so this was a big week! first, all health volunteers had to do their practicums this week. practicum is a chance for us to practice some of the skills and ideas weºve learned about imparting health information to people. so we each had to find a group of people in the community, meet with them to sort of figure out how they operate, what they know, what they want to know, and then develop some sort of activity to do with them to impart some knowledge. many people worked with siblings or neighborhood kids. because i havenºt been doing portuguese class for awhile, iºve been meeting with an activist and going with him to meetings of a group of people living with HIV, so i did my practicum with this group. iºd been to several meetings and talked to the people (all but one are women) about their lives, problems, and what kind of information i might be able to bring them. these people are all taking ARVs, which is great, but one major side effect of ARVs is that they make you hungry, and they can make you sick if you havenºt eaten. and these people are poor, so they donºt have a lot of money to buy food, and thereºs been a drought here so they havenºt been able to grow as much food as they normally could (which would normally be a source of income as well). so they said that they would like more information on nutrition, so i prepared a talk on nutrition. i made a poster of food groups, but instead of using the traditional food pyramid i made a chart with "main foods" in the middle, and then "protective foods" (fruits and vegetables), "energy foods" (fats and sugars), "growth foods" (protiens), and "extra foods" (coffee, soda, cake). i liked this model because it put more of the emphasis on what foods are available (rice, bread and potatoes are all main foods which are relatively cheap and available here and do provide energy and some nutrients) and also grouped foods by what they do for your body. so i made this poster and then had pictures of lots of foods cut out, and had them stick foods on the poster in the right group, talking about why foods go in different groups, and how some foods are good because they fit in more than one group (like dark green leafy vegetables provide vitamins and protien and iron, or peanuts because they provide protein and good fats). then we talked about what foods are easily available, either in nature (you canºt go 5 feet without passing a mango tree), or cheaply in the market. we took off all the foods that were too expensive or unavailable, and they still had lots of foods that they found accessible, which was nice to be able to show because when i asked them before they said they couldnºt find anything. then i also told them about some tricks to add nutrients to their diet, like grinding up eggshells for calcium, or putting an iron nail in the cooking pot to add iron, or drinking the water they cook vegetables in to get the nutrients. they seemed pretty intrigued by these ideas, and overall i felt like it was a pretty successful practicum. iºm going to keep meeting with this group for my last two weeks here, and continue to bring them any other information they ask for. the experience of the concentrated practicum, as well as the experience of meeting with these people twice a week and talking to them about their lives and their problems, has been heavy and stressful at times, but also really instructive, thought-provoking, and hopeful in some ways. (i would like to note here that i didnºt come up with any of this stuff on my own, PC has given us a mountain of manuals, and most of the info i used for my practicum activity came from Where There is No Doctor by David Werner, awesome book).
the other big deal this week was that we all found out our site placements! they drew it out as long as they could, calling us up one by one in groups by province (so i found out first that iºm going to zambezia province), and handing us a folded sheet of paper that we couldnºt open. only once all 57 of us had done this did we open our packets to see what cities and what jobs we had gotten. it was ridiculously nerve wracking. so.....iºm going to quelimane, the capital of zambezia province. i will be living in a house, by myself, in a neighborhood in the outer part of the city. i will be working for ICAP (International Center for AIDS Care and Treatment Programs), an NGO funded by Columbia University. They have several focus areas, but the one that i will be most involved with is treatment adherence, making sure people on ARV treatment stay on it, and finding people who have stopped treatment and getting them back on. ICAP trains peer educators (HIV positive activists) to do this work, and i will be supporting a group of peer educators by being their link with ICAP. this is exactly the job i wanted (a current volunteer was visiting a few weeks ago who works for them and i heard about it from her), so iºm really psyched. thereºs still a lot i donºt know, but thereºs another volunteer visiting this week who works for ICAP also so iºll keep picking her brain, but iºm sure a lot will remain a mystery until i get to site (december 15th!). my job is also not set in stone, so there are a lot of possibilities for what kind of projects i could be working on, and that will just get figured out as time goes on. i feel as impatient as a 3 year old because i want to know as much as possible about my house, the city, my job, etc. but i only have 2 weeks left to wait!
28 November 2008
13 November 2008
site visit
so last weekend we all went on site visits, which is a chance to visit a current PCV living in country and working in our field, to see how they live and work, and of course to experience a different part of the country and more of the awesome public transportation system. itºs also a nice break in the middle of training.
so i went with one other health trainee to vilankulos, a small city on the coast at the north of inhambane province. we had to leave namaacha at 2:30am in order to catch a bus (machibombo) from maputo. i had thought a bus would be better than a chapa. it sounds better, right? well i guess it is in some ways, you get more choice of who you sit by and arenºt quite as squished in, and the seats are taller so you can lean your head back (at least if youºre short like me you can) but thatºs about where the benefits end. the seats were hard, there was even less leg room than on a chapa, and the aisles were stuff with standing people and luggage so it was still hot and squishy and hard to get out. also it was raining and my window was leaking on me a bit. but i was with a bunch of friends going to the same area, and it was fine. our driver seemed to be in a hurry and was ignoring peopleºs requests to stop and pee (it was an 11 hour trip, so stops were definitely needed), and the most memorable moment of the trip up was when a woman screamed at the driver for about 10 minutes about how everyone had to pee, how it was a human right and a biological necessity, how we were paying customers, and that there were women, children, and foreigners (!) on the bus and they all had to pee! it was kind of tense, but also hilarious, and effective! the driver stopped soon after and about 90% of the passengers got off to pee on the side of the road. the word for pee in portuguese is xi-xi ("shee-shee"), and this happened when we were just past the city of xai-xai ("shy-shy), so we dubbed this the xai-xia xi-xi incident!
despite discomforts and shouting incidents, the trip was great to be able to see different parts of mozambique. the scenery change considerably, from mountains and red dirt around maputo, to flat and gray, to lush green. in inhambane province there were palm trees everywhere, as well as mangos, and the dirt turned to sand. we passed through a couple of dencent sized towns/cities (xai-xia, mexixe), drove by some beautiful coastal views around the city of inhambane, went through a lot of rural villages, and passed about a million goats. i mused out loud that the goats could probably take over the country if they wanted. my seat-mate will told me i needed to drink more water (we were all limiting ourselves due to the infrequent bathroom breaks).
we got to vilankulos a little after 5 pm. my two pcv hosts were really nice, they are both just about the complete their two years of service so they had a lot of experience to share, and two of the people from my health group will be replacing them so everything about their site was especially important to notice. vilankulos is a city, small enough to walk around, but big enough to have lots of ammenities, like hotels, restaurants, and well-stocked grocery stores. itºs right on the beach so itºs also quite touristy. there are lots of foreigners visiting, and expats working for ngos and escaping. between the size of the city and the tourist factor, i feel like it would be hard to integrate into the town and make friends because it would be hard to not be seen as a tourist. the two pcvs i visited seemed to like it fine, they have made friends (both mozambican and other foreigners) and had a good time, but salvador, where i lived in brazil, was also very touristy, and despite having had an amazing experience there, i know that i would not prefer to have that experience again. however, if i got that site, or one like it, i know iºd be fine. after all, being able to go to the beach and buy nutella whenever i wanted wouldnºt be all bad!
so both the volunteers i visited work for CARE, an international NGO. they have a really nice office, lots of resources, itºs pretty much the top of the heap in terms of moz health placements. one of them worked "mainstreaming" HIV, adding it into the program for a variety of income generating projects. she did a fair amount of field work, visiting groups in various parts of the province. the other worked with OVC (orphans and vulnerable children) programs doing a lot of monitoring and evaluating. she didnºt do much field work. as much as the office setup was impressive and the jobs really interesting and well-defined, i donºt think the job would be my top choice either. thereºs still a lot we donºt know about possible job placements (like everything) but i would prefer a job where i get to do more hands on work with people, and that has less of an office focus. for instance these girls worked 8-5 five days a week, but a lot of health PCVs work for organizations that operate only a few hours a day or a few days a week in an office setting, and do more field/community work in the other time.
so i still donºt know where iºm going, but i filled out a survey about my preferences for all kinds of site placement variables, and next monday i have an interview with the health area coordinator, so things are moving along! iºm really so excited just to know, so that i can stop imagining and wondering and start thinking concretely about what the next two years will be about!
ok, so, as you the reader may have gathered, travel here is interesting to say the least. and my trip back was no exception. instead of the long bus we came back in two days by chapa. day one i took a chapa from vilankulos to mexixe. on this chapa i was sitting on the crack between seats for half the ride and over a large metal bar for the other half so my butt was killing me by the end. in mexixe we switched chapas. less than an hour into this chapa ride the driver and the cobrador (money taker) started arguing with a few of the passengers. it was in the local language so i didnºt understand anything except the phrase ten meticais (like 40 cents) repeated over and over, so apparently some confusion over payment. finally the chapa stopped, and they kept arguing, and drew a crowd. then they got out and went behind the chapa and started to fight! it didnºt amount to much, no blood was shed or anything, but it was pretty wild. so we spent the night in xai-xai (a town larger than vilankulos but not touristy, nice, tho i didnºt see much of it), and the next day caught a chapa back to maputo. the chapa we caught was probably the nicest one in the country: brand new comfortable seats, and a dvd player! they were showing a south african movie called mr. bones (pretty ridiculous, look it up on imdb), and instead of playing the sound there was brian adams hits blasting on the radio. all things considered, it was great. but just as i was settling in for an unbelievably comfy chapa ride, we pulled over and our driver started talking to another chapa driver. eventually they started telling us to get out, and we didnºt understand why, but we went to the other chapa, and who should be there but 7 other fellow trainees on their way home....i was actualy pretty unhappy about being thrown into a huge group against my will, and the new chapa was seriously less comfortable than the one iºd been forced to leave, but oh well. the rest of the trip was uneventful. but i think thatºs eventful enough! public transportation here is so funny, i simultaneously love and loathe. the vehicles are the farthest thing from comfortable, theyºre hot, smelly, awkward, and of questionable safety, but theyºre endlessly entertaining, and such a great way to witness so much life....
one other anecdote, then iºm off. last night it POURED for real for the first time since iºve been here - which is awesome for them cuz they really need the rain, although i bring several pounds of red mud with me every time i come home. but i woke up at about 11:30 last night and the rain was pounding so hard on my tin roof, i donºt know if the noise woke me up or the resulting desire to pee. anyway, i laid there for over an hour listening to the rain and thunder and seeing my room light up with lightening, and the sound was so loud i could feel it, like when youºre at a concert near the speakers, my whole body was almost shaking. it was pretty awesome.
and lastly, i would like to say a big thank you to all those of you who sent me mail! i got a postcard, a five-part letter, and a package today, and it made me so so happy, so thanks! and to let you all know, timing wise, letters seem to take a little over two weeks, packages 3-5 and counting....but never lose hope!
so i went with one other health trainee to vilankulos, a small city on the coast at the north of inhambane province. we had to leave namaacha at 2:30am in order to catch a bus (machibombo) from maputo. i had thought a bus would be better than a chapa. it sounds better, right? well i guess it is in some ways, you get more choice of who you sit by and arenºt quite as squished in, and the seats are taller so you can lean your head back (at least if youºre short like me you can) but thatºs about where the benefits end. the seats were hard, there was even less leg room than on a chapa, and the aisles were stuff with standing people and luggage so it was still hot and squishy and hard to get out. also it was raining and my window was leaking on me a bit. but i was with a bunch of friends going to the same area, and it was fine. our driver seemed to be in a hurry and was ignoring peopleºs requests to stop and pee (it was an 11 hour trip, so stops were definitely needed), and the most memorable moment of the trip up was when a woman screamed at the driver for about 10 minutes about how everyone had to pee, how it was a human right and a biological necessity, how we were paying customers, and that there were women, children, and foreigners (!) on the bus and they all had to pee! it was kind of tense, but also hilarious, and effective! the driver stopped soon after and about 90% of the passengers got off to pee on the side of the road. the word for pee in portuguese is xi-xi ("shee-shee"), and this happened when we were just past the city of xai-xai ("shy-shy), so we dubbed this the xai-xia xi-xi incident!
despite discomforts and shouting incidents, the trip was great to be able to see different parts of mozambique. the scenery change considerably, from mountains and red dirt around maputo, to flat and gray, to lush green. in inhambane province there were palm trees everywhere, as well as mangos, and the dirt turned to sand. we passed through a couple of dencent sized towns/cities (xai-xia, mexixe), drove by some beautiful coastal views around the city of inhambane, went through a lot of rural villages, and passed about a million goats. i mused out loud that the goats could probably take over the country if they wanted. my seat-mate will told me i needed to drink more water (we were all limiting ourselves due to the infrequent bathroom breaks).
we got to vilankulos a little after 5 pm. my two pcv hosts were really nice, they are both just about the complete their two years of service so they had a lot of experience to share, and two of the people from my health group will be replacing them so everything about their site was especially important to notice. vilankulos is a city, small enough to walk around, but big enough to have lots of ammenities, like hotels, restaurants, and well-stocked grocery stores. itºs right on the beach so itºs also quite touristy. there are lots of foreigners visiting, and expats working for ngos and escaping. between the size of the city and the tourist factor, i feel like it would be hard to integrate into the town and make friends because it would be hard to not be seen as a tourist. the two pcvs i visited seemed to like it fine, they have made friends (both mozambican and other foreigners) and had a good time, but salvador, where i lived in brazil, was also very touristy, and despite having had an amazing experience there, i know that i would not prefer to have that experience again. however, if i got that site, or one like it, i know iºd be fine. after all, being able to go to the beach and buy nutella whenever i wanted wouldnºt be all bad!
so both the volunteers i visited work for CARE, an international NGO. they have a really nice office, lots of resources, itºs pretty much the top of the heap in terms of moz health placements. one of them worked "mainstreaming" HIV, adding it into the program for a variety of income generating projects. she did a fair amount of field work, visiting groups in various parts of the province. the other worked with OVC (orphans and vulnerable children) programs doing a lot of monitoring and evaluating. she didnºt do much field work. as much as the office setup was impressive and the jobs really interesting and well-defined, i donºt think the job would be my top choice either. thereºs still a lot we donºt know about possible job placements (like everything) but i would prefer a job where i get to do more hands on work with people, and that has less of an office focus. for instance these girls worked 8-5 five days a week, but a lot of health PCVs work for organizations that operate only a few hours a day or a few days a week in an office setting, and do more field/community work in the other time.
so i still donºt know where iºm going, but i filled out a survey about my preferences for all kinds of site placement variables, and next monday i have an interview with the health area coordinator, so things are moving along! iºm really so excited just to know, so that i can stop imagining and wondering and start thinking concretely about what the next two years will be about!
ok, so, as you the reader may have gathered, travel here is interesting to say the least. and my trip back was no exception. instead of the long bus we came back in two days by chapa. day one i took a chapa from vilankulos to mexixe. on this chapa i was sitting on the crack between seats for half the ride and over a large metal bar for the other half so my butt was killing me by the end. in mexixe we switched chapas. less than an hour into this chapa ride the driver and the cobrador (money taker) started arguing with a few of the passengers. it was in the local language so i didnºt understand anything except the phrase ten meticais (like 40 cents) repeated over and over, so apparently some confusion over payment. finally the chapa stopped, and they kept arguing, and drew a crowd. then they got out and went behind the chapa and started to fight! it didnºt amount to much, no blood was shed or anything, but it was pretty wild. so we spent the night in xai-xai (a town larger than vilankulos but not touristy, nice, tho i didnºt see much of it), and the next day caught a chapa back to maputo. the chapa we caught was probably the nicest one in the country: brand new comfortable seats, and a dvd player! they were showing a south african movie called mr. bones (pretty ridiculous, look it up on imdb), and instead of playing the sound there was brian adams hits blasting on the radio. all things considered, it was great. but just as i was settling in for an unbelievably comfy chapa ride, we pulled over and our driver started talking to another chapa driver. eventually they started telling us to get out, and we didnºt understand why, but we went to the other chapa, and who should be there but 7 other fellow trainees on their way home....i was actualy pretty unhappy about being thrown into a huge group against my will, and the new chapa was seriously less comfortable than the one iºd been forced to leave, but oh well. the rest of the trip was uneventful. but i think thatºs eventful enough! public transportation here is so funny, i simultaneously love and loathe. the vehicles are the farthest thing from comfortable, theyºre hot, smelly, awkward, and of questionable safety, but theyºre endlessly entertaining, and such a great way to witness so much life....
one other anecdote, then iºm off. last night it POURED for real for the first time since iºve been here - which is awesome for them cuz they really need the rain, although i bring several pounds of red mud with me every time i come home. but i woke up at about 11:30 last night and the rain was pounding so hard on my tin roof, i donºt know if the noise woke me up or the resulting desire to pee. anyway, i laid there for over an hour listening to the rain and thunder and seeing my room light up with lightening, and the sound was so loud i could feel it, like when youºre at a concert near the speakers, my whole body was almost shaking. it was pretty awesome.
and lastly, i would like to say a big thank you to all those of you who sent me mail! i got a postcard, a five-part letter, and a package today, and it made me so so happy, so thanks! and to let you all know, timing wise, letters seem to take a little over two weeks, packages 3-5 and counting....but never lose hope!
01 November 2008
visits
hello readers, sorry itºs been a while, posting is hard because not only do i have to find time to use the internet (and find a time when thereºs not a big line), and have enough money to pay for the internet, i have to be in the the right frame of mind to gather my thoughts and write. but iºm going to try and do that now for you!
so last saturday i went back to maputo for the first time with my language class. we took a chapa, the most common form of transportation here, which is a van about the size of a vw bus, which is supposed to seat 18 plus the driver but almost always ends up holding more (there were 22 plus the driver plus a baby on the way there). the highway between namaacha and maputo is pretty good, and it took just over an hour to get there. the purpose of the trip was mainly to teach us to use chapas, and to get a sense of maputo. we didnºt have a ton of time there, but i got enough of the sense of the city to feel like i would like to go back and explore some more! two things that are very clear though: 1) that maputo is the most (and really the only) "cosmopolitan" place in mozambique. for instance, we went to a cafe and had yummy pastries and lattes and watched cnn. 2) (which is really just a continuation of 1) you can find "everything" in maputo. people bought cell phones with internet. someone bought a basketball. people visited a nike store. people bought peanut butter, honey, diet soda, clothes hangers, basil (all things that are either unavailable or VERY expensive in namaacha). a variety of ethnic restaurants can be found (as can KFC and dominoes). the things that made me the happiest (besides the latte) were the bookstore and the "feira de pau" or wood market, really just a huge craft fair that we only touched the surface of. those of you who know me well will not believe that i resisted buying earrings, but itºs true. but i canºt wait to go back! things i got in maputo: a pretty capulana (cloth to be used as a skirt/shawl/almost anything), whole grain bread, dark chocolate, and a good map of mozambique.
i made two other trips this week with my health group. on monday we visited a hospital outside of maputo that serves people living with HIV and AIDS. it is funded by an italian organization called DREAMS, and it was really impressive. it was a small space, but they are really well organized, have an integrated computer system, offer counseling, labwork, ARVs, and food, all free. they are unfortunately the exception rather than the rule, and at this point are so full that they can only take 60 new patients a month, and the need is immensely greater. so it was really interesting and inspiring, but at the same time disheartening because i know that that is not the situation i am going to find in other places i go here. but it was presented to us as the ideal that all programs could/should strive for.
the other trip was friday to casa do gaito, a catholic-affiliated organization that takes in orphaned boys, or boys whose families canºt care for them. it was also a very impressive facility - they house up to 150 boys from infants to mid-20s, give them counseling and health care, run a school for them which is also open to people in the community, have a church on site which is also a community church, and teach them all kinds of skills (like cooking, metal and wood work, agriculture) that help them take care of themselves and their site, can help generate income for the organization, and gives the boys skills for later in life.
so last saturday i went back to maputo for the first time with my language class. we took a chapa, the most common form of transportation here, which is a van about the size of a vw bus, which is supposed to seat 18 plus the driver but almost always ends up holding more (there were 22 plus the driver plus a baby on the way there). the highway between namaacha and maputo is pretty good, and it took just over an hour to get there. the purpose of the trip was mainly to teach us to use chapas, and to get a sense of maputo. we didnºt have a ton of time there, but i got enough of the sense of the city to feel like i would like to go back and explore some more! two things that are very clear though: 1) that maputo is the most (and really the only) "cosmopolitan" place in mozambique. for instance, we went to a cafe and had yummy pastries and lattes and watched cnn. 2) (which is really just a continuation of 1) you can find "everything" in maputo. people bought cell phones with internet. someone bought a basketball. people visited a nike store. people bought peanut butter, honey, diet soda, clothes hangers, basil (all things that are either unavailable or VERY expensive in namaacha). a variety of ethnic restaurants can be found (as can KFC and dominoes). the things that made me the happiest (besides the latte) were the bookstore and the "feira de pau" or wood market, really just a huge craft fair that we only touched the surface of. those of you who know me well will not believe that i resisted buying earrings, but itºs true. but i canºt wait to go back! things i got in maputo: a pretty capulana (cloth to be used as a skirt/shawl/almost anything), whole grain bread, dark chocolate, and a good map of mozambique.
i made two other trips this week with my health group. on monday we visited a hospital outside of maputo that serves people living with HIV and AIDS. it is funded by an italian organization called DREAMS, and it was really impressive. it was a small space, but they are really well organized, have an integrated computer system, offer counseling, labwork, ARVs, and food, all free. they are unfortunately the exception rather than the rule, and at this point are so full that they can only take 60 new patients a month, and the need is immensely greater. so it was really interesting and inspiring, but at the same time disheartening because i know that that is not the situation i am going to find in other places i go here. but it was presented to us as the ideal that all programs could/should strive for.
the other trip was friday to casa do gaito, a catholic-affiliated organization that takes in orphaned boys, or boys whose families canºt care for them. it was also a very impressive facility - they house up to 150 boys from infants to mid-20s, give them counseling and health care, run a school for them which is also open to people in the community, have a church on site which is also a community church, and teach them all kinds of skills (like cooking, metal and wood work, agriculture) that help them take care of themselves and their site, can help generate income for the organization, and gives the boys skills for later in life.
i also visited two other health posts this week. because i have studied portuguese before i no longer have to go to daily portuguese class, so i have been assigned to help and work with my health tech trainer and visiting health PCVs. this week, with PCV melissa, i visited a family planning clinic and an HIV testing center here in namaacha. the familiy planning clinic has funding from planned parenthood international and offers a variety of birth control options, pregnancy testing, and counseling on family planning and sexual health. it also is a food distribution point for people recieving ARVs at the local hospital (funded by the world food program). and itºs also a meeting point for activistas (volunteer community health activists). itºs a pretty impressive array of services for a center in a small town, but in contrast to the other places i visited it is small, run by 2 people, has little technology, and is underfunded. the HIV testing center is called a GATV (voluntary counseling and testing center) run by the government/ministry of health. they offer free and anonymous rapid HIV testing and counseling. it is a great and necessary service, but it is also understaffed (one person that i know of) and underfunded. it is also underutilized due to the stigma of getting tested in your community.
i write about these health places iºve visited because they represent a significant part of my present and future jobs here. as a PCV my "job" will be to work with an NGO or community organization in the area of public health, and specifically HIV and AIDS, doing work on prevention, testing, counseling, treatment, services, or some combination thereof. so my job now, as a trainee, is to learn as much as i can about HIV and AIDS and other health issues, how they affect and are perceived by people in mozambique, and how the public and private sectors operate in the field of health. it is a complex and daunting topic, and one i am not yet prepared to discuss in depth on a blog, but it is worth noting that HIV and AIDS and public health are topics that i learn about, discuss, and think about every day, both in class and out. i am going to add links to some sites that have info on HIV and AIDS in general and in mozambique to the blog so people who are interested can find out more on their own.
i hope everyone reading this is doing well! donºt forget iºd love to hear how youºre doing too, email, real mail, call, text!
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