Saturday, November 10, 2007

home visits

so, my job at fbs is not very defined. this fact has resulted in confusion, frustration and boredom at times. however, it also allows me more freedom to choose how i want to spend my time. this last week was really exciting as i got to accompany the home based care coordinator, make ndzimandze, on home visits.

i really love getting out of the office, and getting to see what the every day experience of living with hiv/aids is like. it's such a privilege to be able to enter someone's home, sit down at their bedside or on their couch or outside on the grass, and listen to their story. i've probably been on about 15 visits so far, and there's been such a range of everything: ages, severity of symptoms, level of wealth, friendliness, family situations... it's just helping me to realize that the hiv virus is just a sickness, like any other disease. people live for years with it, and many people are still going about their daily lives as before, keeping their status a secret - if they even know it themselves. most of the patients we saw were unable to work though, and stay at home, some of them confined to bed and too weak to even walk.

i've learned some of the warning signs, so that i'm beginning to be able to guess who is positive before they reveal it. the open sores on the legs and feet, that attract buzzing flies that the patient is so accustomed to that they don't even bother to swat them away anymore. the white tongue, a symptom of thrush, which coats the whole digestive tract, weakening the taste buds on the tongue to suppress the appetite, and lessening the ability of the intestines to extract needed nutrients from food.

many of the patients have another condition as well as being positive. one of the most common opportunistic infections to accompany hiv is tb. the amount of drugs patients need to take for this is ridiculous. at one patient's house, a soft-spoken, bed-ridden young man, he reached to his bedside table for a box containing 10 different packets of pills. managing this cocktail of drugs when you barely eat in a day is a challenge. there's an equally staggering number of drugs in the combination of antibiotics and vitamins given to prepare the patient to receive anti-retroviral drugs (arv's). many of the people we visited were at this stage. this treatment is supposed to get rid of any infections and strengthen the body before beginning the arv treatment, which is very harsh on the body.

however, the sad thing is that many people get to this stage, their bodies get stronger and they feel much better, and since they don't feel sick, they don't go back to the hospital to get the arv's. then after a while, their bodies will get run down again, giving hiv more of a chance to reproduce and get stronger. the arv's function to keep the virus at bay, allowing the disease to exist in the body but stopping it from reproducing, which allows the body to gain back strength and function as normally as possible.

there are also people that know they are positive, and so they go to get tested for their CD4 cell count. these are white blood cells that fight hiv - here they're called emasolja (soldiers). but then they never go back to get the results of the test, and without knowing your CD4 cell count, you can't begin treatment for arv's. the government will give you arv's once your count drops below 200. a healthy count is roughly 1500 - 2000.

so i've learned a lot from these visits, as you can see. all of these details of hiv are things that i probably read at some point in a textbook or magazine article, but could never manage to remember. how easy it is to recall them now that i've visited person after person whose futures depend on these numbers! my teacher has been make ndzimandze, a retired government nurse who is now the hbc coordinator at fbs. her wealth of knowledge about hiv, nutrition and basic healthcare combined with her huge network of relatives and acquaintances and her friendly and caring personality make her the perfect person for this daunting job. i feel so lucky to be able to have such a wonderful companion on these difficult visits.

the visits are mostly to homesteads in rural areas, and are conducted entirely in siswati. this has been excellent for developing my siswati. it's so rewarding that i am now able to follow the general gist of a conversation. then afterwards, as we head to the next patient, i get the details and explanations from make. at times my language "handicap" is also an advantage. we visted one middle-aged man who greeted us from bed as his relatives showed us into his room. however, as soon as the interview started, his family and even another care-giver who were accompanying us were required to get up and leave the room. he was positive, but had not come out to his family yet, and so the meeting had to be confidential. i tried not to let on how much i understood of the conversation, looking around instead at the magazine pictures that plastered the walls.

out of all the patients i've seen so far though, ncobile (i changed her name) stands out in my mind. she welcomed us into her one-room apartment that she shares with her 12-year old son and her grandbaby. she looked far too young to have a grandchild. she had received a food parcel from fbs last month, and expressed her warm gratitude for the gift. as she began talking though, her beautiful big eyes filled with tears and her thin frame bent over with sorrow as she told us her story. her first child is a daughter, who at 12 years old had been raped by an uncle. because of this, they left their family home and went to live with some friends in a nearby town. here, the daughter fell in love and had her child with one of the young men from the family they were staying with. however, she then left him for his twin brother, which caused hard feelings in the family and they had to move again, to where they live now. the family also denied any responsibility for the child. the mother, ncobile's daughter, now works in another town, living with another man, and her mother only ever sees her when she's drunk and needs money. however, ncobile has nothing to give her, and can't afford to send her son to school, rent her flat and feed the three of them. she hates the thought of it, but is looking for an orphanage for her granddaughter, since the child's mother doesn't take any responsibility for her. ncobile used to take in sewing, but she is hiv positive now and has been unable to work for a long time. last week when she went looking for work, she found she had lost all of her old customers. they hadn't eaten anything yet on the day we visted, at 2 in the afternoon.

i caught this story in bits and pieces, and sat there in silence, watching her cry as she held her granddaughter on her lap, who was also crying. make and i listened to her story, which spilled out as if it had been bottled up for a long time. at the end, when make asked me to pray for ncobile, i didn't even know what to pray for. i don't remember what i said, and i couldn't think of anything to say to ncobile as we walked out the door. i could only think to give her a hug, but couldn't even express my full sympathy and love in this way because she felt too frail to squeeze very hard. back at the truck, make and i dug into our purses for enough money for a meal, and when we left this with ncobile, she smiled and waved as we pulled out onto the road.

in the truck, i had no questions for make this time, and i thought that maybe she would be used to the emotional stress of home visits by now. but make, normally very chatty, was subdued, and said only, "this is why i hate home visits." we talked about providing help for school fees for ncobile's son through a partner organization, and make said she knew of a good christian orphanage that she would look into. this was the first home visit of the day, and i very much just wanted to curl up into a ball on the seat and not face the world for a little while.

however, we still had a list of patients, and so we pulled up in front of edward's (name changed) house. this was the third time we had come; the previous two times he wasn't there, and we'd been informed by a neighbor that he was visiting the neighborhood beer hall. but he was perched on a stool under a tree with his brother. edward was a tiny, wrinkled, little man, who had a sparkle in his eye as make lectured him on eating spinach and peanut butter to give him good protein. edward gave me hope again though, because on the last visit he had been very thin and weak due to malnutrition. fbs had given him a food parcel, and you could clearly see the result, this little man sitting quietly, but showing definite sparks of life. as i sat there under the tree, looking out at the vibrant green bean field stretching down the hill side, i felt like i wanted to continue to hear people's stories, even the difficult ones. even though they don't all turn out like edward.

Thursday, November 1, 2007

ncp

last saturday i had the priveledge of getting to visit a neighborhood care point, or ncp. these are stations set up around the country to help care for orphaned and vulnerable children (ovc). this particular ncp was at hope house, an assemblies of god church. the pastor also runs an orphanage where they care for 36 children.

we got to meet his wife and relax in their home and enjoy tea and biscuits and watch finding nemo with two of their adorable children, deborah and abigail. this is because we showed up at 11, thinking that there was a service before the children began arriving at 2. unfortunately, there was a miscommunication, so we were left standing out on the hillside until someone spotted us and directed us to the pastor's home. but the wait was lovely, as it was a gorgeous sunny day and we had hiked halfway up a mountain to get there, so the view was just spectacular.

it was also interesting to talk with the pastors wife about the orphanage and the challenges that they face. it was also a good connection, since when she found out where i was from, she invited the fbs health team to come and do a presentation at their church.

the church women who do the cooking arrived around one, and started a fire under the huge black three-legged pot donated by unicef. the pot contained 8 packets of protein-fortified dehydrated vegetable blend, and ahuge quantity of water. looking at the flakes in the boxes donated by usaid, i was skeptical. but as the pot began to bubble, the contents started smelling rather delicious.

the kids began arriving and were herded into a half-finished concrete structure, which will become the new ncp kitchen when it is completed. (for now, they just cook outside.) for half an hour, i enjoyed singing praise songs and listening to the children memorize bible verses. the atmosphere was really fun and upbeat. it was also encouraging because i could sing along to most of the songs, thanks to our nightly prayer times at home which always include a lot of singing.

then the food was ready, and the children lined up with tin plates and spoons to receive a ladle of veggie blend. as they settled down to eat, i peeked into the pot and saw that there was quite a bit left. i scrounged up a cup and the ladies laughingly dished some out for me. i was pleasantly surprised, since the mixture turned out to taste like mashed potatoes with carrots and beef added. which is exactly what it was, fortified with a bunch of b vitamins. apparantly the kids really like it too, because quite a few of them headed back for seconds.

besides getting a solid meal, the ncp also keeps track of vital health stats for the children, and these statistics determine how much food the ncp receives. if a lot of the kids are malnourished, for example, the ncp will receive more food next month. my fellow salter trevor/themba works with the church forum on hiv/aids, coordinating the monitoring of ncps. so after this experience, i'm totally jealous of his job!

so after spending five hours on a mountainside in motjane (just 10 km from the south african border) i was quite sunburned but also very encouraged. it was wonderful to see such a concrete expression of love and care. joy was evident in every party, from the kind and energetic sunday school teacher to the enthusiasm of the children to the care and concern of the pastor and his wife to the friendliness of the cooks.

Saturday, October 20, 2007

ngiyafundza siswati...

this last week has really been one of starting to feel more comfortable here in swaziland, feeling more at home. which is lovely, considering that for the past two months (i've been here two months?!) i've felt really scattered and like i've been trying to figure out how to be myself here.

this past week our siswati classes ended. trevor, jesse and i had been meeting with babe shongwe every afternoon (mon - thurs) from 4:30 - 6:00 for language study. it was a process that was very frustrating at times, but also brought many unexpected surprises. mostly when babe (pronounced bah - bay, it means father, and is used as a term of respect for any married man) would get sidetracked from whatever he was supposed to be teaching us and get onto some topic like kudega. which is a kind of traditional swazi engagement which is actually more like a forced marriage. here's what happens: your boyfriend invites you over to his house to visit and meet his family. then, in the middle of the night, he slips away and comes back at 4 or 5 am with all of his relatives, who come and bang on the door of the room where you're sleeping. when you come to answer the door, they shout "we've dega-ed you!" (or however you say that in siswati) and from that point on, you're considered engaged. you're then required to sing until dawn, and make a big show of crying because now you're forced to leave your family and come live with your in-laws. so while you're singing with the women of the family, all the men from your inlaws family go to your homestead with weapons and knives and stick them in the ground outside your gate. when your family finds them, this is how they know that you will be getting married and leaving them.

that was only one of the many cultural episodes courtesy of babe shongwe, who also has a great sense of humor. one of the more hilarious lessons was just this past week, when we were learning HIV/AIDS-related vocabulary.

*this blog doesn't have a rating, but just be warned that what's coming up is definitely pg-13*

so we learned that the swazi word for condom literally translated means "a coat for the son-in-law" and that the word for penis is "gogo's cigarette". (just to clarify, gogo means grandma) we were all laughing until we cried and were left wondering WHO on earth comes up with these and WHAT were they thinking...

but these very enlightening lessons are now over and we're left on our own for language learning. so i continue to learn alot from my host family, especially the children, who never get tired of answering my continual question of "yini logu?" (what is this?). and percy (remember percy, the lemon-tree-climber?) has agreed to be my siswati tutor, so i'll start meeting with him next week, twice a week, for a little more structured time of siswati conversation.

i feel like i've learned more than i could ever want to know about siswati pronouns and noun classes and how to form negatives and the immediate and remote tenses of past, present and future... but the lessons have been really good in terms of an introduction to siswati and getting a feel for the language structure and some basic vocab. but i feel like the time of real learning still lies ahead. my goal for siswati is to be able to understand people and communicate with them, and to achieve this, i still have a lot left to learn.

the other thing i'm discovering about siswati is that i can know what every word in a sentence means, but still not have a clue what the sentence is saying. this is because a lot of words have multiple, flexible meanings, and you need to know the context to know what the word means in that context. siswati isn't just a language, it's very closely and intimately intertwined with the culture. which makes is a challenge to learn... but one that i'm enjoying, for the most part. it has its share of frustrations, but the rewards are tremendous.

it was the best feeling on the kombi the other night when i had a conversation entirely in siswati with the two women sitting next to me. i was so proud of myself! granted, it was just the basics, greetings, exchanging names, asking where i live, where i'm working, and hey! you speak siswati. well, a little bit, i'm learning... how much is the kombi... but i was just glowing afterwards because i understood everything they said and it felt like a normal interaction. and it was a little glimpse of how awesome it will be then i can actually converse comfortably with people.

Saturday, October 13, 2007

there is some kiss...

for those of you who appreciate poetry, i came across this poem a little while ago and it really spoke to me, especially the bit about the language door and love window. these are good words to hear when you are constantly faced with a language barrier. and i've found them to be true.

there is some kiss we want with our whole lives, the touch of spirit on the body. seawater begs the pearl to break its shell. and the lily, how passionately it needs some wild darling! at night, i open the window and ask the moon to come and press its face against mine. breathe into me. close the language door and open the love window. the moon won't use the door, only the window.

- rumi

Faith Bible School

some of you have been curious about my work situation, so i'll give you a little information about who fbs is and what we're up to right now.

fbs was started in 1976 by zionist bishop isaac dlamini and mennonite missionary darrell hostetter. their goal was to provide biblical training to zionist pastors. the zionists are indigenous, african-initiated churches who initially rejected missionaries' interpretations of christianity and instead blended biblical teachings with traditional practices. a youth wing of fbs started in the 80s, and then the HIV/AIDS project began in 2001, emerging from a group of youth who were inspired by an HIV/AIDS workshop at a youth camp run by fbs. the initial mandate of bible training stopped, and now fbs's main activities are marriage enrichment, peer education in life skills, livelihood skills and HIV/AIDS, home-based care for those suffering from HIV/AIDS and their families, a youth health team that sings and does drama presentations about abstinence and faithfulness in local churches, and an annual youth camp. they still focus on the zionist community, but work with many other churches as well.

so since the focus of fbs has changed so much since it began, they are wanting to conduct a review to figure out what direction fbs wants to take in the future, and whether or not we should change the name to more accurately reflect the work being done. so we've had meetings to develop a questionnaire that we will distribute to those who are active in fbs right now, and to those who were a part of it in the past (eg. when it was still training pastors) to determine what services are needed in the community. so this week i finalized the form, and i think next week we will begin distributing it as well as going to interview some people.

the second big project is the youth camp, which will take place from december 16 - 21. about 250 youth from local churches attend. the executive committee at fbs has been busy planning the theme and the contents of the various workshops and the schedule. so this past week i have also spent time drafting letters inviting speakers, letters to churches inviting the youth to attend, and letters to businesses asking for donations for the camp. the theme is "make a difference" and we'll be focusing on the lives of four biblical heroes (mary, esther, gideon, timothy) who were able to make a difference, even though they were young. we're trying to empower the youth and show them that they can achieve their goals, and have a positive impact on the world. we'll be doing workshops on gender, relationships, HIV/AIDS and spiritual gifts. and also having sports and crafts time and we're planning the last day as a conference day where we'll invite the public and have speakers and the youth will present debates about what they've learned during the week. it already looks like it will be a really good experience and i'm looking forward to it.

after seven weeks eSwatini...

so there aren't ten this time, but i figured i'd just write about things as i experience them so they're fresher, rather than saving them up until i have ten new things. (because after all, who wants to hear about stale experiences?)

1. oh, the marvels of electricity! my family's main house always had power, but since i have my own little thatched-roof hut, i had been using a propane lamp at night. but a couple weeks ago their uncle who works for the swaziland electricity board came and rigged up my little hut, and now i have a lightbulb and a electrical socket! so i can read as late as i want at night and now can heat water for my bath with the electric kettle.

2. THUNDERSTORM! last sunday i experience my first swazi thunderstorm, and it was amazing. so far we've had quite a bit of rain, but it's been the it's-grey-and-chilly-and-drizzling-all-day type. this was entirely different. the day was hot and sunny but with really strong winds, and then then entire sky clouded over in a matter of minutes. then there were hurricane-force winds which actually ripped the tin roofing off a few houses in our area, as i saw the next morning. and the power was out so we ate supper by candlelight, and all went to bed early. but i watched the storm from my window for a long time. the lightening was regular, in a pattern. it would backlight the mountains in the distance and then a few seconds later strike right overhead. and the thunder would shake the valley. it was awesome to behold.

3. emaasi. is something very dear to swazi hearts. in fact, my whole family was thrilled that we were having it for supper. they poured thick rivers of the rich sour milk over the moutains of liphalishi (maize porridge) on their plates. and i was up for trying something new. but as i began eating, no matter how much i kept telling myself that this was really no different than yogurt, it still tasted like barf. after it became evident that i wasn't going to be able to level the pile on my plate, zinhle took pity on me and made me and three year old tema (who likes emaasi about as much as i do) peanut butter sandwiches.

4. two weekends ago, i was lucky enough to be able to attend a traditional swazi wedding. first of all, i got about five marriage proposals right off the bat from men who were already well into the celebrations (by which i mean incredibly drunk for the middle of the afternoon). then the dancing troupe started heading towards me, and i knew i was in for it. they swept me up and we moved en masse to grace various people with our rhythmic stomping. and i was front and center, of course. it was a really interesting experience though. the atmosphere was really fun and positive, and some of the dancing was amazing. there was one point in the ceremony where dancers went one by one into the center of the chanting semi-circle of emahiya*-clad women, and they did these terrific high kicks. if a girl was especially energetic or talented, a warrior clad in skins and carrying a shield would run up and kneel down before her in appreciation, or sometimes she would get oranges or money tossed at her feet.

*emahiya: traditional swazi women's attire, the classic style is a maroon length of cloth printed with a large floral design, sometimes it is blue and depicts the king's face. it is worn tied over the right shoulder with the left shoulder left bare.

life is like...

life is like a lot of things. but today i'm thinking that it's like driving in the swazi mountains - you're always either going up or down, and you're never on a flat plain. that's kind of what my emotions have been like so far: i either feel really good about being here, or things are really difficult. and for the past few weeks it's been really difficult.

as i mentioned a bit in one of my previous blogs, i think i had unrealistic expectations about how i would fit in here. people look at me and just see one in a string of many white, american volunteers. they can't tell what kind of experiences i've had, like living for 13 years in benin. and even if they could, why should they care? as i'm learning, west african and south african culture are vastly different. and why shouldn't they be? they're on opposite ends of an enormous continent. but it's been a bit of a rude awakening.

and also, i know what it's like to be on the other side, receiving a string of volunteers and interns. and how they kind of blend into each other as they come and go. so i'm not surprised when my coworkers at the office forget and call me "nomsa" (the swazi name of the previous salter). but it hurts. because it reminds me how separate our lives are. and it reminds of how essential it is for development work that you settle down and really get to know a place. when i think about the relationships and level of understanding of the culture that i have here compared to how i am able to operate in benin, there's such a huge difference. and it makes me cringe to think about all the miscommunication and confusion and damage caused by well-meaning volunteers who come in trying to help, but with no understanding of the context. and so all i can do is acknowledge that i am an outsider here, and then be sensitive and open to learning as i interact with others and learn the ropes here. and this process is exhausting and difficult, but i know it's necessary and well worth the effort.