Shout Out to Modesta or Can I Go To Med School Now?

Early in November I got to return to Tanga to visit my homestay family and teach the new class all about my favorite topic- mamas and babies! It has been a year since I last saw this family that I lived with for my first two months in Tanzania- when I couldn't speak Swahili, wasn't used to the culture, wasn't used to the heat, and was really terrified of spiders. Despite these barriers, I really loved my mama; she would kill spiders and cockroaches for me, she tried to teach me how to cook (I still gave myself parasites/giardia/I don't know what, but she tried), she saved me from overly forward young men, and when I screamed because a frog jumped on me while taking a shower, she rushed in to rescue me from what she probably expected to be a snake. We laughed uproariously one night when she made a joke about a cow peeing (ngombe ana choo! Actually, she might have been using choo as a verb so my broken Swahili could understand) and my baby dada kept the joke going for several days after that. We both cried when I left at the end of homestay. She put up with my incompetence and ineptitude with love and patience for two months, and, going back, I would finally be able to express my gratitude to her for that, and to actually talk to her! I wasn't incompetent anymore! I could help cook- help more than hinder- now, and I could understand all the gossip about the new PCTs living in the village. My favorite was when my dada came over and her and my mama talked about how one of the PCTs was mwenyeji (a local) because even when he was late, he would still mosey on slowly, greeting everyone, while another PCT dashed to get places- she had poured her chai (tea) into a plastic bottle to take with her to “drink I don't know where!” because she was late. My dada was so frustrated and perturbed at how this girl could take her chai to go just because she was late! Ok, maybe you had to be there, but I still topple over laughing about this. She was so bothered!

So, I am much more capable than I was in Training. That does not mean, though, that I can handle everything. Yesterday after regular clinic, a woman came in with contractions. She was only 6 and a half months along, but this baby was coming out! The kicker was- I WAS THE ONLY ONE THERE! Both the clinical officer and the nurse were gone! So, I delivered a very tiny, 1.5 kilo, premature baby. THAT IS BABY NUMBER 3- BY MYSELF! I clean up the room, all the blood and fecal matter that comes out with the baby, and check on Tiny. Her lungs either aren't fully formed or she has mucus in there, so she was having a really hard time breathing. You could see the effort in her face; when she finally opened her eyes, they would roll back in her head sometimes when she had a particularly hard time breathing. Then another woman comes in with contractions. And another. We only have two beds, so I find an extra mattress and get everyone to fit. Women always come to deliver their babies with an entouarage of other women, so now the clinic was crowded with about 25 women. I told an entourage member of the first women that Tiny needed to be taken to the hospital- we don't have a doctor, and even if they were here, e don't have the supplies to help her. Tanzanians have a habit of asking stupid questions sometimes because of the culture of always asking the white person for help, so in response to my telling her to go to the hospital, she says “But the baby doesn't have a father, the mama doesn't have a husband, what should we do?” With two other women in labour, no actual training on how to deliver babies, and no one there to help me, I looked at that woman with what was probably a very stupid, open mouthed expression, and while I wanted to say “HOW THE FUCK SHOULD I KNOW I SAID THE BABY NEEDS TO GO TO THE HOSPITAL WHAT DOES THAT HAVE TO DO WITH HER HAVING A HUSBAND” I said “sijui” (I don't know).

I could not handle the responsibility anymore, so I called my dada- who also doesn't know how to deliver babies- to come for moral support. I asked her “what do people do when Mama Mosha and Msuya (the nurse and clinical officer) aren't here?!” “They help each other” she responded, “We don't know how to deliver babies, its not our job.” I hugged her, I was so relieved. Modesta, my dada, is 5' tall, 21 years old, but that girl will tell anyone off. One mama was angry about how many people were at the clinic, and Modesta told this woman ho its not our fault! Its the government's fault for not building and staffing more clinics, so people come from outside our catchment area because there are no closer clinics. This mama responded that Modesta and I are no help, we can't help, we are just pretty. Modesta, who works at the clinic for free because we are understaffed, fumed about it the rest of the day.

Moral of the story is 1. I am not always competent to handle situations I get myself into here. 2. My dada Modesta is amazing and this is a shout out to her because she can always handle everything when I go to her for help. 3. Can I go to med school now so I can know what I'm doing?

Somalian Pirates or I Like Lists

I have been in country for more than a year now, and Dec 16 marks a year in my village. I am no longer settling in and figuring things out, in fact, most of my free time has been inundated with work! I have clinic three days a week, I teach at two different primary schools four times a week, and I teach at the secondary school once a week, along with all the necessary prep meetings, plus trying to pull together a girls conference and the evil grant process associated with that. This will ramp up with the next year, when I try to focus more on HIV/AIDs education with an orphans group at a school and a People Living with HIV group in my village. Oh, I miss the good old days of having nothing to do all day! Never fear, though, I still do have some free time. This is what I have done the past two weeks:

read Assholes Finish First

read Lolita (now whenever I criticize a guy, my last thought is always, well, he could be worse- he could be a pedophile)

list all 50 states and their state capitals

list all the countries in the world, broken down by continent and then region (central Asia, east and west Europe, etc)

made a bucket list of things I still want to do in Tanzania before I leave (as motivation to stay here)

made a list of the months I have left and what I will do in each month

made a list of all the cool shit I have already done in Tanzania to make me feel better about what I have spent my time dong in the past year

Have I mentioned that I like making lists?

Whilst listing all the countries in the world, standing in my cushy chair in front of my world map with my notebook and pen, my best friend, Cate, calls me with her latest post COS plan. We had already planned on going to Victora Falls in Zambia, a common venture for TZ PCVs, but she has added to this.... From Lusaka, we will go to Libya to visit her friends there, then take a boat from Tripoli to Athens, Greece to meet her parents, then Eurorail it from Athens across Albania, Montenegro, Bosnia-Herzhgovina, Hungary (do they have really good food in Hungary, or no food at all? Its got to be one or the other with a name like that), Slovakia, Czech Republic, Germany (my motherland(s)!), Netherlands for Christmas, Belgium (WAFFLES!), France, then England! This is why she is my best friend. She is planning the whole thing basically, and I will be there to keep her company and befuddle her plans with spontaneous side trips! At some point along the way I will find a job.

Outrageous plan you say?! Well, its a lot more feasible than my original plan of joining a traveling circus as a tightrope walker and then becoming a Somalian pirate.

A Rich Man's World or Atlas Shrugged

I used to identify as being liberal when I lived in America. Actually, I identified as the kind of liberal described as being “left of Lenin,” when I lived in America. Government stay out of my private life, legalize all drugs, and bring on the taxes and social programs! What is government for if not to offer financial safety nets to its citizens?!

Then I moved to Tanzania.

I've changed since coming here.

I read Ayn Rand for the first time.

I became a racial minority- a model minority, if you will.

I am no longer left of Lenin.

Yesterday a man came to my house to tell me his secret and ask me for help. I had never seen this man before. We are strangers. He is HIV positive. In Tanzania, the government provides ARVs at no charge, but, at least for people in my village, you have to go to the hospital in town to get them, which is a 4,000 shilingi bus ride away. This man had finished his last does of medication, and was asking me for the money to get to town so he could get more. I gave him the money to get to town- what was I supposed to say after he told me he has two kids and his wife already died from AIDs along with their last child! Then, he said, but I will need money to get a place to stay, and food, and the return trip. I didn't give him any more money. He leaves, and I promptly return inside my house and lay on my cement floor, sobbing, then called my best friend to have her convince me to stay in this country.

I wasn't sobbing because of his sad tale and the woes of his life. I wasn't sobbing entirely because of this man, actually. He was more just the needle that broke my camel back. I was sobbing because wherever I go- the clinic, the school, the market, town, on a walk, my front porch, the bus- someone is going to ask me for money, or the bracelet I'm wearing, or the notebook I'm carrying, or the bottle of water I'm drinking from, or the orange I am eating. I have given people my money when they asked for it, or part of my orange, or my water bottle. And every time I do I feel so much worse than when I tell them no. If there are any charitable Christians reading this, you are probably thinking I am gong to Hell. Well, I don't believe in Hell, and you probably don't live in Tanzania, so I don't really care.

People here live with practically nothing. Everyone is poor. If a house has glass windows here, it blows my mind and I stare in dumb fascination. There are two families in my village of at least 5,000 people that have private vehicles. In a place where everyone is a farmer, I have seen two tractors (it might have been the same tractor, just in a different place on a different day.) Electricity hasn't made it into the hills here yet, so no one has electricity. No one has running water. The two communal water spigots in my village may or may not work on any given day. People are poor. And my village is fancy compared to others nearby.

This makes it so hard to turn people down, especially considering how generous so many Tanzanians are to me!

But there is a culture here that if you don't have it, you just go ask your neighbor for his. The inclination isn't to work for something, but to just get it from someone who has worked for it. I'm no economist, but I think this might have something to do with why Tanzania, with all its natural resources, is still a “third world” country.

I am not saying people do not work hard here. People farm by hand- have you ever tried that? People carry 10-50 buckets of water on their heads so their families can have water for a day or two before they do it again. These aren't the people who beg off of their industrious neighbors. They are the industrious neighbors that get begged from. And its not the same people begging that are being generous.

I don't know which came first- this culture of taking from your neighbor, or foreign aid- but foreign aid certainly hasn't helped. And there goes my status as a liberal! I think foreign aid has done more to hurt Tanzania than help. I think foreign aid should be wiped out and people should figure out how to help themselves. That is how you get sustainable development- sink or swim survival- not from USAID giving people latex gloves for free so they can have more babies they can't feed. I will never work in foreign aid again. I had to be here to figure that out. Dear America, lets put the money spent on foreign aid to use fixing problems like homelessness and hunger in America instead of in other countries. I won't get into what else is wrong with America's budget.

Also because of foreign aid, I wear my status of being the rich foreigner on my skin. If you're white, you're rich and you're here to give us money. Hence this man coming to me when he couldn't get to town to go to the hospital. I had a man come to my house on another occasion and very sincerely- on his knees, hands clasped in front of him as if in prayer- propose to me. He had lost his job, and by marrying me, he explained, he would be able to have money. Oh, buddy, do I wish I had the money you think would so magically appear upon marrying me!

I suppose my purpose in writing this is that if you are applying to the Peace Corps, know it's ok to say no. Whenever I don't say no, I feel like I have been taken advantage of, like I have no backbone with which to stand up for myself, and I resent the people I live with. And that is when I think about leaving. I love everyone and feel great about being here when I work at the clinic or teach at schools or have crazy conversations about sex with the men hanging out in the madukani, but when I give more of myself than I want to, I don't want to be here. We are volunteers who are probably better off than our host country nationals, but that doesn't make us sacrificial lambs that people can pick apart because their need is greater.

Discovering Ayn Rand while in the Peace Corps may have been the worse thing for me to do, or the best. At least I know other people are as selfish as I am and are ok with it.

Also, thank you ABBA- you are a huge part my This is a 40 Year Old Divorcee playlist.

Oh, the man returned today because his bicycle broke and he wanted money to fix it. The white girl gave me money yesterday, she'll give me money again! I very politely told him no and have had a much better day.

USAID vs Kat or I Want a Sambusa

One of the many reasons I joined Peace Corps was because I wanted to gain experience in international development. Well, I have, and I think I never want to do international or any kind of development work again.

Why such strong feelings? At present I am working on a grant with my sitemates to do a girls' empowerment conference. Girls and boys conferences are a common thing for PCVs to organize to teach a small group of youth about HIV prevention, gender equality, and gender specific issues. It requires a grant- a very detailed, tedious, repetitive, confusing grant process that takes forever and is really difficult to do when you don't have electricity and live in a village! As I have completed my first year in country, and am nearing a full year in my site, I have been thinking a lot about the future. Also, I have a short attention span and am rather anxious to get onto the next adventure in my life, whatever that might be. I have been thinking a lot about returning to school, after doing something that will somehow accrue money in order to pay for that school. Do I want a masters in public health? Global health, or epidemiology? Do I want to face the dreaded MCAT and apply to med school? Do I want to do something completely different? What do I want to do with my life?! Another reason I did Peace Corps was to postpone answering this question, but unfortunately the question hasn't disappeared yet. Its rearing its ugly head at me, and I am as indecisive and flighty as ever. If my opinion of this grant writing business is any indication, though, anything requiring grants in my future is out! No, I do not want to write the same thing four times in different wording and formatting so you, Grant Coordinator, can tell me to fix it and do it again!

The other day I had a crazy time at my clinic. I had one of those days when I think wistfully of one day practicing medicine in America, where when a man comes in with crazy green blisters all over his hands that then turn into open sores and scabs and you have to test him for HIV, there are gloves available rather than stealing them from the fancy delivery kits (thanks USAID) and then getting scolded for doing so. Or a doctor who knew how to use insulin would be present, so we wouldn't have to ship the patient and insulin (which needs to be refrigerated) to another village an hour away, or at least if we had to do that, there would be ice packs or something, rather than scraping the ice build up from the sides of the freezer to pack around the insulin in a used mebendazole bottle. I love working at my clinic- its the thing that occupies the majority of my time, and I love working with mamas and babies, teaching, and then doing all the stuff I'm not qualified for or supposed to be doing according to Peace Corps. But there in lies the problem- I'm not qualified, I don't know what I'm doing, the people who are qualified don't know what they are doing either because this is Tanzania, and we never have the supplies we need. I can dream of medicine in America, where things are clean and there is money, but everyone else I live and work with can't escape these conditions. And in my puny little role as a volunteer, with a whopping 23 years of experience in absolutely nothing, don't know how to change that. I sound really dejected- I'm not. I know what I can reasonably accomplish in my two years here, and I don't expect more of myself. Peace Corps would be a lot harder if I did. My clinic debacles are funny in hindsight, experience, and make for great stories. If I do ever pursue development work in the future, I will be much better prepared for it by doing this now. And I am eternally grateful that I was lucky enough to be born where and when I was so I can go back to better conditions when I choose.

Things I Would Never Say in America or This is Actually a Quote List

(This will probably only be funny to other TZ PCVs)

I want to see your village! -Rachel

How did I get food on this hand (referring to my left)? -Kat

Ugh, he just gave me the wiggly finger! -Safi

The ants are my friends. -Rachel

Am I a whore because I drank alone in a bar? -Maria

I have lights in my fucking choo! -Maria

I'm afraid to wear pants! -Kat

Did your diarrhea look like veggie curry or soup? -Cate

The last time I bathed was... last Thursday? -Maria

The shit I just took looked just like chocolate soft serve ice cream! -Maria

A woman peed on me today. -Kat

It only takes three hours to get there? You're so close! -Kat

People make the weirdest sounds when they talk to goats. -Kat

You don't use toilet paper anymore? -Kat to Chuck. He doesn't.
The monkeys have ben SO LOUD lately!- Rachel
I like your spigot -Safi
Where are my oven rocks? -Rachel

Karibu New Trainees! or You Are Going to Think I Smell So Bad

The calendar of sessions has been decided, we have argued over the content of each session, we are writing and editing tech language and welcome books, and we are almost ready for out n00bs to arrive in country next week! It has been almost a year since I arrived in Tanzania, and being back in Tanga is cause for some reflection.

What I have noticed through my reflection:

I have been amongst Americans for five days now, haven't shaved my legs yet, and don't really care.

Even though its hot, humid, and I'm sweaty, I don't mind that the guesti doesn't have water and I can't shower.

The ants in the sugar bowel are just added protein.

I have no secret that would embarrass me anymore- not about diarrhea, not about menstruation, not my dancing in public, not my BO.

Dear new PCTs,

You are going to come and be afraid of the gigantic spiders and the rats in your homestay house, and not appreciate the ants on the fish that your family keeps in a filing cabinet, and you are going to be appalled at how the PCV facilitators you meet smell and uninhibitedly describe their most explosive bout of diarrhea and eat everything in site, but one day, you will learn to live peaceably with the rats, and you will get better at killing the terrifying spiders or just accept that they won't attack you, and you will relish that you don't have to bucket bathe twice a day like you did during homestay, and you too will smell as bad as I do.

Many of the instructional sessions for PST have been standardized across all of Peace Corps, so during this Training of Trainers week of planning, we had a session introducing us to these standardized packages and the theory behind them, the policies that people in Washington came up with to streamline training for all Peace Corps countries. Washington has separated topics into health, agriculture, environment, economic development... so in the field you get health PCVs, or agriculture PCVs, or environment PCVs, but really most volunteers do some of everything, or an environment PCV will mostly work on health issues, all depending on what is happening in the community. The clear lines that Washington's policies delineated get blurred and crossed in the field, and that made me think of how different policy and fieldwork are. I imagined people sitting in air conditioned offices in Washington DC, wearing suits, going to lunch at the deli across the paved street, clean, urban, while I am sitting in a room with no electricity, the cantilevered windows opened to allow a humid breeze, transitioning between two different languages to exchange information, wearing my Tanzanian kitenge dress, my feet dusty from walking through the sand to get here. The theory and thoughtfulness- and I would assume experience in the field, as well- that went into creating the policy is valid, but what it turns into while being implemented, with each person's individual personalities and environments, is completely different, and policy just doesn't matter that much in the daily lives of a PCV. Working here is challenging; you have to be flexible and calm in the face of changes and misunderstandings that don't necessarily arise while working with fellow Americans in America so the policy makers in their nice clean offices don't think about them. That makes me feel incredibly superior, if dirtier and less professional.

August or I Looked Like a Wrinkled Old Man When I Was Born

August has shaped up to be an exciting month. I will proceed in chronological order...

I got a staph infection in my foot that made it swell until I looked like I had elephantiasis and I couldn't walk for a couple days. The Peace Corps doctor was amazing, though, got me on super strong antibiotics, and has followed up amazingly, and I am all normal except for missing one toenail and looking a little like I was exposed to nuclear radiation.

The clinic had been short staffed - more so than usual- while my mama, the nurse, and the new nurse we got from the district were both in town, so I was left running the clinic myself while my baba, the clinical officer, was in and out with back pain and a tooth ache. I go to clinic one morning, I notice a woman is in the other room having contractions, but that's normal, so I continue with weighing babies. The bibi who has escorted the mama comes out to ask for my help, and I tell her the doctor is coming, I can't really help you, I don't know how to deliver a baby. I tell a kid to go get the doctor and tell him to come quickly. I continue with clinic. The bibi comes back out and insists, come in now, so I go look at the mama, expecting to see nothing. Uh, yeah, the baby is crowning... I run back outside, the kid still hasn't left, I yell at him, Athumani, go now, FAST! I return to the room, clumsily put gloves on not steady hands, thinking about how every baby I have seen delivered has been born with the umbilical cord wrapped around its neck and I am terrified of this kid getting strangled by it I don't know how to avoid that from happening this baby could die... The bibi and this other mama are in the room standing behind me, yelling at me, I have finally gotten the gloves on all of my fingers, the mama gives one push, the head pops out, the neck is cord-free, the shoulders pop out, the baby twists around so its facing up, and slips out into my hands in a gush of blood and slime! Wrap up the baby, clamp, string, scissors to cut... why is that mama rubbing the other mama's belly like that? Oh, shit, the placenta! A retained placenta can lead to sepsis this is the time when women hemorrhage and bleed out after giving birth rubbing the belly or stimulating the nipples causes oxytocin to be released which will help stop the bleeding rub the belly get the placenta out... BTW that shit is slippery. It is not possible to grab the umbilical cord and pull because it is impossible to hold onto the cord, covered in bloody slime as it is. The mama has to push again, and you ineffectually pull, and eventually it pops out in another rush of blood and clear fluid. Relief rushes over me, everyone is alive, the crying- breathing- baby has been wrapped up and is being held, I'm helping the mama clean up, wiping up blood, then I went and taught about exclusive breastfeeding and finished clinic!

On a different afternoon, I was siting on my couch, when my cat- correction, Ruthie's cat, there is no love lost between this animal and I, I take no ownership of it- comes in carrying some mewling animal I assume is a rodent it plans on eating in my house in typical fashion. This is an on going war between us. To my horror, she jumps onto my couch with it before I have untangled myself from my blanket enough to stop her.... and I realize she is carrying a kitten. I still think she's going to eat it when I realize that the kitten looks just like her, and its probably her kitten. So now is when you are probably thinking didn't you realize your cat was pregnant? My response would be 1. What is the gestation period of a cat? 2. I didn't want my cat to have kittens, so I thought of other reasons for her belly to be so firm. So, I am now the owner of two kittens. They're kind of funny- they are just now figuring out how to walk, so they stumble around on legs that tend to go awry in unintended directions, and they have a habit of picking their feet up higher than necessary, as if they were tip toeing cautiously, or stomping their feet.

The next Monday I delivered another baby solo. I was much calmer this time, none of the panic I had the first time. This of course has nothing to do with development work or my actually role as a Peace Corps Volunteer, but its really cool. In a letter from my mother for my birthday, she wrote that now that I have experienced a baby's delivery, I would know what a special experience it was when I was born! Sorry to disappoint, but a baby's delivery is gross and slimy, with explosions of blood and goo, and I'm sure its nice for the mama when its all done and they get to move onto a new kind of pain from labour pains, but I haven't experienced the wonderfullness yet. I do think its crazy though that one person comes out of another person like that, after having lived in a liquid filled bubble for nine months, and having grown from the chance meeting of two traveling cells. I am thrilled I didn't kill anyone.

Then It was my birthday! I celebrated in my vill by making cakes and sharing them with all the families that take care of me, and I had an American visitor in the form of a traveling PCV, which really made it feel so much more like a birthday.

Also happening this month is the Tanzania census, which I got to take part in as a current resident of Tanzania. Teachers around the country were trained in how to fill out the census forms, and then went door to door in their communities to ask every household their names, ages, marital status, level of education... and if they grow corn, pigeon peas, cassava, or keep cows, goats, or chickens. My grandmother sent me a birthday card, and in it she tells me how much she thinks of me, loves me... and how someone tried to scam her, falsifying my cousins presence in a Peruvian jail, so she writes to me, “Please don't get into trouble, because I won't believe you.” I recently discovered Gotye and the video of “Somebody That I Used To Know.” Uh, yeah, I'm a little behind the times. I want that final scene from his video, when he is so exposed, looking at her while her paint is being removed so openly and obviously vulnerable, as a still to hang in my house and look at always. It is such a well done, emotional video, with their purposeful eye contact, or lack thereof, and facial expressions, and his punctuated sighs. Today, my dear sitemate Rachel was waiting to meet me in town, and from afar sees a small figure swathed in fabric, and thought it was me... no, it was a tiny black man. Thanks Rachel.