Sunday, April 27, 2008

The Test

Read the entry titled “The Scare” below, as it will make this entry make a little more sense. This happened last Thursday.

To both set an example and actually know how a test was conducted, a nearby volunteer, Adam, and I decided to go to the clinic to see what it was like to be tested for HIV here in rural South Africa. We are also organizing an event, where we plan on educating the villagers about the virus and felt a little hypocritical telling people to get tested, if we hadn’t been tested ourselves. This way we would know exactly what went on behind the closed door of the testing room.

So we walked into the clinic and asked about getting an HIV test (hopefully the villagers aren’t getting the wrong idea about us… one of our friends had already laughed that we were going to go Brokeback ~ a reference to movie where they are two gay cowboys). They were a bit surprised, perhaps by our openness to getting tested, or perhaps because they think it is a disease that wouldn’t affect the makgoa, the white men.

We waited around for a bit, as some of the staff were on a lunch break, and then we were ushered into a room where the counseling and testing was done. We explained what we were doing and that we would like to take pictures, and so, she told us, that was ok, though she seemed a little confused at our ease that another person would watch the test being administrated. We asked if we could use the pictures in publications- yes. So the pre-test counseling began. First did I know what HIV was and how it was transmitted? Yes, it was a virus that attacks the human immune system and is contracted through bodily fluids, such as blood, semen and breast-milk. Then came the questions that I hadn’t thought about before, how would I react to a positive result?

Um, wow. I hadn’t thought of this. I knew I was negative, but how would I react? I answered as best I could that I would be shocked, as I would have no clue where I would have contracted the virus. I would probably tell my family and friends and discuss my options with a doctor. Then I would, though probably haltingly, get on with my life.

It was then that the irrational fear crept in. How would I really react to a positive test? What if everyone had been wrong about me cutting myself with the knife? What if I was the first documented anomaly? The fear of the unknown was back. I was nervous.

Then it was time to sign the form saying that I had gone through the counseling. Ok not too bad. Why was I nervous? I really didn’t have anything to fear. At the same time, I realized that if I was going through this fear and I really had nothing to fear, I could only imagine what others who had engaged in more risky behaviors would be going through.

Then a few questions about my age, nationality (race), whether I had sex, and if I had sex did I use protection, and it was time for the test. Then we went through what the test would entail. A nurse, not the counselor, would come in to prick my finger. She told me to relax and asked me how I felt. I said nervous.

Ok done. A small prick. Not too bad. Like getting tested for iron before donating blood… though I have felt faint after that.

Then the blood would drip into at small hole on a testing device. They would then add a few drops of a solution. I felt her squeeze, a little more pain..

The mixture would travel up a strip in the test. If one line showed up near the end of the test, I was negative, if one showed up at the beginning of the strip and the end, I was positive. If I was positive, they would do another test. If that was positive, they would send out my blood for an ELISA (a very sensitive assay).

Now it was time to wait. Slowly the mixture advanced… this was agonizing. Seconds elapsed… why was I nervous? I couldn’t have gotten the virus. Unless there was something that scientists didn’t know? More seconds went by. Maybe a minute.

The line stopped. One line. Negative. Phew. I could breathe normally again.

Adam was next. He was also nervous. We both had waived our privacy rights so we could document what happened. Time for me to take pictures.

We then went through post-testing counseling in which we were asked how we felt- relieved. Then a reminder on how to avoid contracting HIV and we were done.

The counselor took an interest in what we were doing and we are now working on a brochure explaining what happens during the test. The more people now about what will happen, the less they will fear.

Then it was off to a meeting at a local NGO about setting up our event, which is a tournament to encourage learners to make good life choices and bolster their confidence. We plan on hosting a soccer tournament between the primary schools and then having a healthy living celebration afterwards. Some speeches, traditional dancing, etc. Anyone that gets tested for HIV will receive a bracelet handmade by a women’s group (soon to be founded) in the village. We’re still hashing out the details, but our counterpart seems quite excited about it, as are we. Ok, more updates to come soon.

The Scare

As I mentioned before, these updates will be in no particular order, as this details something that happened nearly 8 months ago, which means it was and still is quite memorable.

My first impressions of site were that I was living in a dry, fairly barren scrubland. The wind would pick up small spirals of dirt at times and whip them around just well enough so that the dust would get everywhere. There were few trees to speak of, and it hadn’t rained during the entire time I had been in South Africa. This picture should help a little. The picture is staged... if I wanted to hitchhike, that road wouldn't be a good road for it as I have only seen three cars on it... my entire time here.

During my first month at site the rains came. They came suddenly, though with some warning, as a massive windstorm precluded them. I was still in the process of settling in to my place and getting accustomed to my schools and my life as a Peace Corps Volunteer. Nights were cold, so cold I would often resort to pulling my entire duvet and microfiber blanket over me when I slept.

Rain on a zinc roof is deafening; it sounds like marbles. I walked to the window and watched the sheer sheets of rain fall, illuminated at intervals by cold sparks of lightning. I had two leaks which I promptly put buckets under and put a towel under the door as rain water had begun to seep in that entry.

The next day, everything was drenched… and cold. The clear sky was replaced by gray clouds, the sunshine with drizzle that stung your cheeks. The goats and sheep had been in the kraal (corral) overnight and my host mom asked me to come help out, as several of them had gotten stuck in the newly formed mud. I donned my rain gear- pants, jacket, and Gore-Tex Hiking boots- and helped drag the hapless animals into the shelter of an entryway to the house. They were in various stages of hypothermia, some more gone than others. A lamb and a kid were among them and while we were building a fire to warm them, the lamb stopped breathing. It was incredibly sad. One minute struggling for breath, the next silent, no longer moving. Dead. My host mother took a look at the goats and realized that they were probably beyond saving, so she called an older gentleman and a young man from the village and we slaughtered the animals in a wheelbarrow.

I won’t go into a lot of details on slaughtering, but I’ll explain a bit. After hastening their deaths by cutting their throats, we let the blood drain into buckets, then it was time to skin them, which was done by cutting around the hooves and working towards the center of the body. Later on, we removed the innards, etc, but skinning takes a while and was done by two of us at a time. Skinning involved cutting the skin away from the fleshy portion, which can be quite easy in some parts, as there is just some easily cut connective tissue there, but in other areas, you need to really use the knife. While cutting through one of the not so easy sections, the knife the teenager was using slipped and he cut himself. Not too deeply, but blood did begin coming out, so I had him wash it out and used supplies from my Peace Corps Medical kit to bandage him. Then we headed back to work. I continued with skinning… and my knife slipped as well.

A cut on my hand…

Then I realized what had happened…. and time slowed down. A hazy fear started to grow. I dropped the knife and walked over to the tap to wash out the cut. I had cut myself… a teenager had also cut himself. Was it deep? I squeezed the wound, nothing, then after some more squeezing blood did come out.

Oh shoot…….

My vision clouded a bit.

Did I cut myself with the same knife the teenager had cut himself with? Was the teenager HIV positive? He looked to be about 18… oh man… no. This shouldn’t be happening. Could he be infected? Did I just infect myself by helping slaughter a goat? I made sure blood came out of the wound, made sure anything was washed away. A slight panic had set in. I bandaged my hand and then cleaned the knife, something I hadn’t done before. Why had I not cleaned it after the last accident? Was it even the same knife? Why can’t I remember the knife he was using? Please… let it be a different knife…

I knew the possibility of me being infected were slim. First the teenager had to be HIV positive, then I had to have been using the same knife, the virus had to stay alive for the minutes between our cuts, fairly unlikely given the fact that we were cutting the skin away at that time, and I had to have cut myself deeply enough to transfer the virus from the knife.

The chance was really slim… but there was still a chance… Shoot. An irrational fear set in. Despite this, after bandaging myself, I decided to continue helping out. After we finished skinning the goats, I made sure to ask several times if the teenager knew his HIV status. At first he didn’t understand. A little more panic… he didn’t know? Then he told me no… he was negative. Again I asked, just to make sure.. my SeTswana and his English exacerbating the situation. Yes, he seemed to understand.. he was negative, but was he? He probably hadn’t been tested. In stead of calming me, my panic just stayed at the same level it had been before.

How could I have been this careless? I thought again at the chance of me being infected. Slim to none, but if it was slim… could it have happened? I had been so careful all along… one slip-up. I knew what HIV would bring. I had studied the virus in Immunology, and some of my other science classes at Rice…. I would tell Julie, my girlfriend, and end the romantic relationship- our relationship had been rough enough during these months of separation, she had never wanted me to go to Africa and it would be my own fault, it would be over; I would have another 20-30 years to live, and probably devote myself to others similarly infected. That one instant could change everything.

Was I going to be another statistic?

I knew if I was going to do Post Exposure Prophylaxis (medicines to decrease your chance of infection after exposure) I would need to begin taking them within 72 hours in order for them to be effective. The clock was ticking. I went to the schools and worked, observing teachers and the way the school was set up, seeing how things did and didn’t get done. The fears had been allayed by my reexamination of what had happened, but I wanted to make sure. I was fine, but in matters like this, just to be extra careful, I wanted a professional opinion.

I came home… and though I knew I was being irrational of my fear of being infected, I called the Peace Corps Medical Officer. I explained the situation. She informed me that the chances of me being infected were slim (um… thanks) because the virus doesn’t survive very long outside of the body. How long? She didn’t know the exact answer but thought it was in the range of tens of seconds. I asked her if I should take Post Exposure Prophylaxis… she said it was up to me, but that she wouldn’t recommend it as chance of side effects (liver-damage) far outweighed the chance that I was infected. Still I wasn’t completely reassured. I emailed Anita, my sister, who is studying to be a doctor. The email came back the next day and allayed some of my fears. What the Peace Corps Medical Officer had told me was true. I should not be afraid of being infected. All the ifs, made it seem incredibly unlikely that the virus was transferred, if he had it at all. And beyond that, the virus doesn’t survive outside the body for long at all.

Ok, I wasn’t infected, but had tasted the fear associated with a possible infection. Though it was a relief to be reassured, I was angry at myself for being in that situation. I should have known better, after all, I studied the virus, and knew how to handle myself around blood. I decided against telling my parents and friends, as it might actually make them more afraid for me. If I had actually been at risk, though, I would have told them, it would be unfair to keep that from them. But just to tell them to make them worried, that is ridiculous.

I bought gloves to use the next time I slaughtered an animal.

Thanks again to Julie for correcting my abysmal grammar. :)

Sunday, April 13, 2008

Longtom Marathon - March 29, 2008

This entry was written on March 29, same day as elections in Zimbabwe. I was going to wait til those results were announced as well to post this, but I've grown tired of waiting...

This morning at 7 am, there were 21.1 kilometers (13 miles) of incredibly gorgeous mountain roads stretched ahead of me. Two hours and one minute later, they were behind me as I crossed the finish line in the stadium in Lydenburg, Mpumalanga.

I began “training” for the marathon about five weeks ago and averaged 1 run a week, mostly due to rains or working late, interrupted by an incredible trip to visit Julie, my girlfriend. Any funds I collected were donated to an organization called KLM to benefit carefully scholars in Mpumalanga. See the entry labeled Kids and No more Chia Pet.

As this was my first half-marathon, it was very interesting. Since I had been running on flat sandy ground, the ups and downs of the mountains were quite a novel experience- especially the three major climbs in the course. The downhill portions were rather nice, though they presented their own challenges. For me, the most difficult portions for me where kilometers 3-5 and the final three kilometers in the race, which I took seriously enough to finish, but was enjoying it throughout (I think I even managed to smile in photos), looking at the scenery and chatting with other volunteers who were running the race with me. There were 68 participating, about half ran, the other half walked and two participated in the Ultra… a race of 56 km (34 miles). I had a great time and it was nice to be able to run with other volunteers, most of who had not run a half marathon before. I started with one, then was a bit faster on a climb and then another volunteer joined me, and then another. We stayed together for about 16 km and then with three kilometers left one sped up and I stayed with him, but his burst lasted until the 1,5 km mark, where I continued the pace and finished.

I ended up with one of the top 10 times of the volunteers and one of the top three in my group, which I was quite satisfied with, because I had only hoped to finish. What made life even better (besides the free food/water/powerade) was the free massage that we could get at the end of the race. I don’t think I’ve ever had my legs massaged before, but it was pretty good.

Right when I finished I was rather tired, but after some liquids and about five minutes, I was feeling really great. Sure my calves hurt and I had a small blister, but I had energy, which was kind of surprising. I stayed around to watch other volunteers finish the race while continuing to drink copious amounts of free liquids.

Now I’m sitting at the Backpacker’s (Sort of like a hostel) in Sabie and just finished watching a fire display. (Fire on the ends of chains twirled quickly, fire breathing, etc.) I made sure to replace the calories I lost by eating lots and splitting a six-pack with another volunteer. All of us are in various stages of pain and some of us walk a bit differently, but it has been great to see everyone and hope that you enjoy the pictures, whenever I'm able to access and use them. Thanks to Mr. Fine for use of the photos I have up already.

Saturday, April 12, 2008

The inevitable

Saturday dawned with clear blue African sky. No alarm this morning, it’s Saturday, after all and I was up late last night calling back to America. I didn’t have a funeral to attend and I wasn't headed to town, which is nice for a change. However, my host father invited me to come to the neighboring village with him to check the mail and status of the family’s bakkie (truck) which was rattling a little bit more than usual. After 460000 kilometers of driving on roads that look like a giant washboard, its highly likely that something has come loose. Today, the dirt road only felt corrugated in places, a noted improvement since the scraping trucks came through last week. Fortunately, it hasn’t rained since then.

The car repair shop/garage is like any other house here, chickens, some corn growing in the yard, chicken wire fence, a concrete block house with a zinc roof, a lean dog on a rope- but with the addition of three cars in various states of repair sitting in the yard. The owner wasn’t in. We waited, then a rattling engine told us the owner was on his way. He pulled his car (which was probably at least 30 years old… and looked it) into the red dirt yard and told us he would need his co-worker, who has at a funeral a few blocks away, so we headed to the funeral. As we approached the house, I recognized it. But here it was:

Another large striped tent. More women cooking copious amounts of food for possibly hundreds of people. The slow acapella music that rises, falls, and stretches like a mournful dirge on an accordion. Another BaTswanan funeral. Except this one was different. This was a house I knew. It was where another Peace Corps volunteer, Adam, lived and so I had met his host family. The inevitable had come.

The last time I had been here, I had helped take his host sister to the clinic. We had known that she was ill ever since we arrived. The few times I saw her last year she was obviously sick, but around and walking. Not the last time I came. She had been thin before, but now she was emaciated and walked with the aid of a cane while she braced herself against the wall. When she ran out of wall, her mother and I helped her into the truck, which was waiting a short distance from the front of the house.

I assumed she had AIDS or was rapidly progressing that way. After all, she was just a little older than me, 27 most likely, a prime group, and her symptoms seemed to fit. Seeing her so frail, frailer than her ~50 year old mother, was shocking to say the least. My first instinct was concern for myself, a bit of paranoia due partially due to the knowledge of what the virus does. Then I came to my senses, the virus will not travel through skin. She needed help to get to the clinic. She was a person who needed a hand to get somewhere, so I offered her mine. She smiled and took it.

We all knew that she would pass away sooner than the rest of us, but that didn’t stop her from smiling with her mother and me. To her I was Thabiso the moithaopi, the volunteer from the next village who was just offering her someone to lean on and speaking in SeTswana, the native tongue of the area. She might have been a bit surprised, as it is still supposedly uncommon for a white person to act in that way unless they are a doctor or nurse. Her mother was also smiling, joking around as well when I left them at the clinic. Earlier, Adam, the Peace Corps Volunteer who lives in that particular village had mentioned she had been in Joburg for awhile and hadn’t been able to keep food down. We knew she would probably not make it to the end of our service here.

Two days later, I boarded a plane to visit Julie, my girlfriend, in Germany, for a long awaited reunion. However, that incident was a very poignant reminder of where I was before leaving on vacation for a couple of weeks.

Adam’s host sister didn’t make it to the end of our service. She held on for another month and a half and passed away sometime this week. I would not have known except for just happening on the funeral to find the coworker. The word had not made it out to my village. And there I was, a bit stunned. The funeral was winding down, as I could see people leaving, having eaten. People recognized me and asked if I had come to the funeral; I mentioned that I didn’t know she had passed away. They asked me about Adam, who is on vacation right now and probably doesn’t know his host sister passed away. I texted him, but doubt he’ll get the text until he arrives back in country.

I suppose it was a shock because it was just by chance that I stumbled upon the funeral. Since then, I’ve dwelled on it. My last memory of her is of her smiling, knowing full well she was going to die. A noble way to go. Smiling. Despite the virus that crippled her well beyond her years, despite the fact that she was a victim of one of largest pandemics in recent history, she was smiling.

It’s incidents like this that put my life in perspective. Not because I take comfort in the fact that other people suffer more than I do, but that even in suffering, there can be joy. Life, no matter how long we have to live it, should be enjoyed. Be happy with what you have and treasure it. Suffering, at times, seems like a conscious decision.

Wednesday, April 9, 2008

Introducing Capture the Flag/Hat African Style

The camp isn't all about learning, though much of it is. I should mention that I'm conducting a skills camp (just myself this time), to help improve enthusiasm for learning and getting some other skills up to par for the children. They seem to enjoy it, as do I, though it's always a bit of a relief when it's over.

It's great to see about 15 kids waiting for me when I come (early) to set up. The rest come pretty much on time, because they know that we will start on time. Those that arrive early get to read books, which they do quite well. I think the reason they come is because they get to play with tan-grams (picture). I've got some kids that are whizzes at them.

I redid the classic song "This land is your Land" to make it more applicable to South Africa, and used it as a listening exercise (the guitar picture is actually from my last camp, where I had other volunteers helping me out... and taking pictures). Most of the kids spelled everything correctly (besides shores... I got a lot of shows, I forgot to roll my r when I pronounced it for them) and were enthused to sing. They've made strides in math as well and today I showed them a simple circuit, something which they were incredibly blown away by. Yesterday I showed them a triple-beam balance, and then a simple balance where they all tried to find rocks that weighed about the same as the 250g weight I had... some brought bricks... it was amusing.

I have a few trouble makers here and there, but for the most part they are good. It takes them forever to settle down sometimes, though I imagine having 60 adults all be quiet when they are doing something exciting would also be a challenge.... I get a lot more respect from them now than I did earlier. At first, when they found out I wouldn't hit them for misbehaving, they relished in that new found freedom, but know we've broken through that gap. I even have a few teacher's pets. ;) I'm also using the camp to try out different classroom management styles to see which one is the most effective here.

Everyday, when they behave, we finish by playing games. Last camp Duck, Duck, Goose was a hit and this time capture the flag has taken over as supreme king of the playground. I let them go through the choosing of teams, explaining of the rules all on their own, trying to stay in the shadows as much as possible because I don't want them to think they need me to play the game. Although.. I used a hat and a bandanna the first time I showed them, and it's become a game where they only use their hats.

Friday, April 4, 2008

The return of the Camp

I'm hosting a Skills camp for learners at my schools. 65 came today. I need a nap.


The church was dark and empty.

Yet another moment where I must have misunderstood what the parishioner told me. I guess that meant no Good Friday service. (Later I found out the Good Friday service was in the next village, 23 km away)

I was determined to make it to an Easter Service and so I traveled to one of the neighboring sites where there was a Roman Catholic Mission. It took me most of the day to travel and when I arrived, the priest (from East Africa) greeted me. He was playing with the children, sometimes instructing them, but it was literally a scene that could have come from a missionary advert. Smiling faces, children running up to hug the priest. I suppose in these villages, he's the only father figure some children know.

The greatest was when the children thought the priest and I were brothers.. on account of our noses. All of the villagers' noses are rather small, almost squashed looking. Whereas my nose is rather large (hence the teasing I get from family and friends) and looks like I have a nose and a third. Then it dawned on them... wait... the priest is black... and you are white. Realizing that the children viewed my nose as a more prominent feature than my skin color brought a huge smile to my face, as well as bit of laughter. The priest hadn't stopped smiling since I had seen them. Working with children can do that to you.

Then the priest, the children, and I watched America's popular export- wrestling. This was all a bit surreal. The pictures of the Pope and Jesus on the wall. A priest. Children. And wrestling. A long talk with the priest afterwards made me smile even more as he was down to earth and just full of joy. He shared his frustrations as well, but they were overshadowed with this amazing sense of happiness just to be alive.

I met with two other volunteers, one had come for the Tridium, and we shared stories until the Easter Vigil Service, which was packed. The next morning, we also attended the Easter service, which was even more packed. After all, we were spending the night at the mission house, so it was at least a show of solidarity with the priest.

And so after cooking and then watching Batman Begins (courtesy of a fellow volunteer, Thanks AJ) with the priests, I headed back to site for the computer workshop (see previous entry).