Sunday Morning~ Blantyre

July 9, 2017

“Ukakwera pa msana wa njobvu usati pansi palibe mame” ~ When you are on an elephant’s back, do not say there is no dew on the grass.

~ Malawian proverb

Hi Everyone,

If ever there was a proverb that described the insane lack of compassion in our country’s leadership right now, this is it. If the grass had any motivation, it wouldn’t have anything to complain about. I love the way Malawians pull these out appropriately and seamlessly insert them into casual conversation. It’s a skill I aspire to.  Since I’m traveling so much these days for Community Health, I have a bit of time for political discussions with the drivers when we hear snippets of world news on the radio. This proverb came up when we were talking about the U.S. health care situation and I tried to explain the political ramifications of our current plight. I tell you, if you ever want to find our predicament more ludicrous than it is, try describing it to someone in a developing country.

I was asked to say the closing prayer at our meeting on Friday, and I choked. To be fair, I had been up sick most of the night and was not at the top of my game. Bertha, had done the opening prayer and it went on for several minutes with nary a pause for breath. Flowed out of her like she were reciting the Pledge of Allegiance. These prayers are all ad lib. It’s not like we say the “Our Father”. I could have done that (and probably should have). The one leading the meeting usually calls on one of the attendees to say the prayer and the chosen never falters. There is always an opening and closing prayer. I’ve only been asked once before, and I somehow pulled it off reasonably but couldn’t manage to be that quick on Friday. Usually the prayers sound as if we were asking administration for better working conditions. The requests are quite literal. The students before an exam will ask God “for the correct answers.” But there are often lots of thanks thrown in there for a good balance. I had been sitting for the previous hour wanting to go home and back to bed. I had a chithenje wrapped around my shoulders with my feet in front of the small space heater fortuitously located at my end of the table. I couldn’t get warm. That was Friday, and by far the coldest day we’ve had here. It was in the 50’s during the day and cooler at night. Anyway, we had gotten through the exam vetting and were finished with the model ward proposal and other agenda items, and I was congratulating myself for making it through the entire thing without falling asleep. I planned to work at home for the rest of the afternoon and get the proposal edited and sent. Well, that’s what I planned to do. What I knew I would do was go home, lie down on the couch and go to sleep. Anyway, when the meeting was finally done, Elizabeth said, “Linda, would you do the closing prayer?” I think I audibly groaned. Then, knowing I couldn’t refuse, sat up and said some lame stuff about being grateful to be able to work with these women and help improve things, or something like that. Then I realized I hadn’t said “God” yet, so threw that in somehow and I think I ended by saying, “That’s it. Amen.” It was short. It didn’t flow with the divine spirit that Bertha showed. I went home and felt bad about it before I fell asleep.

Whatever illness had come over me the evening before was short lived, thank goodness. It hit me like a ton of bricks about 8 pm and I felt feverish and nauseated. I thought it might be the onset of malaria, though that’s unlikely since I’m under the net so early I hardly ever even get a mosquito bite. Plus I’m bundled up in long pants and fleece under a blanket as soon as it’s dark, so I didn’t think that was it. I couldn’t get warm, couldn’t throw up, though I wanted to, and just rolled around in the bed moaning. Finally after a few antacids, the stomach pain let up enough for me to fall asleep for a little while, and I felt better in the morning, but still have no appetite. Not sure what it was, but it’s going away. I didn’t eat anything weird. At least I don’t have to worry about George catching it. Our water was off for awhile this week and when it came back on it might have had some bacteria in it. I’m thinking that might be the problem (especially after our tour of the water board). We filter our drinking water, but I wash vegetables from the tap, so who knows. Anyway. I had made a bunch of good food and it’s sitting there uneaten. I’ll give it to the guards if it doesn’t appeal to me today.

My first year students finished up their community health rotation this week. Our two field trips included a rural and urban village, and the assignment was to talk to villagers about living situations and health care choices and write up a report about it. Monday we went to Mpemba, the rural village. The students were required to wear their white uniforms and caps, which seemed impractical to me, but it’s expected, so they all brought a chithenje to wrap around themselves to keep the white white. A Health Surveillance Assistant (HSA), a villager trained in basic health and sanitation, showed us to the chief’s house. The views were spectacular. It’s a  village situated about fifteen kilometers from Blantyre, on a hillside overlooking the escarpment to the Shire Valley. Stunning setting. Gorgeous views. I wanted to live there. I instantly noticed the difference in the student’s demeanor compared to when they are working in the wards. Their interactions with the villagers were so much more fluid and natural, despite the fact that we were in uniforms and they were in rags. The ease of the students’ questions, the follow-ups to the responses, the HSA’s comfort and posture all struck me as so much healthier than the behavior I see at the health centers. The women were thoughtful and eager to share. Some of us sat on rocks, others spread zithenje and sat on the ground. At one house a woman brought out a bamboo mat for us to sit on and placed it on a steep hillside. I kept sliding down the hill and had to struggle to stay on the mat while staying decent in my uniform skirt. The older women sat in front, most wearing headscarfs and old blazers. There were some younger women with short sleeves and bare arms and I shivered looking at them. I had on a sweater and was still chilly. The younger women didn’t say much; the elders did the talking. Some had babies bundled up in several layers of zitenje and blankets. When they breastfed it was a chore to get the kid close enough to the breast to get it into their mouths. The students asked about pit latrines and refuse pits, about water supply and proximity, how far they had to walk to the nearest clinic, how they fed their families. I was struck by how polite and respectful the students were in this setting. At the clinics many students take on an air of superiority and don’t speak to the women with such reverence. I’m not surprised that women don’t want to go to the health centers. After we talked with several groups, we walked around the market area to see what vegetables and grains cost and compare it with what the villagers earned in a month which, for some, was zero. On the bus back to campus I asked if the students felt they were learning anything from the experience?  All twenty replied in singsong unison, “Yes Madam”.  “Like what?” I asked. They said they hadn’t realized that five families shared one pit latrine, there were no refuse pits, the trash and garbage just got tossed in the bushes. Most families don’t make enough to buy food at the market. I started a follow up to that but they were squealing and laughing and eating the sugar cane they got at a bargain, and I didn’t know what points I wanted to make, so chatted with Lily for the ride home.

Tuesday I was with fourth year students in Bvumbwe, attending another home visit and dreading handing them back their case studies. I always hate being there when they see their grades and then I have to deal with their response. I know it’s part of the job, and I do it, but I don’t like it. I find it exhausting. I’m lenient with grading and I still get complaints! Well, they really shouldn’t be considered complaints, though that’s how the faculty sees it. It’s really just being forced to rationalize why they didn’t get credit for something. Most of the time my response is, “Because it was absent. You didn’t include that. As I wrote in the comment section.” and then they begrudgingly accept the deduction. I feel bad though, because they aren’t taught strong writing skills and having to express themselves in writing is a challenge for them. They sometimes think they’ve included something that is totally different from what was asked for. They didn’t understand because it’s in English not Chichewa and they get penalized. Next year I want to work more on this with the first years. I won’t be seeing the fourth years again after I go on home leave and I’m going to miss them. Well, some of them. When we are done with the group discussion at the end of the day, and I ask if anyone else has something they want to say, the class leader always says, “I’d like to thank you for coming. We have learned a lot today.”  I’m not sure if this is sincere or not but it never fails to humble me.  Of course, there are a few others who are looking at their phones and acting bored, but when the day is through, I see the ones still looking at me and it makes me want to go back. This week is their last week there and Thursday afternoon their assignment is to meet with the health center staff, report on their experience, and give recommendations for improving care there. That should be interesting. I didn’t make up these assignments, so I’m hoping the staff takes it well. I told the students they should be respectful. I’m sure they will be but I’ve seen the staff get defensive and since I’ll be there on my own without another faculty member, I just hope it’s not confrontational.

Wednesday, with the first years (the term freshman is never used here. they say ‘first years, second years’, etc.) was an outing to an urban village, one I’d passed many times on the way to Zomba and didn’t know existed. It’s like a cliff dwelling behind a busy market on the main road. Fascinating. Had no idea it was there. It was very different from Mpemba with the sweeping lush views. This was cheek to jowl, filthy, collapsing dwellings, with narrow paths between. One latrine for eight to ten families, though they do have water taps in a central squares dotted throughout.  It is steep though, and carrying the water on their heads, even though they don’t have to walk as far, looked superhuman. They do their laundry at the base of the steep hill in a disgusting polluted river. Awful. We stood while the students talked to villagers; there is no place I would have sat in this place. Most of the families worked at the market, so had more money to buy food, but the living conditions were way worse. Pigs were raised right alongside the children. There were crude pig pens five feet away from kitchens, which I suppose, made it convenient to toss them some scraps. In the center was a nursery school for orphans. There were two hundred kids, ages three to five. Adorable and amazingly healthy looking. A group of women volunteers run it, with some funding from an NGO. A “kitchen” where they cook nsima and beans every day is located just outside the door, and that is all the kids get to eat. Lily asked if they ever get a vegetable? Nope, never. I looked around at the rock-hard clay and wondered if we could do a permagarden there? The more I read about permagardens, the more I want to start them in challenging areas. The classroom was one big bunker with the alphabet written on the dark cement walls in colored chalk. There was not a stick of furniture or toy or anything else. Just a big empty cement room with two hundred kids along the perimeter. Benito, our class leader, was a teacher before he started university and jumped right in and led the kids in song. It was beautiful. He is a sight to behold. Everyone loves Benito. When there was a pause in the activity, Lily asked if I wanted to address the kids? Ugh! I hate that! I am not as quick on my feet as they are! I said, “I don’t know what to say!” She said, “It doesn’t matter. Just say something.”  Apparently, a mzungu is a rare sighting in this village. When we were walking through some narrow passageway, I heard some kids saying something and Benito, behind me, started laughing. I asked what they said, and he told me, ”One child said, ‘I saw an mzungu! And the other replied, ‘Yes! I know! I saw it too!’” Anyway, it was another time this week I felt like I did a crappy job of public speaking. I said, “I want to tell you I’m happy to be here and see how healthy and smart you all are.” It was stupid and trite but they all clapped when Benito translated it. Like she said, it didn’t matter, but I wish she’d given me a heads up.  I’ve got to get a few prayers and stump speeches prepared. This feels too awkward.

George is in Maine and sounds so happy. As I sit here on my porch, listening to the birds and local sounds it seems strange to go home in the middle of a stint like this. I find it hard to bridge the two worlds. I’m looking forward to my trip and seeing my family and friends but it is so different from this existence and requires a mental adjustment. George said, “I can’t believe how easy everything is here!” I remember that feeling. Need something? Just go buy it. When was the last time a grocery store ran out of tonic water? It happens regularly here. Which is why we buy it whenever we see it. But you adjust your activity and mindset and get along just fine. Getting somewhere seems so simple at home. Gas stations don’t run out of petrol. Banks usually have money. If a restaurant has something on the menu, it’s usually something they can serve you. You can even go to church and have some time left of your Sunday to do something else! My house is rented, so I’ll have time to wander around once George comes back here in August. I’m actually looking forward to being homeless and not having to go to work!  I’ve got a tent and friends and family and I am so fortunate. I could never have imagined the turn my life has taken since that foggy morning in Berkeley waiting for the train. I’m sitting on an elephant’s back and I don’t take it for granted.

Love to all,

Linda