Christmas Time (Don't Let the Bells End!!)

 

Well, folks, I’m coming up to the two week landmark here at site.  Two down, 102 to go, not that I’m counting.  Given this special occasion, I think it’s time to reflect on what has been an interesting, at times quiet, at times overwhelming, but all the same, enjoyable two weeks here in Mangunde, and also look forward to the exciting holiday coming up.

In two weeks, here are a few things I’ve accomplished:

          -Watched 7 movies

          -Watched the entire first season of Big Bang Theory!

          -Written my first 2 singles on guitar (“Shrimp Samosas” and “They were saying tudo bom”)

          -Built an outdoor casa de banho because I was getting tired of nearly falling into the toilet every time I try to shower in my cramped bathroom

          -Created a legit garden behind my house – four beds, double dug

          -1 crossword puzzle without cheating, about 10 with cheating

          -Read one book in full and the first 20 pages of 5 others

          -Invented three killer dishes – peanut curry rice, cashew pineapple fried rice, garlic naan with tomato basil pasta

          -Learned that if your bread doesn’t rise, just make tortillas

          -Gave a sermon and played the offertory at the Acacia tree church

          -Volunteered at the health clinic

          -Learned two words in Ndau – mamuka and tamuka

Let me stress that this is not going to be my life for the next two years - as much as I enjoy crossword puzzles and movies I don’t thing that would be a good thing.  When the school year begins January 15^th, there will be students on campus and plenty of work to do planning lessons and going to classes.

Today I want to tell you about my experience at the health center the other day.  To give you some background, there is a small health center here on the school grounds.  The health center is funded and run by the Italian mission, ESMABAMA, which runs the school.  As far as I can tell, there is one Italian doctor, 4 or 5 foreign nurses and a number of Mozambican nurses and technicians.  The health center services some 1,700 chronic patients from the surrounding villages, many of whom are HIV positive and come to the center monthly to receive their anti-retroviral medication.  There is also a maternity ward, a lab, and a lady outside who sells 5 mangos for 1 metical (about 3 cents).

Whenever I walked past the health center in the past I noticed that it was packed with patients waiting by the dozens outside of the wards and in the waiting gazebos outside.  Since I know that the health center is very understaffed I decided to ask if there was anything I could do to help during these weeks before school starts.  They accepted my offer I began the day by observing her consultations with patients in the Banco de Socorro.  The very first two patients who came in were two young boys who had been attacked by crocodiles in the river earlier that day, seriously, that river warning was no joke.  Both kids had one leg fully bandaged in a cast and had their hands and arms heavily bandaged.  I must say, the kids were remarkably stoic for 10 year-olds who had just been attacked by a crocodile.  One thing that is for sure is that Mozambicans are tough cookies. 

The next patient who came in was a gaunt woman whom I was told was severely anemic.  Apparently she was only 20 years old, but she was very weak, could hardly stand up and could only generate enough energy to whisper.  This was particularly difficult to watch, because the doctor ordered a blood test and then a blood transfusion, but the nurse could not get any blood to come out when he tried to take the samples.  As the woman was grimacing, the nurse must have tried 4 different veins before being able to squeeze enough blood out for the samples.  They tried to get some basic information out of her, where she was from, what family members she had with her, etc.  What I noticed throughout my day, however, was that even the simplest things can be extremely difficult to figure out in this setting.  Some things as perfunctory as age, family members and address can be nearly impossible to ascertain with language and cultural barriers. 

The last patient I observed was a very emaciated woman with her infant who couldn’t have been older than a 6 or 7 months.  The woman was HIV positive and the child had not yet been tested.  What struck me with this interaction was how difficult it was to get across what seemed to be, to me, simple instruction.  She had been taking ARVs but was clearly confused about the different pills and the schedule of when to take what drugs.  She had also been given nutritional supplements for her (because she was gravely skinny), but she had been giving them to the child.  In addition, they had been giving here powdered formula milk so that she would not breast feed the child, but there were complications in the milk running out, and mixing it with the contaminated river water instead of well water. 

When dealing with language and cultural barriers so deeply entrenched, what may have seem like simple yet vastly important instructions turn out to not be simple at all.  If she doesn’t take her ARVs regularly and continues breast-feeding the infant there is a fair chance he will be infected with HIV if he hasn’t already been infected.  The Italian doctor spoke Portuguese, but, like almost all of the patients, this patient only spoke Ndau, the local language, so a translator had to be used.  While very knowledgeable, neither the doctor, translator, nor the company making the drugs and other supplements could possibly understand all of the deep-rooted cultural, economic and environmental barriers to following a drug regimen in this context.  I watched this happen over and over while I was there - with ARVs, malaria medication, formula milk, and other things, patients were simply confused, and it was difficult to watch. 

This is not to say that the health center isn’t doing important and very impressive work.  Besides being struck with some of the difficulties that they were encountering, I was also deeply impressed with the amount and quality of work that the clinic does on a daily basis.  In addition to providing HIV tests, ARV regimens, malaria treatment, and emergency treatment of other ailments, the health center has a team of activistas who do community education about HIV/AIDS and do home visits for patients who are too weak to come to the center.  This health center is truly indispensable to the health of its surrounding communities.  Due to this, I was surprised to hear that the government of Mozambique is actually trying to make it difficult for these types of NGO-funded organizations to do their work in Mozambique.  Within the last two months, the government has raised the price of a yearly visa for Mozambique to over $1,000 USD, which is a huge increase from what it was previously.  As Peace Corps Volunteers, we have also had to deal with this visa complication.  We don’t actually have our passports right now because PC is trying to work out a solution with the Mozambican government.  Anyway, I assumed this was just an economic decision, but apparently it may have been motivated by Mozambique try to reduce its dependence on foreign aid.  I think, however, that this could have grim consequences for the thousands of communities still relying on NGOs for vital health services.  Something to think about. 

Sorry, no one probably finds this interesting except me, so I’m going to move on.  Here’s a vignette: the other day I noticed my maid, Gracinda, was collecting the millipedes from under the shower mat and between the cracks in the house outside.  I was suspicious about her intentions for these little critters after my experience on the first night here with the fireflies (we collected them by the hundreds outside on our window and then they proceeded to eat them like chips the next morning).  To give you an image, these millipedes are grotesque but kind of cool looking creatures - about 5 inches long and 1 cm in diameter with exactly 1,000 legs, maybe.  Once we had a good size bucket full of them, they are everywhere, literally (every time I take a bucket bath I lift up the mat and kick out 5 or 6 from underneath), she proceeded to the kitchen, and I was like, oh no.. 

Fast forward to dinner that night.  Sitting at the table, hungry from a long day in the heat; two covered pots sit expectantly on the table.  First pot…rice, phew, safe.  Second pot…a mound of fried millipedes.  Oh no..  In her defense, Gracinda cooked them well so that they, in fact, didn’t really look like millipedes anymore.  I mean, you couldn’t really distinguish all of the 1,000 legs or the waxy exoskeleton.  At this point, they looked more like crusty fried tootsie rolls.  I could not stifle my laughter as they dug into the crusty tootsie rolls.  My plate looked like this: a mound of rice, with one lonely millipede staring at me from the top of the rice mountain.  I threw it down the hatch.  I don’t think it tasted too bad, but I really couldn’t tell.  The repugnant association with having a millipede in my mouth overpowered any flavor I may have found in the little guys.  I think it was like an over-salted piece of burnt popcorn if I had to guess though.  Both Gracinda and her husband found it very odd that I had this guttural rejection of eating millipedes and asked me earnestly whether we eat these in America.  I couldn’t help but have a good laugh after that. 

Now I’m off to Gorongosa, a site a few hours north of here to reunite with other Sofala volunteers for Christmas.  There won’t be any snow, Christmas lights or Christmas trees, but I’m excited to see some familiar faces again and enjoy the company of friends for the holiday.  I’m hoping to at least have a creative Christmas cookie decorating competition and watch “A Christmas Story” 3 or 4 times.  We’ll see!

Merry Christmas!