Wednesday, April 30, 2008
And on top of that, I drove solo to accomplish the task. Again, this may sound like small potatoes, but in a month, I have learned to drive a stick-shift on the left side of the road which I definitely didn't think was possible when I first got here. Having spent about 90% of my driving years in cities with great public transportation, and siblings who were always happy to call dibs on local driving, I never really needed to become completely natural behind the wheel before. But here, it's necessary. This town is small, but just big enough that driving is a must. And it's full of hills and potholes, which (much to my dismay when I first got here), means manual driving is also a must! So, I forced myself to learn and keep trying and I think I've really overcome the bulk of my mental roadblock. And I think others are noticing my improvement too. In fact, just a week ago, whenever I hopped into the driver seat from home, our guards would look at me with shear panic, suggesting that maybe, "mama, you try driving in big spaces first, yes??" But now, I have one of the drivers actually asking me for a lesson or two! I've still got lots of practice ahead of me, but looking back at my first few lessons, feeling panicked just thinking about driving, stalling at every stop, begging to swap seats when I thought I just couldn't do it, I can honestly say I've already come a long way. In fact, I purposely didn't mention anything about my driving practice on here until now because I was worried I'd jinx myself and just never learn to do it.
So, two small steps forward this week and I'm sure many tougher roads ahead... but I'll take it as it comes and will hopefully make it out in one piece at the end. But for now, things are pretty good. It's a long holiday weekend here, so we're off to see Lesotho's little northern brother, Swaziland for a few days!
More to come!
Friday, April 25, 2008
Oh yea, and we've also had a new roommate for the past week-- a Basotho man from the mountains who has likely never left his village before and doesn't speak a lick of English. He's here while his daughter is admitted at a hospital in town and I think he's just as perplexed by us as we are about him. He stays in one of the living/storage rooms where we now have 6 huge cases of powdered milk stacked floor-to-ceiling and never turns on the light on (maybe he's not used to electricity). He either sits in that room in the dark or walks around our house in his cowboy hat and trusty Basotho blanket, singing songs.
Sometimes I feel like I'm part of a circus. (Did I mention there REALLY is a traveling circus in town for the week!!)
It's like my friends in India used to say, "Aise he hay." It is like this only.
Thursday, April 24, 2008
This week, I’ve been busy with my second volunteer gig, working with a health organization linked to a US-university, assisting with a baseline survey of hospital intake and record-keeping systems, particularly in the outpatient department, or OPD. This is where patients line up every day with ailments ranging from broken bones and asthma attacks, to malnutrition, pneumonia, and STIs. My job is to simply observe, to watch doctors (almost none of which are from here), nurses, translators, patients, and everyone else involved in the OPD and take note of the overall process. Essentially, I’m conducting a systems analysis of what happens in the OPD, from when a patient first enters until he or she is discharged. It’s fascinating stuff for me and I’m very aware of how lucky I am to be given access to doctors, patients, and exam rooms, something that would ever happen back home. It’s also a really scary thing, to be plopped into the middle of a bustling foreign hospital and given access to one of the most crowded and gruesome wards.
I walked through the waiting area, where patients sit on wooden benches for hours, sometimes waiting all day without being seen. Elderly men sit coughing and sighing, young women look down at the ground in silence, and mothers wearing traditional Basotho blankets sit with babies clinging to their backs and toddlers playing at their feet. Inside the OPD, there are a series of closet-sized exam rooms, one next to the other. Whether separated by curtains or actual doors, people come and go freely while exams are taking place, regardless of whether the doctor is simply consulting with a patient, inserting an IV, or doing a pelvic exam. No privacy. Nurses and others casually pull back the curtain and look in while patients lie on uncovered beds half-naked. And while I instinctively look away and want to feel embarrassed for the exposed patients, I eventually realize I am the only one embarrassed and this is just part of a different hospital culture.
I observed the difference between doctors, some recruited from within Africa, with an ever-calm presence (I can’t tell if they’re half-bored, disinterested, or simply unmoved—perhaps used to these kinds of cases.). Then there are the newly arrived American medical residents, fresh and idealistic, here for one month and eager to get real experience and save every patient, with their pocket-sized medical handbooks and mini Purell containers at hand. They send patients for multiple tests, x-rays, and lab-work before committing to a diagnosis. They try to mentor their young translators, local high school students, who bask in the attention and praise. At the other hospital, the translators are not really translators. They are hospital assistants, men whose job it is to keep order in the waiting room, call in patients, and handle odd-jobs for doctors or nurses. They happen to translate in their spare time because none of the doctors speak Sesotho, as they have all been recruited from elsewhere. The doctor may not even look the patient in the eye and often communicates only with the translator, who sometimes leans in the doorway or sits slumped in a chair, half-asleep, barking the questions back to the patients in Sesotho. Do you breastfeed the child? What is your HIV status? Any discharge? It’s so bizarre watching these non-clinical employees asking questions like that, but that’s how it has to be. At yesterday’s visit, it seemed to be as strange as taking construction workers off the street and bringing them into a doctor’s office, asking them to discuss child nutrition and menstrual cycles with strangers! Again, maybe much like I’m the only one embarrassed at the lack of privacy, maybe again I’m the only one that thinks this is strange or out of place.
The doctors stare down at each patient’s ‘Bukana’—a passport-like book containing hand-written medical history and diagnoses from previous doctor’s visits that all Basotho own and carry with them to hospitals or clinics. Not a bad idea actually. I can think of the multiple dentists I’ve seen, back in the U.S. and the hassle of trying to transfer my records between them. I wouldn’t have minded being given my own records and x-rays back after each visit. The problem here arises when you start investigating how the hospitals retain information about their patients, diagnoses, status, etc. Truth is… most of the time they don’t. When a patient leaves, Bukana in hand, oftentimes so does the entire record of the visit, as if it never happened. Patients come and go, so anonymously, like numbered slips at the deli counter. This makes it nearly impossible to report back to the government or donors accurate figures of patients seen, disease burden on different hospitals, or drugs and equipment needed. It’s a big job, but that’s why this research is so important—to figure out what’s happening (or not happening) now and to help figure out a way to capture all of that important medical data. If I learn nothing else from this experience, at least I am becoming more sensitized to this culture and am learning to try and see every situation, doctor, and hospital from both sides of the coin.
In any case, the event was the perfect chance for me to bond with some Basotho kids and be myself, truly in my element! I jumped into some of the small group activities to sing songs and play games with them. I kicked around a soccer ball with kids waiting for their next match, and I just chit-chatted with some girls who were curious to know where I was from and whether I was “friends with Beyonce or Alicia Keys.” After sharing the disappointing news that I was not, in fact, friends with their favorite American pop-stars and could not guarantee an upcoming concert in Lesotho, the girls still stuck around and chatted with me. We talked about life in Lesotho, what they wanted to be when they grew up (a teacher, a singer, a nurse…), and then I thought I’d take the opportunity to broach the subject of HIV, while we were already at an HIV-centered event. I asked them if they knew what it was and how it’s spread (the ever-present tutor in me, always quizzing…). Even in a country with more than 30% prevalence, it’s still tough to grasp having such serious, adult conversations with children (okay, all the kids at the even were 12 and above, which out here is considered ‘adult.’). I thought back to the Sesame Street show my sister worked on a few years ago—tailored for South African audiences, with an HIV+ muppet named “Kami,” meant to break down HIV stigma and teach kids the basics. I remember being shocked at the time, wondering how American parents would react if their pre-schoolers watched TV shows with messages about infectious diseases and death! However, in this part of the world, children know about the disease before they’re old enough to go to school. With parents, uncles, friends, and teachers disappearing around them, kids here get a real-life lesson in HIV and death at a young age. So I quizzed away, figuring my HIV questions were nothing new to these young teens.
I asked if the girls had opted for testing that day and all three admitted that they hadn’t. I thought maybe I could try to talk through it with them and show them the benefits of knowing and at least leave that day having helped get just three, or even one child tested. One girl (a feisty little dramatic one, with a killer smile and a red-carpet attitude) told me she was scared. Of the actual testing?, I asked. Of knowing, she replied. She didn’t want to know because if she was positive, then her family wouldn’t accept her anymore and in her own words, her life would be over. She said she was “too young” and had her whole life to live. I told her that being young is exactly another reason why she should know, to make sure she can live that long, happy life. Her words sounded so adult to me, almost displaced, coming from her petite school-outfitted frame as she reached into a bag of sweet gummies which had been given to her by one of the British reporters present at the event. I watched her and listened to this girl explain to me why she’d rather not know. And who am I to argue? I can absolutely understand how scary the concept of knowing or not knowing could be, especially for young teenagers, and especially in a reality where it was likely that one of those three adorable, charming girls was positive.
In the end, my persuasion attempts proved futile and I realized no matter what I said, these girls had made up their minds about not knowing. So I just let it go for now and hung out with them, learned some Sesotho songs, raced a few of them to the end of the soccer field (they beat me every time!), and just enjoyed giving them some much-deserved and maybe all-too-rare attention. Before I knew it, I was fully surrounded by a sea of young girls, all wanting to talk, to ask me questions, and to stand next to me. I loved it and wished I could give each of them the world. It brought me back for just a moment, to my days volunteering at a rural high school in India, years ago. I thought of my students, especially the young girls who would gather around me during our tutoring sessions. Many of them shared one-room houses with families of four, five, six… Many would likely be married off soon after completing high school. I remember watching them with pride at inter-school sports competitions, as if they were my own sisters or children. I believe that the best insight into a country and culture is through its children, with the capacity to love everyone, with an understanding of the real world beyond their years, and who won’t hide the truth, ugly or not.
So I looked at these girls, seemingly happy with the simple things and I gladly stood by them, watching traditional drummers and dancers perform in the field and watching as the final match came to a dramatic end. The DJ blasted some dance music and I entertained the girls with my attempts to mimic their smooth moves. Hugs and handshakes were exchanged and we said our goodbyes. I left the event, slightly sunburned and exhausted, and though I hadn’t directly contributed to getting any kids tested, I left knowing I had gotten so much out of my day and out of the time spent with these kids. I also couldn’t help but think about the sad reality of the to-know-or-not-to-know dilemma these kids are faced with and similar realities of other kids I’ve known in other places. I wished for a minute that I could somehow lift that off of them and give them back the simple childhoods of soccer, homework, sleepovers, and pop-stars that they all deserved.
Tuesday, April 15, 2008
During that time, I also had the chance to accompany one of the residents to the public hospital in Maseru, which I had been curious to see firsthand after hearing some horrific stories and descriptions of the crumbling, understaffed place. The stories didn’t even match the harsh reality of the place. It’s a crumbling complex of over-crowded wards in different buildings, which you walk to through a series of neglected courtyards of dirt patches with trash strewn everywhere and a cemetery of old, used hospital beds and equipment. There is no main entrance, no reception or waiting rooms—just open corridors, and walls stained with mildew, dirt, and questionable substances. The smell hit me right away—nothing in particular, just the smell of sickness and death, with a strong undertone of urine.
We wandered right into the women’s ward, looking for some patients the resident had admitted recently. Dozens of patients sat on a crowded bench as a handful of overworked and seemingly desensitized nurses came and went. Patients lie on beds lined right next to each other without curtains to separate them and with barely any standing room between them. I saw a woman holding a small bundle with a man by her side—an intimate moment shared with a room full of disinterested onlookers. Young women my age sat on the benches, wearing only typical Basotho blankets to cover themselves, the blankets casually falling past their shoulders, an uncovered breast exposed. I turned away and suddenly felt overly aware of my presence and other-ness. Why should these young women have to receive treatment at a place like this, when I myself—I could be in their shoes—would never accept that for myself?? How is it that this has come to be their reality and not mine? When we finally caught a nurse, she didn’t know where our patients had gone. No one really even knew their names. They were gone, either discharged or just another lost face in this hospital.
Next was the men’s ward. We just strolled in without being checked or stopped. We walked up to check up on one of the resident's patients. The man had been stabbed multiple times and had a crude tube inserted into his chest to help bleed out the remaining air from his punctured lung. I started to feel a little nauseous and had to look away. The patient didn’t seem affected either way by a small bit of attention from the resident.
We repeated the same scavenger hunt in the children’s ward and couldn’t find any of the kids we were looking for. In particular, we asked about a young child that had been sent over from the mountains with a growth from his spine sticking out of his body. He needed surgery which couldn’t be provided in the mountains but we learned he had been discharged without it because they simply didn’t have the means or resources to provide it. Imagine—just sent off like that, sent back to his remote home, possibly sent off for a death sentence. The doctors said no. No more options for this boy. And to think, he was one of the lucky ones to be sent to this hospital in the first place!
As you can imagine, the visit was eye-opening for me. The harsh reality is undeniable. There are no decent hospitals, almost no doctors (I've heard that there are often no more than 3 in there at any given time!) and certainly not much optimism or hope—neither in the physical building itself nor within those inside it. There is no medical school in Lesotho so doctors must be trained outside, oftentimes in South Africa. After becoming doctors, there is little incentive to return. Consequently, many doctors come here from countries that are worse off, and are sometimes offered only modest food and housing stipends an no salaries in exchange for their much-needed service. And it's not as if the donor community turns a blind eye. I've already met fellow expats out here working at this place, trying to make a difference. And there have been donations to this hospital as well, but they don’t last long. New x-ray machines were supposedly stolen soon after arrival, and resold to private clinics in the area.
So, what options do these people have? How can anyone break this cycle? Perhaps to my fresh, non-clinical eyes the situation seems more shocking and bleak than it really is. After all, the visiting doctor didn’t seem as horrified. (Maybe he’s seen worse?) All I know is that the visit helped start to paint a picture of the health crisis out here, even from one person’s non-medical standpoint and that no matter how you look at it, it seems things can only go up from here. Or at least I can only hope, right??
My first trip across the border was last Thursday evening with a group of about 5 friends out to dinner. We had to stop on both the Lesotho and South African sides of the border to be stamped in and out. The guards gave us a hard time about having a full car and even tested Jeremy’s vocabulary knowledge of the word “overloaded” just to be cheeky, but ultimately got bored and waved us through. We went to a BBQ & ribs place and I tried the “tortilla and beef” meal which was about as close to fajitas as I’ll get here. The tortilla was pretty much dead-on, surprisingly and it came with pseudo-guacamole and plain yogurt for sour cream! Not bad, though maybe next time I’ll stick to what they do best!
The next trip over was just with Jeremy on Saturday for a day-hike at a nearby conservation area, recommended by a friend. We drove past Ladybrand and into the next small town, at which point nobody could point us in the direction of this park. After a few wrong turns, we finally found an unpaved road which led through beautiful red-orange mountains to a place called Korannaberg, a privately owned farm and conservancy where there’s a quaint lodge and a variety of marked hiking trails. We chose a quick route and wandered up through tall-grass fields, lush, damp forest, rocky boulders, small waterfalls, and even steep mountain passes. (See pics at the right!) It was a brisk hike, with a beautiful backdrop and we made it back to the lodge in a couple of hours, in time to beat the rain. (Did I mention the next rain cloud out here is always a few minutes away, at least this time of year).
I’m really hoping to take advantage of being so close to so many great hiking spots and naturally beautiful places. I used to say the same thing in DC, being so close to tons of VA and MD parks, but I rarely crossed over, making excuses like I don't feel like renting a Flexcar, or I don't know where to go, or I’d rather hang out by the market…but really, I should have crossed over much more often. Heck, I didn’t even need a passport to do it! Now, even though I may need a passport, we’ve got our trusty Rav4, a stock of guidebooks, and definitely some free time, so no excuses! My personal goal is to go on a hike or visit a new place in the area at least once every 2 weeks. Next up is Semonkong Lodge, here in Lesotho for a weekend getaway coming up. I’m a big advocate of checking out your local surroundings first when abroad, before venturing out too far, too often. (My Semester at Sea friends can vouch for that method!) So I’ll finally get to see a new side of my new ‘home,’ to get a peek at some great Lesotho-mountain views, to go pony trekking (at last!), and to get a break from Maseru and thoughts of job and house-hunting. So, here’s to close borders, a plethora of border stamps and no excuses! Off we go!
Wednesday, April 9, 2008
It’s hard not to compare this arrival to other arrivals before—particularly India, a land of extremes. Sensory overload. Crowds everywhere. The sense of going back in time, to another era, another world altogether. Brand new smells (spice, sewage!) and new sights (auto-rickshaws dodging cows and barefoot babies) and sounds (honking, singing, praying). No, no, this is something else. This is a small-town in the middle of the mountains. Just after a few days here, I walked along the main street and bumped into 2 or 3 people I knew. That would be unheard of in India. I could walk the city for hours and only pass by strangers. Or maybe this is just what living in a small town is like, wherever you go: not much to do or see, just the basics and lots of familiar faces. I wouldn't know-- this may just be my very first small town experience, having grown up in a suburb of NYC and lived most my other years in DC. Who knew?
While I don’t have so much to report on just yet, I will say this: the people here are very warm and welcoming. Everyone greets me on the street with a smile and ‘hello,’ or “du mela, meh!” And despite my natural inclination to think, what are they trying to get out of me? or what’s the catch?, they really are just being friendly, which I can definitely appreciate. Another thing I realized right away is that I’m not going to be roughing it half as much as I initially envisioned. The supermarket sells everything from Kellogg’s cereal and fresh-baked bread to Pantene shampoo, luggage, and clothing! And while there aren’t many restaurants, I can still choose from Indian, Chinese, fast-food, Mediterranean pizza (sort of), Italian, or standard continental buffet. Plus, I just discovered there is a bakery that sells croissants and scones (again, sort of). And did I mention the gym?? All I will say is that it’s a massive complex with weights, treadmills, squash courts, and a swimming pool. Even the king himself is a member! Hold on, though... Before you roll your eyes and lose all sympathy for me and my big move into the 'wild,' let me remind you that life aint all roses n peaches out here. There’s bureaucracy, corruption, bribery, and hassles. After all, more than half of the statements in my last entry were actually true! (still not telling...) Not to mention, the health crisis, threatening to diminish the entire country if not controlled soon.
But here I am, for better or worse. I’ll take the good with the bad, with hopes that soon enough I can do my part to contribute to all the great work being done here. And in the meantime, you won’t hear me complaining while eating my morning scone!
Monday, April 7, 2008
Try and guess which of the following statements are true and which are completely made up!
1. A traveling circus is coming to Maseru.
2. This weekend, the Lesotho Housing Authority evicted us for no legit reason.
3. I was hired to be His Majesty, the King of Lesotho's personal fashion consultant.
4. I came down with a mysterious 6-hour fever Saturday night.
5. I watched an international jazz band perform on Saturday night.
6. Not only can I now drive a stick-shift on the left side of the road, but I also got a flying lesson this weekend.
7. Jeremy was offered a chance to see the inside of a Lesotho jail this weekend.
8. Jeremy ran on a treadmill next to his Majesty this weekend.
I'm not telling....
Have fun! :)
Wednesday, April 2, 2008
Before I get to why I’m here (which is another entry altogether!) let me share how I got here.
After deciding to make the big move, there have been a few major slap-in-the-face moments that brought me closer to the reality of it. The first was buying my plane ticket, which at least gave me an exact date to look forward to. Next was quitting my job—probably the hardest thing, given that I actually enjoyed my job and really liked my coworkers. I was so pleasantly surprised with the support I got from colleagues when I broke the news. Maybe this kind of thing is less of a shock when you already work in the development sector, but people really reached out to support and encourage me (and to throw me kickin’ farewell Happy Hours!) Last but not least, was the whole process of purging—getting rid of all the stuff I’d accumulated in DC—getting back to the basics again and preparing to pack it all up. There’s something equally terrifying and liberating about getting rid of just about everything you own. It’s the combination of feeling terrified to let go of the life you’re comfortable with, but at the same time realizing that by tossing it all, you are becoming totally mobile and free to do anything in the world or go anywhere without being held down by furniture and ‘stuff.’
Just a few weeks ago, I had a yard sale and practically gave away all of the belongings from my small 1-bedroom apartment in the quaint Eastern Market neighborhood of
It’s all about taking one last deep breath and just letting go. *sigh*
I have to admit though, this isn’t the first time I’ve done this (much to my family’s dismay). After spending the summer after college graduation waitressing in DC, I finally decided to pack up and move to
Honestly, the purging part has never been too hard for me. I’m what you'd call a natural-born ‘purger,’ the polar opposite of a pack-rat. If it were up to me, I’d toss everything (well, I guess I just did!). Ask anyone who knows me well and they’ll probably roll their eyes and agree that I’m sometimes relentless, even cruel, when it comes to tossing things and purging. I have a nasty habit of cleaning up messes before they're finished being made and filling garbage bags jam-packed with household goods, family keepsakes, and belongings during my regular “spring cleaning” modes at home. Maybe it’s a detachment to “things” or maybe it’s as simple as disliking clutter. I’m not sure. All I know is I’m down to the basics yet again and I kind of like it. So, to all of you out there who ‘inherited’ some of my goods in DC, I hope you’re enjoying them. As for me, I’m ready to live a simpler life out here in the
Tuesday, April 1, 2008
Ever since I was a little girl, the thought of airplane travel always incited a tangible excitement and anticipation in me, not just for the upcoming trip, a break from school, work, or life-- but for all of the little things that go into preparing for the trip that I looked forward to and knew were really only justifiable before a trip. Back then, this meant going to the grocery store the night before to stock up on “fun snacks.” What, you may ask is the difference between any old snack and a “fun” snack?? Well, in the eyes of a seven-year old child (ok—and still to this day, I’ll admit) this would include anything you would never normally toss into your shopping cart, especially anything bite-sized, in individual packs, or generally unnecessary and unhealthy. We always stocked up on a good balance of salty n sweet travel-friendly snacks that would never fly on just a regular day. This could be anything from miniature cereal boxes, fruit roll-ups, mini animal crackers (yep, the kind with the little string attached for child-friendly carrying), and any snack that comes with accessories, like a small dipping apparatus, toppings, or a prize. Yep, fun snacks.
No matter how many trips I’ve taken since those days, I can still remember exactly the way I felt back then, just before one of our family trips to
We all woke up before sunrise (… always the early morning flights out of
And don’t get me started on the actual airplane experience. To this day, I love being on planes—whether a quick flight to Florida, a 4-layover vacation to Japan, a spontaneous weekend trip to Puerto Rico, or an 18-hour nonstop flight to Africa In Economy nonetheless). I really do love it-- despite having had my fair share of stressful airport drama (i.e.- running through airports, begging at the check-in counter, dodging crowds, wrong terminals, rearranging overweight luggage, delayed flights, you name it!) Not to mention those few, shall I say, “rustic” flights throughout the years, like the mosquito-filled budget airline in Thailand, the wild turbulence landing in Kathmandu, the wobbly 20-seaters with no restrooms, or even my most recent propeller-jet from Jo’Burg into Maseru, in which the flight attendant personally briefed little old me on how to evacuate everyone from the plane, need be!
But I survived each and every one of those trips and still find myself getting excited as I board airplanes. Everything from the in-flight movies, personal eye mask, and even those countless ‘mystery meals.’ Hell, I even love the crappy mini toothpaste! The small treats, the luxury, the forced relaxation of a flight, and most of all the idea of going somewhere new are all why I choose to live the kind of life.
It’s a life that takes me to beautiful (and sometimes ugly) faraway places where I often stand out and sometimes get sick. It’s a life that forces me to get passport refills every 2 years. It’s a life that gives my mom aneurysms as I announce my new destinations over Thanksgiving dinner. It’s a life that has me sell all my belongings and pack the rest into a few suitcases. It’s a life without guarantees and sometimes without health insurance. But it’s a life that I think I will look back at one day from a rocking chair and be proud of, to know that I might not have been the biggest this or the best that out there, but I wasn’t afraid to live.
And yes, it’s a life in which I still give myself permission, even as a grown adult, to indulge in “fun snacks” before a trip. So, what may have started as my mother’s clever way of getting four young children to make it through a three-hour flight to Florida at 6am has now evolved into a family tradition that has come to represent a lot more to me than bite-sized snacks and chewing gum.
(Just for the record though, I still buy those mini boxes of animal crackers!)