I spoiled the election...
Send to your friends, especially those who are not voting!
Brent Keener Spoils Presidential Election
Thursday, October 30, 2008
Rantings & Updates
“When I give money to the poor, they call me a saint. When I ask why the poor have no money, they call me a communist.” — Dom Helda Camara
"Tell me what you think about money, and I can tell you what you think about God." -Billy Graham
I’m back! So the infection isn’t anything to worry about, at least not at this point. However, they want to keep me in Gaborone for a few days for “observation” – completely against my will – but I guess the last experience ruined their trust in my body :)
As for America, I am so glad to not be there right now! Haha. Generally speaking, I miss my country (and leaving it is the best way to realize how much you love it), but my oh my elections bring out the worst in us. Why are Americans so hostile about politics? Why are both sides tearing down signs and yelling and resorting to slimy TV ads? C’mon guys, really. Our country so immature in this regard. Both sides consistently resort to emotion-based campaigning rather arguments based on logic, facts, or reason. Barack, with his pretty adjectives and poetic prose and McCain with his never-ending suggestions that if - you - vote - for - the - socialist - black - Muslim - we’re - going - to - be - the - next - Syria - because - the - A - Rabs - will - take - over. It’s ridiculous. And what’s even more ridiculous is how people fall for it, on both sides. How many people can lay out reasons, based on policy, why they support or do not support a candidate? Too few. Too many are voting for Obama because they hate Bush, and even more are voting for McCain because they are scared of Obama (which, let’s be honest – a lot of that stems from his color and his name. A recent NEWSWEEK poll showed that a large number Americans STILL think he is Muslim. C’mon people – he met his Muslim father ONCE in his life, and was mostly raised by his Christian [and white, if that matters to you] grandparents.)
But, wow, the Republicans are really fumbling aren’t they? They’re like a cube of ice on a hot stove – sliding in the wake of their own mess. Unfortunately, in my opinion, their whole school of thought has our country in a very uncomfortable place. Corporations are becoming more powerful than the Government (many of them are so rich they could BUY countries if they wanted to… is that where we want our future? Wal-Mart buying Bangladesh?), poverty in the US is at it’s highest in decades while our global reputation is at its lowest – even among European states, who have historically been our closest allies. Even internally, our divisions are becoming hostile. And, to me, the current administration’s largest shame is how dichotomized they’ve made us – how at one point you couldn’t criticize the war and still call yourself patriotic, how you can’t support talks with Iran without being a terrorist-appealer, how you can’t try to mediate the fact that the rich are getting richer and the poor are getting poorer without being a socialist, how if you say you are embarrassed at some of our country’s behavior that somehow means you are un-American or un-patriotic, and how you can’t possibly believe in God and vote Democratic. It’s a shame really. Manufacturers are losing jobs to China, India, etc. so that the big dogs can make a bigger profit – and that’s all very ironic, since these small-town people tend to vote Republican, when that party overwhelming encourages and makes it easier for outsourcing to occur. Same with small-town farmers – they tend to vote Republican when that party – particularly this administration – has favored ‘factory’ farms over Farmer Joe.
And I know a lot of people are weary about having such a ‘radical’ candidate running for office, but it’s merely a response to 8 years of radicalism from the right. When you have 8 years of total disregard for separation of powers, checks and balances, and even international law, you’re bound to have an opposition candidate with a more multilateral view of the world.
“If this were a dictatorship, it would be a heck of a lot easier, just so long as I'm the dictator” -George W. Bush, December 2000
But, I guess our country suffers from the same tension that most places do, and the same tension that we endure as individuals – the painful tension of trying to move forward while at the same time holding on to what we were.
“I look at my environment and wonder where the fire went – what happened to everything we used to be?” -Lauryn Hil
Anyway, a lot has been going on at the clinic. My good friend, and the person with whom I work the most closely, is being forced to step down. She is our PMTCT counselor, is HIV-positive, and she has become pregnant (upon accepting her job, she was required to sign a document saying that she will not become pregnant). Since she is HIV-positive and part of her job is to discourage positive women from becoming pregnant, in the Government’s eyes her pregnancy is hypocritical and therefore unacceptable. I have mixed feelings on the issue. In my opinion, the sole purpose of PMTCT is so that women can live a normal life – i.e. become pregnant and still have HIV-negative babies. Additionally, telling HIV-positive women that they should not have babies essentially means the Government is discouraging more than 50% of Botswana’s women from becoming pregnant. And in many developing countries, economic growth is strongly correlated to (or at least heavily influenced by) population growth. Consequently, the issue is quite complex and I see both sides’ arguments. But of course, on a personal level, I am quite disappointed.
The rains have come! Well, just once, but it’s a start. And when it rains here, it isn’t a drizzle – it’s like gray sheets of water slamming down from the sky… so enjoyable, unless you’re in transit. The negative side of the rain, of course, is that now is when all the creatures come out to play. So mosquitoes and bugs in general have been worse, and snakes and scorpions are rearing their ugly heads. A snake has been slithering its way around the clinic compound at night, which is worrying many people as the tracks are quite large. Our doctor killed one at his house last week, and the theory goes that once you kill one the others start to come. Many of the snakes in this area are quite harmless, but Botswana is home to some of the world’s deadliest, including adders. So it may be a long rainy season.
My ‘son’ is doing ok – he and his younger brother are still consistently underweight when they come in for their monthly weigh-ins, but not much seems to be happening as a result. His father is doing very well and has been exceptionally pleasant lately. I’m trying to build a positive relationship with him so that when my Kalanga is good enough, I can politely request he bring the kids in for testing without him wanting to kill me. Wish me luck on that! Having your kids tested seems like Parenting 101 to us, but a lot of men – self included – tend to avoid medical settings at all cost, and of course culture plays a large role here.
"Tell me what you think about money, and I can tell you what you think about God." -Billy Graham
I’m back! So the infection isn’t anything to worry about, at least not at this point. However, they want to keep me in Gaborone for a few days for “observation” – completely against my will – but I guess the last experience ruined their trust in my body :)
As for America, I am so glad to not be there right now! Haha. Generally speaking, I miss my country (and leaving it is the best way to realize how much you love it), but my oh my elections bring out the worst in us. Why are Americans so hostile about politics? Why are both sides tearing down signs and yelling and resorting to slimy TV ads? C’mon guys, really. Our country so immature in this regard. Both sides consistently resort to emotion-based campaigning rather arguments based on logic, facts, or reason. Barack, with his pretty adjectives and poetic prose and McCain with his never-ending suggestions that if - you - vote - for - the - socialist - black - Muslim - we’re - going - to - be - the - next - Syria - because - the - A - Rabs - will - take - over. It’s ridiculous. And what’s even more ridiculous is how people fall for it, on both sides. How many people can lay out reasons, based on policy, why they support or do not support a candidate? Too few. Too many are voting for Obama because they hate Bush, and even more are voting for McCain because they are scared of Obama (which, let’s be honest – a lot of that stems from his color and his name. A recent NEWSWEEK poll showed that a large number Americans STILL think he is Muslim. C’mon people – he met his Muslim father ONCE in his life, and was mostly raised by his Christian [and white, if that matters to you] grandparents.)
But, wow, the Republicans are really fumbling aren’t they? They’re like a cube of ice on a hot stove – sliding in the wake of their own mess. Unfortunately, in my opinion, their whole school of thought has our country in a very uncomfortable place. Corporations are becoming more powerful than the Government (many of them are so rich they could BUY countries if they wanted to… is that where we want our future? Wal-Mart buying Bangladesh?), poverty in the US is at it’s highest in decades while our global reputation is at its lowest – even among European states, who have historically been our closest allies. Even internally, our divisions are becoming hostile. And, to me, the current administration’s largest shame is how dichotomized they’ve made us – how at one point you couldn’t criticize the war and still call yourself patriotic, how you can’t support talks with Iran without being a terrorist-appealer, how you can’t try to mediate the fact that the rich are getting richer and the poor are getting poorer without being a socialist, how if you say you are embarrassed at some of our country’s behavior that somehow means you are un-American or un-patriotic, and how you can’t possibly believe in God and vote Democratic. It’s a shame really. Manufacturers are losing jobs to China, India, etc. so that the big dogs can make a bigger profit – and that’s all very ironic, since these small-town people tend to vote Republican, when that party overwhelming encourages and makes it easier for outsourcing to occur. Same with small-town farmers – they tend to vote Republican when that party – particularly this administration – has favored ‘factory’ farms over Farmer Joe.
And I know a lot of people are weary about having such a ‘radical’ candidate running for office, but it’s merely a response to 8 years of radicalism from the right. When you have 8 years of total disregard for separation of powers, checks and balances, and even international law, you’re bound to have an opposition candidate with a more multilateral view of the world.
“If this were a dictatorship, it would be a heck of a lot easier, just so long as I'm the dictator” -George W. Bush, December 2000
But, I guess our country suffers from the same tension that most places do, and the same tension that we endure as individuals – the painful tension of trying to move forward while at the same time holding on to what we were.
“I look at my environment and wonder where the fire went – what happened to everything we used to be?” -Lauryn Hil
Anyway, a lot has been going on at the clinic. My good friend, and the person with whom I work the most closely, is being forced to step down. She is our PMTCT counselor, is HIV-positive, and she has become pregnant (upon accepting her job, she was required to sign a document saying that she will not become pregnant). Since she is HIV-positive and part of her job is to discourage positive women from becoming pregnant, in the Government’s eyes her pregnancy is hypocritical and therefore unacceptable. I have mixed feelings on the issue. In my opinion, the sole purpose of PMTCT is so that women can live a normal life – i.e. become pregnant and still have HIV-negative babies. Additionally, telling HIV-positive women that they should not have babies essentially means the Government is discouraging more than 50% of Botswana’s women from becoming pregnant. And in many developing countries, economic growth is strongly correlated to (or at least heavily influenced by) population growth. Consequently, the issue is quite complex and I see both sides’ arguments. But of course, on a personal level, I am quite disappointed.
The rains have come! Well, just once, but it’s a start. And when it rains here, it isn’t a drizzle – it’s like gray sheets of water slamming down from the sky… so enjoyable, unless you’re in transit. The negative side of the rain, of course, is that now is when all the creatures come out to play. So mosquitoes and bugs in general have been worse, and snakes and scorpions are rearing their ugly heads. A snake has been slithering its way around the clinic compound at night, which is worrying many people as the tracks are quite large. Our doctor killed one at his house last week, and the theory goes that once you kill one the others start to come. Many of the snakes in this area are quite harmless, but Botswana is home to some of the world’s deadliest, including adders. So it may be a long rainy season.
My ‘son’ is doing ok – he and his younger brother are still consistently underweight when they come in for their monthly weigh-ins, but not much seems to be happening as a result. His father is doing very well and has been exceptionally pleasant lately. I’m trying to build a positive relationship with him so that when my Kalanga is good enough, I can politely request he bring the kids in for testing without him wanting to kill me. Wish me luck on that! Having your kids tested seems like Parenting 101 to us, but a lot of men – self included – tend to avoid medical settings at all cost, and of course culture plays a large role here.
Monday, October 27, 2008
Maybe that curse is true...
I am in Francistown waiting for the train to Gaborone so that I can go back to the hospital and see the surgeon... again. One of my scars is infected, below the surface, and the tissue underneath is still bone-hard, and is it secreting some puss. The nurses at the clinic did some painful prodding and think the infection is quite deep; if they are right, I'll be having another procedure (though this one should be even more minor than the last) to remove the infection. Fun. Let's hope this time it does not result in several more weeks of hospitalization!
A lot has been happening these past few weeks, and so at some point during my captivity in Gaborone I will type an update and post it here when I pass through Francistown to go back home... whenever that may be.
Hope all is well at home!
A lot has been happening these past few weeks, and so at some point during my captivity in Gaborone I will type an update and post it here when I pass through Francistown to go back home... whenever that may be.
Hope all is well at home!
Saturday, October 11, 2008
Thursday, October 2, 2008
It's Been A While
It has been a very interesting month, one which I am very happy to have ended. It began with me heading to Kanye for a workshop, with a stop in Francistown to see my friend prior to catching the night train. She and I were walking her new puppy when, out of the blue, a massive black dog came running towards us and began devouring her puppy. My first and not my brightest reaction was to pick up the puppy because in the US - generally speaking - if you remove puppy then the dog is likely to bugger off. Unfortunately the dog decided to go after us. Well done Brent. But the three of us (myself, friend, and dog) all made it out alive; unfortunately my friend's leg was mauled. We were rushed to the Ftown hospital and treated, and consequently I was unable to make the train that night - a small price to pay considering that 3 weeks later my friend still can't walk without assistance. But she will be ok, as is the puppy. I guess the result was a lot better than it could have been, but the sound of large dogs barking will likely not be the same, for either of us, for some time.
A few days later I managed to catch a ride to Kanye for a fashionably-late arrival to our workshop. Within days I began to develop some pains in my lower right abdomen, which at first I thought was a pulled muscle after an intense workout. However the pains continued along with some other symptoms and towards the end of the workshop I was sent to Gaborone for a sonogram, CAT scan, blood work, etc. Apparently my appendix was near bursting so within two hours I was checking out of my hotel and checking in to the hospital for a laproscopic appendectomy. The surgery itself went ok and I was out in a few days. I was driven to a friend's house in Molepolole for further recovery; however, a few hours after arrival I developed a high fever, severe vomiting and diarrhea, inability to walk, and loss of circulation in my hands and feet. I had memories circa 2006 of my malarial experience in eastern Ghana. So, within just a short time the driver turned around and collected me and we met an ambulance half way, who rushed me back to the same hospital - and same ward - in Gaborone. It turns out I had a minor infection and something called pseudo-membrane nescolitis, a condition the Dr. claims he hasn't seen in over 15 years. I am so lucky. So that took 5 days and 6 nights in the hospital to recover from, during which I developed some surface-level internal bleeding (which supposedly isn't too worrisome, though two weeks after the surgery I am still having some bruising and small pain - and not near the incisions). Then they had me stay in a lodge in Gaborone for an additional 5 days for observation. Now I am determined to make it home today! One more day in Gaborone will have me both depressed and bankrupt. (The cost of one meal in Gabs is roughly equivalent to my daily wage... so you can imagine what buying 2-3 meals a day has done to my living allowance. I'll get a small per-diem to help compensate the loss but it certainly wont suffice). So I'll be living very very simply this quarter, something I can certainly afford to do with a little bit of effort.
Despite the range of medical issues that have arisen, I have been impressed with the care here. The hospital I was in was NOTHING like those in Ghana - so there was actually running water and there were no goats going through my bags while I was sleeping. They even served meals! The PC staff has also been great. But I think we are all ready to send me back to Maitengwe, haha. So tonight I will catch the train from Gaborone to Francistown (I have a first class sleeper... which isn't as classy as it sounds but it does provide me with a bed on which to sleep) and I will arrive in Ftown tomorrow morning. After a boring 2+ hour bus ride tomorrow I should be safely and happily at home, where I am told I have quite a large number of mail waiting for me... so a big THANKS to everyone who has sent something in the past month. I am not sure when I'll next come to Francistown. While my house is low on food, my energy is likely to be lower so it will be at least a week before I will feel strong enough to head to Francistown as it makes for an exhausting day of travel.
So that's been my September. Who's had a worse month: me or America? I vote the latter. The hospital and the hotels have done a good job of keeping me up to date with the news. Geeze, I could say a ton about the political and economic situation of our country at the moment, but those of you who agree with me will find it redundant and those of you who don't are unlikely to alter your opinions anyway so I guess my ramblings would be completely futile, eh? :)
A few days later I managed to catch a ride to Kanye for a fashionably-late arrival to our workshop. Within days I began to develop some pains in my lower right abdomen, which at first I thought was a pulled muscle after an intense workout. However the pains continued along with some other symptoms and towards the end of the workshop I was sent to Gaborone for a sonogram, CAT scan, blood work, etc. Apparently my appendix was near bursting so within two hours I was checking out of my hotel and checking in to the hospital for a laproscopic appendectomy. The surgery itself went ok and I was out in a few days. I was driven to a friend's house in Molepolole for further recovery; however, a few hours after arrival I developed a high fever, severe vomiting and diarrhea, inability to walk, and loss of circulation in my hands and feet. I had memories circa 2006 of my malarial experience in eastern Ghana. So, within just a short time the driver turned around and collected me and we met an ambulance half way, who rushed me back to the same hospital - and same ward - in Gaborone. It turns out I had a minor infection and something called pseudo-membrane nescolitis, a condition the Dr. claims he hasn't seen in over 15 years. I am so lucky. So that took 5 days and 6 nights in the hospital to recover from, during which I developed some surface-level internal bleeding (which supposedly isn't too worrisome, though two weeks after the surgery I am still having some bruising and small pain - and not near the incisions). Then they had me stay in a lodge in Gaborone for an additional 5 days for observation. Now I am determined to make it home today! One more day in Gaborone will have me both depressed and bankrupt. (The cost of one meal in Gabs is roughly equivalent to my daily wage... so you can imagine what buying 2-3 meals a day has done to my living allowance. I'll get a small per-diem to help compensate the loss but it certainly wont suffice). So I'll be living very very simply this quarter, something I can certainly afford to do with a little bit of effort.
Despite the range of medical issues that have arisen, I have been impressed with the care here. The hospital I was in was NOTHING like those in Ghana - so there was actually running water and there were no goats going through my bags while I was sleeping. They even served meals! The PC staff has also been great. But I think we are all ready to send me back to Maitengwe, haha. So tonight I will catch the train from Gaborone to Francistown (I have a first class sleeper... which isn't as classy as it sounds but it does provide me with a bed on which to sleep) and I will arrive in Ftown tomorrow morning. After a boring 2+ hour bus ride tomorrow I should be safely and happily at home, where I am told I have quite a large number of mail waiting for me... so a big THANKS to everyone who has sent something in the past month. I am not sure when I'll next come to Francistown. While my house is low on food, my energy is likely to be lower so it will be at least a week before I will feel strong enough to head to Francistown as it makes for an exhausting day of travel.
So that's been my September. Who's had a worse month: me or America? I vote the latter. The hospital and the hotels have done a good job of keeping me up to date with the news. Geeze, I could say a ton about the political and economic situation of our country at the moment, but those of you who agree with me will find it redundant and those of you who don't are unlikely to alter your opinions anyway so I guess my ramblings would be completely futile, eh? :)
Saturday, September 6, 2008
Videos
Unfortunately they wont upload here but they are (very slowly) uploading on Facebook. So if you are not a facebook member, convince someone who is to show you my videos. There is one that is DEFINITELY worth watching!
Friday, August 22, 2008
All Quiet on the 'Tswana Front
Hello friends. No news here really. I've been in a bit of a funk the past few weeks, allowing things to marinate longer than I should. But I am on my way out of it, and the person we are on the other side of our funks is always so refreshing and clean.
Congratulations to my great friend Ginnie for her Peace Corps placement in Kenya. Jealousy aside, I am extremely happy for you and I know you are going to absolutely LOVE it. You'll see a lot of differences from Ghana - good and bad. Maybe I'll just have to travel my way home, via Nairobi... (sorry mom!)
Anyway hope all is well at home - PC provides us with Newsweek Magazine so I am fairly caught up on the news, save the few week lag that it takes to get here.
I'll be on again in two weeks, when I will be in transit to a workshop in the southern part of the country. Hopefully I'll have something interesting to say then.
Saturday, August 9, 2008
Calling for Entertainment!
“I think that life here [in Africa] is much more in line with our rhythm as human beings really. Because when I go home I see people who look completely stressed out, and it is as if, in one way, people are never really satisfied. There are such high demands. There are demands here as well, but here the human being is allowed to take up space… at home it is production which counts… Life seems so close here compared to [home]… [But] who is right and who is wrong? Is it that we have taught ourselves to WORK and do it wholeheartedly and with all our energy, while the Tanzanian has learned to LIVE and do that with the same enthusiasm and pleasure and energy? For whom or for what is it that we rush through life recklessly working? What is it that makes us REAL human beings? Is our welfare really worth the price we have to pay: not having time to care, or to take care of, or to be friendly, generous, smiling and hospitable?” -Excerpt from an interview in The Paternalism of Partnership
So while my days are fairly busy, by late afternoon I am mostly on my own and, as I am experiencing opposite seasons to you, the sun is usually down by 6:00 leaving me with plenty of alone time inside the house with not much to do. Those of you who know me know I love my alone time; however, those of you who know me know that my alone time without occupation only leaves me thinking. And those of you who are human know that it’s probably not the wisest idea to have a semi-cynical young man (who is approaching a quarter-life crisis, no less) sitting in his concrete house in the unbearably-cold and eternally quiet village of Maitengwe, Botswana thinking about Life & Co. Did I milk it enough? SO, that being said, I am requesting that you keep me from thinking by filling my time with books and music… no need to rush, but over the next few months if the feeling strikes you, then go ahead. Don’t know what to send? Well, those of you who know me also know that I always have a running list of books to read and music to explore!
How many of you realized in the last paragraph that you have no idea who I am? Don’t feel bad, I don’t either… LOL just kidding!
Anyway, if you are interested in sending me anything please click here to open the list.
Speaking of lists, I have updated the list of things that are good to send (the link to which is posted on the right side of this page) so feel free to peruse that as well. I think I am getting spoiled!!!
Also, I’d like to send some specific thank you’s out to a few people:
To Heather, a former colleague who I haven’t heard from in years – thank you for finding me and sending me some magazines! The kindness of past but familiar friends means so much when, at times, you feel like you have no one.
To Rick – well, I could write a thousand things to say thank you for, but most recently thank you for the INCREDIBLY thoughtful boxes of goodies for the children. You have no idea the joy they will bring these children, many of whom have never seen the things you sent. I’ll do my best to photograph their experiences but I am not at all a photographer. The fun began Sunday with about 8 or so kids, and the number has grown every day. Friday I left the clinic to find just over 25 kids waiting outside my house to play lol. They’re such good kids too. So we’ve been playing football (ie American soccer) every day since Sunday and we all have you to thank for the fun. Maybe we’ll form a World Cup team!
To my father, thank you for buying the clinic some bicycles. Walking over an hour one-way to do a home visit was annoying enough now… I cannot imagine what it would have been like in the blazing heat of December! You are a good, good man I hope to be able to put one foot in the shoes that you’ll leave behind one day… just don’t leave them behind anytime in the next 50 years, ok?
What else? The 3-yr-old-window tapping boy is officially coming home with me to the US lol just kidding. He comes to the clinic every morning before school to give me a hug (and sometimes charms his way into getting tea or breakfast from me) and then a lot of times he comes afterwards as well.
The other day we watched Robots (thanks again, Rick!). Well, he watched Robots and I watched him watch Robots. I have to say, seeing a 3 yr old watch his first movie is something I cannot explain, especially when it’s this 3 yr old. It was probably one of the Top 10 most beautiful moments of my life so far. In fact, I am not sure that he’d ever seen a screen before. So for him, Robots (which is one of those computer generated movies like Toy Story) was more than just seeing real people on a computer screen – it was like seeing something from a dream, or from the future.
I will say though, he is sad way too often. It’s not normal. I’ve never seen a 3 year old so… raw? You know most kids just stare and drool and don’t know their elbow from their buttocks, but this one is aware of his reality - I think even more than his older siblings. Three year olds don’t just wander to the clinic and from 50 feet away walk towards you without a slightest hint of a smile, and then just walk straight into your legs and collapse, breathing heavily. Some days no matter what I do, he won’t smile. He won’t smile, he won’t speak, he won’t cry, he’ll barely blink. It’s like he’s just completely numb. On a more joyous note, the other day during our morning meeting we heard a kid outside the office singing in Kalanga, “I’m the son of Kagiso! I’m the son of Kasigo!” and sure enough we opened the door to find him shaking his booty at the old ladies waiting to be seen. He’s a ham, that one. But also fire and ice.
As for some breakthroughs? Well this week we had a few. The American Embassy has agreed to come take a look at our orphan center next week. They are interested in helping us build a nice kitchen so that the two old ladies who cook for the 45+ children EVERYDAY can have a better facility in which to work, instead of just an open fire outside. (It just hit me how incredibly dedicated these women are. I admit, I hadn’t really thought about it until actually writing it down. But cooking for 45+ children everyday? You try it… and wait ‘til you’re old). So someone is coming on Wednesday and I have been charged to show him around and charm him a bit. I will say, the Maitengwe HBC (HBC = Home Based Care, the organization that operates the center) is very committed & responsible. They don’t want handouts; they just want help. So as their input for the kitchen, they have agreed to provide the bricks, the sand, and the concrete. THIS IS DEVELOPMENT: working together.
Some other good news has yielded some bad news, which I am hoping will later result into more good news. The guardian of the 3-yr-old-window-tapping boy has mostly been bed-ridden for some time. (By the way, I choose not to use names because these are real people with real lives, and the stories being told are theirs and not mine… so the least I can do is respect their privacy. I apologize that it makes the reading less user-friendly). I convinced the nurses to do a home visit, something we don’t normally do unless the patient is registered as a Home Based Care Patient or unless they are HIV-positive & pregnant. Anyway, he agreed to come in for some blood work (that’s the good news). Then Thursday we discovered that his CD4 count was less than 30 (that’s the bad news). For those of you who do not know – and to put it very simply – HIV attacks a certain protein (like a cluster of cells) called the CD4, which in turn destabilizes the immune system. HIV-negative people enjoy the privilege of having 700+ CD4 cells (usually more like 1,000+). And the main technical difference between HIV and AIDS is that someone is considered to have AIDS when their CD4-count drops below 200. So, having less than 30 is incredibly low – near death, really. In fact, it’s among the lowest we’ve seen this month. What’s even worse than the bad news is that this man does not want to take HAART (highly active antiretroviral therapy/treatment). He claims that his brother took the drugs and died anyway so what’s the point (again, relating back to my point about resignation in my last entry).
So, essentially this means that he has a month or so to live, if he is lucky. I am trying to convince the nurses to bring him back in and further convince him, but they’re resisting – and I don’t blame them. This is happening all over this village – heck, all over the world – and we just don’t have the time, capacity, staff, nor energy to follow every person and give them some ‘You Can Beat It!’ speech when at the end of the day, many people don’t – even with HAART. And ARV’s must be taken with faithful adherence, so someone who isn’t serious about taking them is likely to fail, and die. Unfortunately we can’t convince people to save their own lives. ‘And why should we?!?’ the overly conservative side in you might ask? Well, because if he goes he leaves behind 6 WONDERFUL kids (14, 12, 10, 7, 3, and 1) who, as far as I know, will have no one else here to care for them. So they will be taken by the state and sent to Francistown where there is – to put it bluntly – an orphan farm, where they will remain until they are 18. That being said, being taken by the state is a LOT better than what would happen in most African countries – so praise Botswana for at least having a state-run system where they can be fed and educated, though I am sure the conditions are not at all desirable.
So THAT is why each person should be followed and convinced – because an individual dying is not the worst thing that can happen, but leaving behind children with no guidance and love is. All the amazing things that have been done in this country since 1966 are in jeopardy and of course it’s the innocent who will suffer. Anyway, we’ll see what we can do but I am expecting this worse. After all, 15% of all children in Botswana are orphans, making up 8% of the total population.
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The entry above was written with the intention of being uploaded last weekend. However, the cost of transport to Francistown went up 30% so I told myself I would wait another week when I was more in need of food so as to kill more birds with one stone (this is the second time transport has gone up since I’ve been in Maitengwe… if it goes up again – which it surely will – it will likely be unjustifiable to go. Already the round-trip cost is equivalent to nearly two days of my wages, excluding the money I spend once I am here).
Anyway, before posting I wanted to share some updates – both good news! Firstly, some men from the American embassy came to see the Centre. It was kind of odd seeing Americans here, and I honestly found it difficult to speak as eloquently as I would like. They probably thought I had some sort of speech impediment but I have just become so used to speaking very simply and slowly. Anyway, they seemed impressed with the work we are doing at MHBC and would like to help us build the kitchen for the kids. However they have not yet received their new budget so the details of their commitment are pending. We are hoping for good news by the month’s end!
On more microcosmic yet larger news, the guardian of my window-tapping-boy has decided to give HAART a try! I had convinced one of the counselors to go back to his house and while he was fairly apathetic at the time – a few days later one of the nurses informed me that he had come in on his own accord and filled out the paperwork. Whether my persistent visits had anything to do with it, I don’t know. Either way I am happy to see he is at least going to give it a shot. It by no means guarantees a happy ending, but it least puts the option of a happy ending back on the table. Let’s just hope he stays committed because the medication requires responsible adherence to work properly, and intense side effects often discourage people from continuing.
So how’s that for good news from Africa?
I had hoped to upload some pictures and videos but unfortunately the connection is really bad today. Maybe next time!
Saturday, July 19, 2008
“Your view of other cultures and that they are poor says more about you than the place you’re trying to help.” -Lemn Sissay
Been missing me? Sorry it’s been so long since I have written. I’ve been so busy settling in, adjusting, and absorbing my surroundings. Things are pretty good here. While the difficult days are frequent at this stage, I really am happy to be where I am. The clinic staff are all great, and while of course at the moment I have the discomfort of being the awkward white person who doesn’t know nine-tenths of what people are saying, I am confident about my role, both at the clinic and in the village, and am so thankful and humbled about my surroundings.
Maitengwe is indeed an intense place. Once a month ‘new’ mothers (new meaning given birth in the last two years) come in and have their babies weighed, to make sure they are gaining weight. We also keep bio’s on the moms. I was perusing the list today and noticed the ages of the mothers: 16… 19…. 14…. 21… 48….51…. 57…. Um, what? “Where are all the mothers aged 25-45?” my inquiring mind naturally asked (though already sort of knowing the answer): The nurse kind of chuckles as if it should be 100% obvious: “They’re late.” [i.e. they’re dead]. So what you find now is a bunch of young mothers (often victims of rape, or being married off – i.e. being sold – to old men) and grandmothers who are taking care of their dead daughter’s orphans. We had a 12 year old give birth the other day, and let me just say it’s highly unlikely that she wanted the pregnancy. The oldest people (which in Africa is like 50+... hell the life expectancy here is well under 40, so don’t be offended when I speak of ‘old people’… it’s all relative!) have largely avoided HIV, save the occasionally grandpa having an affair and bringing HIV home to granny. However, the elderly are the ones faced with an increasing burden as their sons and daughters are passing, leaving them to care for many children – not to mention themselves! Being old is hard enough, especially here. This is a very cursory explanation; it’s far more complex than I make it sound or understand.
Our lay counselor was ‘arguing’ with me the other day how HIV was not a problem in Maitengwe. And I said, “You do realize that most people in this village have HIV, right?” Her response: “Not most… maybe just 50%.” When I told her the prevalence rate of the US, and how this region in Bots is among the highest in the world, she refused to believe and has asked me to print statistics to prove it. This is from the person who does our testing! She thinks, with support from other staff, that TB and cancer are bigger problems - despite that TB is the number one cause of death for people with HIV (in other words, they’d probably be able to survive it if it weren’t for the HIV. Thus, they are really dying of HIV and not TB). I asked how many people in Maitengwe have cancer, and she said maybe three dozen, compared to the 4,000 or so with HIV. But cancer is a bigger problem, she claims, because at least with HIV you can take drugs and live for 15+ years, but with cancer you’re doomed to die. She clearly does not believe in utilitarianism haha. But I see a lot of resignation here with regards to HIV and I guess I can understand it. There are signs everywhere, and radio messages, and posters, and, and, and… so I guess if my country had been trying, at least publicly, SO HARD for over a decade to combat HIV but we were still struggling at reducing prevalence OR we could just take drugs and live with it, then I guess I’d probably be resigned and just take the drugs and do the best I can do being HIV positive ya know? So I guess in their minds it isn’t a big problem because they can live with HIV. The problem is that I don’t think they have fully grasped the magnitude of transmission. Plus, a lot of men don’t get tested and therefore don’t take the drugs… so…
Meanwhile, I was flipping through our books for the last yr (our clinic does an exceptional job of recording, for the resources that we have) and June was a ‘good month’ because only 4/15 new pregnant mothers were positive. The good news is most positive pregnant women are signing up for PMTCT services, and in the last year we only had a handful of babies being born HIV-positive. Now we can only hope they are able to stay HIV-negative until they become coherent enough to make their own sexual choices. The hope is in the youth; really, they are the only shot left – my heart races when I think of what this place may be like in 20 yrs.
It’s come to my attention that I never really fully explained what I am doing here in Botswana, so let me take this opportunity to explain what I am doing, at least in theory. I will be assisting with the implementation of Botswana’s PMTCT (prevention of mother-to-child-transmission) program. Started in 2004, it was the first program of its kind in Africa. Technically, Botswana had been providing free PMTCT services since 1999 but not on the scale nor with the vigor that the 2004 program offered. A very cursory explanation of the routine is that women begin taking ART around 6 months into their pregnancy (it is not commonly known that HIV is most commonly passed from mother to child during the actual labor and/or post-labor process, not through gestation, so it is safe to wait until the 6 month point. It’s amazing how much of the body is separated from blood). Then during labor they are given some other ARVs and the babies are put on them as well for usually 12 weeks or so. The mothers are encouraged to exclusively breastfeed (meaning absolutely no bottles) or to exclusively use bottles. This may sound odd, as breast milk is a method of HIV transmission; however, assuming that there are no open sores, the mouth is not a vector of transmission, hence why oral sex does not transmit HIV. So a baby swallowing HIV-positive breast milk will not give the baby HIV unless the baby has open sores. Bottle-feeding a baby typically causes sores in a baby’s mouth, as the nipples are not quite as suitable for the mouth as the mother’s. God makes things better than we do, eh? Thus, if the mother is not exclusively breastfeeding she is likely to pass on the virus by way of the open sores caused by the bottles. ‘Why not just do exclusive bottle feeding with formula,’ you might ask? Well we do for HIV-positive women in America (mostly). The problem in Africa is that formula is very expensive, and therefore unattainable for the general population – not to mention that it’s best if refrigerated. Moreover, our clinic has been out of formula for several months – so the women who initially chose to bottle-feed their children are now forced to breastfeed their kids, due to the absence of formula. This is hugely problematic. Therefore, exclusive breastfeeding is the most culturally-appropriate method and is what’s promoted here in Botswana. My ‘job’ if you want to call it that is to help assist with the uptake and adherence to this program. More generally, I am here to build capacity in the community. Maitengwe already has a PMTCT counselor (most clinics here do) and I am not here to take the job of a Batswana – that isn’t sustainable. The development perspective of the Peace Corps, with which I agree, is to build the capacity of the community – not to come in, do this and that, and then leave; that isn’t helping the community in the long run. We need to be doing things that can be continued when we exit. Thus, my role is to examine the situation as-is, tweak it as necessary, and enable/empower the clinic staff as well as other community members to move things to the next step. Development doesn’t work if there isn’t a sense of ownership for the community. “You cannot develop people; people must develop themselves” is a paraphrase of the famous quote by former Tanzanian President Julius Nyerere. I agree with him.
Secondarily, I will be working with the orphan community in Maitengwe. As previously mentioned, there is a whole generation of people missing in this country and so there are a lot of orphaned children. Unfortunately the older people in this country are slow to accept change, but the youth are still quite moldable and so my job is to help empower the youth to make good decisions as they grow up (Sometimes I think development is just a new form of colonization… but that’s neither here nor there). You can’t exactly tell a 7 year old girl that she needs to use a condom, but you can teach a 7 year old girl how to stand up for herself, how to say no to boys, how to respect herself as a person, how to value education over being offered gifts by older men, and hope that those lessons will translate into her sexual life when the time comes (which unfortunately for girls it comes all-too young here).
However a lot of my work with the children is indirect. I am helping the umbrella organization, Maitengwe Home Based Care, secure funding for their development by drafting proposals, submitting requests for funding, inviting donors to come visit, etc. THE GLOBAL FUND, one of the world’s top organizations combating HIV/AIDS recently pulled out of Botswana (for political reasons) and since then MHBC has been suffering financially. (And if any you at any time feel compelled to contribute, we can have a discussion about that, as it’s a complex issue.) I have to say, so far I am pretty impressed with MHBC. The money seems to be going where it needs to be going, the staff are incredibly dedicated (most are volunteer), and the organization is genuinely willing to do all it can to be self-sufficient, and I am assisting with that process – seeking to help them establish income-generating activities so as not to rely on external donors. But it’s difficult, as their burden is greater than their capacity. I am in communication with the American Embassy, trying to get them to build a kitchen so we can more efficiently cook for the orphans. Those of you who come to visit will no doubt be incredibly moved by the Project Manager and her commitment to the organization and the children it supports. She is seriously the Mother Teresa of this village LOL. And she calls me ‘son’ & gives me free oranges :)
Speaking of orphans, I have a confession to make. *Big breath* For the first time in my adult life, I am having paternal feelings. Did you fall out of your chair? I know, sometimes I do too. I was working out one day when I randomly heard a soft tap on my window. I looked down to see this small boy, maybe 3 years old, dirty and wearing nothing but shorts. He was as cute as can be, as they often are, and we had played for some time and he went on about his way. I didn’t think too much of it, as it happens all the time here. Then the other week, a girl - about 10 or so - came in to have her baby brother weighed (she is essentially the mother as they are an orphaned family of 5) and brought with her the boy that had tapped on my window. I see so many kids that, although I recognized him, at first I was wondering from where - but then when he smiled I remembered him as the one underneath my window. I talked to the girl for some time, weighed the baby, etc. The eldest girl is too thin, perhaps a victim of what likely killed her parents, but she is obviously strong - too strong for someone her age, and too young to be as ‘old’ as she has to be.
Anyway, while she and the nurses communicated about the baby’s health, I played with the 3 yr-old-window-tapping boy. This one, among all the other kids I have met, has something about him. Most of the kids here under 5 are scared of me (for many of them I am the first white person they have ever seen). Not this one, man, he is a pistol. But I think what is most captivating about him is that he is sad. For having such energy, and the best smile in Maitengwe, behind his big eyes you can see that he is suffering – and the worst part is that I think he knows it. So I walked them to my house, gave them sweets, got their names, and sent them on their way. I walked back to the clinic and the nurses said, “Kagiso, we have never seen you so in to a child!” I sighed and said, “That’s my son.” They laughed at me, as they do a lot, but I reiterated: “I am serious, that one is my son. I feel it in my bones!” We all laughed it off, but I wondered why this one got inside of me. I am supposed to be the Tinman, free of all that mushy emotional stuff! Throughout my times in Africa, I have of course come across hundreds of charming and endearing kids – they’ve made me laugh and cry (privately, of course…) but at the end of the day that’s all it was.
Days went by and I did not see the children, until the other day I had one of the nurses take me to where they stay. They have a ‘guardian’ and those are big quotation marks. I wont comment any further at the moment. His brothers and sisters are all wonderful too, and I feel so much for this family, but there’s something about this one in particular. I stayed for a short time and met the other siblings and began to leave as he ran after me and said, ndo shaka yenda (I want to go) and he wrapped his arms around my leg, and I found my steps being accompanied by the weight of the 3 yr-old-window-tapping boy. The nurse said, “Kagiso, I think he knows he is your son too.” LOL.
Then today (sorry LAST story!) we had a morning meeting as usual and then were awaiting the mass arrival of the patients when a nurse said “Kagiso, turn around” and sure enough there was the 3-yr-old-window-tapping boy – sad as can be – a few feet behind me. Rather than walking to the orphan center, he walked to the clinic. He wrapped his arms around my legs and sighed. Bless him lol. I asked him if he was sad (In Kalanga, by the way – I am proud) and he said yes… I asked why but I didn’t understand the answer. I picked him up and took him to my house for hot tea (mornings are still BITTER here) then took him to the school. I went to the orphan center to have lunch with the kids and played with them afterwards. I was seated Indian style, kids going crazy all around me of course, and you-know-who pushed his way through the crowd, sat on my lap, took my right arm and wrapped it around him, did the same with the left arm, and began hitting any kid who tried to get my attention, haha. The teacher said, “He doesn’t want to share his father.” That’s when the coldness kicked in and I said, “Ok byeeeeee!” LOL. I went back to work for the afternoon, but sure enough, at the end of the day – he showed up again. So I took him back to my house and we snacked and danced (pictures at http://www.facebook.com/album.php?aid=2262019&l=ba27b&id=6213504) and off he ran back home (barefoot as always) and with a bag of potatoes for the rest of family.
I guess while I can write proposals, raise funds, and give talks, at the end of the day it’s in the small ways that I may make a difference – right? Eesh, was that romantic optimism? What’s happening to me...
Meanwhile, I can die a happy man! An older woman said she wants to have a baby with me so that it will have my nose. FINALLY – my nose isn’t the source of laughter and criticism! Haha.
If you made it this far, thanks for reading. Hope all is well at home.
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