Malaria

This past weekend I ran some trainings for the leaders of girls groups, with the main goal being to equip the women with basic knowledge of our girls group program and how to be a good facilitator, as well as with basic (sexual) health information so that they can hopefully begin to effectively lead girls groups in their own communities. I was super excited for the weekend to finally be realized, as I believed that it would be the first of many important steps in actually building some inchoate vestiges of sustainability into Peace Corps Moz’s girls group program. And even within the midst of a few unanticipated and utterly demoralizing logistical trials (one being that a Peace Corps staff member had suggested to me the location, which inadvertently ended up being a venue primarily used by men and their prostitutes: perhaps not the best place to lead a conference with women you are hoping will be positive role-models for young girls), I do honestly believe that we in part reached our goal. One of the women commented, “I have learned so much, which I will guard in my heart and in my mind so that I can help our girls and the future of women in Mozambique.”  She wins.

            A last minute programming addition was the catalyst from which our last day was finally able to be what I had envisioned that the training could be: a bunch of women dancing and singing, certificate in hand, pumped to go home and get the ball rolling. In honor of April being World Malaria Month, and April 25 being World Malaria Day, we decided to incorporate some malaria information and games into the otherwise heavily anti-HIV focused campaign of the conference. In sub-saharan Africa, every two minutes, 3 children under the age of 5 die of malaria. Malaria is the number one killer of children under 5 in Mozambique specifically, as 142 of every 1000 children do not make it to celebrate their fifth birthday, and 42% of these deaths are linked to malaria. Malaria is the number one cause of death for all ages here as well, accounting for 29% of all deaths in Mozambique, while HIV/AIDS comes in at “only” 27%. I have been unable to find the exact number of people who die from malaria each year in Mozambique, but these statistics are staggering enough. HIV/AIDS gets all the attention, though malaria is a much more deadly peril. Though all provinces of Mozambique are considered to have high malaria threats, the northern part of the country, where I live, is most affected. And unlike its more legendary killing counterpart, HIV/AIDS, it is preventable and treatable, as well as more realistically eradicated. The game we played at the conference dealt with this first aspect of malaria: prevention. The rains came late this year, and therefore malaria is still a threat at this time of year, with the big mud puddles serving as breeding grounds for hoards of mosquitoes. Therefore, one area of prevention is to get rid of standing water around the house. Also, properly hung and utilized mosquito nets over every sleeping area, using naturally found and grown bug repellents (lemongrass, etc), and cutting down overgrown weeds are methods of prevention. The winners of our prevention-game each won a medically treated bed net as a prize. Aside from the lack of knowledge about or the plain neglect of adherence to simple preventative measures, I believe, in my admittedly inexpert opinion, that the number one contributing factor to the malaria epidemic in Mozambique is how “malaria” has become synonymous for “sick.” A far too frequent conversation here:

Me: Where is so-and-so today?

Person A: Oh, he is out sick with malaria.

Me: Did he do a malaria test at the hospital?

Person A: No.

Me: Then perhaps he doesn’t actually malaria, and perhaps just has the flu. He should go to the hospital and get a malaria test.

Person A: look of disbelief on face

By equating “malaria” with “sick,” the scariness and realness of the disease becomes less influential, because people are constantly overcoming and living through bouts of assumed “malaria.” The great threat that malaria does play will never be realized and taken to heart until this myth that all flu-like symptoms implicate malaria has begun to dissipate. Not only do constant real malaria infections regularly keep people at home and absent from school or work, only adding to the lower productivity of many aspects of society here, but to be honest, people are systematically dying by something that is easily cured with medication. Even when someone is rightfully diagnosed by means of a malaria test at the hospital, it is quite common for the hospital to then be out of stock of Coartem, the anti-malarial drug, (and quite often, the hospital has run out of the diagnostic tests) leaving people understandably less inclined to return to the hospital and wait for hours in line for their malaria test the next time they are sick.

            As Peace Corps Volunteers, it is beaten into us during training the importance of adhering to our malaria-prophylaxis daily or weekly regimen. I have probably lost half the volume of the hair on my head as a side effect of my weekly malaria-prophylaxis pill over the last 19 months (not to mention the vivid dreams and occasional mid-sleep hallucination of rats climbing all over my mosquito net), but at least I am protected. We are given bed nets and a constant supply of bug repellent. We have both the rapid malaria test as well as the anti-malarial drug easily available in our Peace Corps issued med kits. I don’t even know a single PCV who has ever even had malaria. And yet our counterparts, students, friends, neighbors, etc all remain at an extremely heightened risk every day. Our school year is only 4 months young and already, 2 students have passed away. All I know is that they were sick, and then the school posted a notice on the front gate, ambiguously informing us of their passing. Though it is incredibly rare for someone to have their neighborhood-gossip-chain cause of death actually be “malaria,” due to the already explained misconceptions regarding this particular disease, I can’t be sure that malaria was not the principal cause, and I am statistically inclined to say that it was. The average lifespan in Mozambique is about half that in the US, and dealing with death is an overly routine experience. Yes, malaria’s more famous mortal counterpart HIV/AIDS, with its assumed link to sexual promiscuity and all that accompanies this fact, is also a massive player in this circuit, but malaria must start to be seen as on the same level, as it attacks the most vulnerable: children under 5 and pregnant women.

            Bet nets are the most eminent means of prevention. The previous ideal for net distribution was one per household, which leaves the children, who often sleep on reed mats on the floor and have also not yet developed any semblance of immunity against the disease, wholly unprotected. Now, the suggestion is one net per sleeping area (most people don’t have beds), but they are expensive and even if received for free, often end up being sold in the market the next day as a vehicle for easy cash used for something deemed more important. People also are often uninformed as to proper use of the nets, occasionally using them as blankets or not knowing how to hang them up. It seems for the first time that the more attention is being paid and more funds allocated to prevent the biggest killer in Africa, as it rightfully should.

Topic 5: Religion

Mozambicans may think they, and they only, are correct, religion-wise, and everyone else is wrong, but this certainty will certainly not prevent them from treating someone from an opposing religion any different. I have never encountered any animosity or any acrimonious words. They only want to know that you have a religion. This is the only thing that matters: you believe in something. “Are you Catholic?” they ask me. “No, then Muslim? Seventh Day Adventist? Jehova’s Witness? Do you go to the Jesus is the Man church?” (probably the buildings say, “Jesus is the Lord” but it is the same word for lord and man so I prefer this interpretation). I respond negatively to all and they seemed stumped and concerned. I temporarily relieve their pain when I say I’m Jewish. Then they think more deeply about this and realize they have no idea what I am talking about. My preferred way to continue, especially when talking to a Christian, is to say, “Well, Jesus was a Jew.” They invariably do no understand, apparently this core tenet of Judeo-Christian teaching is not imparted here. “We use half the same Bible,” I continue. Now, they are really skeptical, thinking, what in hell is the white lady babbling about? Half the same Bible? Bull-shit. So I conclude, leaving them forever thinking that I am crazy, by saying “Somos irmãos” (we’re brothers) in a tone that says, “Don’t worry.” They are quite mystified and puzzled, but at least, according to them, I have a religion. Even if it is some seemingly made-up, crazy, never-before-heard-of, white, American, lady religion.

Last year, I taught my students to say “Happy New Year” in Hebrew around the time of Rosh HaShana. They thought it was absolutely awesome (if awesome means hilarious and crazy, but in a good way). Now I am often greeted by my old students with “L’Shanah Tovah” at all times of year. I respond with “Feliz Ano Novo” (Happy New Year in Portuguese) and they laugh and laugh and laugh. Pouco a pouco (little by little), we are all learning.

But just being Catholic, or Muslim, or believing “Jesus is the Man,” is not sufficient. They intertwine the Western tradition into the traditional religion. And no one has a problem with it. Jesus is one thing, but feiticeiros, evil spirits, are quite another. They will go to the curse-disseminating person, put a curse on you for stealing their vegetables, and then go to Mass. Hey man, whatever floats your boat, just please don’t curse me for failing you when you most likely never showed up to class and therefore deserve it (this has happened to other Peace Corps Volunteers).

Superstitions are also very common and vary depending on your region. In our training town, women weren’t allowed to eat raw coconut because they will get diarrhea. But seeing as coconut meat is pure fiber, I don’t see how having a uterus makes you any more susceptible to diarrhea-by-coconut. Here, in Invinha, women can’t eat turtles, or you will have turtle-shaped babies. I have two problems with this: one, I have never seen anyone (man, woman, or child) selling a turtle or eating a turtle, nor have I seen a turtle strolling down the dirt road. So I’m confused as to the origin of this superstition. Two, what would a turtle-shaped baby really look like? I’m not going to lie, I would like to see that.

When people go to Mass, they dress to the nines. “Sunday best” is an understatement. Full prom-dresses, disco suits, baseball tees, whatever is sparkling clean and new is what you wear to church, no matter what era it is from or how crazy you look. If you don’t really have any money, then you scrub your one outfit so that it is as clean as it can possibly be, even if that risks putting holes in it. But damn, your capulana may have a hole and be held together by a thread, but you are looking good. Once dressed and ready to go, you often travel miles on foot to church. Once you arrive, you spend the next 2 hours wailing. One of the only things Mozambicans assuredly learn in primary school is how to carry a tune, so church music here is absolutely beautiful. But then some of the women start with the wailing and its all downhill. Loud, nonstop, 2 hours of pure screaming. Like I said, Mozambicans love them some religion.

If I were a Mozambican woman, I would be a nun. They have a great life: food security, a job (many are teachers, nurses, school directors, etc), educational opportunities and, most awesomely, socially-accepted exemption from marrying a Mozambican man. The order of the nuns in Invinha is based in Portugal so each nun, while completing her training, is sent to Portugal. All the nuns have thus been to Europe, and thus kinda have an understanding of what my world is like back home, which is interesting for all involved parties. The nuns in Invinha are great: smart, funny, happy, compassionate, and giving. And they are some of the only Mozambicans I have ever met to know what Judaism is (though they do seem a little worried that my people do not consider Jesus as our Savior) so we get along swimmingly.

One Ball Bowz

My dog Bowzer was the runt of his litter. He was a puny little thing to say the least. Once, when he was an adolescent puppy of about 4 or 5 months, we actually found a banana that was practically bigger than he was. He was always covered in wounds from the fights that he invariably lost at the hands of the bigger dogs, aka any other adult dog in the entire country. But his size was not the only thing that let him down in the Mozambican dog-fighting circuit. He was also just the chillest, most non-chalant, most relaxed dog ever. He simply just went with the flow and tagged along with whatever happened to be going on at the moment: dog fights, a jog into the bush with his owner, a trip to the market, an afternoon snooze under a mango tree on a hot day. Bowzer was down for anything. When the other dogs were running wild, Bowzer was right behind them, nipping at their heels, mostly just wanting to join in the fun and play around rather than fight. His preferred spot to doze off the day was in his reed-basket turned bed, contorted in any of a multitude of ridiculous sleeping positions. But most strangely, Bowzer was famous: famous throughout the neighborhood. Now why would everyone around, from a culture that both abhors and fears dogs, inevitably know about the dog of the crazy white teacher, you might ask. Well, Bowzer only had one testicle, the other one apparently undescended. The women in my neighborhood thought this fact was absolutely hilarious and would constantly blame Bowzer’s odd-dog behavior on it (as well as claim that any eccentric or bizarre human male must be as such because he is “like Bowzer,” aka with only one ball). Thus, my old roommate and I nicknamed him as “One Ball Bowz.” Basically, Bowzer was a character and I loved him dearly up until his passing just a few days ago, shortly after his first birthday.

            I am running a few trainings in the northern part of the country for the leaders of girls groups and I needed to go to a city about four hours away to access our girl’s group national bank account. So I was hitchhiking outside Invinha. And Bowzer, my other dog Devin, and two random dogs were apparently keeping me company as I waited. The four dogs were wreaking havoc in the middle of the road when a car pulled up. I was mostly concerned with flagging it down, seeing as it seemed like a safe, quick ride. I was wrong. The car ignored me and plowed right in the middle of the dogs, running over Bowzer’s two back legs, and then speeding away. Somehow Bowzer managed to drag himself to the shoulder of the road and I streaked over to him. The bones in his two back legs were severely broken and sticking straight out of his leg. It was clear he would never walk again. He was shaking from pain and couldn’t lift his head. As I tried to comfort him, I ultimately decided to pay some guys from the bush 100 meticais (about four dollars) to take him into the bush and kill him, ending the suffering he was undoubtedly experiencing. Meanwhile, a crowd formed and mocked me for petting this dying dog and talking to it in English, practically in tears. (Why is the white teacher crying over a lowly dog?) As I walked away with his collar in my hand, I heard him squealing in pain, as I can only assume he was being dragged away to face his fate. But I honestly believe I made the right decision. Even in the US it probably would have been difficult to salvage his legs, considering two of them were totally and completely mangled. If it had been only leg, I would have tried to find some, however far-fetched, way to amputate just the one leg, making me not only the crazy white lady with the uni-balled dog but also the crazy white lady with the uni-balled, three-legged dog (which I admit, would have been quite the legacy to leave on the community of Invinha). I briefly considered buying a lot of rat poison to feed to him as a means of euthanasia, but I’m glad I didn’t, as I learned afterwards that death by rat poison is incredibly painful and protracted. So, I believe the guys from the bush snapped his neck with a rope/chord. But I really had no other options. There is no vet that can administer whatever drug they use to humanely put down dogs in the US. Dogs are not a man’s best friend here during their lifetime, so that which ends it is apparently equally callous. Thankfully, Bowzer didn’t suffer too long, but as I write this, Devin and I are for sure mourning and feeling his loss.

            The week before this incident, the students at my school completed their first trimester final exams, for the first time administered by the Ministry of Education. This means that not only were the English exams full of grammatical errors, but they were also completely un-evaluative and irrelevant to the students’ lives. The text that the students had to comprehend for the 11^th grade exam was about pets in America: how we buy them their own food, treat them as a member of the family, and even use them to assist people with disabilities. Then the essay they were to write was to describe their favorite pet. This topic could not have been further removed from my students understanding of the world. Not only did they not know the word for pet when I translated it to Portuguese to help them out, but they also just do not view dogs and cats in this anthropomorphized and personified sense. It would be like asking an urban American student to write about killing a chicken, goat, or pig for dinner. Essentially, the test was exactly what I predicted it to be: the worst test they could have possibly thought to give, which is, however, another story and another tirade for another day. But as the crowd stood deriding me as I was saying goodbye to Bowzer, I couldn’t help but think about this dichotomy, between how I, an American, and the people of Invinha differ so greatly in our ideas of how dogs can fit into our lives. Obviously, there is no right answer. My dogs are seen as my children to my neighbors because of how I treat them, while Mozambicans use dogs solely to deter unwanted intruders. We all have our place.

But this blog goes out to One Ball Bowz, an odd, little dog that I absolutely loved.