09 February 2009

work?

here's what i've been doing: i've been going every morning to one of the three hospitals icap works in. the peer educators give palestras (lectures) about various health topics to waiting patients, and i'm trying to observe them to get an idea of how their work goes, what kind of information they're spreading, etc. they start between 6:30 and 7 (am!) so i have to get up FAR earlier than i'd otherwise opt for, and it's unfortunately often already hot at that hour. and, also unfortunately, they often either don't show up on the days i go, or have already given their talks by the time i get there. the few times i have gotten to see the talks they have mostly been given in echuabo, the local language, which i only know one word in so far (manguana, means tomorrow). after the palestra i tend to just hang out with the peer educators and other hospital staff to try and get a better idea of the work they do and the process the patients go through. each of the three hospitals has a different setup, different levels of staffing, and different roles for the peer educators, so i'm still learning the system in each place. because of the nature of the agreement between peace corps and the moz government i'm not allowed to work with patients directly because i am not a trained health worker, but i have been able to observe many steps in the patient process, from registering new patients, to accompanying them to various appointments, to counseling sessions, to picking up their medications. as i said, the peer educators' role varies from site to site, but they are basically supporting the patients by explaining the process to them, walking them to their different appointments within the hospital, and answering questions and providing moral support. this also is a huge help to the hospital staff as the hospitals tend to be overcrowded and understaffed. the staff and the peer educators work very hard under very hectic, stressful conditions, and i get tired just watching them do their work!

one of the other activities the peer educators do is called busca (search) for patients who have abandoned treatment. they find out why the patient has abandoned (often has to do with the distance and/or cost of transportation, because they don't have enough food and they don't feel strong enough to continue treatment, because of fear of or actual discrimination within their family or community, or because of a misunderstanding of how often they are supposed to take their medication or visit the hospital), and provide moral support and try to convince them to return to the hospital. i have only gotten to go along on one busca so far, and the patient was actually at the hospital that day, and hadn't abandoned, there was just a mix-up with the data collection! but it's a really integral part of the peer educators' work and one i'm looking forward to participating in more. another activity that the peer educators do is called cha positivo (positive tea), which are meetings open to everyone (positive and non-positive patients, hospital staff, family and friends, etc.) to discuss issues surrounding hiv and aids, transmission, prevention, treatment, adherence, discrimination, etc. they happen once a month at each of the three hospitals, and so far i've attended two. they involve theater skits, speeches, and open discussions about all these issues, and provide a safe space for people to ask questions or talk about their experiences. afterwords there's a little snack (hence calling it a tea). it's a really interesting activity. between the two i've attended there was a large disparity in the amount of participation of non-peer educators and in the level of interest in the discussion, but helping the peer educators improve the format of future chas to be more participatory is one of my projects/goals, so we'll see how those go in the future.

so as i said i'm almost always at a hospital in the mornings, i often go home for lunch in the middle of the day, and then i have often come into the office in the afternoon to catch up on internet, catch up with Alison and my bosses, and do things to help the peer educators like make photocopies, turn in requisitions, remind staff of things they said they'd do for them, etc. Alison and i have also started offering informal english and computer lessons to interested office staff a few afternoons a week. there's been a lot of interest (although not always a corresponding attendance!), and it's a nice way to get to know some office staff better and to be able to support them in a small way.

so i've definitely been doing work, at least in the sense that i've been going places and talking to people every day, but so many days i feel i'm never going to figure out exactly what i'm supposed to be doing here! i think it's taking longer because i have 3 groups to work with, so it's taking 3 times as long to get to know people, develop relationships with them, and figure out what things i can help with. but it is going......slooooowwly. later this month icap is going to be training some new peer educators in quelimane to help reinforce two of the groups that have fewer people, and i'll get to participate in that training, which i'm looking forward to because it will give me a better idea of what type of work the peer educators are trained to do, and what areas i can work with them on.

let's see, in non-work news, i got my furniture and it has changed my life and made my house SO much homier. i have made several good friends in my neighborhood and am meeting new neighbors all the time. i've been cooking and baking (in a dutch oven, aka a small pot inside a larger pot) up a storm which is really fun, but it's a good thing i walk a lot! i discovered i like pineapple, then discovered that if you don't eat it fast enough it ferments, and therefor discovered how to make a pineapple upside-down cake! i bought a bike, which made getting around to the different hospitals much easier, but it got stolen from one of the hospitals last week (boo!). but i'll replace it soon, and buy a lock! between city traffic and GIANT and FREQUENT potholes, biking can be a bit terrifying, but it also gave me a sense of independence, and as much as i like walking sometimes it's good to be able to get places more quickly, and i certainly didn't mind the extra exercise! it's been raining more so it's cooled off a bit so i'm MUCH happier temperature-wise. and one of my favorite new things that makes me smile is the fact that bike taxi drivers, when they want to get around someone and they don't have a bell, yell "bee-beep" at whoever's in their way!

as always, i apologize for the delays in posting, and i hope everyone reading this is doing well. other than being hot (although less so) and tired from getting up early and running around all over the place, i am doing fine. beijos (kisses)!