Saturday, July 28, 2012

Nipive

As a secondary school teacher, I mostly come in contact with people who are Mozambican middle/working class (I apologize if that is politically incorrect, but it is true). The kids come from families that are somehow able to get the money together for matriculation fees, a uniform, pens, notebooks, and test costs. The kids must live close enough to (or have someone who is caring for them that lives close enough to) a secondary school to walk there and back each day, which means they can’t be too far out in the middle of nowhere (only kinda far). The teachers have some education at least and a steady job, and therefore are upper middle class usually, if not wholly upper class. But then again, many students are from families that are dirt-ass poor. These are the kids with clearly hand-me-down, faded uniforms with holes, showing up to a test without a pen. Daniel, the kid that works for me, is one such student. Now that he has a “job,” he appears to be a little more well-off, because he knows I will always give him pen and paper and I bought him new uniforms this year. But, as I learned first hand when I paid his family a visit last week, he is one of those kids doing whatever he can to get out of the situation he was born into and give back to his family.
Daniel had invited me months ago to his house, but I could never go because you can only get within 7km of his house by car on Thursdays. So finally, last Thursday, during the school break, we went. We got in a chapa going to the feira in Nipive that happens every Thursday (“feira” being big market and Nipive being his home locality, about 50km from Invinha). We got out and started our 7km trek through the bush. We passed a smattering of super spread-out mud huts and fields full of beans and mandioca. We scrambled over rock faces and over streams, until we reached Rio Licungo, a huge river that is just near his family’s house. I swear, it was idyllic. Apparently, as Daniel told me later, he was very worried that I would complain about how long the walk was, and was surprised and relieved when I didn’t. Thanks for the vote of confidence, man. We got there, and though Daniel had called someone with a phone who lives around there the day before to inform them we were coming, no one had passed on the message, so here Daniel comes striding into the yard with this white lady behind him. All trillion of his nieces and nephews came running up to hug him, as their uncle from the “big city” (Invinha being a big city because you can buy salt and onions everyday of the week!) had finally paid a visit. They were followed by a horde of female relatives. After greeting us, the women went to work to feed us. It was 8am and they labored to pound the shells off the rice from their fields, cut up fish, and wash the “fancy plates.” While they worked (I was not allowed to help), I took in the view from their reed mat. The compound had 3 one-room mud houses and a bamboo-ed cooking area, with tons of banana, orange, lemon, mango, and avocado trees. The mountains that grace Gurue district splashed the background. It was interesting to see Daniel in this environment, where he and his “big city” nature are king: he was checking in on all the kids, giving out small-value coins, sitting in a chair (while women sat on the ground), and was dressed to the nines to show off his status (in all borrowed clothes that he had told me he had ironed, though how I do not know).
Daniel’s aunt, that matriarch of the massive family, who had taken him in when his mother and father passed away, was this adorable little old woman (probably like 45-50) who I could actually talk to because she had been to a few years of school during colonial times. The 25 year-old-ish women did not speak Portuguese, so I mostly interacted with this one aunt and the bloated-belly, dressed in rags kids who were currently enrolled in primary school, but if I have learned one thing in almost 2 years as a Mozambican teacher, probably not learning much. The whole time, the aunt profusely apologized for not making a good sauce for our fish and rice because she didn’t have any oil. It was a sauce with water, salt, and tomatoes, made in one of those super old-school clay pots. I told her I didn’t like oil anyway, and that the fish was very tasty, and she seemed slightly relieved. And the fish was actually some of the best fish I have had in Mozambique (the taste most likely improved because I had walked 7km in the hot sun and because it wasn’t doused in oil like Mozambicans are prone to doing). We were also treated to mucodo, rice soaked in water, and then pounded into a crumbly yet brick-like substance with sugar. After we ate, per usual, as when I meet Mozambicans not too familiar with Americans, we went through the whole song and dance: “In your land, do you have bananas?” Yes. “Rice?” Yes. “Fish?” Yes. “Salt?” Yes. “Garlic?” Yes. “Corn?” Yes. “Xima?” Not exactly. Sad, confused face on the part of my interrogator ensues. Soon enough, it was time to head back to the feira and catch a car home. But not before the white lady handed out the stuff from the “big city” that she had brought: on Daniel’s instruction I had brought 2kg of sugar, 2 kg of salt, bricks of soap, a bag of bread rolls, and some capulana for the women. All things they can’t make at home. I had also brought snickerdoodle cookies for them to try. At first Daniel wouldn’t let me pass them out because he said they wouldn’t like them as the taste would be too foreign. But I insisted: who doesn’t like a snickerdoodle? And low and behold, they loved them. So we trudged back, with me promising to come back again with my “machine to take photos” (my camera is currently broken) and to spend the night so the aunt could teach me how to make some dish I had never heard of. I hope I get the chance. Once at the feira, I bought us some Mozambican “popsicles” (slightly frozen juice in plastic baggies), bought a cabbage from another aunt who was selling there, and bought the first aunt some clearly-desired oil. I only ran into 3 people who called me “Ingrid-ee,” after an American woman who had spent a year living in Nipive doing research on a Fulbright scholarship. I have met Ingrid and she is blonde. But all young, white woman are the same, aren’t they? Overall, it was a really great day.
Now, I lived with a Mozambican family for 3 months at the beginning of my service, but they were relatively well-off. This family was not. They literally live off what they grow and what the few older siblings that have married slightly closer to opportunities are able to send home. Daniel failed 10th grade last year and is repeating but he is still the most educated person ever in his family. I am helping him build a house here in Invinha so he no longer has to rent (when I am gone and therefore stop paying his rent), and I told the aunt that she must send some of the younger kids to the house so they can take advantage of the slightly better primary schools and the secondary school in Invinha. We shall see what happens. I am also going to try to get one of the young girls into the girls dorm here with the nuns. She had impressed me with her addition and subtraction skills when I quizzed her. Congrats Juleca.
Only recently have I been witnessing the poorer, and more prevalent, Mozambique up close. It is easy to forget in the education bubble that even though my students seem illiterate and at times utterly hopeless, they are still probably some of the most literate and with the most opportunities in their entire families. Many of the women giving birth at the hospital have definitely not gone to school and are from butt-fuck nowhere, but are doing the best they can. Daniel’s family graciously took me in and showed their gratitude for giving Daniel a job and house (the aunt bowed to me when I gave her a capulana. Awkward).
And finally, my favorite relative I met that day was one brother-in-law we saw in the road. (Daniel has only 2 sisters yet like 5 brothers-in-law; clearly their term is more inclusive than ours because though men can multiple wives, women are bound to one man). This guy must have some sort of miniscule income. Note the outfit: he had on bright pink pants, a yellow polo that said “Chloe” on the pocket, a checkered tie, one glove, a faded Cincinnati Bengals beanie, and he was carrying a white, pleather purse. Stylin’
But in good news, some genius finally learned how to fix the water pump. Apparently, there was something blocking the water in the pipe. For 5 months. But now it is clean and working like a charm.

Tuesday, July 10, 2012

The Train


It is rumored by some fellow PCVs that Mozambique runs one of the only passenger trains left in this part of Africa. I have been reading my Mozambique guidebooks and have not found anything to confirm this, but I do know that the train I took last week is AWESOME.

Mozambique is a large country, with most of its area stretching from north to south, with most of the development in the south, stemming from bustling Maputo, the capital, which lies practically on the country’s southern border with South Africa. Most of the traffic and roads that are passable and frequented take people in this longitude-direction. In the far north, there are not many paved roads and a promising throughway east to west is only traversable with a private car, and even then, not at all times of year. Because of all this, the train, which takes you from Nampula (Mozambique’s third largest city and about 150-200km from a large industrial port on the Indian Ocean) west to Cuamba (an extremely dusty, wild-west-esque town that lies at the south of a province that is mostly pure bush and wild reserves, but which also borders Malawi and Lake Malawi). Therefore, this form of transport is highly utilized by people wanting to travel east to west, and it brings a lot of produce and other goodies to this more humble, northern part of the country. One of the PCVs that live in Cuamba is a walking billboard for the train, so a few friends and I decided to take it, and then visit the famously beautiful lake.

We got to the train station at 4am with our second-class tickets in hand. Second-class is the highest class offered, and sometimes it is not even an option. Third-class is much cheaper, but you are packed in on hard wooden benches, well over-capacity, and with ever-accumulating sacks of onions, beans, corn, and more. So we broke the bank and spent the extra $8 to travel in the “lap of luxury:” second-class. We were three people, and got our own little room with a futon-like padded bed/seat. We spent the 11-hour ride lounging with our feet up, playing cards, drinking beer, and eating the food that could be bought through the window at every stop. Or we could often be found standing in the hallway, with our heads out the window, taking in the breathtaking, mountainous scenery. The train traveled at a grand-spanking 30-40mph and had some technical problems, but we didn’t care. Honestly, it was the most comfortable travel experience I have ever had (there is even a cantina that sells beer and half-chicken with fried potatoes! Imagine that, Mozambique). Yes, on a 10-hour international flight, you now get your own personal TV and movie selection, and free drinks, but you are still sitting immobile in a 2ft by 2ft box when in economy class. This was like having our own living room as we rumbled, grumbled, and bumped along, with the whole 2 cars we witnessed on the adjacent road all day, easily passing us (it is the dry season, however, and thus the roads are a little easier to maneuver). Some of the train stops are probably only denoted by an interesting looking-tree, but others have cement 1-room stations. At every stop, there are women and children selling food through the windows: large, discounted quantities of tomatoes, carrots, and onions; huge sacks of who knows what; and snacks, which we eagerly bought up: boiled eggs, roasted peanuts, tangerines, oranges, bananas, bread, Mozambican falafel, etc. I. LOVE. THE. TRAIN. Really though, the train should be featured on a travel show, and should be a hit with the truly fledgling tourist-industry here.

I have also been continuing to volunteer at the hospital, and every time, I notice new things. The women bring these forms to their pre-natal visits, of which they usually get 1 or 2 during their pregnancies, and children have cards to keep track of weight, vaccinations, de-worming meds, vitamin A doses, etc. And it makes sense, there are no computers to store the information, but on the other hand, the majority of the people frequenting a health posts out in the bush are illiterate. They don’t know their age, which is why women with 7 children will say they are 20 years old, they rarely speak Portuguese, and they cannot read or understand the date that is listed for them to return for their next consult. But what are Irma and I to do? Neither of us is from northern Zambézia (Irma is from a neighboring province) and therefore we don’t speak the local language. So we try our best. As opposed to the education system, I believe that even a half-assed health system is better than nothing. Even if all we accomplished in five hours was giving 30 babies vaccines against polio and giving out 30 packets of birth control (to women who think they don’t have to take it on days they don’t have sex or if their husband if not there, because they don’t understand the instructions we give them…), that is still something important. Even if the infant or maternal mortality rate is lowered only by 1% because of this health post, its existence and the work the small staff does are justified. But I have recently had an internal debate. Apparently, the measles vaccine, once the bottle is opened, must be administered that same day. So if they only administer 2 doses out of a 10-dose bottle, they have wasted 8 whole vaccines and run out before their new Ministry of Health/UniCef shipment. So they implemented a new system: they only offer the measles vaccine on Fridays. At first glance, this seems to make sense. But everyday, women come in from 3 hours away to get the vaccine and Irma tells them to come back on Friday. Now, even if they understood the words Irma said, because they attended at least some school, they inevitably don’t have anything that tells them the date at home. So I assume many do not come back on the right day and many babies are without the measles vaccine even though the health post has it in stock. So which is better: giving out the vaccine everyday and running out before the end of each month because of the wasted doses, or only giving it out to the people who happen to be there on Fridays? Which system inoculates more babies? I am truly searching for an answer. Yet it seems to be a veritable conundrum that can only be solved with a statistical study that I have no desire to instigate.

I asked Irma why women come from so far to the Invinha health post when they have them in other towns nearby. Her answer: 1. They like to have a nun around and 2. Because our health post employees steal less of the medications than they give out. Apparently, other health workers throughout the country (and I assume the continent) steal the meds and sell them to people who need them at a higher price than the almost miniscule fee they are supposed to give them out for at the health post. The supply runs out quickly and only those with money are getting meds. Invinha is famous for actually giving out vaccines and medications, and only stealing a little. I’m glad that is the bar upon which a trustworthy, health center is judged at.

In the US, I feel like doctors, nurses, and family members are very supportive and encouraging of a woman in labor. Here, they are not. They leave them be and really the only interaction between nurse or traditional midwife and patient is to check how many centimeters she is. So here I come, white, with no nursing experience, and I am holding women’s hands and telling them things I think might motivate them about how great they are doing. And every single time, Irma, the other female nurse, and the 2 traditional midwives laugh and make fun of me. And I only slightly care because I just can’t sit back and watch women in pain, screaming in Elomwe about who knows what, without trying to give them some support. Here, the family members that come with the women to the health post to give birth (friend, sister, mother, aunt, or other random female relative) must stay outside, shooting the shit with the other relatives-in-waiting, cooking over fires, and only entering the birthing room to give sips of water and capulana to the screeching women. But they form a small community out there, as I assume men in the 50s in the US did, though instead of cigars and scotch, they have corn mush and sugar cane.

 I would like to dedicate this post to my grandma Ruth, a true matriarch, and an absolutely incredible grandmother, mother, wife, and so much more. I love you and miss you and am doing my best to approximate a version of the world´s best stuffing.

Thursday, July 5, 2012

BABIES!

Well today, 4th of July, I delivered 2 babies.
I have recently been helping out one of the nuns that is a nurse in her shifts at the health post. Usually, I just help vaccinate babies, give out birth control, and give brief pre-natal visits (which solely includes an HIV test and measuring their bellies). I prefer this side of the 6-room health post because I get to play with babies and see super pregnant women who walked on foot for hours from deep in the bush (some of which are my old students who dropped out of school after becoming pregnant). The other side of the health post is where the sick people go. Who would want to deal with babies with diarrhea or old men with worms oozing from their wounds when they could play with healthy babies and laugh after watching super bush women stare at the scale and be scared to step on it or to stand on it completely in the wrong way? It is also awesome to witness women that, when asked how many children they have given birth to, say “João, António, Maria, Octávio” and then show you five fingers. Or to hear the argument that ensues among the women waiting with their babies in the hall after someone has responded to the question “when was the baby born?” with the answer “day 33.” Irma Laurinda (the nun who is a nurse) lets me give vitamin A drops to babies, administer the polio vaccine (again, giving drops to babies), and measure the pregnant ladies’ bellies. Many of the women have scars in sets of three lines or in patterns on their thighs and abdomens that I meant to ask Irma about as we walked home, but I forgot. I assume they are either part of an initiation rite for young girls or a “treatment” from a traditional healer. I will keep you posted. Irma says soon I will graduate to injections. Aside from the fact that I have absolutely no medical training, the fact that I am white and a college grad apparently deems me sufficiently qualified for such tasks in the eyes of the staff at a rural, supply-less health post in the middle of Mozambique.
But today, I delivered 2 babies.
Irma was on baby-delivery duty today so I tagged along. There were four women in the room, all laying there mostly naked on hard beds with no sheets, blankets, or pillows, and all moaning at different frequencies. In a mandate of utter cruelty, the women in the early stages of labor must watch the women in total agony two feet away. One woman was wrapped so tightly in her capulana to try to block out the noise and to attempt to not witness her inevitable fate, I thought she might suffocate. Another woman had come in to get a routine pre-natal consult and Irma realized this lady was about to give birth right then so off we went to deliver. This woman, I never knew her name since she didn’t speak a lick of Portuguese, had previously birthed 8 other children, 5 of whom were still alive. Now, the Mozambican bedside manner is nonexistent, so while Irma chastised the lady for being lazy and not “giving enough force,” I held her hand and told her I believed in her and all that other mushy shit I thought might motivate her through the pain. And had she understood a word of my Portuguese, perhaps I would have helped. But I do know she appreciated my presence on some level because when I had briefly run over to where another lady on the verge of giving birth was screaming on the other side of the room, she yelled something I didn’t understand and motioned for me to come back. So I stayed by her side and wiped the sweat from her face on the capulana she had brought with her to the “hospital” (giving birth in Mozambique is BYO because you must bring your own sheets, baby-swaddling stuff, and post-partum diaper paraphernalia). And finally, after crapping all over the bed, bleeding uncontrollably, and splaying fluid everywhere (which I realize is normal, but no one seemed too concerned about the fact that she was lying right on top of the mattress that the next woman in labor would use), my new best friend gave birth to a beautiful baby girl. “CONGRATULATIONS! IT’S A GIRL!” I yelled and she kinda grunted unhappily, not too interested in holding her daughter. I, on the other hand, ooh-ed and ahh-ed over the baby for about 45 minutes. Irma kept saying that the lady should name her Ana after me, but seeing as the lady didn’t understand us, I would bet that didn’t actually happen. But then immediately, with almost no warning, the other lady gave birth to a huge baby boy. “CONGRATULATIONS! IT’S A BOY!” I yelled, and the new mother, as this was her first, bluntly said, “A man? Damn. A man was what has made me suffer and now I have another man to take care of.” Point. Well. Taken.
Overall, it was awesome. I was there on a good day: all the mothers and babies lived. Apparently, that squigy ball thing that is used to take fluid from the babies’ noses has been misplaced for some time at this health post, and a lot of babies are dying because of it. Apparently, this is not something that comes in the monthly supply box. But not today did anyone succumb to this ridiculous and preventable death. (I have asked my sister to bring a box of these things when she comes to visit at the end of the month so the problem will temporarily be solved then). But the experience really made me think: here are these women, giving birth with no fetal monitors, no epidurals, not much sanitation, no doctors, no family members allowed in, no fucking sheets on their beds, squeezed in one room with all the other women in labor, with their vaginas out for the world to see through the windows, and they are birthing beautiful babies. At least a lot of the time. High-risk pregnancies are sent to the city, but still it is crazy to realize how natural the whole process is when in the US, it seems very scientific. When my new best friend’s baby had its head out, I literally froze, thinking “I can’t touch it, I don’t know what I am doing!” but I later realized that was stupid. I had on gloves and a mask and all I really had to do was gently ease her out. But I was concerned at that moment about not fucking it all up and wrapping the umbilical chord around the baby’s neck or something. Maybe next time I will actually “receive” the baby. Irma then regaled me over our late-afternoon “lunch” about women who routinely come running into the “hospital” bleeding everywhere and clutching a 20 minute-old baby: “I didn’t make it and gave birth in the middle of the road!” they yell. And about the women who give birth on their dirt floors because their husband and their friends are all out at the moment. She must cut the chord herself, and then trudge hours to on foot to the hospital. These stories and the poverty they represent, and not actually seeing all the blood and gore of a baby being born are what make me sick to my stomach.
Unfortunately, this was also the first day that a woman we had been giving a pre-natal visit to came back with a positive HIV test. I will never forget her face. She was young and beautiful, slightly cross-eyed from needing but never having had the means to buy glasses, and wearing a bright green shirt that said, no joke, “I am a sex god.” She just broke down upon hearing the news. In a crazy twist of emotions, this was only about an hour before I held a healthy newborn in my arms. As an education volunteer, I know people who are HIV positive, but unlike health volunteers, my daily work doesn’t revolve around it. So I was not prepared. But I don’t think that hearing someone deliver that news is something anyone is ever prepared for.
Last week, two of my favorite neighborhood kids, Gigantinho and Belsa, were in a motorcycle accident with their father. Gigantinho came away with just a wound on his forehead that is healing nicely. Belsa, on the other hand, has half of her face covered in bandages. The skin on half her face is totally off and one of her nostrils is mostly gone. As I told their mom, I am relieved that solely aesthetic parts of them were injured, but it is still pretty bad. The risk of infection and who knows what else with the not up to par care they received at the health center makes my heart break. Any sort of reconstruction is clearly a pipe dream and out of the question, and that is why any sort of skin ailment, burns, or a guy I saw with massive growths all around his face, are secondary to other complaints and illnesses. But they are kids, and resilient, and I am not too worried about permanent damage. It is still shitty and scary, and why you can get kicked out of Peace Corps for riding motorcycles.