Friday, October 21, 2011

One month down, 25 to go

I’ve been in country for a little over one month now! It’s gone by so fast! This past week I was in Semolale, a small village near the eastern border of Botswana with a current PCV for shadowing. The purpose of shadowing is to give us a chance to see what current PCVs are doing in daily life, how they’ve integrated into their communities, etc. It was really an eye-opening experience for me and I enjoyed it a lot. We left early on Monday morning and were dropped off at the bus stop in Gaborone, and then were left to our own devices (finally!) to get on the correct bus and all that. My first bus ride was about 6 hours which wasn’t so bad except that for some reason Batswana like to keep the windows shut on the bus and the woman next to me kept making me close my window! With no AC, this makes for a VERY hot bus ride! Anyway, it was nice to see some more of the country and just actually be doing something on my own. The emptiness of the country struck me again as we would drive for miles without seeing any people or houses, just goats and donkeys! I switched buses in a village called Bobonong and then had about an hour ride from there to Semolale. 
My host, Jen, met me at the General Dealer which is the only store in the village and is about a five minute walk from her house. Jen is in the CCB (Community Capacity Building) program which is not the program that I’m in which is life skills, so some of the things that she does I won’t be doing, but it was all still cool to see. She works mainly in the clinic whereas I’ll be working mainly in the schools, but she also does some work with the primary school in the village. On Tuesday it was ARV day at the clinic which is when HIV-positive people who are on treatment come to get examined by the doctor and get a new set of medication. Jen sits with the doctor during all the appointments and fills out paperwork for ordering blood and other lab tests as well as scheduling patients for their next appointments. Patients who are having adherence issues are only given two weeks supply of medicine at a time so that the doctor can keep closer track of them to make sure they are adhering to their medication.  Adherence is a big issue because if patients don’t take their medicine or take it only sporadically, the virus will build up tolerance making the first-line drugs ineffective. This makes them more infectious to other people and causes them to have to switch to second-line treatment which is more expensive. The Government of Botswana provides free ARV treatment (with the help of PEPFAR which is a US program that provides monetary aid to African countries which makes ARVs more affordable) to HIV-positive people who qualify. In order to qualify patients have to wait for their CD4 count to drop to a certain level since there are too many HIV-positive people to put everyone on ARV treatment immediately. Anyway, when we got to the clinic on Tuesday morning there were a lot of people ranging in ages from 2 to 65 and everything in between waiting for their turn to see the doctor. Not everyone on treatment comes every Tuesday; patients are staggered so that the clinic isn’t overwhelmed on a given Tuesday. If a patient is adhering well they will be given a six-month supply of medication and only have to come in to the clinic twice a year. Some are given a three month supply, some one month, etc. Patients have to come to the clinic the week before they are scheduled to get medication to get blood drawn so tests can be done to track their CD4 count. This process can be inconvenient and time consuming for adult patients since they may have to travel far (the Semolale clinic serves 2 other surrounding villages as well) and might have to take off a full day of work. However, it’s especially harrowing for babies on treatment. When I was there, there was a 2-year-old who was just starting treatment and had to have blood drawn, but babies’ veins are too small to take blood from their arm so the doctor has to use the femoral artery which is in the upper thigh. The nurses had to hold the baby down so that the doctor could get enough blood. It was really painful to watch because the baby was screaming and crying and it really struck me how devastating HIV is. I had to walk away from the situation because I couldn’t fight the tears. It was so hard to see a child in pain like that and know that they have to go through something so terrible at no fault of their own.  It’s especially sad and frustrating because with the correct treatment mother to child transmission is highly preventable. PMTCT (prevention of mother to child transmission) therapy is also free for all HIV-positive pregnant women and is very effective if followed correctly in preventing the baby from being born HIV-positive. Yet, there are still babies being born with HIV. There are various reasons for this, but I think I would like to work on PMTCT as a secondary project when I get to site. Anyway, the rest of the day was spent with patients and was very interesting. I won’t be working daily at a clinic since I’m Life Skills, but I would like to at least spend some time at my local clinic.  
That night we ate tacos, yum! (If anyone is wondering what they can mail me, tortillas and taco seasoning are highly appreciated!)Other meals throughout the week included homemade Pizza, soya burgers, and pasta! The next day we spent some time at the clinic and that afternoon we went to the primary school and I sat in on a life skills lesson that Jen gave about transmission of HIV. It was helpful to see a lesson in an actual classroom of children since that’s what I will be doing. The lesson went well, although it is sometimes hard to tell whether they are absorbing the information or not. At the end of the week we conducted a focus group about youth opinions on the government and economy and about the US government which was part of my assignment for the shadowing week. It was hard to find people to attend because the required age ranges were either from 13-18 or 19-25 and since there is no secondary school in Semolale there aren’t many youth around. We managed to get together a group of 19-25 year olds, mostly special constables from the police station. We discussed their attitudes towards the government and what they saw as the biggest issues facing their community. We also talked about what they thought about the US which was really interesting because some words that came up were “heaven”, “everything”, “peace”, and “better life”. They were really shocked to find out that there are people living in the US that are homeless and that there are US citizens who are HIV-positive but can’t get on treatment because they can’t afford it.
Overall, it was a really interesting week and I could go on and on about all of the things that I learned, but I don’t want to bore you all! We only have three weeks left of training and I have a feeling it’s going to go by fast! This Friday we get our site assignments which is very exciting and on Saturday we get to go to Gaborone for a party that the Peace Corps is throwing to celebrate Peace Corps’ 50th anniversary! Should be a good week.

Sunday, October 9, 2011

Day-to-day life, The Coronation, and Botswana Cook-off!

We’re half way through training now, and it’s really flying by! This past week went really fast and was generally really fun. Day-to-day I generally wake up around 6:30, eat cornflakes for breakfast, have language class for 4 hours, and then lunch at the training center which I pack and is usually a PB+J and an apple, and then various training sessions for the afternoon. Sometimes we go downtown after training for a little bit and hang out at the Ko Gae CafĂ© which is basically the only place that we can hang out and get food/beer that isn’t super sketchy or full of really drunk men. We have to be home before dark so that means I’m back at my house by 6:30-6:45 every night. For dinner usually either I or my host mom cooks  since there’s only two of us in the house. We usually have either rice or mele meal which is this corn meal-type mush/porridge that kind of has the consistency of gluey mashed potatoes but actually isn’t so bad. It doesn’t taste like much on its own but we have it with some kind of vegetable (spinach or cabbage usually) and the two things mixed together is pretty good. It’s been very easy to stay vegetarian here but the diet consists of a lot of starch and a lot of carbs so I’m afraid I’m going to gain weight! Sometimes we also have baked beans or if my host mom is having meat too I’ll make a veggie burger or some other meat substitute which I was so surprised that they have here and taste pretty good. We usually watch the news while we eat dinner which is interesting because it is totally absent of crime or other depressing news like we generally get back home. They usually have about 4 or 5 headlines about politics in Botswana or other African countries, maybe some news about the economy or businesses and other stories like that. Pretty different than the headlines in the States which are usually riddled with murder and rape and all that! It’s important to note though that Botswana is a REALLY sparsely populated place. There are less than 2 million people here and it’s really noticeable, especially after living in a city for the past 4 years. There’s no one here! Really! Its nuts.
Anyway, we had our first language proficiency interview this week which was kind of scary but went well and I understood a lot more than I thought I would so that was good. On Friday we went to the coronation of the new Chief of the Bangwaketse tribe which is the tribe of the area that we are living in. It was a long day but the president was there which was really cool! Also really interesting because if the US president was at an event the security would be crazy, but there wasn’t even a metal detector here! Everyone just walked in and took their seats and the president showed up (on time surprisingly!) escorted by maybe 2 or 3 police officers and just walked down the aisle casually. Another funny thing was that even though this was like a really big event, Batswana are still so informal! People were answering phone calls, eating in the audience, chatting during speeches etc. It was pretty interesting and indicative of the laid-back nature of the culture here. Also interesting was that the chief has to kill a leopard (he get special permission to do this from the government) and wear the skin of the leopard during the coronation. He was also given a spear and a shield from his uncles…and he also got a car!? Talk about a mix of modernity and tradition! Anyway, the event was cool and the luncheon afterward was chaotic of course…they ran out of plates and silverware in about the first five minutes so people were using napkins and random pieces of tinfoil for their food and it was really hectic.
On Saturday we had a cooking practicum aka Iron Chef: Botswana. We split into five groups and each group had to bring something they cooked in on Saturday morning which was tasted by a panel of judges and the winners got pizza! Everyone’s food was awesome. My group made a really good vegetable soup and some kind of weird version of kettle corn with peanut butter on it since we couldn’t make caramel, but it actually turned out tasty! We didn’t win, but the winning group shared their pizza with everyone (except it was a meat-lover’s so I didn’t eat it L ) and it was a really fun day.
Anyway, it’s Sunday now which means its laundry day! We are all leaving early tomorrow morning to travel to current volunteers’ houses to shadow them for the week which I’m really pumped for! Our first experience with Botswana public transport will definitely be an adventure I think!

Saturday, October 1, 2011

Cultural day, baboons, and training!

Well it’s been over 2 weeks now! The second week of training flew by as I have a feeling will the rest of training. Everyone in the group seems to be opening up and getting more comfortable so it has been nice to feel more connected with everyone. This week we got to do some fun cultural stuff which was great! On Monday night we went to the Kgotla, which is basically the main gathering place for the people of the village, for cultural night which included a choir and a really awesome traditional dance group. The dances involved a lot of stomping and the use of noise makers which the dancers had tied around their ankles. I unfortunately didn’t have my camera with me because we didn’t find out we were going to the event until a few minutes before we left, so I don’t have any pictures, but it was really awesome to watch! They also had some people there from other African countries such as Angola who spoke a bit about their culture. Well, needless to say, the large group of Americans stuck out of the crowd and it wasn’t long before the Emcee of the evening called us out and told us we had to come to the stage and perform for everyone! He wouldn’t take no for an answer, so about half of us got up and after a 5 second huddle decided that we would sing and dance the Macarena in front of 100
Batswana after they had just done incredible dances for us! It was pretty hilarious and everyone laughed (with us or at us?) a lot. I think they appreciated the effort at least!
On Wednesday we went to Gabarone to do some immigration stuff and set up our bank accounts which of course took way longer than expected. But we saw a huge family of Baboons on our way which was awesome! Haven't seen any other wildlife except cows and donkeys, so that was really exciting. This worked in our favor though because we got to eat lunch at the mall in the city which meant American food! I had a grilled cheese and tomato sandwich and it was amazing! I have been craving cheese because it is not at all part of the daily diet here, but I am realizing that it was DEFINITELY a part of my daily diet back home! 
On Thursday we had an interesting session about stigma and HIV and got to talk to a panel of people living with HIV. They told us their stories and how they are coping and what it was like to tell their friends and family their status. It was really interesting to hear what they had to say and I was impressed at how well they were coping, especially the youngest woman of the three who was only 28 and just found out her status a year ago. I can’t imagine being in her position. Stigma is a huge issue here though and it was one of the major contributing factors to the spread of the virus because people are afraid to test or reveal their status to their partners. Hopefully our group can be a drop in the bucket towards breaking down the stigma and contributing to the prevention of the virus. As training goes on I’m getting very excited to start working and start my service. Since the Peace Corps program here is so targeted I think it will really be able to make a difference in the long run in preventing new infections. The people we have interacted with so far have all been very welcoming and stressed the importance of our role in making a difference in Botswana. It’s hard sometimes to feel like anything we do will make an impact, but since the program is focused on capacity building and sustainability I think all of us really do have the potential to make an impact! at least I hope so...we'll see if the optimisim remains..