Monday, September 21, 2009

Where are we? A different side of Africa

I flew into South Africa five days ago for medical care and since I got off that plane I have felt at many moments that I could be in America. First of all, the Johannesburg airport is unlike most other airports in Africa. It is huge and modern, comparable to a big airport in the States. The dream continued as we descended to the parking garage, full of nice, new cards – Toyotas, Mercedes, BMWs, Volkswagon, you name it. As my driver took me from Johannesburg to Pretoria, I marvelled at the smooth highways with multiple lanes, the shopping malls, and gated housing developments. Just like the urban sprawl you see in the States. This certainly wasn’t the Africa I’ve grown accustomed to.

My friend Aubrey, another PCV, and I have been mall-hopping at a few of the newest malls in Pretoria. So many things have blown our minds that are such stark contrasts from our normal posts in Mozambique and Cameroon.

Case #1: The food. You can get anything you want – Greek, Thai, Chinese take-out, Italian, Smoothie Shops, even sushi! There are supermarkets with organic foods. We’ve eaten cheese, real chocolate cake, strawberries – all of which have been missing in our lives for the past year. I’ve been eying McDonald’s and frequented it for a Big Mac yesterday before I have to return to McDonald-less Mozambique.

Case #2: Western Fashion. Aubrey and I have been out of Western fashion for the past year, and I was feeling a tad bit self-conscious about my style and appearance being thrown back into it all. Don’t get me wrong, Western style has its influence in Mozambique, especially in big towns and cities, but not like in South Africa where you could easily mistake anyone on the street for being American. It’s still considered high fashion in Mozambique to sport your capulana (African fabric) proudly, but in Pretoria it’s all Western clothes. It was so strange seeing so much highlighted hair, stiletto heels, miniskirts, leggings, and crazy make-up after living a simpler lifestyle the past year.

Case #3: US Stores. Aubrey and I did a double-take when we walked by a store selling Gap, Banana Republic, Clinique, Estee Lauder, Bobbi Brown, and on and on. Yes, I am aware that many American stores are international, but not in the Africa where I’ve been living.

Case #4: More similar environments and opportunities. South African youth (in the big cities) and American youth have many similar educational opportunities from what I can tell – there are good public schools, private schools, boarding schools, many types of universities (correspondence, public, private). Many South African teens have regular access to internet, watch many of the same movies Americans do, have travel opportunities, and seem to face many of the same issues that Americans do. Credit cards and debit cards are taken everywhere. There are big office buildings everywhere. Of course, some of these similarities are because the US and South Africa share English as a common language – especially with media overlap.

Case #5: Health Care. There are top of the line hospitals, tons of specialists, latest medical tech available – you just feel like you are in good hands.

However, there are some noticeable differences to remind me that I’m not in America. Many people have tried speaking to me in Afrikaans and are taken aback when I open my mouth and say in an American accent that sorry but I do not understand Afrikaans. Another difference is the largely dichotomous world that exists. The majority of white people I’ve seen seem well-off, at least well-off enough to have a car. The PCVs and I often either walk or ride the mini-buses for public transportation. We can’t help but notice that we are the only white people we’ve seen on public transport and have often been asked on the sidewalk by friendly black folks why we are not driving. Another reminder that we are near Mozambique is the shantytowns north of Pretoria that have cropped up to house the minders. Many immigrants live in these shantytowns from Mozambique and other surrounding South African countries.

This vacation to South Africa has been interesting for a number of reasons. In many ways it has felt like being home – English speaking, houses full of comfort and luxury, delicious food, and dressing up. I’ve enjoyed it, but am also seeing the Western World through new eyes after a year of living without running water, shoddy electricity, limited internet, and lower maintenance fashion. Each way of life has its advantages and it is fun to slip between the two trying to keep sight of the best of both worlds.

Why High Kicks are Dangerous

If anhyone is interested in a ridiculously detailed account of my whole medical evacuation to South Africa, then happy reading...

Last Monday I had to be medically evacuated from South Africa. Why, you might ask? To have the nose job that I never wanted. I might as well explain from the beginning. I've been working with a high school girls group since April and we have been talking about taking a field trip to visit a nearby girls group about an hour away. This is a huge deal because field trips are practically unheard of in these parts and so it took us months to get it off the ground! But it finally happened; I woke up early and organized 50 snacks and had rented out a private mini-bus for my girls. I was responsible for everything that day so nervous about how it’d go. When we got there I was overwhelmed because there were 50 Mozambican high schoolers, 2 Mozambican professors, and me - the sole foreigner. The first thing the girls wanted to do was play soccer so they all looked at me to get the game up and running. We decided to play 2 25 minute halves and my girls begged me to play. I had been stressed out trying to get this whole field trip off the ground, so I decided to play and during the first half I remember how much I loved playing sports and how therapeutic it was for me (I felt the stress just leaving my body). It was awesome watching my girls running around, most of them barefoot playing and just being able to be kids, free of responsibility for the moment, which is pretty rare here. I marvelled at their natural talent and also at how they had no concept of some important rules. Most noticeably I remember thinking, man those high kicks are dangerous....foreshadowing for what was to come.

This whole first half was a great bonding moment with my high school girls - they were impressed I could actually play soccer well and so glad I was out there with them. The last minute of the first half my team had a breakaway and 4 of the girls kicked the ball down the field and scored. Oh how they cheered! Then we had a 10 minute halftime where our 11th grade goalie, Isabel had to nurse her 6 month old baby (different worlds). I said maybe I'd sit out for the second half, but my girls begged me to stay in so I stayed in. Maybe 15 minutes into the second half there was a corner kick near the goal I was defending so I headed the ball. The ball went to the ground, but the offender was a minute late and reared back and did a high kick...right into my face. I've had plenty of bloody noses from sports injury, but not like this. Blood poured out everywhere and the girls rushed to wipe the blood from my face. Someone screamed in Portuguese not to touch my blood because it was not sanitary - they had no concept of this, only concerned about helping me. As more blood than I'd ever seen poured out my body at once, a guy came and poured a whole jug of water on my face and then someone helped me walk off the field. They took off one of the 2 tank tops I was wearing to use as a compress. As you can imagine this was quite the scene - one white girl and foreigner down on the field with blood everywhere. I'm just glad I didn't pass out because I had little sleep the night before and had eaten very little that day. I was a bit scared when I felt my nose and the bone was tilting to the right side, especially for vanity sake! It could have been much worse though - I'm so happy my teeth weren't knocked out.

Luckily I was in the town with the most PCVs in Mozambique - 4 total! One lived nearby and we got in a car, which took me to the local hospital where no doctor was scheduled to be all day, and so I ended up with my nose tilted to the right, gauze to stop the bleeding, and 10 concerned Mozambicans standing around my hospital bed watching me intently. On the way to the hospital I called the other 2 female PCVs who dropped everything and ran right over and escorted me out of the hospital to their house where they nursed me all day - making sure I kept ice on my nose, cooking me lunch, watching DVDs on the computer screen, and talking with me to distract me from the pain. Oh yeah, and it was crazy - 3 of my high school girls cried because they were so worried about me and walked over to make sure I was okay afterwards and I think the poor girl who broke it will always be known as "the girl who broke the mulongo's face" (me being mulongo - meaning white foreigner) - poor thing, I told her it was okay and just an accident, but I think she learned why high kicks are dangerous.

A Peace Corps car left and drove the 2.5 hour drive from the capitol to come pick me up and take me home, but because of traffic I did not arrive at the health clinic in Maputo until 6 pm (over 7 hours after the time of the injury). But I was so lucky to have the best medical care from Peace Corps - to have a private car come get me and a doctor I knew waiting at the hospital for me. They took 4 x-rays of my nose and face without any cape to protect my body from the radiation. Then I had to wait 2 more hours to get a second opinion to confirm the first doctor's assessment that I needed to go to Pretoria, South Africa to get the best medical care to get my nose popped back in place. There was a PCV named Tiffany being my sort of angel for the day sitting with me in the waiting room.

Finally around 930 pm last night, the second doctor checked me out with 5 medical personnel all chattering in Portuguese. This doctor assured me that he was just going to feel the bone, but then started pushing hard and I wiggled at the pain. He sneakily tried to shout from them to give me anaesthesia while I was sitting up in a chair to set my nose that had at this point been out of line for 10 hours. He muttered something about how Americans and our culture were so picky about our medical treatment, and stopped trying because I put up a fight. Damn right, I was going to be choosy when a doctor was trying to fix my nose without my consent! That was honestly the worst part of the whole experience, but also a valuable learning experience. In developing countries, you have to be assertive about your medical care and once I recounted this part to the doctors in South Africa they told me I did well to refuse that treatment.

Then I finally went to the hotel PC booked for me with painkillers and my friend Tiffany to get rest. The other PCVs have been great calling and texting to see if I need anything. The PCV that lives closest to Maputo has an adopted expatriate family who heard about my accident and invited me to their American -like home to spend the day watching movies and eating delicious meals to pass the time before I got medically evacuated to Pretoria, South Africa for examination and surgery.

In South Africa, I was met by Peace Corps doctors who referred me to a specialist who was able to do the surgery last Wednesday, no problems. Well, I was bummed that I would have to spend my birthday all alone in South Africa, but it has actually turned into an incredible trip. As it turns out, I bumped into my childhood friend Aubrey who is a PCV in the Cameroon and just happened to be medically evacuated at the same time Aubrey and I both grew up in Hammond, LA but had not seen each other for almost 13 years. We reconnected after 13 years, and she just so happens to a complete sweetheart and volunteered going to the hospital on surgery day so I wouldn't be alone, so she had me laughing with her great sense of humor in the prep room, watched my stuff while I was under, and really made the experience 100% better. (We also figured out that our last vacation together was a family trip to Disneyworld when we were 8 years old, ha, the world is smaller than ya think…)

The day after surgery we went on a safari, which I had never done! We saw tons of animals - giraffes, elephants, rhinos, zebras, impala, etc. and it turned out to be a good birthday present. I went with 5 other PCVs who had been medically evacuated and Aubrey and I sat in the back having a ball!

My healing has been miraculously fast too – I was not in too much pain and do not even need the splint. Thanks for all your prayers, and please rest assured that what started as a bad accident turned out better than okay! Appreciate all the support.

Radio Interview

A month ago a local radio station commenced in our town, which is funded by UNICEF. I think the radio station will serve as a highly effective tool in Chibuto for distributing information to large amounts of people and also uniting the community. The station is broadcasted in a mix of Portuguese and Changana, the local language, to reach different target audiences.

Our friend Binaisa is serving as a journalist on the radio project and asked if he could interview Abby and me about Peace Corps and our role in the community. I was honored because I have never been asked to do a radio interview before, impressed by Binaisa’s well thought-out questions, and a little nervous to do the interview in Portuguese!

Binaisa also knows Abby and I run a local kid’s program three times a week. Separate from the original broad interview Binaisa planned, he called last week to see if he could shadow us at our program,“Care,” and do an additional story on us. Again flattered, we accepted and Binaisa set out with us at 8 am to walk the 7 kilometers to our most remote location. As we walked into “the bush,” Binaisa remarked on all the open land that just sat there but could be turned into prosperous farmland. He greeted old ladies tending the field and asked children if they went to school, and if not, why they did not go. Binaisa is assertive and is constantly dreaming up ways to improve the lives of his community members – a characteristic I admire in him.

Once we arrived, Binaisa taped parts of our lessons that day for the radio interview. Our theme was “Care for your future” and we talked about why it is important to stay in school and then the children brainstormed simple goals they’d like to achieve in their futures. Binaisa chose a few of our star kids from each session and recorded interviews about what they were learning from our program. Finally back at our house that afternoon, Binaisa did a closing interview specifically related to the day’s activities and asked how we could expand upon our kid’s program and involve more community members in the future. Abby and I did not receive these questions in advance (ha) so we did our best to think of intelligent answers and respond in Portuguese on the spot. Afterwards, we both agreed that it was super helpful that there were two of us because when one of us began to struggle articulating a thought the other would jump in and help. It was a good feeling having our work recognized and applauded in the community. As a bonus, the following day the high school principal was interviewed and he mentioned the young women’s club we have started and how we do HIV prevention and teach the girls income-generating skills. The next day a professor informed me, and I was happily surprised because I did not think the principal was following our work that closely. I mention these radio interviews because it feels like validation that our projects are succeeding even though I have many days when I wake up feeling like our projects are failing to get off the ground or are just underappreciated. Slowly but surely, we’re getting places! In any case like they always say, no mountain was ever moved in one day.

Thursday, September 3, 2009

Public Health Ambassadors

My good friend Sarah and I were heading south to the capitol on Saturday morning for some meetings. We decided to hitchhike because it’s usually both safer and more comfortable. We had been standing on the side of the road less than five minutes (lucky day) when a truck pulled over to pick us up. Sarah and I squeezed in the back of the pick-up truck and we began a long conversation with a family of four brothers. Three of the brothers were only going halfway to Maputo so the first half of the trip was spent talking about what Sarah and I are doing as Peace Corps Volunteers in Mozambique. They were really curious about the Mozambican foods we liked, if we spoke any of the local languages, and they also wanted to practice their English with us. We are usually able to “wow” the locals with our knowledge of matapa, the local cassava dish, and our few phrases of Changana, their mother language. We had a grand ‘ol time chatting and hugged three of the sweet Mozambican brothers bye-bye halfway through the journey…

As Sarah and I continued on with Silva, the driver, we learned a lot about his interesting story. Silva has been working in the South African mines for 10 years now to support his family. It surprised me when Silva said he was a miner because every miner I’ve met in my community seems to have a low economic status. Silva was well-dressed, a car owner for 7 years, and although not formally well-educated, he was conversationally fluent in English and an intelligent guy. We learned that he works for a black South African man who owns many mines and is a multimillionaire. Silva is a chief supervisor for all the Mozambican workers at his mine. There are 1,600 miners and they work 8 hour shifts each day. Silva had a lot of hours to drive so picked Sarah and I up so he would not have to go alone and so that he could practice his English.

As many people say, Silva said that if he ever had the opportunity to go to America, he would stay there forever. To him, America was this ideal of endless opportunities and a life without problems (He was correct about us having ample opportunities, but of course everywhere has its own problems). Silva could not imagine why we would choose to come here for two years, and what about our husbands or boyfriends? Who were are sexual partners for these two years? How could you make it through without being sexually active? There is this mentality that it is impossible to live without having sex for any period of time after puberty that many Mozambicans have. Yes, it is natural and a biological urge that all humans have, but in his mind there was no way to abstain for long periods of time. Sarah and I did not actually answer all of his questions directly, but we did do a lot of explaining about safe sex practices, which rolled right into a great discussion on HIV and AIDS.

During this trip I was exhausted so I was expecting to lazily snooze in the back seat, but I perked up hearing Sarah share all this wonderful health information to him in the front seat. Sarah was first campaigning for the use of condoms and why it’s a good idea to use them and I observed Silva listening intently. From there, Silva started asking questions about HIV. Sarah explained the three main ways someone can get HIV – unprotected sex, dirty needles, and mother to child transmission. Silva wanted to know if an HIV positive mother can give birth to a child without HIV; the answer is yes, almost certainly if the mother is on the appropriate ARV meds during her pregnancy. One of the most interesting debates was when Silva and Sarah debated HIV testing. Sarah said that you should get tested every 3 months, but Silva wanted to know why that was necessary if he and his wife were only sleeping with one another and they were both negative. Sarah replied that would be okay if both partners were absolutely 100 percent faithful and he got a kick out of that! “You women,” he said, “You are sneaky and we have to watch out for you and what you will do behind our backs!” Truthfully though, one of the main reasons that Mozambique and other countries in Southern Africa have a high HIV prevalence rate is that having concurrent sex partners is tolerated culturally. I was proud of Sarah for her role as a informal “public health ambassador” and happy that Silva seemed so receptive. Silva is in a good position to share his newly acquired health knowledge with other miners, which is a career known to be associated with a high HIV positive rate. The miners often spend long months away from home and travel back and forth, which is one of the trends tied to the rapid spread of HIV in Mozambique.

This instance of Sarah as a public health ambassador is just one example of many I know where volunteers have had a chance to informally discuss and answer HIV-related questions with interested Mozambicans. It is rather humorous how the conversations usually come up with female volunteers in public transport. Often the drivers or a passenger will say they want to marry us, help us make a baby, or some other forward comment along those lines without knowing our names. Usually we’ll reply that sorry we already have a boyfriend (be it a fictitious one or not) and are not interested. Then when they find out we are here for two years with a boyfriend far away, they get concerned about how we are making it. Finally, the conversation switches to more of a consequential talk about what we are doing over here and they usually ask us a lot of questions, which is ultimately a really awesome thing. Just one of the many benefits of living in a community for two years where Mozambicans really feel comfortable asking us and we feel equipped to answer.