3 weeks in my bed

trying to stop these demons that keep, 

dancing in my head. 

I keep waiting for the time when I can finally say 

“this has all been wonderful but now I’m on my way”  -Phish 

My good friend Penny said to me “you just can’t catch a break, can you?” She was referring to my seemingly magnetism for injuries and illnesses here in Namibia, as I had just been randomly stung by a insect, on my eye lid, twice. I don’t understand it, I’m not really a sick person at home, I mean, yes I do have frightful allergies which seem to be more psychosomatic then anything else. BUT in general I am fairly healthy, I get the usual cold, I drink too much beer with my friends and then spend a day laying on the couch, and I did have a bout with appendicitis in 2007 but, really, that’s the gist of my health excitement for the last 7 years or so. I’ve been in Namibia for 8 months and have experienced a cornucopia of maladies: 

• Tick/mosquito bites that didn’t heal for 8 weeks
• Tick Fever/Tick-borne Malaria 
• Bronchitis
• Laytex Allergies 
• “General Malaise”
• Heat Exaustion 
• Acute Sinusitis (for 3 months) 
• Benign Fibroid Adenoma (9 of them)
• Fractured toe 
• Sciatica 
• Bed Bugs 
• Miscellanies insect sting 

After ranting and raving about the injustice of this to my friend Chaz, he suggested that maybe my body was rejecting Namibia. 

Well, that about explains it.

Well friends, I have some big news to share… I will be leaving Namibia in 4 weeks. Yes, my placement here has come to an end, while the length of my contract has always been flexible I had intended on (and agreed upon) staying 18 months- or until March of 2010. However, things evolve and change as situations tend to do and after many many discussions with VSO, we have come to an agreement that I would finish my placement after 8 months. Technically speaking, VSO has deemed my placement a failure, as the Ministry of Health and Social Services has failed to follow the terms of the contract they agreed upon. The two biggest issues is the lack of a counterpart (actually I believe Ms. N is supposed to be my counterpart but, as you may have gathered from my stories of her, she has little to no interest in collaborating with me- in fact I suspect she thinks I want to take her job) and general lack of support for any service I can provide to the region (providing me with a translator so I can contribute to meetings, listening to suggestions I have, providing me with transport to see the outreach services etc.). So, without these two things- nothing I am doing here is sustainable, meaning nothing will continue once I leave.
Sustainable development is the latest fad of the development world- and I think its a good one. Essentially, the theory is the same as the proverb: “if you give a man a fish, he eats for a day; teach a man to fish and he eats for a lifetime” and I see it every day here. Programs volunteers worked tirelessly on are set up and run beautifully while they are here, but as soon as the volunteer goes the support dwindles and participation fades until its yet another failed project. Without a counterpart or local liaison who can help the volunteer to understand the nuances of the culture and adapt the volunteer’s ideas to fit that culture’s needs- any idea that is presented without the partnership faces huge challenges to even get off the ground in the absence of the volunteer. Here in Namibia, the people have only just overcome years of apartheid where they were oppressed and told what to do by a group of people who had no understanding of their culture and their beliefs. 19 years later there are still foreigners crawling all over the country telling them what to do, how to teach their children, how to dress in a meeting, what they should enact as laws. And I wonder how much good this is doing? And without a partnership with a local person to tailor the knowledge of the volunteer to the needs of the community how much different is volunteering to colonialism?
I believe in sustainable development, seeing as though I wasn’t developing anything sustainable- I honestly did not want to spend anymore of someone else’s money and my own effort to attempt to make changes when it was clear the community was resistant to. So, with that heavy reasoning (and some exciting personal opportunities that I could not ignore) I accepted VSO’s offer to send me home 10 months early.
Its a disappointment, but I have learned so much being here. I really have. Aside from all the typical volunteer blatherings (I experienced a different culture! I saw THE REAL Africa! I held an orphaned baby and saw the eyes of the world! ) I learned some very important life lessons:

• Communication is essential, without it you can’t connect with others.
• Its impossible to compare people’s lives- each person is different with different experiences, thoughts and reactions.
• There is no such thing as a selfless action- even the most giving efforts feed us in some way and that is what keeps us going.
• Rudeness, malice and spite are not bound to language or culture; luckily the same holds true for kindness, forgiveness and happiness.
• Everybody deserves a little grace sometimes.
• There’s no place like home. 

So, here in Namibia- the land of dust and sunshine, colors are bit misrepresented. The paint on buildings is the only thing that lends color to the world of sand and concrete that is Outapi, however some time spent in the sun and that color slowly fades- a brilliant red fades to a dusty rose within a month, the same goes for all the other colors of the rainbow… so when you see color here, its eye catching. Really. Most colors in the environment come from clothing, the meme dresses worn by the woman are made out of shiny polyester fabric so the colors remain vivid even after months of exposure to dust, sunshine and sweat. Hooray! Its not beige! Also I think that folks here in the north are desperate for color so they find whatever brightly colored item of clothing they can and wear it. Florescent yellow turtle neck? Pair it with a orange and green striped skirt! Red Hello Kitty pajama pants? That’ll work perfectly with my royal purple plaid shirt! This is nice, not only does it brighten the area around the hospital, but it alerts me to their presence laying on the sidewalk outside the clinic and saves me a potentially nasty fall. Why are they laying on the sidewalk you ask? Oh. Meme. Its hot here. Very hot.

My placement description described the level of dress that I was expected to show up of work in as “smart.” My American friends and I joked about this, since we don’t use that word to describe clothing, so there was many jokes about what “smart” meant… a tshirt with algebraic equations on it? Pants inscribed with the magna carta? A scarf with a picture of Shakespeare? Little did I know, smart is a style of dress. It means fancy. That is the best way I can translate it into American English- fancy dress. In American we say dress for the job you want, not the job you have. Well, apparently, all Namibians want to hold public office, either that or are auditioning to be extras at the prom.

I digress, this need for color coupled with the desire to overdress for work is my only explanation for why a staff member at Oshikuku hospital turned up for a meeting in this outfit:

Beige snakeskin pointed-toe dress shoes.
Olive socks- delicately patterned with a beige/taupe argyle
Black, fitted and pleated, pin-striped pants.
Navy and white vertically striped dress shirt (with a contrasting horizontal stripe pattern on the collar)
Green tie with gray, gold and red diamond pattern
Iridescent, taffeta royal eggplant vest.

Smartly dressed indeed!

With every summer comes the rainy season, and with it the oshanas fill up, fish grow, plants flourish and Ovamboland becomes beautiful…. Efundja in oshiwambo means floods, or more particularly in this sense “water that rolls in from Angola.” I never saw this mysterious flood of water occur, but I hear it has happened. 

I also spent the weekend in Ruacana, visiting the falls and a himba village.

I’ll come home when the clowns come home. (Widespread Panic)

Well my good friends, its been an eventful week. Yes, sir… event-filled. I somehow managed to find myself on the regional management team’s Supervisory Support Visit schedule. I am not entirely how this happened to me, I know there was a meeting which I was busy taking notes (for you, my loyal readers) and I overheard many people discussing a visit and many many people requesting to be excused. This should have been a sign. But, no I did not focus my attentions on the events of one meeting and thus was subjected to 6 lengthy days of pointless meetings. What goes around, comes around- eh?

So, let me explain what the supervisory support visits are all about. The regional team alerts each of the 4 districts that it would like to provide some “support” to 2 clinics and 1 Health Facility in the region, this alert typically happens about 24 hours before the visit is scheduled to happen. The facility is supposed to be closed and a health profile is to be prepared.The regional team meets at the district hospital, travels to each facility, discusses the health profile, tours the facility and makes recommendations. After all the facilities have been seen we meet back at the district hospital to “debrief” the information back to the district management team.

At least that is how it is supposed to happen.

So the visits went like this: We (the regional team) would arrive at the regional office where we would get in the cars and head out into the bush- Of course the cars were never ready and/or the team wasn’t ready so this involved 1-4 hours of waiting at the regional office for the cars to be ready once we were all piled into the baakies (trucks) we then took off on a 30min-2 hour drive to the site. We were typically welcomed by the staff of the clinic, however the 20+ patients who were lined up outside seemed fairly concerned if not down right annoyed. They must have had some idea what was coming- the clinic would be closed for an indeterminate amount of time and they would have so sit and wait in the sun until it reopened or walk back to their village and try again tomorrow. So we, our group of 17, would be ushered into a relatively small room and we would give introductions and then the clinic would present their health profile. This was interesting on two levels one- the first day I was introduced as “The region’s sweetcake” Yes. The regional director went on to explain that I am shared between Outapi District Hospital and Omusati Region like a sweetcake. She listed all my winning traits they are thankful for- my smile, my funny accent, my blonde hair the list went on until I finally put her out of her misery and introduced myself. You see, she didn’t remember how to pronounce my name, so she just started babbling. Then as a group we practiced saying my name. My favorite was when Ndapandula Shikwanmbae said to me: “Oh! Meme. You have such a hard name to pronounce. Why you named this?” Uhhh I don’t know Ndapandula. So, after the 8th visit I must admit my colleagues had gotten quite good at saying Kreshna Skybul. I’m proud of them, really.
The other entertaining thing about this meeting is that almost none of the clinics had enough chairs for all of us, so there were some rather creative seating options. These included: a brick, a horizontal IV Stand resting on 2 buckets, a ventilator, window sills and my favorite: a table that was shared by 5 people (Your’s truly was seated with one leg over the regional director and one leg over Ms. N and no back rest. For 3 hours). After that experience I hightailed it from the car to the clinic and claimed a chair before the start of each meeting.
Following this presentation, which included a session of grammatical error correction from the regional team, a tour of the clinic was given. Most of the clinics were basically clean and seemed to be decently stocked, and I was looking for crutches and accessibility options- so my tour was pretty quick. No one had crutches and none of the clinics were accessible for people in wheelchairs.
Then the recommendations were given. This took about 3-4 hours. I can’t explain how ridiculous some of the recommendations were in two ways- firstly that this had to be said in the first place OR that the issue they are raising is not important compared to some other HUGE issue. But here were some of the more absurd ones:

(In response to the request that the Health Center be upgraded to hospital status based on the number of patients it sees and the severity of the cases they then have to refer to a larger and far away facility) “I want to thank you for your request. It was considered. However, you failed to introduce yourself and your staff members so I did not who I was talking to and do not know who is asking for this upgrade. Therefore I can only deny your request.”
“The problem with this facility is like the problem with the last facility. We have not opened the meeting with a prayer. How can we expect anything to improve with when have not asked God for guidance and we have no thanked Him for what he has provided. Oh! You all have christian names, but you do not want to thank God…”

“You can not use expired Anti-RetroVirals to treat your HIV patients. They won’t work”

(In response to a Nurse’s request for a car for their facility- which she told a story about how a pregnant mother came in, required emergency care and when the clinic called for a ambulance the transport director denied the request because the driver has already driven that day and it was 9pm at night and he was tired) “You must request transport the day before you want transport at night, that way we can allow our driver to rest during the day”

(Following a complaint from the nurse that transport is not picking up their HIV tests so they can not actually tell people their result and thus are not testing any one) “More importantly, I noticed your flag of Namibia is faded and tattered. Can you explain why you are not respecting your country?”

“I would like to see our clinics taking a part in preventing HIV transmission, our community has started doing it. My church prevents HIV by using 2 buckets when baptizing children. One to scoop water out of and the other to catch the water that might have HIV in it from the child’s head.” (note: this gem of ignorance came from the leader of our special programs division, our number one most important special program? HIV…)

“Dear colleauges. This clinic is having a problem charging their cell phone. How can was assist them to charge this phone?” (Followed by a 45 minute discussion of various different charging methods).

(In response to my suggestion that we start to develop a plan to reach the outreach clinics for NEXT year’s flood, again the floods happen EVERY January-April) “Kreshna. This is a disaster. How can you predict when a disaster is going to happen? If you don’t know when it will happen you can not plan!” (oh, i know… how about a calendar????).

It wasn’t all bad- I got to see some of the clinics that were really trying, in the midst of a flood, expired medications (it seemed that ALL the clinics were using expired medications and they were all be stored on the damp floor and the ones that said “do not expose to sunlight” seemed for some inexplicable reason to be laid out on the shelf of the only window of the clinic), poor training, lack of transport etc. But they were really trying to help and they really cared. And that counts for something, if not everything.

I ran into Crutch Man this morning (In case you are wondering- he was looking dapper, as always. Now that the weather has turned colder… in the mid 80’s… he has taken to adding a tweed jacket to his plaid ensemble. You can imagine the effect this has on the ladies…). so Crutch Man greeted me warmly as always. I remarked that it was a lovely overcast, cool day. And Crutch Man said: “Oh, Crutches. Yes. The clouds. Yes. They are full of water. They are having too much water. But, this morning, early this morning they were not ready to let down their water” he pauses and sniffs the air, cracks a huge smile and said “But I think, Crutches, I think maybe, this afternoon. The clouds. They will let down their water. Too much water. With thunder. I think, yes.” So I wait… for the rain, the water to come- because Crutch Man said its coming.

We already have a lot of water “oh the water- it is too much” driving between Oshikati and Outapi is like driving over a lake. The oshanas (which were puddles when I arrive here in September) are full of water and fish! The whole of my region is flooded, closing all but 12 of our 49 health facilities. Cholera is coming (its across the river in Angola). Malaria cases are increasing on a frightening basis. People live on the side of the road, having been flooded out of their homes they remove there possessions and set up camp on the only high ground in the region- the tar road. Everywhere you look- the water, steely gray and still, reflects the bars and homes it has flooded. This happens every year, so its no big surprise but its still strangely beautiful to me. The colors here are so vivid that gray becomes gunmetal, slate, steel, silver, pewter- words that describe the color in other ways. Gray next to green, becomes more alive somehow. The dark clouds are reflected in the water making the ground shimmery and silver, contrasting with the bright green of the grasses which now have a chance to grow and the bright paint on the shebeens (bars) that are now full of water. My favorite shebeen is flooded, which is good news in the sense that it cuts down on the drinking that goes on in this particular village- but I must say its a bit of a sad scene- you see its named “Welcome to Medium Life Bar.” Its a small concrete structure, painted in bright colors, now surrounded by gray-silver water and abandoned. But, I guess its still true- this is Medium Life. Not great, but not terrible… the water spreads disease, breeds mosquitos and isolates people but it also makes the crops grow and feeds the village.

So, we wait for the floods from Angola. To bring us more water. Its a blessing and a curse.

Yesterday started out easily enough. It was a bright sunny day, and the hospital was abuzz with debate about how long the water from Angola will hold off [note: I have no idea what this refers to- if it is in fact  the event of a flood of water that comes from north caused either by heavy rains or the release of water from a large damn OR if it refers to the large amount of water that has and will continue to flood the oshanas here in the region which they like to blame on Angola.] So, yes it was a lovely stroll through the hospital, the morning is when the cleaners clean so the hospital was in its most hygienic state and the 30+ people who live outside the hospital had packed up their mattresses so walking to the clinic wasn’t too difficult. I greeted the nurses and cleaners in my department and continued my walk to the regional office to greet Ms. N. 

She really is a pleasure to work with. So many different ways of expressing disgust!  Sometimes she uses her tone of voice, her body language but my favorite it is when she uses just her facial expression to let me know that, never, at any point, am I welcome in her office. She does this by staring directly at the wall behind me when she addresses me, when she does actually have to make visual contact with me she does so by narrowing her eyes, curling her lip and expelling her breath through her nose in a snorting fashion. Similar to how you look at a container of spoiled milk. Again, I’m very glad to have given up my comfortable life in The States to help her.  

She is a delight. So this morning she grunted at me as usual and picked up the phone (what better way to show respectful communication then to choose to use the phone as soon as a person greets you?). Normally, this would frustrate me, but as it turns out Ms. N was in the midst of a crisis. It seems that one of her many friends had a pain in her stomach. Now, I may not have shared this with you yet but Ms. N has a special relationship with Tate Jesus. Yes, she is one of the chosen few that Tate Jesus works through. Oh joy for me. I learned this when one day she asked if I went to church to which I replied, no and she immediately pulled over at the nearest church to pray for my soul. We’re destined to become friends, really. Anyway, back to the crisis. So Ms. N’s tells this person that the pain is the devil that is stuck in her womb and that they must pray to remove the devil. The prayer (which bordered on an exorcism) went like this:

Lord, why have you sent this devil to us? This pain inside, it is the devil. the devil is here. We must fight the devil, fight, fight, fight. In the name of Tate Jesus, we will fight the devil. In the name of Tate Jesus his love will kill the devil! Oh, sister- you must fight the devil! Together, in the name of Tate Jesus, we will expell the devil from your womb! In the name of Tate Jesus, we say GO AWAY DEVIL! BAH! BAH! DEVIL GO AWAY IN THE NAME OF TATE JESUS! BAH! GO AWAY! Oh, thank you Tate Jesus, thank you. 

All of this was done in a loud/shouting manner with hand motions. Yes, hand motions. After a silent moment, she calmly explains to the person on the other end of the phone that the devil has been expelled from her womb and she will have no pain anymore, if she is right with the lord. 

So, really everyone is a winner here. 

Oh! You are back! 

Yes, I have returned 

You were gone. 

Yes, I went home. 

Oh! You were gone, now you come back. Oh! 

Yes. 

Oh! You were gone a long time. 

Yes. 

Oh! But now you come back. 

Yes, I am here. 

Oh! Long time. 

This conversation continues in a similar fashion until I pull my hand out of their grasp and walk away, only to be greeted by the next person and start the entire conversation all over again. The day itself was fairly uneventful, our new Medical Rehab Worker managed just fine in my absence- though he continues to record “MVA” (Motor Vehicle Accident) as a diagnosis and I doubt that he is recording all the treatments he does. Ms. N was happy to see me, she greeted me with a exuberant “Ugh. Kreshna. You are back”  and I once again reflected on the usefulness of my having traveled 12,000 miles to share my skills with her. 

I was lucky enough to attend a Regional Management Team Meeting- which was highly entertaining. The regional director is a bit of a character- she is what the brits call “switched on” meaning that she “gets it.”  My favorite part about her is that she had shaved her eyebrows and penciled them in as a thin sharp V that points down the slope of her nose. The whole look is menacing, yet comical- which suits her perfectly. She works, a lot and is highly frustrated by the normal way of business here. Much like any other institution- she is the only one who can get things done, no one will do anything without her approval, or for lack a better term- without her lighting a fire under someone’s ass. 

And light fires she does. She was fired up at the RMT meeting, it seems as though there is a Nursing Conference in Windhoek in 3 months and the Ministry has been asked to nominate 15 Nurses to go and of those nurses 9 were required to be nominated for 1 of 3 awards (Outstanding performance, Call to Duty and Leadership). Now I know what you are thinking- what if none of the nurses that we have in Omusati excell in any of these areas? Ah, well that in fact does not matter- 9 Nurses MUST be nominated. So, the RMT was given the task of determining how many Nurses from each district should be nominated. Again, I know what you are thinking… we have 5 districts- so 3 from each  and from that pool select the 9 that have the qualities that match the awards. Ha, again its clear to me that you haven’t spent any time in Namibia. No, no what we did (for an hour- yes you read right AN HOUR) was discuss a complicated mathematic formula which would allow us to determine the percentage of the Nursing staff in each district, then from that number we could decide how many Nurses to nominate from each district. After much discuss regarding how many nurses Okahao has versus how many nurses Tsandi has (no one knew the exact number so they “estimated” which I think made the percentage equation totally useless) a percentage was reached. This number was largely ignored. After debate and some intense mathematics the totals were as follows: Okahao- 2, Tsandi- 3, Outapi- 4, Oshikuku- 5, Regional- 1. The task of determining the 9 Nurses who will need to be nominated for the awards was tabled until the next meeting. The regional director played an intricate role here- when the deliberations became too lengthy she would stamp her foot and say: Colleagues! You must try harder to come to a decision. These are our Nurses. We must honor them!”

Good times, good good times. 

Following the great debate and mathematics exercise we then discussed why the dentist is stranded at bush clinics for 3-4 hours past working hours on a regular basis. I love the dentist, his name is Mr. Mbacko and is from Kenya- so naturally we’re tight seeing as though we have President Obama in common. He is quite fed up with the system here in Namibia, but he’s getting paid a ton of money and has a fancy car so he puts up with it- for the most part. He is annoyed that he gets left in the middle of no where regularly. So, the regional director asked the transportation representative what the problem was. The conversation went like this:

RD: Transport, what do you have to say for yourself? 

(silence from Transport Rep. she covers her face with her hands) 

RD: Yes, do you have anything to say about leaving a colleague in the bush until 9pm? 

Transport Rep. turns her body away from the rep and with one hand over her eyes and the other over her mouth mumbles… no. 

The RD then rants and raves some more about how the ministry has 10 drivers and 8 cars yet there never is any transport. All the sudden the Transport Rep. perks up and (still addressing the ceiling, with mouth covered) says: “Oh! #42 go to Swap and #69 go to Windhoek and with the workshops and what what and this person wants a long distance car and what what” Huh. this apparently made sense to most of the room because everyone started nodding in agreement. The RD then announced that there will be no more transportation problems because the transport office will learn how to manage their vehicles. Siigh…. I hear the dentist got back from the Ruacana Clinic at 8:30 last night. So, apparently they have not learned how to manage the vehicles yet.

But I’ve been here for 7 days…          (moe.) 

Well I just returned from 3 weeks of traveling through South Africa’s Western Cape. Its a beautiful area (take a look at my pictures by clicking on the link to the left labeled “pictures”), strange though. I am coming from a poor desolate desert full of black namibians who speak minimal english and just spent 3 weeks is a beautiful paradise of green leafy plants and mountains and ocean and white south africans. It all seems very uncomfortable and awkward. Most people in Outapi have never been to Windhoek much less South Africa. Here I am, I’ve been in their country for 4 months and I’ve seen far more of their country then they have. The unfairness of it all boggles my mind and it seems that the easiest thing to do is go by the volunteer standby “you can’t compare your life to that of your counterpart- you both come from completely different places” which makes me feel a little less guilty that I just spent more then a weeks salary on lotion at the body shop.

But Capetown was a lovely city, very western and comfortable. All the food tasted like it should, everyone spoke english and the bartender at our hostel had an ipod full of phish. So, I was a content girl. Strangely, all the comforts of home made me miss home all the more. VSO and most volunteer organizations will tell you that volunteers go through cycles- where they get in country and love it because its new and different and exciting. Then the reality sets in (I live in a shitty apartment next to a TB Ward…. I left my life for this????) and all you want to do is go home. But then after a month of so, things pick back up you have a few good days and alas, Namibia is great, the country is great etc. etc. and the ups and downs continue throughout your placement. 

So. I’m in the homesick, I want to go home, Namibia is stupid, Africa is stupid, Volunteering is a pointless phase. Hopefully this will pass quickly.