What is worse than getting beat by girls in chitenges? (Zamruns Part II)

Early Wednesday morning, before the journey to Kalomo, I set off on my usual run. The Lusaka teachers had ended their strike and for the first time, children of all ages filled the sidewalks on their way to school. I made a right onto Addis Ababa and continued on the dirt path, parallel to the road. I caught up to a group of school boys, who couldn’t have been older than 7 or 8. At first they seemed surprised to see me and then the bravest starting running alongside me. At this point I remembered the advice Jon gave me… “Don’t forget to spread love and get people psyched around the world with high fives and fist pumps”. As a FPIT (fist-pumper-in-training), I decided to go with the traditional high-five. I held out my palm to the boy, smiling (and clearly not looking ahead). Just as his hand was about to hit mine, my foot caught on something and I was suddenly flying through the air. The flight ended as my body slammed down and slid across the ground, like I was stealing home. At this point, the boy looked at me with a mix of fear and shock. I tried to explain to him that humor was the proper response and that it is OK to laugh when people trip and fall….I mean I do it all the time (the laughing part of course, not the tripping). But he couldn’t stop staring at the bleeding gash on my arm. And I couldn’t stop thinking about how lucky I was that I didn’t take Jon’s second piece of advice to bring my camera on the run…

Ground control to Major Tom

To follow up an incredible morning of flying through the gorge on the end of a rope, I decided to spend the afternoon flying through the air on a microlight flight. You are probably wondering what the heck a microlight plane is…and apparently I should have asked the same question of the person selling me the ticket, as I showed up in a dress and flip flops. As you can see below, I was quickly given a flight suit to put on over the dress and was told I would have to fly barefoot…which makes the pictures even more classic.

I had a bit of time to wait at the airfield before “Flying Kangaroo” (my Australian pilot) was ready. A friend from the backpacker had joined me to watch and we sat with another American (we’ll call him Tennessee), who was also taking a micro-flight. His Zambian pilot, aka “Likes to Watch Top Gun”, aka probably needs some help coming up with a new tagline, was also not ready. As we waited, Tennessee was trying his hardest to impress us with his attempts at witty commentary. Also, he apparently didn’t see my triumphant face-first jump into the gorge earlier and was convinced I was going to freak out in the go-cart with wings. At one point he said, “We’ll just see who has the wettest panties at the end”. To which I quickly replied, “You wear panties?”A chorus of laughter from everyone (including Zambians who usually don’t get my jokes) around followed… and Tennessee was silent untill Flying Kangaroo was ready for me.

I was strapped into the ‘student-pilot’ seat. Yes folks, that one is going on the ole’ resume. Next, I was given earphones and a microphone to communicate with the Kangaroo. He said, “Karen, can you hear me?” I said, “Ground control to Major Tom”. He didn’t laugh. Apparently the Flying Kangaroo wasn’t a fan of David Bowie.

The pictures from the flight will tell the rest of story. One thing is for sure, I will never forget seeing ‘The Smoke that Thunders’ from clouds above…

Just because you can fit through the hole, doesn't mean you should crawl through it...

After catching up over late night beers and early morning coffee, the ladies caught a flight back to South Africa and I caught a shuttle to the falls. This was not my first trip to the falls – I had been on the Zimbabwean side in November 2006. However, the falls looked completely different – and not just because I was viewing from Zambia, but because there a significantly greater amount of water (November is dry season and June is still reaping the benefits of rainy season).

I spent the first two hours walking in awe – soaked by the mist, with the roaring water vibrating in my ears. For most parts of the trail, I was the only person in sight. Mainly because walking the path closest to the falls required one to commit to becoming completely drenched. Fortunately, I was wearing a hand-me-down trash bag inspired poncho and Teva sandals. Most others were sticking to the dryer routes.

I finally made it to the end of the trail to find two rainbows and the bridge to Zimbabwe in the distance. As I turned around, I nearly bumped into a young woman wearing a Gortex jacket, pants and hiking boots. Her father laughed, making a joke about how our two very different outfits were serving the same purpose with the same effectiveness. I ended tagging along with them for the next hour or two on the trail. The father was a renowned physician and researcher, while the daughter was about to start medical school in Chicago. In addition to our common health-related interests, they were both from NY and I was appreciating the return of sarcasm to conversations.

We decided that we wanted to cross the bridge to Zimbabwe, which can be done without any special visas, just a bridge pass. We followed a path that was marked ‘To Bridge’, but it ended at a fence and a great deal of barb wire. However, there was a hole in the fence, and lo’ and behold, it was big enough to crawl through. The father crawled through first and as the daughter began to protest, I followed suit and she was left with no choice. In the process of climbing through the fence and young British man on the other side asked if I was trying to break into Zimbabwe. I laughed at the prospect…

However, as soon as we made it through the fence and down onto the bridge, we were greeted by a guard with a carbine, very angry about the offence (of-fence suddenly the word is so fitting) we just committed. I was not worried about being shot or jailed, but I was definitely panicking that we were going to have to pay an exorbitant fine or bribe. Fortunately, the good doctor was a good talker, while his daughter and I played dumb quite well. Before the guard could object, we were all back through the fence and briskly making our way away from the crime scene.

Rejoicing in our freedom, we made our way back to their five-star hotel for some wine and lunch…

Aligning of the African Stars...

With Kalomo, district of last site visit, only being a two hour bus ride from Mosi-o-Tunya (The Smoke that Thunders in Tonga), otherwise known as Victoria Falls, I had no choice but to make the journey. I hopped on the bus and arrived in Livingstone close to 6pm. The first backpacker was full. A group of three recent college grads from Texas offered me the fourth spot in their four-man tent, but as tempting as it was to stay in a tent with three smelly boys who had been driving across the continent, I had to decline. I hauled my pack to the next spot that was recommended and found plenty of space – however, they suggested that I stay at their affiliate backpacker down the street. (There is a reason for all the details – I promise). I bought a beer and sat by the pool, waiting for a lift to the new spot. A half hour or so later, my ride was leaving and I went to collect my bags in the bar area. There was another American woman at the bar asking about her money that was locked in the safe. She looked familiar…

(Now a little more background…. Two very close friends from SF (Debbie and Carolyn) were traveling through South Africa and Namibia for three weeks in June. We had tried our best to make a plan to meet somewhere, but given my crazy schedule and their limited time in Africa, we weren’t able to make it happen. Debbie’s good friend from college, who I had met ONCE in January, was the third travel companion.)

Anyways, I figured I was wrong, but decided it was worth a shot to ask…. “Ashley?” I said. The woman turned to look at me and said, “Karen?” Then we both screamed. Turns out they were evacuated from a 6 day hike along the coast in South Africa because the swells were too high. In a very last minute decision, they bought flights to Livingstone to see the falls. Debbie knew I was out in the bush and therefore couldn’t be reached, so she didn’t bother emailing the last minute change of plans.

Deb and Caro were outside in a shuttle that had picked them up from a sunset cruise and I charged out the door of the backpacker bar and banged on the window. Screams, jumping and hugging quickly followed….I was shaking for a good twenty minutes afterwards. I don’t think I was aware of how much I was in need of a familiar face.

I never speak of fate or destiny – but truly the stars aligned to make this reunion happen, as they were far too many necessary pieces for it to be pure coincidence.

Who needs coffee to wake you up?

Adrenaline junkies from across the world make their way to Livingstone, as it is just falls short of beating out Queenstown, New Zealand for the adrenaline capital of the world title. With that said, I had no choice but to get my lifetime adrenaline fix on Sunday morning…

After a night of dancing with the locals (in a town with more white people than anywhere I have been in Zambia, I still ended up in the bar with ONLY Zambians…perhaps because I went out with the staff at the backpacker, instead of the other guests), I woke up early to head to the famous Gorge Swing, which entails a 53 meter free fall in 3.5 seconds. I had heard from most people that it was even scarier than the bungee jump off the bridge, but of course I only chose it over the bungee because it was half the price.

I arrived at the swing with 5 Canadian volunteers, four Brazilians and Montana (the nickname I bestowed upon him b/c I couldn’t remember his name). One Canadian refused to jump and all of the other females paired up for tandem jumps. There were a couple options for the swing…step forward and make the decision to jump or go backwards and have the guides make it for you. In this position, they strap your feet together and the guy holds your harness, as you are lean back, and then he releases you. Most people prefer this option because you don’t have to look down.

All of the tandem ladies went backwards, but only after a great deal of freaking-out/nearly backing-out antics on the platform. Montana and I watched, discussing how we would do our single jumps. We both decided on face-first because it seemed more intense. Montana went first and I had his camera ready to capture the jump. “1, 2, 3, Go”. But nothing. He was still standing. Before I could even set down his camera, he was turning around and getting his feet strapped together.

I had no choice but to still go face first – I had been chatting up the guides all morning and couldn’t let them down, right? As I looked down, toes curled over the edge of the platform, I thought I was going to pass out. “Karen, are you ready?...1, 2, 3…” and suddenly I was free-falling for the longest 3.5 seconds of my life. I have never experienced that kind of adrenaline surge and not sure if I care to ever again….

After hiking back up the gorge, I was awarded a nice cold Mosi for my star performance. Take a look at the video from the platform.

Mosi-o-Tunya...'The Smoke that Thunders'

More pics and stories to come (was accused of sneaking into Zimbabwe by at man with a machine gun) when I have time to update...but here are a few from the weekend at Victoria Falls...

Back to the bush...

After a brief, but very busy two-day stay in Lusaka, I am back on the road tomorrow, making my way to the Southern Province and Tonga people. Hopefully, the site visit will be followed by a quick visit to Victoria Falls over the weekend...

The irony of enouraging women to deliver in facilities...

As previously mentioned, there is a strong emphasis on delivering in a facility in Zambia. However, in many cases, the clinics I have seen leave much to be desired, and I wonder whether women are not better off in their home. I have seen decrepit delivery beds, covered in black mold. I have seen blood splattered on the walls and sterilization buckets without any bleach. I have seen women lying on cots in dark rooms, without anyone comforting them or coaching them through contractions. And women chastised for not bringing a cloths, soap and an umbilical clamp because the clinic had nothing to offer. Life’s risky start is not confined to home deliveries…

Childbirth is not easy in the village...

The number of expected pregnancies in the community and the number of facility deliveries per month are standard questions I now ask during site visits. It is not surprising to see a large discrepancy between the two estimates. In one clinic, situated in a community averaging 54 births a month, only 9-10 took place in the facility.

The extreme distances women have to travel, coupled with nonexistent infrastructure are largely to blame. Most babies also arrive quite unexpectedly. In reviewing forms at a clinic, I noticed that the expected delivery dates were recorded as entire months (i.e. November 2009). It is no wonder that babies are born on the roadside, to mothers in route to the clinic.

In addition, there is a grave shortage of providers in the rural areas. In some clinics, staff members typically responsible for maintenance and facility upkeep (no medical training) are taking on clinical duties to compensate. In other clinics, the sole provider is male, which results in cultural and gender-based barriers to facility deliveries. Consequently, many women choose to deliver the baby at home, with a trusted, yet often untrained traditional birth attendant.

Several maternal health programs in the rural communities are emphasizing ‘birth-preparedness’. Women are advised to have a plan for getting to a facility to deliver and set aside money for transportation. However, men are the decision-makers in the family and subsequently crucial players in determining whether or not women deliver in facilities. Therefore, these programs must go hand-in-hand with initiatives that push male involvement. During site visits, I have met plenty of incredibly supportive husbands and male community health workers. But I have also heard numerous stories of women dying from severe complications in home-deliveries, while husbands deliberate whether or not to organize money and transport to take them to a clinic. Even worse are complications that require hospitalization. For many villages I have visited, this means a five-hour ride on a horrible road to reach the nearest hospital. Since transport beyond a bicycle or oxcart is generally unavailable, an ambulance or district vehicle will first need to drive to the clinic and then return with the woman.

All of these delays limit chances for survival. Take for instance a home delivery with complications… first the complications (emergencies) must be recognized, which can be challenging if there is no provider or the provider is untrained. Then the husband must decide to seek facility care and organize transport, yet another delay. Then the woman will need to be transported to the facility, which could be as far as 30 km on a dirt road, usually traveling by bicycle or oxcart. Finally, if the complications are severe, it will take an additional 10 hours for the woman to reach the hospital by ambulance (and this is dependent on whether there is money for fuel). It is no wonder that the maternal mortality rate is so high…

Honest Musungu

Through the site visits, I am not just learning about rural healthcare, but also the rural economy. Each trip is laden with purchases from local producers. The prices are considerably cheaper than Lusaka, so the team I travel with goes out of their way to purchase whatever is available (It can be rather ridiculous at times). But everything must be bought in large quantities. I came home from the first site visit with 13 eggplants, 9 cucumbers, 17 green peppers and 20 tomatoes.

Each province specializes in different crops, insects and rodents. Mice were the specialty in the Eastern Province. In the Northern Province, location of the most recent site visit, the hot items were cassava, groundnuts, rice and caterpillars. I had no interest in buying caterpillars or rice – especially the minimum of 100 pounds – but I was suckered into purchasing groundnuts (peanuts, shelled and fresh from ground). For a whopping 10,000 kwacha ($2), I returned to Lusaka with at least 6 pounds of groundnuts. As for cassava – I had no idea what it was…

It so happens that this very popular starch is in fact a root. We stopped at a cassava farm on the last day. After the purchases were made, the owner of the farm suggested I try some. She brought out a plate with large chunks of raw cassava, which had been soaking and softening in water. I took a bite and nodded approval. Then our team of four hopped in the truck and we continued down the road. They all kept watching me take small bites and finally one asked, “So what do you really think?” “Well… I think it tastes horrible...” Relieved that I no longer had to pretend I liked it, I chucked what remained out the window. Everyone laughed, agreed, and threw theirs out the window as well. It turns out that while the rural folks have an abundance of cassava, the city-folk are better at preparing it – I heard stories of roasting, buttering, and salting cassava for the next 20 minutes. (It also so happens that while the rural folks are incredibly lean and healthy, over 30% of people in Lusaka are considered obese).

We continued our journey from the farm. Once we reached the main town area, we stopped at a health provider’s house because I was hoping to retrain her on some of the technical aspects of the project. The provider worked and stayed at the rural health center the majority of the time, but occasionally visited her family in town, which was the case this day. Unfortunately, her daughter informed us that we had just missed her and she was already heading back to the rural health center. As we drove down the road from her house, we almost ran over a drunken man who was stumbling towards us. A colleague explained that it was her husband and that he was always drunk, had to stop working as a result, blah, blah, blah. The conversation then turned to how everyone was surprised that she went back to the rural village on a Saturday night, instead of staying in town until Sunday or Monday morning.

“If he was my husband, I would go back on a Saturday night too”, I commented.

“Musungu – you have made me laugh today”, I heard from the front seat.

Musungu's Music

12 hours on the road to reach the Northern Province meant a great deal of gospel and country music (yes Dolly and Kenny Rogers both accompanied me on this last trip) …the two favorite genres of the national coordinator (Rabecca), who I travel with. However, halfway through the journey we stopped at a fuel station where several young men were selling dubbed cds and Rabecca bought five new ones to add to our collection. Since Rabecca is the epitome of church-going grandmother, you can imagine my surprise when the first song to play on her new cd was “Sexual Healing”. I teased her for the next couple of days, but somehow the joke evolved, so that each time the song played, everyone would comment that it was my favorite song, which was a bit embarrassing as new people were introduced to the vehicle. It also became customary for everyone to look at me as I sang the lines, “Wake up, wake up, wake up….let’s make love tonight” invoking my best Marvin Gaye impression. Yet another significant contribution I have made in my attempts at a cross-cultural exchange.

Village Boreholes

While there is no electricity and we sleep at night with a candle stuck to the floor to ward off black magic (yes – I would agree – major fire hazard), there are plenty of boreholes (wells) throughout the villages. I enjoy hanging out at the boreholes, as this is where you can find most women and children. One day, the well was empty, except for some boys and men standing around. A jug of water was set on the head of a small girl, barely 3 years old. Her little arms stretched up to hold the jug and the man let go. She immediately started crying loudly…the jug was clearly too heavy, but she wouldn’t let go….just stood there, with tears streaming down her face. I went over, picked it off her head, dumped some water out and put it back on her head. She then slowly walked home by herself….not spilling a drop, which is more than I can say for myself when carrying a cup of coffee across the kitchen.

My favorite game...

Another video...(be sure to watch the first one -- scroll down)

10 very pregnant women came to the clinic to meet with us during the site visit.  The least we could do was give them transport back.  I have up my spot inside the car, so that the two most pregnant women could have a proper seat.  I was in the back with 8 others, 1 small boy and four 50kg bags of rice.  The pickup was very small too, so the 30 minute pothole laden ride was lots of fun for all.

Pics from the Pickup

1 month in the bush versus 15 years...  I gave him some kwacha to buy shoes.  He also was quite small for his age...I was told he probably suffered from stunted growth from malnutrition.


Riding in the pickup truck with 8 very pregnant women and four 50 kg bags of rice.

Must Watch This!! Musungu Leaving the Village...

My last site visit was in the Northern Province.  It took 12 hours to drive from Lusaka and each village was at least another 4 hour drive from the district center.  Given these distances, the villages are rarely visited, especially by musungus.  During a meeting with the health providers, people of all ages kept trying to cram into the small room to get a glimpse of the musungu.  My colleagues were concerned that the village headman would think we were holding some sort of political meeting because of the commotion.  We kicked everyone out, but as we proceeded speaking with the health providers, I noticed hundreds of eyes peering through the crack and holes in the wall. The video above was taken as we were departing.  I was sitting in the back of a pickup truck because there was no room in the cab. 

Typical Zambian food.
Antenatal Clinic 

German friends, cycling from Cape Town to Nairobi.
The usual -- dancing in circles with village women.
Women singing a coming of age song to me.
Little girl who sat on my lap for majority of 6 hour bus ride, while her mother slept.
Roadside stop in route to Lusaka.

Zamruns

There is a great deal of pride in this country.  They eat Zambeef for dinner, Zamloaf for breakfast and plant Zamseeds in their fields.  This is probably because the majority of products in Zambia are imported from South Africa…thus, they need to emphasize the few that are produced here. 

While in the bush, I have told the villagers that we should change the name of guineafowl to Zamfowl.  I have also coined my morning runs through the towns and villages as Zamruns...

The roads and paths are busy as soon as the sun rises, so it is impossible to avoid traffic.  During the Zamruns,I cut in and out groups of school children…occasionally joined by a pedestrian (both children and adults) who takes an interest and runs alongside me for a few blocks. 

I have been running in Lusaka for nearly a month and subsequently people are beginning to remember me.  The man who sells talk time on the corner of street calls out, “You – I see you…strong heart”.  A lorry drives by honking and the group of men sitting in the open back move their arms in a running motion and give a thumbs up sign.  The taxicab driver comments that he is surprised I am not running to my destination.  Naturally, I start to feel like a celebrity….   

Then…on recent run through a village, two twelve year old girls in chitenges and sandals started running behind me.  I turned around and made some comment about running. As they followed, step for step, they laughed hysterically and called out “running…running” in a voice mimicking mine.  I figured they wouldn’t last long...but they continued to run and laugh, as I continued to get more out of breath.  I was nearing the area where I loop back and decided to challenge them to a sprinting finish.  There I was – $120 running shoes, fancy lycra running top and a high-tech sport watch, clocking my every step – schooled by two girls in flip flops and skirts.  Celebrity status deflated, I high-fived the girls and jogged back home.  

If I knew then...

As we discussed some of the extreme challenges associated with reproductive health in rural communities, a colleague commented that if she knew then what she knows now, she would never have had any children.  Her first delivery was in a rural health center, similar to the some of the facilities I visit.  She shared a cot in the labor ward with two other women and had to walk 7 miles back home the day after the baby was born.  Her second child was born in the ‘private’ health facility and even though the doctor did not make it in time for the delivery, he didn’t miss the chance to still make her pay high out of pocket fees.  The third delivery was prolonged, and without proper medical care, she suffered irreversible damage and was seconds away from a fistula. 

It is no wonder then that when we raced into the health center to warn the staff that an extremely ill woman was being carried by her appendages (no such thing as a stretcher) from the backseat of the truck, that they would assume it was pregnancy related.  However, the woman from the oxcart was more likely a victim of malaria. 

It was as we were making our way to the final clinic visit in Masaiti, that we first passed by the oxcart. It careened off the road to make way for our Land Rover.  I glanced in their direction to see what they were carrying.  It was then that I thought I noticed a woman lying in the middle, most likely surrounded by her daughters and sisters.  Maximo hadn’t noticed and swiftly passed the cart, leaving a trail of dust behind us. I yelled that he needed to go back.  I wasn’t sure what I saw, but I definitely wasn’t going to continue without checking.  (While the oxcart is able to transport people who are unable to sit or stand, it is by far the slowest form of transportation on the bumpy dirt roads).

While waiting for the woman to stabilize, I spent some time chatting with her daughter, the mother of William.  She was 25 and William was her third child.  She actually had left the village and was living in Lusaka, but was called when her mother became ill.  She had to arrange for her own transport from Lusaka to the village and then she needed to organize the money (15,000 kwacha or $3) for the oxcart to get her mother to the rural facility, all the while the woman’s health was deteriorating because of the delay.  “You see, everyone gives money for the funeral, but will do nothing to prevent death in the first place”, the daughter explained to me.    

As we continued talking, another young woman joined us.  At first I thought she was child, but she was introduced as the wife of a man working at the clinic.  I inquired about her age and was told she was 13…a child after all.  In the afternoon, I heard of another young woman who was 11 and with child.  I would rather not think about this than to comment.  Later, as we drove on the dirt road away from the village, I noticed a painted sign on a school that read, “If you educate a girl, you educate a nation”…     

William's grandmother was brought to clinic on oxcart/ambulance below.

Cross-Cultural Exchange

I am slowly becoming more acculturated to Zambian life.  During our long journeys to rural health clinics, I have learned to tell the driver that I need to ‘wash my feet’ when I need to go to bathroom. I have also learned how to do this without actually needing to wash my feet afterwards J

I have learned that when you ask someone to do something, you need to be very direct about the timeframe.  Instead of ‘Maximo, you need to get directions from Angela so we can find the last clinic’, I need to say, ‘Maximo, you need to get directions NOW’ or ‘Maximo, Angela is ready for you to get directions from her NOW’.   

I have learned that when someone trips when walking or drops a glass on the floor, I should say ‘sorry’, but when the MC to an event arrives 2 hours late, I should not expect him to say ‘sorry’. 

I have learned that it is inappropriate to ask someone how old she is, but completely acceptable to ask how much she weighs.

I have learned that every culture blames someone else for their problems and in the case of Zambia, the Chinese are guilty…. “selling faulty electronics, administering bad medicines and doing karate all day long” they are clearly to blame.

I have learned that no one understands what public health entails and everyone thinks that I am a doctor, no matter how often I explain I am not. 

And finally, I have learned that even in a country with barely enough blondes to count on one hand, everyone seems to know the difference between a blonde and a mosquito…

Now I imagine you are wondering about the exchange portion of this cross-cultural experience.  I have tried my best to impress new friends and acquaintances with stories of the American culture.  However, the only thing that seems to catch their fancy is the culture of divorce. 

“Karen, tell her what you do if you don’t like your husband anymore”. 

“You get rid of him and find a better one”, I say smirking.

“Wow – that is really nice – I like that”.  

(Not a big surprise….given my impressions of Zambian men so far)

 

Site Visits

Rural Women's Health 

This is Africa

Pictures

Antenatal Clinic visit - Petauke

Life's Risky Start in Zambia

The more time I spend in this country, the more I realize how truly fortunate I am to be a woman in the US – and for once, this statement is purely based on access to health care  – all other observations and ranting aside.  I will probably never view pregnancy and childbirth quite the same either.  In the US, pregnant women ‘glow’ or so I hear people say – they go to the doctor for regular checkups, and pack a bag to prepare for the delivery, well before the due date.  In most of the rural areas I have visited, it is very surprising to see any woman above the age of 17 without a protruding stomach and another child strapped on her back.  No one asks these women how far along they are in the pregnancy or if it is a girl or boy.  If these women pack a bag, they are packing soap, clean cloths, and an umbilical clamp because these things are not provided by the health facility.  However, most women have no need to pack a bag… it is estimated that 75% of women in the rural communities don’t actually make it to a health facility ….their children come into this world as they lay on a dirt floor, perhaps with someone to help if they are lucky.

With misoprostol, these women are at least given a fighting chance.  Maternal mortality is somewhere between 591 and 729 deaths per 100,000 live births.  Post-partum hemorrhaging (PPH) is the leading cause of maternal death.  Among the benefits of misoprostol is that it can be orally self-administered immediately after the birth of the baby and prevent PPH.  For women delivering at home, misoprostol can be life saving.   

During my last site visit in Petauke, it was the antenatal clinic (ANC) day for two of the health facilities.   One day a week is designated for antenatal education sessions and individual counseling for pregnant women.  Nearly thirty women were waiting to meet with Sister Hilda, the only trained provider, and I was told this was a light day.  On average she will counsel 50 women a week.  Now, thanks to the efforts of Venture Strategies, misoprostol education is included in the antenatal education sessions. After their individual appointments and screening, women are given the option of taking misoprostol home with them.  An overwhelming number agree to do so, tucking the packet of three tablets into the corner of their chitenge (traditional skirt) as they head back to their homes.

After spending some time with the women, questioning them on what they learned during the ANC, I left the maternal ward of the facility and gave Sister Hilda a hug, thanking her for her incredible commitment to the women and the community.  As I rounded the corner, I passed by another line of general treatment patients.  Men, women and children were all crowded on to the porch of the front of the clinic, trying to avoid the beating sun.   Sister Hilda has an assistant to help with the screening, but eventually she would need to treat all of these patients as well.

I left the site visit feeling frustrated and sad, even though it was evident that the project was going well.  I believe in the importance of the work at hand, but in reality, it is just a drop in the bucket, given the incredible amount of need in these communities.  I started feeling a bit more optimistic by the third clinic visit.  It was a very impressive facility, with a new addition built in 2007…this indicates progress, right? I glanced up at the ceiling of the new building and noticed the asbestos…            

This is Africa

Part of the excitement of travel is the unexpected and in Africa, it is best not to have expectations at all.   Rather than getting overwhelmingly frustrated every time something goes awry, the most weathered travelers will say “TIA”….this is Africa. 

Friday, June 5

Our team returned from the final health facility visit in Petauke at noon.  I made a last minute decision the night before to not return to Lusaka with the group and instead hop on a bus and head to Mfuwe, home of South Luangwa National Park….supposedly one of the best game parks in Africa.  The map made it look like a relatively easy journey – I had heard a two hour bus ride to Chipata, followed by another 2-3 hour mini-bus ride to Mfuwe.  However, most musungus fly into Mfuwe, so I didn’t have much to go on and when you ask locals, they always seem to underestimate the time and distance. 

After the final site visit, I had the driver drop me off at the junction where the buses to Chipata passed through.  I sat on my backpack under a tree with a group of men, who were also waiting there with coolers of drinks to sell passengers as the buses passed through.  I asked how soon till the next bus to Chipata and was told very soon…

After the first hour of waiting, and a countless number of people asking if I was Peace Corps (apparently Peace Corps volunteers are the only other musungus to make it to this part of Zambia), two German friends from Lusaka rode by on bicycles.  These guys are riding from Cape Town to Nairobi to raise funds for an orphanage, which one of them started.  They have definitely made the top of my list for coolest people I have I met in Lusaka.  I jumped up yelling, “Emmanuel” and they both steered of the road, equally surprised to see me in this town so far off the beaten path.  We chatted for a bit and then they proceeded, leaving me to wait for the bus that would nearly run them off the road shortly after….

Anyways, two hours after being told “very soon”, the bus arrived.  I shoved into a seat near the front and waved goodbye to all of my new bus stop friends as we drove away.  This first leg of the trip was rather uneventful, except for the unfortunate incident in which we ran over a rather large pig.  Because of my front and center position on the bus, I was able to see the play-by-play of Wilbur’s demise. 

Given our later than anticipated departure, I was pleased to find a minibus to Mfuwe “ready” to leave.  The dirt roads in between the two towns, with notorious potholes and a propensity for animal visitors, are not recommended to travel at night.  However, since it was only 4:30pm and the man who sold me a seat promised we would be leaving in five minutes, I figured I was in the clear.  But then again, TIA.

Over an hour later, we finally rolled out of the parking lot.  I glanced at my watch, quickly calculating how many minutes of daylight were left – not enough.  In addition, with each revolution of the tires, the entire vehicle sounded like it was going to fall apart.  They had also piled so much weight on the roof that it actually started to sag in the middle and only one door was functioning.  (It was all starting to make sense why most musungus fly).  We didn’t make it more than 500 meters and the driver pulled into an auto shop, claiming he needed to quickly fix our spare tire.  After 30 minutes in the shop, I phoned the lodge where I had made a reservation to inform them I would be arriving later than planned.  At this point the men were take turns hitting the tire with a sledge hammer.  While I am no mechanic, their method seemed counterproductive. TIA.

They finally got their fill of hammering the tire and put it back in the vehicle.  It was 6:30pm when we left the auto shop and what little trace of daylight remained was wasted when the driver decided he needed bread for the journey and made yet another stop.

When it was clear that we were on our way, I relaxed, well sort of; my knees were smashed into the seat in front of me because they had added another bench to the minibus to maximize passengers, consequently minimizing leg room to that only fit for a child.  Needless to say, it was probably the most uncomfortable position I could have possibly been in for a 3 hour pot-hole ridden road trip.  I turned to check in on the family behind me…a mother and her three small children, who I had spent some time playing with during the long waits.  The mother sat with one child on her lap and the second nestled into her side.   The third, a boy around 4 or 5 years old, was left with very little room and was trying to rest his head against the window.  Being a chronic car sleeper – I am familiar with all positions and the “head against glass window on bumpy road” is probably the worst.  While, I had no leg room, I did have a bit of space next to me, so I signaled to the mother that the boy should sit with me.  She couldn’t understand my signals, but didn’t protest as I lifted him over the seat.  However, he stared at me with bulging eyes. Everyone else in the minibus was also staring...something that would become quite commonplace by the end of the journey.  Nonetheless, once I convinced him to lay his head on my lap, he was asleep in 30 seconds.

About 1.5 hours into the drive, the vehicle died.  I nervously glanced at my fellow passengers and in unison, we all checked our cell phones for reception…and of course, there was none. (cue horror film music)  The same three stooges who were using the sledge hammer on the tire earlier, attempted to fix the vehicle in a similarly asinine way, running around and banging things.  Again, while I am no mechanic, it can’t be a good sign when someone starts to hit the dashboard in an attempt to get the car to turn on.  It was at this point that I also noticed that they had been starting the car all along by touching two wires together. TIA.

Two other cars passed us on the road and no one made any attempt to flag them down.  Deciding that I was not going to be complacent anymore and needed to be ready when the next car drove by, I started to make my way out of the vehicle.  Since I had no close access to a functioning door, this required elaborate movements over the backs of seats and heads of people.  Finally free and standing on the road, I noticed all of the other passengers eyeing me weirdly from inside.  I then noticed headlights in the distance.  As the car approached, I ran out into the road and flapped my arms like a crazy woman.  As it came closer, I realized it wasn’t slowing down and was in fact racing towards me.  I threw my body into the ditch, simultaneously yelling “stopppppppppp” as it zoomed by.  Now all of the other passengers had their faces pressed against the window glass and shaking their heads.

Brushing the dirt off my pants, I looked up to see the vehicle moving forward.  I had to run and catch it, but all the while, I was yelling “woohoo……wooooooo”, and punching my fist in the air. 

The next three hours of the journey, albeit bumpy, were without interruption.  We dropped off passengers along the way, with finally just the family I mentioned early, a young guy and me remaining.  We arrived at the family’s home and I had to gently wake my sleeping friend.  The children, still half asleep were deposited on the side of the road, meanwhile their father, who came to meet the minibus, was having a heated discussion with the driver.  I figured he was probably angry because they were so late in dropping off his young children and wife.  However, the driver was actually demanding more money and refused to give them their luggage unless he was given another 10,000 kwacha ($2), explained Chilufya, the other remaining passenger.  However, the father did not have any more money and had paid the price negotiated, which the driver was now denying.  The father looked very worried and the children looked exhausted and scared.  I searched for my headlamp, found the 10pin in my bag, and handed it to the driver.  As for what happened next, I can only say that my thinking was clouded by all of the earlier events and while I am not proud of my behavior, it seemed completely rational at the time.  So anyways, I handed the driver the 10 pin and then I asked Chilufya to translate, “Take the money, but you should know that I think you are the biggest asshole I have ever met and I have met a lot of assholes.  I wrote down your license plate number and I am going to report you and this piece of shit bus to the police.  And if they don’t do anything, I am going to call a friend up north, who knows just the right person to take care of you”.  (Through stories from colleagues, I knew that everyone was afraid of the black magic in the north).  Chilufya shook his head and mumbled something to the driver and his minions.  I don’t think he told them what I said because Chilufya is clearly far smarter me and recognized that I still needed to be dropped off safely. 

Which they did at the fueling station in Mfuwe and I was then ushered into an open-air safari vehicle by a guide from the lodge who had been waiting over two hours for my arrival.  The camp where I made a reservation was 5 km off the tarmac and situated right outside the official park.  However, since there are no fences separating the park from non-park, animals roam freely between the two.

As we turned off the tarmac, I was already well into grilling the guide about his life, dreams and aspirations… He was so caught up in my interrogation that he nearly ran smack into an elephant.  The sleeve of my shirt practically brushed the elephant’s behind.  He slammed on the breaks and I looked to the left where eight huge elephants were eating leaves, all within reach of my outside arm.  TIA.

We finally made it to camp and I was given my own chalet, with a porch that looked out to the Luagwa River, home to more hippos than any other place in Africa.  Finally, at midnight I crashed into bed and fell asleep listening to hippos call across the water.

Saturday, June 6

Before my alarm could do its job five hours later, I was jolted awake by the sound of very fast running.  Heart racing, I peered out the window, but saw nothing.  I made my way to the main lodge and Andrew, the safari guide, asked if I heard the four lions running by a half hour earlier… TIA!

Andrew and I set off for the morning drive, accompanied by an aunt-niece duo from Oregon.  This was their 11^th drive of the week, so Andrew asked if there was anything I wanted to see in particular.  I told him I liked everything… However, the duo really liked everything and suddenly we were stopping for every damn bird in the park and having a full discussion about its mating and nesting behaviors.  I know I should appreciate birds, just like I know I should appreciate modern art – but I don’t. Sure we saw plenty of elephants and giraffe, and even a herd of 200 buffalo, but we seemed to be stalking robins and love-birds, and I really wanted to see some lions.  I had given up hope, tuning out the discussion about the physiology of the woodpecker, when Andrew abruptly threw the truck into reverse.  He pointed to the right….and there, basking in the sunlight, were 6 lions, all within spitting distance of the safari vehicle.  He explained how the women do all of the hunting and provide for the pride…….I told him it sounds like the rest of Africa and he laughed, agreeing.   Andrew situated us even closer and I spent the next twenty minutes getting a lion’s share of photos for the day. 

After the lion encounter, we had tea in a field of impalas and set off for the journey back to camp, passing elephants, giraffes and zebra along the way.  I had a five hour break between game drives, so went to hang by the pool, which was near the river, which was full of hippos.  TIA.

The night drive was even more incredible.  The two other passengers spoke only enough English to say they wanted to see a leopard (a very elusive animal), which left lots of opportunity for me to talk to Phillemon, the guide and Mago, the spotter.  The drive started early enough for a couple hours of daylight, sundowners in a picturesque location, followed by two hours of spotting nocturnal animals with a spotlight.  Five minutes into the drive we passed a field with antelope, warthogs, baboons and a variety of other animals.  It seriously looked like a scene out of the Lion King and I am embarrassed to say that I started singing circle of life without even realizing it.  There was nearly a full moon, which Phillemon said made it even more difficult to spot a leopard….we saw plenty of hyenas though, definitely one of the ugliest animals out there.  Just as the night drive was winding down and Phillemon pointed out the Southern Cross, lo’ and behold, Mago spotted a leopard.  It was absolutely amazing – creeping through the grass, stalking a nearby impala.  While we wanted to wait for the kill, we were ruining the leopard’s game by sticking around. 

Returning to camp at 9pm, I was able to get a few hours of sleep before catching a 2am bus back to Lusaka.  This time my alarm was intercepted by the sound of a hippo munching on grass.  I peered out the window and it was nearly on the porch...fortunately, it had returned to the river before I needed to exit.  I had been warned not to startle a hippo.  I jumped in a safari vehicle and was escorted back to town, passing several hyenas on the way.  We had heard lions howling in the night, as well as the alarm calls of puku and baboons.  Now with hyenas in the area, it was clear that the lions had found dinner in the camp during the night.  TIA.

Back in Lusaka

A very fruitful site visit in Petauke last week, followed quite an adventure in the bush over the weekend (take a close look at my friends in the background of the picture).  Lots of updates to post...will try to catch up tonight before leaving again on Wednesday.

NYT: Where Life's Start is a Deadly Risk

Where Life's Start is a Deadly Risk

Childbirth in Tanzania

Back to the Bush

Leaving the chaos of the MOH and heading back to the bush (Petauke) for a site visit.  There is a game park very close, so I might try to sneak a game drive in....

Not sure when I will return, but will post more pictures.  Have been sorting out camera issues for the last week.

Musungu Goes to a Wedding

With Tracy’s in August, weddings have been a major source of conversation in the Weidert family.  Therefore, I couldn’t pass up the opportunity to see an official Zambian wedding on Saturday night, when my friend Oliver extended an invitation one hour before showdown. I cancelled my dinner plans and put on my finest dress, which is not saying much, but interesting enough, even though it was a floor length Roxy bohemian dress, most of the Zambians thought I was wearing a traditional dress.  Bonus points for musungu. 

We arrived late, which was rather awkward, as we walked through the entrance just as the bridal party was making their grand entrance.     Not to be mistaken for the traditional announcing of names done in American weddings… these bridesmaids and groomsmen had been rehearsing a dance for several weeks leading up to the big day.   Little did I know that this was just the first of a series of dances, including several costume changes.  Even the cutting of the cake was the accompanied by a bridal party performance.     Thinking about my upcoming role as maid of honor and my propensity to get pulled aside in dance class for remedial help, I realized I would never be a very good Zambian bridesmaid.  However, I have to say that there was one part of this ceremony that I especially appreciated.  During the initial dancing entrance, guests would run up to the different bridesmaids and groomsmen and stuff money down their dresses and into their pockets I asked the purpose and was told it was to show appreciation. What do you think, Tracy?  This could fund ‘Spring Break 2010’.

After an extremely long rant by the MC (not entirely sure what he was saying, as it was in Nyanja and only some was translated, but everyone was laughing), even more speeches began.  All the while, I kept staring at the bride because she seemed rather unhappy for a newlywed.   The first orator (her new uncle) said that ‘they hope to see a better version of her, now that she married his nephew.  If she has problems, she should no longer go to her family – they are not her family anymore.’  Then the minister stood up and started talking about ‘if your husband says he is gone on ‘business’, it is not your place to assume the worst – you just have to assume that he is just providing for your family’.  (Easier said than done – remember all the extramarital girlfriends I mentioned in an earlier blog?).  The MC stood back up and made a joke about husbands and prostitution, and then it was the father of the bride’s turn.  He went on to describe what a wife was…’wise, industrious, financial and economical’.  Industrious was a reference to the work she would do to take care of the home, and the financial and economical referred to how she wasn’t supposed to spend a lot of money.  Then he began with husband…’honorable, understanding, supportive’….and then I rolled my eyes and tuned out.  Needless to say, the bride’s disposition began making a lot more sense. 

During the final speech, crates of beer suddenly appeared and the real celebration began – this was very reminiscent of weddings at home – the men were just much better dancers.

I should also mention that the mother and father of the bride were in beautiful matching dresses.  I laughed to myself when I first saw them, thinking about how my father wouldn’t be caught dead wearing a gown, let alone one that matched my mother.   Then I was inspired…Mom and Dad – I am getting some custom-made.  Do you have color preferences?   I am thinking blue to compliment your eyes.