with the spiders, except for the really big ones, and lizards, grasshoppers, etc. in our house). Abby usually takes care of the huge spiders. Divide and conquer. We will prevail. That's our motto. Abby and I are slowly becoming geniuses in the kitchen (thanks to Abby's expertise, I have a long way to go). We have started planning out our weekly meal schedule every Sunday night and and spend a lot of time listening to old jazz musicians (LA influence), country (my influence), and Argentinean tango tunes (Abby's influence) while making dinner. It's really been a lotta fun. I reached way down deep and have even eaten a few tomatoes every now and then. I still don't like them much, but we'll see.

We were checking out a reef in the Indian Ocean yesterday, which was beautiful, and joking about how ridiculous our new "relationship" is, as we had to hold each other's hands to steady ourselves to maneuver around barnacles. We have a full list of reasons she is my new wifey.

It begins… Routine beach trips, check.

Romantic dinners accompanied with jazz music daily, check.

Kid, check. I suppose a further explanation is necessary. We dramatically decided to call our new fridge our baby because we admire it on a daily basis exclaiming how perfect it is while drinking the cold water it provides us. This is what brings us the most joy after 8 hours of sweating in the office.

Pet, check. Well almost. Abby and I took an hour-long bus ride to pick up our kitten last week arguing amicably about the name on the way. Only a few hours after we arrived the cat disappeared, and it stayed gone until after we had to leave for work the next morning. I guess it knew we were coming to take it away from mommy dearest. Abby and I went home empty-handed and depressed, and I think I might have annoyed her a little by singing, "Oh the cat came back the very next day…" all the way home. And it did, by the way. An hour after we left. Life huh, I just have to shake my head sometimes.

Hosting dinner parties, check. Abby and I have now hosted dinner parties for both community members and PCVs. I like to think we're a dynamic duo. I'm going to close with saying that if any of you dear readers happen to take a trip to Mozambique before Thanksgiving 2010, Abby and I would be more than happy to host one week-long continuous dinner party for you…it'll be good food and a good time, that I can promise.

Saturday, January 10, 2009

Reality Check 1/10

Although I am not planning on becoming disillusioned with development work after my first full week on the job, it was definitely more challenging that I anticipated. I never wanted to fool myself into thinking that this would be easy, but Abby and I experienced a bit of the honeymoon phase when we first arrived at site. We went through the, "Oh my gosh, do you believe we're living in Africa on our own" moments, and, "wasn't that neighbor so nice to drop over a pineapple to welcome us" comments. It was love. Plus, spending Saturday afternoons at the Indian Ocean and timing my evening runs to correspond with the sunsets has been spectacular. That aside, I found my first 40-hour workweek to put me on the brink of tears, and by Wednesday night was begging my family to call so I could vent my frustrations.

What I regained from my family's call on Thursday was perspective. Frustration one is that the concept of having a job orientation is practically non-existent. I received no formal introductions from my co-workers nor the orderly, informative meeting in which expectations are laid out clearly on your first day on the job—all the things I've grown so accustomed to in the States.

Frustration two is the work pace is much slower and even when your colleagues are in the office I think they take breaks for longer than they actually work. This is going to be an adjustment because I like to function productively, efficiently and methodically jumping from one task to the next. Thankfully I was warned in advanced by a fellow PC volunteer, already a year into his service, that some work days are mostly spent just sitting under mango trees. Though he too disliked this at the outset of his service, it has turned out to be one of his favorite things. Right now sitting instead of working seems like a waste of time to me when there is so much that needs to be done! But I must pause and ask myself, what can I learn from this difference? Although I can easily point and judge what I don't like about this system, is my way the only right way?

Frustration three is that some key people in my organization came hours late each day so I began feeling a little like, why bother? I knew this was a pessimistic thought process and entirely too early in the game to give in (which I won't ever do), so I realized I needed to speak with my family to talk sense into me. After patiently listening to my string of complaints, they gave me good advice and a healthy dose of reality. Just what I needed. To address my frustrations, my father posed responses such as, "Gracey, stop judging and being hard on your co-workers and start getting to know them. So what, you didn't get an official introduction? Maybe your bosses aren't trained at leading people formally. So what, your collective 'productivity' in one day is not out the roof? You, little lady, were very privileged and surrounded by ambitious individuals and given a solid education. You've got to give people a break and learn they are doing the best they can given their circumstances. You need to understand that people not given so many windows and doors of opportunity are not inclined to be as driven as what you're used to." On and on, we went.

"Well dad, my middle-aged co-workers put me in uncomfortable situations by asking me for money the first week and I don't like that. And I'm tired of being asked pointed questions about where I'm going every time I leave the house. It'll be two years before I have any sort of anonymity." By this point I had the dramatic juices flowing. My dad countered with tough love, both typical and necessary. "Well Gracey, that's life and there's not a damn thing you can do to change that. You are a white American and most of the world associates that with money." My father knows me and how I liked to be well-liked and hate disappointing people. It is really hard for me to say no when someone asks for help or a favor. And I know myself that I like life to be neat and tidy and people to always be respectful, but who am I kidding? It's just not, it's messy everywhere, just easier to disguise sometimes in America where most people have enough.

In regards to my colleagues' requests for money, I did say no, which I have had to do many times here muttering how I did not have any with me to give. After being solicited for money, the other PC volunteers and I usually grumble to each other about how we're only volunteers, poor students really, certainly not rich. However, my friend helped me come to this realization. Compared to most of the world, we are rich in several ways. We are rich in material possessions – most of us brought our laptops, I-pods, and nice clothes. We are rich in opportunities – all of the PCVs are college graduates, many with plans to move back to pursue further education or enter the work force. Growing up we were asked what we wanted to be, with the real possibility that we could actually be whatever we wanted. We are rich in knowledge – we know how to read and write, and had well-trained teachers. We are rich in access to health care – specialized health services and the best technology are at our fingertips. We are rich in having families to care for us – almost everyday I meet a kid who either tells me that they were orphaned long ago. So you see, we are lucky, and we are rich. (The only thing I worry is that in all those riches, do we lose richness of spirit and remembering that we need to care for one another in all of our wealth?)

I finally reached the end of my cyclical arguments that all hinted at the classic, "Why bother, am I wasting my time, will I really accomplish anything in these two years" sort of thoughts. My father answered with a quote from Mother Teresa (those preachers, I swear, always a preachin' even when they ain't on the pulpit), but it resonated with me. "You just concern yourself with your drop in the bucket and don't worry about the rest of the ocean, my dear." Done. Okay. Keeping that in mind, I can feel good about what I'm doing. I can remember that if I were to give up on my task here, it would be for selfish reasons (but sometimes I have trouble remembering not everything needs to be about me). Moreover, I am just enough of an idealist to hope that there are enough other people out their putting their drops in the bucket that this world can be turned into a better place despite all the suffering, obstacles, and petty frustrations. This experience is forcing me to reflect and ask all the tough questions life has to offer while simultaneously accepting that I am probably not going to know the answers in this lifetime. Even so, I say vale a pena (it's worth it) to do what you can…

*For the record, my second week of work has already been much better and I am adjusting. It will just take time, patience, and hard work. Some of my more general frustrations with work last week were just the environment – most of the activists speak in Changana, the local dialect, which I do not understand yet. It is also a billion degrees and miserable during the days, so that wore me thin.

Less than a week after writing this a fantastic, already started project fell into my lap, which will keep me plenty busy and is a huge undertaking. The previous volunteer at my organization started a community center outside the city - my job is to finish constructing it and conduct programs for orphans and help mothers with incoming-generating projects. We are going to raise chicks to sell for a profit and the maes are going to learn how to sew so they can teach the orphans. Again, I’m excited - oh the ups and downs of development work...

Sunday, January 4, 2009

A life in the day of a girl, both here and there January 4, 2009

Most of you know my family is made up of four girls, and you know it well because I always talk about my sisters. One of the first questions I am typically asked in Chibuto is to describe my sisters, their age, what they do, how many kids they have back home. I cannot help but compare my sisters to girls their same age here in Mozambique and the contrast is drastic. The US provides women with many unique opportunities and a more equal status on many accounts. My 13-year old sister Molly does all the typical stuff you do as an American teenager. Molly plays on her school's sports teams and a club soccer team. She is really into hanging out with her friends, her youth group, and being the big dog at her middle school. Molly, like me, is blessed with a privileged lifestyle and has had ample time to be a kid and just play. Although Molly assumes some household responsibilities such as helping clean house and occasionally cooking pancakes for our family on Saturday mornings, she does them on her own accord.

Most 13-year olds in Mozambique cannot afford to live their youth like this and instead assume full household responsibilities by Molly's age. A typical day for an average middle-class Mozambican girl would be something like this: Wake up at 5 a.m. and cook breakfast for the whole family. As the eggs are deep-frying (and I really mean DEEP frying), the teenager would be sweeping and mopping the floors and setting the table for tea. Her other morning duties would include carting huge buckets of water for hours and washing dishes. Much of her afternoon would be consumed with the same; she'd cook lunch and dinner and clean more. I am always left asking when is there time for the young girls to play and study? One thing is for sure – the 13-year olds understand the concept of "you've got to work to live," which is something I fear our generation in America is in danger of forgetting. The 13-year olds gain a hard work ethic and domestic self-sufficiency, but are forced to grow up so fast. One negative consequence is the age of average sexual debut for girls in Mozambique is 12 years old (for boys it is 16).

That brings me to think about my other younger sisters, Sarah Frances (17) and Kristi (20). At 17, Sarah is busy driving, playing school sports, and about to apply for colleges. Kristi is a junior in college. In both their lives, education is the main focus and what they dedicated most of their time to. I have made friends with my sweet 17-year old neighbor, Xena, who always greets me with a smile when I buy fresh bread in the mornings. She is always standing, barefoot and pregnant. My other neighbors, a set of 22-year old twins already have a coupla kids apiece. There is literally an army of kids forever shouting our names from their house when we go by. Although I should be careful to judge their lifestyle choices and the cultural norms (because I am a huge fan of big families myself), I have to question if this is really best for the girls, the families, all the kids being brought into this world? Are these young girls ready and responsible enough to care for families? Is this ideal for them? Are they equipped to provide enough food for their kids? Would it be better to facilitate a cultural change so that the girls can stay in school longer and wait to have babies? Is that even possible? How can they be informed earlier about their reproductive systems and reproductive health in a way that makes sense to them? My challenge is to begin to answer these questions so that the young women in Mozambique can one day have the same rights to education given to Molly, Sarah, Kristi, and me if they so desire.

I do not want to present a skewed vision of the life in a day of the girl here. There are exceptions and occasionally I run into girls who have a comparable lifestyle to you and me in the States – they have finished high school and either have jobs or are pursuing higher education. Even then, many of them already have a family on the side. Still more often that not, I meet young girls who do not speak much Portuguese because they had to quit school at a young age. One of the Millennium Development Goals is to increase education for girls in developing countries by 2015 (broadly speaking). Let's see what we can do to work towards that goal – we've got 6 years to make something good happen and time is a-ticking.

*After writing this blog, the next day my 22-year old neighbor Sarah, the twin that already has a couple of children, came by to talk with me. First, we compared days and I learned that she gets up at 3 am every morning to walk to work in their garden. Tough work in, my opinion. Then we started chatting about families and after asking how many kids I wanted, I posed the question back towards her. Sarah answered that she'd already had enough, and that had not really wanted the second one. I launched into my little spiel about ways to prevent unwanted pregnancies, and she had no previous knowledge of birth control pills. Oh education, how vital I am learning it is! Maybe just maybe, if I went back to grade school, I would never try and play hooky again knowing what I know now and seeing what a blessing schooling is. But then again…