Until yesterday, it had been a week of contentment, comfort, ease. It had been a week where I felt I’ve been here for a long time, where I felt I almost belonged, where at the very least, I knew how things worked, it was okay, I knew how to deal with it all, in a positive way even. Contentment until yesterday evening, where all my worst impressions of Zambians and Africa just got reinforced ten fold, and left me feeling shaky and shitty, even now, hours later.
Went out to dinner with a friend at this Ethiopian restaurant that we really enjoyed the last time we went. Here’s how the conversation with our waiter goes.
US: We’d like the combination platter. Do we get to choose which dishes we get in the combination?
HIM: Yes
US: Okay, we’d like a, b and c.
HIM: Okay, you want a, b and c.
US: Yes
HIM: Coming right up
….Dinner, conversation, yummyness. Then the bill. It’s way more than we expected it to be. What’s going on?
They charged us for three individual entrees, as opposed to the combination platter which comes with three varieties. The ensuing argument goes on for about 20 minutes, getting involved two night managers, the cook and our waiter. Nobody seems to be hearing us, what we’re saying, and the waiter doesn’t own up to exactly what was said. Nobody seems to acknowledge the misunderstanding. They keep telling us, but you chose three dishes, and you ate three dishes, we can show you the order than went into the cook. And we say, but he told us we could choose which ones we wanted in the combination, and they say, but you chose this one this one and this one.
And then, in the way I hate so much, they play the guilt card.
LADY IN CHARGE: Well who’s going to pay for this? I’m tired of paying for customers, I won’t do it anymore. And your waiter, are you going to take the money from him? He has worked all day. Just pay the bill. Who else is going to pay it? The money has to be there in the morning. Just pay the bill!
Yup Sarah, there she goes again, the rich selfish mzungu, trying to take advantage, doesn’t want to pay her bill, making a big deal, trying to make them pay, isn’t that typical of those whites. She’s white, she has plenty of money, why is she making a big deal out of this. Stupid mzungu, didn’t she realize what she was eating?
Nobody will let us call the real manager. It’s late. My friend is frustrated, she’s raising her voice, cursing. The lady in charge gets insulted and really stops listening. My friend is living on a very tight budget this year, essentially making a Zambian salary, and wasn’t expecting to pay this much for dinner. And the more they refuse to listen, the angrier she gets. I’m trying to remain calm, speak nicely to the lady, see if we can clarify what the other is saying, she won’t even let me talk. I want to scream, but I don’t. Finally, I just want to leave all the money and get out of there. My friend keeps saying we’re not paying. I don’t want this argument to continue. I never make a big deal out of these things. But the principle of it infuriates me.
At home, it would have been a conversation with a manager, a restaurant error, and correction. It’s the cost of doing business. But because it’s Zambia, and it’s late, and the manager isn’t there, nobody present is allowed to make the call, “yup, that was an error, let them pay what they thought they were paying for, we write it off as the cost of doing business.” Nobody was there to say that. So any money we didn’t pay would have come off somebody else’s paycheck. And thus they were (almost) legitimately mad at us, and yelling at us to “just pay!”
Of course I don’t want someone else to have to pay for the error. As always, they guilted me into paying. But the fact that there was no mechanism to account for that kind of error is ludicrous.
The worst part for me though, the image I cannot get out of my head, is an older Zambian gentleman who was sitting at a table near the register, listening to this whole argument, starting at us, with this subtle smirk on his face that kept getting bigger and bigger. My phone rings, it’s the taxi driver telling me he’s waiting for us outside. I hang up. The man looks at me, large smirk on his face now, and he says,
“Look at you, spending all that money on your phone!”
I want to punch him, scream at him, cry all at the same time. I’m shocked, I’m outraged. I’m speechless. Forget about the fact that when somebody calls you, it doesn’t cost you anything. In his mind, I am the selfish mzungu, taking advantage, always taking advantage, thinking I can get away with it. Why won’t I just pay, I have the money.
All I can manage to say, all I can think to say is,
“Where do you get off judging me?” I probably look like I’m about to cry because that’s how I feel. And he just keep smiling, in fact, I think his smile got bigger.
All of this happened after a dinner conversation we had had about the lack of regard for others and lack of personal responsibility that’s so pervasive here. In manifests itself in all aspects of life.
-Walking down the street and people not letting you by, especially on our morning runs when clearly we’re running and want to keep running. Just because, why should they move to let you by?
-The garbage strewn all over every free patch of space on the street, tossed carelessly from cars, from hands, as if it magically disappears after.
-Cars and buses driving by where pedestrians are non-entities, they would rather run you over than slow down and in fact will give you dirty looks if you try to cross. You know how usually, you cross the street and wave at the person in the car waiting for you, as a courtesy, as a thanks? Here, the driver will wave at you, as you’re standing there in the middle of the crosswalk. Thanks for waiting!
-In line anywhere, waiting for anything, or should I say, lack of lines.
-At work, where leisure time, leave time, tea break and knocking off early rule over all, and actually working is just an after thought.
-In almost anybody starting up a conversation with you, because they always want something else. The ultimate goal-A marriage proposal and ticket to America.
-By the constant blame game. Our day and night guards stabbing each other in the back in who’s fault it is that some thing happened. Never ever admitting fault, or saying I’m sorry, especially to a woman.
-In the perception that they will be handed everything they need, largely by all the aid money pouring in. What have you brought us this morning Sarah?
Those are feelings I try not to dwell on. When I do my work here each day, I try to focus on all the things I like about Zambians, and all the promise this country holds.
But I have to admit that I’m having a hard time feeling positive about any of it right now. When Zambians ask me if I like it here, what I like best about it, it’s getting harder and harder for me to list the positives. The sense of entitlement infuriates me. Payback for centuries of mistreatment at the hand of the white man. That’s why I’m here apparently, to give them what they deserve after all this time. Why else would I be here? I will never be seen as someone trying to defy the stereotype, to put history in the past, to start anew, as here because I want to help, even in my own small way. It’s too late for that. The stereotype will never be broken.
I hate when Zambians make me hate them. But as far as I’m concerned, Zambia, and Africa, is going to shit.
Friday, January 30, 2009
Tuesday, January 27, 2009
Inauguration Day in Lusaka
…Huddled around radios in the forgotten corners of the earth…
Indeed, we huddled, 2 ½ months later, around CNN international projected from the TV onto the wall, and there were more than 30 of us, and there was a potluck, and we all sat, on couches, cushions and floors, and some stood, and we cheered, and cried, and shared the historic moment, so that we’ll always remember, when somebody asks us in the future, where were you on that day, we can say, I was in Lusaka, Zambia, in a house on Martin Luther King Rd., watching with 30 of my closest American and non-American (Canadian, Australian, Dutch, British) friends.
In honor of the occasion, I made a cake and
In the taxi on the way home, they were playing over the inauguration speech on the radio, and the next day, all the Zambians were asking if I had watched. They love him here. They fight over Obama shirts. They have pictures of him on their desks at work, next to the family photos, cousin Obama.
Sunday, January 18, 2009
TIA (this is Africa)
In the two weeks since I’ve gotten back from Cape Town, time has flown. Unlike the last time I arrived in Lusaka, in July, when everything was fresh and new and everything took adjusting to, this time it was like coming home after a vacation and all the good and bad that entails. It was both unwelcoming and comforting to slip back into the well developed routine-the early morning runs, daily greetings at the office, navigating transport arrangements and refreshment orders at work, evenings of cooking dinners, watching movies, reading, blogging, chatting and of course, weekend get togethers. I wasn’t so excited to get back to the crowds of Lusaka, the traffic, the exhaust, the burning garbage and always being on the defensive. But it felt good to get back to work starting from the place I had paused, rather than starting anew.
When I first arrived in Lusaka, each week was an achievement, another week here, another week toward some mark, one month, two months. Yesterday marked six months here, but I almost forgot it.
The first Monday back, there was already so much going on. The OPD/ART integration at Chazanga clinic is less than 30 days away. Matero Main Clinic will not be far behind. It’s amazing to think that nine months of planning went into integrating at Ng’ombe, the first clinic, and Chazanga will take us less than three. The really interesting part will probably be the information we gather from long term monitoring. More than a year’s worth of data about patient HIV testing, ART enrollment, overall numbers of clinic visits and patient waiting times will tell us a lot about the wider applicability of this integrated system. But for now, we plan, we implement, and we monitor.
The peer educator program at Chipata and George is headed towards the end of its pilot period. The September training feels like it just happened, but now they’re done with four and a half months. My (somewhat) daunting task is to complete an evaluation of that program in the next month. That way, by the official end of the program on February 28th, we will have an answer for them as to whether or not we can renew their contracts. It’s our program, but the ministry of health has to give the okay, and if they say the program goes, then it goes. From the way things look now, if the program does get stopped, it seems that it will be entirely a funding issue. They don’t want to continue programs that they will be expected to fund down the road.
That highlights the dynamic relationship between Zambian government funding of health programs and outside funding. There is a staggering amount of outside money coming into this country for health, specifically for HIV. If you look the annual national spending on health, about 10% of that comes from the Zambian government. The rest is outside funding, like PEPFAR and Global Fund money, most of which is directed at HIV. HIV treatment has massively dwarfed everything else, and while it’s great to have so many people being treated, the health infrastructure here was weak to begin with and has been strained even more so since PEPFAR.
So while the ministry of health is happy to have programs like peer educators working with TB-HIV patients, I don’t know how much hope there is for them ever funding it themselves. But I’m going to try and get them to agree, to at least let us continue this program for now.
I made a stop at George Clinic last week to pick up somebody on the way to somewhere else, and I ran into one of the TB-HIV peers. She’s the one I feel the most conflicted about, she’s the one I like a lot, but who takes advantage of me as much as she can, by telling me how poor and destitute her family is. The first thing she says to me after greeting me is, “Sarah, what have you brought us today?” There are so many snide, rude, angry, sarcastic things I want to say to her, because she never stops. Of course I don’t actually say those things, and I just have to smile and joke it away and say I don’t have anything for them.
I wonder if it would matter to her to know how hard I’m working to keep her current job, how even if the peer educator program doesn’t continue, I’m working on getting another job for all four of them within CIDRZ. Would that change her attitude toward me? Would it ever be enough? Or would she continue the emotional blackmail. She is poor and I am white (=rich) so therefore she is entitled to everything I have.
Working at an NGO has made me a bit bitter. It’s highlighted that very tricky, shady border between getting programs started and sustainability, and I think I might be losing faith that the sustainability part ever really happens. Not just in health, but in other areas as well.
Last night, as I was driving with a friend over a very rough, pot-holy road, in a nice neighborhood, that clearly hasn’t been repaired since it was built, I was reminded of one of my most vivid memories from Tanzania. I was with Johanna and Alea in the coastal city of Lindi. This is still a beautiful town in many ways, built along a sheltered bay on the Indian Ocean. It used to be the German administrative town, and there are many old, very solidly built buildings that were built and run by the Germans until they were handed over to Tanzania at independence. But rather than use and maintain these buildings they already had, they let them fall into disrepair. If you walk the streets of Lindi today, you will pass by big, solid, crumbling buildings, with newer, thatch roofed huts dispersed between them.
Somehow this turned into another sustainability rant, although I didn’t mean it to be so. But I think it highlights how every day here is a swing of emotions, between the satisfaction of accomplishment, the wonder and appreciation of another culture, and the stress and frustration at how things work here. But as they say, for all the good and the bad, TIA.
Some more memorable patients
Each week I go to Kara Clinic, I see at least one patient who stays in my memory. Sometimes it’s a patient’s story, others it’s a demeanor, a mood, a facial expression, sometimes it’s a medical condition, and sometimes it’s all of those.
Last week I saw a little girl, let’s call her Violet, brought in by a young, professionally dressed woman who turned out to be her aunt. Violet was 8 years old, though she looked younger. She was scrawny and slight, but it was hard to tell exactly how much so because she was wrapped in many layers of sweaters, jackets and a warm winter cap. She said not a word the entire time, but was clearly very aware of it all, for she responded to questions with a nod or shake of her head.
In bits a pieces, through cryptic words from the aunt, and what was written on Violet’s chart, we determined that this little girl was newly diagnosed with HIV and was there for her initial enrollment H & P. Both of her parents were recently “late.” The aunt made it quite clear that Violet did not yet know her own status, and so it was not okay for us to say “HIV” out loud.
But at age 8, sick as she was, with two dead parents, how could she not know?
During the physical exam, there is a checklist of systems to go through, body parts to examine. During most of my exams that I’ve done at the clinic, there will be one, perhaps two, abnormal findings. The rest get ticked in the column on the left “normal, normal, normal.” Violet’s “abnormals” far outnumbered her normals. She had tinea (ringworm) on her face, head, body and extremities. She had a chronic ear infection draining pus. She had a thick patch of candida growing on the tip of her tongue. The undersides of her eyelids were a pale white, a sign of severe anemia. I could feel her enlarged liver on my abdominal exam. She had crackles in her lungs.
As I sought to examine each system, she dutifully and quietly followed my directions. Open your mouth. Take a deep breath. Lay down on your back. Squeeze my fingers as tight as you can. With each, I made an unexpected and unwanted discovery. Each was a reminder of the awful virus ravaging her body.
All I could keep thinking was that she had not been told. In many ways, I understand how hard it must be to have that conversation with an 8-year-old girl. This was a new diagnosis, she had not yet been started on her ARVs, and so it was all rather new. But it’s a conversation that must be had soon. I kept looking at her young aunt, who looked scared, worried, sad and stressed. I would not wish that position on anybody and I know she’s going to need all the help she can get.
I’ve heard about children here who have been taking their ARVs for years, for as long as they can remember, and have never been told why. Surely the damage from not understanding their illness, being lied to about their illness, is worse than the struggle of learning to live with it?
CIDRZ has pediatric peer educators and pediatric support groups that attempt to address all these issues and lend support to both the children and their caregivers. These are issues children should never have to deal with. This is yet another consequence of this epidemic: an entire generation of children forced to accept HIV as part of them, to have never known life without it.
Last week my patient was memorable for her symptoms. Last week I found myself being that student (or intern or doctor) who gets excited about pathology for learning’s sake. Surely we don’t wish uncommon pathology on people, or any pathology for that matter. But there it was, playing out in front of me and it’s kind of thing I’ll always remember, “back when I was in Zambia, I saw that women with the…” Maybe I’ll see it again in the future and recognize it because of her.
When I entered the room, a middle aged woman sat in a wheel chair, blankets piled thick on her lap and around her legs, disheveled hair, a far off gaze, and distinct but faint urine nursing home smell. She was accompanied by a sister and nephew. This woman, I learned from the PA, had had HIV for many years and had struggled with adherence to her medication. She had documented in her chart long stretches of time when she had not returned for follow up visits and medication pick up. Clearly this doesn’t lend itself so well to successful treatment. She had come in on this visit because over the period of several weeks, she had a steady and progressive paralysis of her body. It started in her feet and had now reached all the way to her abdomen. She had lost all sensation in those same areas. She had also become incontinent of urine, but had not had a bowel movement for three weeks.
It was her sister who did most of the talking. While the patient could talk, she didn’t seem much in the mood. I’m not sure I would be in the mood to talk about adherence either if I had very quickly lost use of and control over half of my body.
I reached down to that file cabinet of physical exam knowledge in my brain that hasn’t been used much in several months and opened the drawer for the neuro exam. But there it all was, ready to go, sensation, motor, reflexes, dermatome by dermatome, nerve by nerve. And I have to admit, although perhaps a bit gruesome sounding, it was very interesting to palpate the abdomen of somebody who had not had a bowel movement for 21 days.
There are many things that can cause those types of neurological symptoms in an AIDS patient. We sent her over to UTH, the teaching hospital, for admission. But it’s certainly the most advanced AIDS-related neurological syndrome that I’ve gotten to see myself.
By the end of the visit, we had her talking a bit more and I think she might have even smiled a little when I wished her well and said goodbye.
Wednesday, January 7, 2009
Cape Town Pictures
Pictures are up on picasa. They may be out of order, but due to the wonders of Zambian internet, I'm having trouble checking.
Here's just a sample:
Monday, January 5, 2009
Cape Town
Happy New Year 2009, from Lusaka!
Right around this time of the year, we always say it’s pretty unbelievable that it’s year XXXX and it takes a good couple of months to write the correct date. But I think this year is especially so to me. Since I started out as M09 (my graduation year), it’s hard for me to believe 2009 is here. But I guess now that I’m doing this whole Zambia thing, M10 is the big year.
Several years back, a friend of mine told me about his trip to Cape Town. It sounded beautiful and wonderful and I always hoped I could go. But it all seemed so impossibly far away, I never imagined it would ever happen. Last week, as I sat on a rock, at the Cape of Good Hope, at the south-western most point in Africa, watching two oceans converge, I had to admit that we never really know what will happen.
It was an amazing trip. In the couple weeks before I left Lusaka, I was crazy busy and barely had any time to think about it and then all of a sudden, there I was on a plane headed to South Africa. Cape Town is now one of my favorite cities in the whole world.
Table Mountain and this whole ridge of smaller mountains kind of cuts the city in two halves, sheltering the narrower Atlantic side from the winder expanse along the Indian Ocean. These are steep, sheer cliff kind of mountains and in some spots, it wouldn’t be too hard to find yourself in the ocean from a plunge off the top. Everything is green and lush, particularly the valleys to the east, wine country. The city creeps all the way up the edge of the mountains, as far as houses can safely be built, and there's ocean all around. Our little VW Golf Chico had quite the time making it up some of those hills. With the best of all worlds- mountains, ocean, beach, harbor and valleys, Cape Town has activities to fit all tastes.
Highlights of my trip:
-Climbing Table Mountain and taking the (rotating!) cable car down
-Climbing Lions Head for sunset
-Paragliding off of lions head (yup, I ran off of a mountain) down to Camps Bay below
-Relaxing on the beaches at Camps Bay and Clifton
-Walking around Cape Point and the Cape of Good Hope
-Playing with the penguins at Boulder Beach
-Watching the surfers on the crazy waves at Muizenburg
-Trip to Robben Island (the prison where Nelson Mandela was held)
-Full day wine tour/wine tasting in Stellenbosch
-Kirstenbosch botanical gardens, sheltered by Table Mountain
-The Waterfront
-Massage at the salon
-Shopping
-Relaxing by the rock pool of an exclusive hotel/spa
-New Years Eve at Fashion TV Café (free tickets, we met the owner by the pool)
-Staying for 2 nights in a trailer park on the roof of a hotel
-Making wonderful friends, my Cape Town posse, at the Backpack, our “boutique” hostel
-Hanging out in Gardens, my new favorite neighborhood (Cambridge watch out) along Kloof St, which has every store and restaurant you could ever need
-Pronouncing fun names like Kloof, Buiten Gracht (affectionately referred to by us as butt crack) and Labia (yes, there’s a movie theater called Labia)
-Wine, wine and more wine
-Sushi, fish, Vietnamese, sushi, fish Braii, Italian, cheese, coffee, sushi
It felt good to be in a nice city, a western feeling city, a clean city. No bugs, no mosquito nets, no trash in the street, no horrible car exhaust, no burning garbage, no people wearing smelly clothing.
I have to admit, when I went, I was so ready to get away from everything Zambian. I wanted to be in a western style city, I wanted to feel normal again. Well, I got that, and then some. Cape Town, at least the parts you see as a tourist, is really white. Like really really white. Like you go there and you can forget you're in Africa. It's kinda weird at first, I was thinking, where are all the black Africans? Along the waterfront we saw a black African group singing and dancing, and it almost seemed out of place, like it could have been the identical performance taking place at the South Street Seaport in New York City, with no context to the actual place.
In some ways, I enjoyed that because it was a mental rest from the energy it takes to interact with Zambians on the street. But it also got me thinking a lot about race relations there and really gave me a good sense for the legacy of apartheid. Race relations there are incredibly complex and it felt like one of the most segregated places I had ever visited. It’s not just Blacks and Whites, but Colourds and Indians as well.
Although Cape Town is safer than most places in South Africa, the security issues are still there. A lot of the shops, even in the middle of the day, have gates and you have to be buzzed in to. Even not fancy shops, just regular clothing stores. I don't think I've ever gone somewhere like that. It got me thinking, well, how do they decide who to buzz in and who not to buzz in?
We had an experience on New Year’s Day that really highlighted the racial divide. We decided to drive down to Camps Bay for dinner. Normally, Camps Bay is like South Beach, Miami or Orange County, California. Fancy houses on the hills above the beach, trendy restaurants, beach clubs, fancy hotels, and shops. Very few black Africans. But on New Year’s Day, there was massive traffic driving down to the beach, way more than ever before and also, there were black Africans everywhere, and only blacks! More than I had ever seen since I got to South Africa. They were all dressed like they'd been spending the day on the beach. But now they were walking in the middle of the streets, hanging out, dancing. We wondered if there was some kind of street fair or something. As we drove by the beach, we could see there were so many people that you couldn't even see the sand in some places.
We finally got to park and go into a restaurant to ask, and they said that January 1st there's some of cleansing ritual and they all come to the beach. But get this, most of the restaurants were closing (at like 6 pm!) because they were afraid of security issues, that there weren't enough police for crown control and safety concerns, they advised us to leave the area. Leave, because there were so many blacks! Now, I think partly this is a vicious circle thing, and I wonder how justified they really were in closing their restaurants and scaring us away. Or maybe it was just a crowd thing, not a black thing, but I’m skeptical. Cape Town and the surrounding townships (equivalent to our compounds in Lusaka, essentially shantytowns where the blacks live) is like two completely different countries in one, and they coexist without having anything to do with each other. In Cape Town, when you do see someone black, they are probably the cleaning lady at your hotel or the taxi driver.
So while I loved Cape Town, I think it's nothing like the rest of South Africa and it almost makes me happy that Zambia doesn't have those same race issues, at least not nearly that bad. If I stand out here as a white person, maybe that's a good thing. The majority of whites in Zambia aren’t actually Zambians, and so there’s certainly no sense of “Whose country is this?”
A final reflection, a pleasant discovery I made in my interactions with people there. People admire what I am doing in Zambia. Sometimes it even blows them away that I would be doing this kind of work, just helping people, with no earning potential or anything. We met two guys who illustrate this.
S is 26, has been working as a consultant that helps companies restructure (ie who gets fired) since he graduated college, and he hates it. He's taking a long term leave of absence from work, and traveling the world to go find himself. Sounds cliché, but I think it's great. You don’t meet too many Americans, at that age, who actually get out of corporate America and just go traveling instead. Now that he’s out, he’s not sure he wants to go back. He can list at least six other things he’d rather be doing. He saw what we’re doing at CIDRZ as something to strive for.
M is also in his late 20s, Australian but working in London, at some sort of financial/banking type job. When he met us, he couldn’t stop telling us how impressed he was by our work. He was thinking about it so much that he brought it up in a conversation with his travel buddy, and reflected that conversation to us later. "I can't remember the last time I did something for somebody else," he told us. He wanted to know details, like true details of our day to day jobs, what it is we actually do and how we feel about what we’re doing.
After having met us, he is truly contemplating totally changing his career. And so is S. I guess because I've been involved with this kind of work for so long, and never really thought about my career in terms of money, I never thought about it any other way. It's a given. Helping others is the essence of what I do. So part of me feels proud to tell people what I'm doing, and if by meeting us, people like M and S decide to do something good, I think that's awesome.
Alright, enough reflection for now. I'm back in Lusaka, back to real life, or real life here anyway. The coming months are going to be massively busy, with my peer educator program evaluation and two more clinics being integrated. But I think that's a good thing. Keeping my mind occupied.
But for the next few weeks, I think every time I close my eyes, I’ll be walking along Kloof St. in the shadow of Table Moutain, a ten minutes drive from the ocean.
Pictures coming soon!
Right around this time of the year, we always say it’s pretty unbelievable that it’s year XXXX and it takes a good couple of months to write the correct date. But I think this year is especially so to me. Since I started out as M09 (my graduation year), it’s hard for me to believe 2009 is here. But I guess now that I’m doing this whole Zambia thing, M10 is the big year.
Several years back, a friend of mine told me about his trip to Cape Town. It sounded beautiful and wonderful and I always hoped I could go. But it all seemed so impossibly far away, I never imagined it would ever happen. Last week, as I sat on a rock, at the Cape of Good Hope, at the south-western most point in Africa, watching two oceans converge, I had to admit that we never really know what will happen.
It was an amazing trip. In the couple weeks before I left Lusaka, I was crazy busy and barely had any time to think about it and then all of a sudden, there I was on a plane headed to South Africa. Cape Town is now one of my favorite cities in the whole world.
Table Mountain and this whole ridge of smaller mountains kind of cuts the city in two halves, sheltering the narrower Atlantic side from the winder expanse along the Indian Ocean. These are steep, sheer cliff kind of mountains and in some spots, it wouldn’t be too hard to find yourself in the ocean from a plunge off the top. Everything is green and lush, particularly the valleys to the east, wine country. The city creeps all the way up the edge of the mountains, as far as houses can safely be built, and there's ocean all around. Our little VW Golf Chico had quite the time making it up some of those hills. With the best of all worlds- mountains, ocean, beach, harbor and valleys, Cape Town has activities to fit all tastes.
Highlights of my trip:
-Climbing Table Mountain and taking the (rotating!) cable car down
-Climbing Lions Head for sunset
-Paragliding off of lions head (yup, I ran off of a mountain) down to Camps Bay below
-Relaxing on the beaches at Camps Bay and Clifton
-Walking around Cape Point and the Cape of Good Hope
-Playing with the penguins at Boulder Beach
-Watching the surfers on the crazy waves at Muizenburg
-Trip to Robben Island (the prison where Nelson Mandela was held)
-Full day wine tour/wine tasting in Stellenbosch
-Kirstenbosch botanical gardens, sheltered by Table Mountain
-The Waterfront
-Massage at the salon
-Shopping
-Relaxing by the rock pool of an exclusive hotel/spa
-New Years Eve at Fashion TV Café (free tickets, we met the owner by the pool)
-Staying for 2 nights in a trailer park on the roof of a hotel
-Making wonderful friends, my Cape Town posse, at the Backpack, our “boutique” hostel
-Hanging out in Gardens, my new favorite neighborhood (Cambridge watch out) along Kloof St, which has every store and restaurant you could ever need
-Pronouncing fun names like Kloof, Buiten Gracht (affectionately referred to by us as butt crack) and Labia (yes, there’s a movie theater called Labia)
-Wine, wine and more wine
-Sushi, fish, Vietnamese, sushi, fish Braii, Italian, cheese, coffee, sushi
It felt good to be in a nice city, a western feeling city, a clean city. No bugs, no mosquito nets, no trash in the street, no horrible car exhaust, no burning garbage, no people wearing smelly clothing.
I have to admit, when I went, I was so ready to get away from everything Zambian. I wanted to be in a western style city, I wanted to feel normal again. Well, I got that, and then some. Cape Town, at least the parts you see as a tourist, is really white. Like really really white. Like you go there and you can forget you're in Africa. It's kinda weird at first, I was thinking, where are all the black Africans? Along the waterfront we saw a black African group singing and dancing, and it almost seemed out of place, like it could have been the identical performance taking place at the South Street Seaport in New York City, with no context to the actual place.
In some ways, I enjoyed that because it was a mental rest from the energy it takes to interact with Zambians on the street. But it also got me thinking a lot about race relations there and really gave me a good sense for the legacy of apartheid. Race relations there are incredibly complex and it felt like one of the most segregated places I had ever visited. It’s not just Blacks and Whites, but Colourds and Indians as well.
Although Cape Town is safer than most places in South Africa, the security issues are still there. A lot of the shops, even in the middle of the day, have gates and you have to be buzzed in to. Even not fancy shops, just regular clothing stores. I don't think I've ever gone somewhere like that. It got me thinking, well, how do they decide who to buzz in and who not to buzz in?
We had an experience on New Year’s Day that really highlighted the racial divide. We decided to drive down to Camps Bay for dinner. Normally, Camps Bay is like South Beach, Miami or Orange County, California. Fancy houses on the hills above the beach, trendy restaurants, beach clubs, fancy hotels, and shops. Very few black Africans. But on New Year’s Day, there was massive traffic driving down to the beach, way more than ever before and also, there were black Africans everywhere, and only blacks! More than I had ever seen since I got to South Africa. They were all dressed like they'd been spending the day on the beach. But now they were walking in the middle of the streets, hanging out, dancing. We wondered if there was some kind of street fair or something. As we drove by the beach, we could see there were so many people that you couldn't even see the sand in some places.
We finally got to park and go into a restaurant to ask, and they said that January 1st there's some of cleansing ritual and they all come to the beach. But get this, most of the restaurants were closing (at like 6 pm!) because they were afraid of security issues, that there weren't enough police for crown control and safety concerns, they advised us to leave the area. Leave, because there were so many blacks! Now, I think partly this is a vicious circle thing, and I wonder how justified they really were in closing their restaurants and scaring us away. Or maybe it was just a crowd thing, not a black thing, but I’m skeptical. Cape Town and the surrounding townships (equivalent to our compounds in Lusaka, essentially shantytowns where the blacks live) is like two completely different countries in one, and they coexist without having anything to do with each other. In Cape Town, when you do see someone black, they are probably the cleaning lady at your hotel or the taxi driver.
So while I loved Cape Town, I think it's nothing like the rest of South Africa and it almost makes me happy that Zambia doesn't have those same race issues, at least not nearly that bad. If I stand out here as a white person, maybe that's a good thing. The majority of whites in Zambia aren’t actually Zambians, and so there’s certainly no sense of “Whose country is this?”
A final reflection, a pleasant discovery I made in my interactions with people there. People admire what I am doing in Zambia. Sometimes it even blows them away that I would be doing this kind of work, just helping people, with no earning potential or anything. We met two guys who illustrate this.
S is 26, has been working as a consultant that helps companies restructure (ie who gets fired) since he graduated college, and he hates it. He's taking a long term leave of absence from work, and traveling the world to go find himself. Sounds cliché, but I think it's great. You don’t meet too many Americans, at that age, who actually get out of corporate America and just go traveling instead. Now that he’s out, he’s not sure he wants to go back. He can list at least six other things he’d rather be doing. He saw what we’re doing at CIDRZ as something to strive for.
M is also in his late 20s, Australian but working in London, at some sort of financial/banking type job. When he met us, he couldn’t stop telling us how impressed he was by our work. He was thinking about it so much that he brought it up in a conversation with his travel buddy, and reflected that conversation to us later. "I can't remember the last time I did something for somebody else," he told us. He wanted to know details, like true details of our day to day jobs, what it is we actually do and how we feel about what we’re doing.
After having met us, he is truly contemplating totally changing his career. And so is S. I guess because I've been involved with this kind of work for so long, and never really thought about my career in terms of money, I never thought about it any other way. It's a given. Helping others is the essence of what I do. So part of me feels proud to tell people what I'm doing, and if by meeting us, people like M and S decide to do something good, I think that's awesome.
Alright, enough reflection for now. I'm back in Lusaka, back to real life, or real life here anyway. The coming months are going to be massively busy, with my peer educator program evaluation and two more clinics being integrated. But I think that's a good thing. Keeping my mind occupied.
But for the next few weeks, I think every time I close my eyes, I’ll be walking along Kloof St. in the shadow of Table Moutain, a ten minutes drive from the ocean.
Pictures coming soon!
Tuesday, December 23, 2008
Workin' Late
I think you know you’ve been working here for a while, that you’re settled into your projects, that maybe you even really know what’s going on, when you start staying late at the office.
To Zambians, the concept of staying late at the office is totally foreign. The exodus at 5 pm is rapid and complete. Within the period of five minutes, the office goes from bustling to almost silent. The aircon gets shut off, the lights turned down, computer monitors go black. If you peak into the CIDRZ offices past 5, the only faces you’ll see are white.
It’s the same for lunch. Between the hours of 13:00 and 14:00, you can never expect that anything will get done. Even if you have a meeting that starts at 14:00, a meeting you’ve confirmed with many people, including the driver, that you need to leave the office early in order to make it in time and they all say yes, sure, no problem. Inevitably, at 13:45 when you’ve arranged your day to take lunch early and get back to the office and go, the driver will be lounging and just beginning his large plate of nshima. (The pharmacists here have a joke about nshima. The way you feel after lunch, after you’ve eaten a large plate of nshima, it’s like you’ve had nshimazipam.)
Up until now, I’ve managed to be fairly Zambian about my after hours working. Usually if I’m in the office after 5 pm, it’s to use the internet for personal reasons. But all of a sudden, everything is happening at once. The fact that I’m leaving on Wednesday means there’s at least four days worth of work to do before then. Today found me drafting IRB exemption forms for my peer educator evaluation, rewriting an abstract about the OPD-ART integration for a conference, and playing architect as I did a site visit at our newest clinic to be integrated, attempting to draft the entire clinic building layout with a pencil on plain paper (map not drawn to scale). I don’t think tomorrow will be any better. Drafting another clinic, finishing the abstract, submitting to the IRB, presenting data to the drama group on their performances. And oh yeah, packing. I’m going to Cape Town on Wednesday!
To Zambians, the concept of staying late at the office is totally foreign. The exodus at 5 pm is rapid and complete. Within the period of five minutes, the office goes from bustling to almost silent. The aircon gets shut off, the lights turned down, computer monitors go black. If you peak into the CIDRZ offices past 5, the only faces you’ll see are white.
It’s the same for lunch. Between the hours of 13:00 and 14:00, you can never expect that anything will get done. Even if you have a meeting that starts at 14:00, a meeting you’ve confirmed with many people, including the driver, that you need to leave the office early in order to make it in time and they all say yes, sure, no problem. Inevitably, at 13:45 when you’ve arranged your day to take lunch early and get back to the office and go, the driver will be lounging and just beginning his large plate of nshima. (The pharmacists here have a joke about nshima. The way you feel after lunch, after you’ve eaten a large plate of nshima, it’s like you’ve had nshimazipam.)
Up until now, I’ve managed to be fairly Zambian about my after hours working. Usually if I’m in the office after 5 pm, it’s to use the internet for personal reasons. But all of a sudden, everything is happening at once. The fact that I’m leaving on Wednesday means there’s at least four days worth of work to do before then. Today found me drafting IRB exemption forms for my peer educator evaluation, rewriting an abstract about the OPD-ART integration for a conference, and playing architect as I did a site visit at our newest clinic to be integrated, attempting to draft the entire clinic building layout with a pencil on plain paper (map not drawn to scale). I don’t think tomorrow will be any better. Drafting another clinic, finishing the abstract, submitting to the IRB, presenting data to the drama group on their performances. And oh yeah, packing. I’m going to Cape Town on Wednesday!
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