Hilariousness

--Overheard at the health center: "Alma, why don't you take one of the mosquito nets for pregnant women? The mosquitoes are really getting at your face!" Unfortunately I have yet to find the word for pimple in Kinyarwanda. 

--Overheard at the market: “Alma, are you a nun? We must find you a husband immediately! We will find you a Rwandan husband in no time!”

--Overheard at the bread store/tea shop: “You are American! Take me to America! I know the visa is complicated, but you can marry me, it will be no problem!
 

--Responses to “If you want to marry me, you must give my father 600 cows” have included:

• Your father is crazy. 
• Only President Kagame has that many cows.
• I have 800 cows. Call your father. 
• They have cows in America?
• How many children does your father have? Only three?! No sons?! He cannot ask for so much!
• My favorite: And how many cows did your father give when he married your mother?

--The Kinyarwanda expression for someone who is courting/dating: umuhinzi. Also means farmer or farming. In Rwanda you are not a player, rather, you are a farmer.
 

--I milked a cow. It was amazing. Also really hard, but amazing. I can die happy now.


Other miscellaneous:
Check out my amazing and talented sister Daniela dance Swan Lake!

Conference Culture

In the world of aid, conferences and trainings are huge. In many ways, it makes sense. Bringing together professionals, healthcare workers, and other various community leaders to share information about health, education, and development is a good idea in any setting. But I’m starting to think too much of a good thing can be bad.

During the first fifteen weeks of 2011 the ten nurses and high level administrators at my health center have attended a cumulative total of fourteen weeks worth of trainings and conferences. This does not include the various lower level administrative staff and nurses who also attend conferences.

These trainings are almost always sponsored by international NGOs or foreign aid agencies like USAID, UNICEF, or Save the Children. The events generally take place at nice hotels in the larger cities. Hosting organizations provide all attendees with lodging, food, transport, and per diem. Topics include family planning, vaccination procedures and policies, HIV/AIDS, tuberculosis, etc. and are repeated often. Three different nurses at my health center have attended three separate conferences on TB this year.

I sat in on a very modest two-day conference held at my health center where the daily per diem was 30,000 RWF. The standard salary for a nurse at my health center is around 90,000 RWF a month (approximately 150USD). Needless to say, people are ager to attend trainings and conferences. This creates quite a bit of tension and animosity among staff.

I do think trainings are important and beneficial for development. I am, however, becoming much less enthusiastic about them.

A few weeks ago, there was quite a bit of drama at the health center. Two nurses were mad at each other. Turns out a nurse (we’ll call her Nancy), was attending a conference in Butare, the big city two hours away, with one of the administrators (we’ll call him Bob). Another Nurse (we’ll call her Betty) was furious. The conference’s topic was Betty’s area of expertise, but Bob decides who goes to the conferences, and he chose Nancy. Betty is an older nurse, married with children. Nancy is a younger nurse, single and flirtatious. Bob is also a well-known womanizer. Everyone at work thinks Bob invited Nancy to the conference so he could sleep with her. … And I thought I was going to miss Grey’s Anatomy!

Ascaris Lumbricoides

In Peace Corps they tell you to celebrate the small victories, so allow me to gloat. Last Monday I correctly identified a case of worms.

Every Monday morning between ten and twenty malnourished children and their mothers come into the clinic for Out Patient Therapeutic Treatment. My counterpart, the health center nutritionist, and I weigh the children (who are generally between six months and five years of age) to check for progress and give out Plumpynut. Plumpynut is a Ready to Use Therapeutic Food (RUTF). A highly nutritious food bar, sort of like a Slim Fast bar except instead of overweight American adults eating it to lose weight; malnourished African children eat it to gain weight.

Mondays are both heartbreaking and incredibly inspiring. To say these kids are adorable doesn’t even begin to describe it. Now that I’m relatively established none of the kids cry when they see me. In fact, some even run to greet and hug me when they arrive at the health center!

Generally speaking, there are two general types of malnutrition: chronic and acute. Acute malnutrition is generally more temporary and if quickly addressed, ramifications are not severe. Children with acute malnutrition often have swollen cheeks and bellies. Chronic malnutrition is a result of long-term malnutrition. It causes stunting, hair loss, and generally slows the development of children. Eventually your body loses the ability to absorb nutrients so treatment is more complicated and can require years of medical attention. (To my friends who studied nutrition or are in med school-- please forgive this dumb-ed down explanation).

Both types of malnutrition affect your body’s ability to fight off foreign bacteria and viruses, which is particularly problematic for small children living in environments with very poor hygiene.

Surrounded by malnourished children on a daily basis, I am slowly learning to identify the warning signs and characteristics of the various levels. So, last Monday when I saw a very upset four-year-old girl with a particularly swollen stomach, but normally sized ankles, wrists, and cheeks I knew something was wrong. After consulting with my counterpart I took my small friend to the lab and where the technicians identified the intestinal parasite causing her pain and weight loss.

I feel a little embarrassed to admit I did take advantage of my umuzungu status to break protocol, insurance procedures, and lines in order to get the diagnosis and the drugs to cure her. I do not plan to act in this manner for the next two years, but I’m not losing any sleep about it this time. At a health center that serves over 12,000 people staffed with only ten nurses (no doctors) there are times people rush and patients get overlooked.

I am hoping that as my language skills improve and health center staff trusts me more, I will be able to help address more of these types of issues. Plumpynut will not cure malnutrition in a child with worms just like ibuprofen will not kill the tuberculosis virus misdiagnosed as a common cold.

While I personally cannot positively diagnose any of it or provide care to cure it, I can work on making it easier and more effective for those who do.

Genocide Memorial Week

April 7^th marked the beginning of a three-month national mourning period to commemorate the victims of the 1994 Genocide. During the week of April 7-13^th the National Commission to Fight Against Genocide organizes events nationwide to honor the memory of those who perished.

Leading up, I had hoped the week and the events scheduled in my community would be a chance for me to be a positive presence and really integrate in my community. In retrospect it was incredibly naïve and insensitive of me to expect genocide victims and survivors to discuss such traumatic events with the new foreign white girl in town who barely understands the language. To put it simply, the week was depressing and I think confusing for everyone, including myself.

I woke up on the 7^th and prepared myself for the community event at the local memorial site, which I knew was planned. I was unclear at what time everything was happening (a common predicament in my life), but I figured I would just go with my roommates.

As the minutes and then hours passed with no sign of life from my roommates’ rooms other than the really loud radio playing sad songs about the genocide, I began to get anxious. Finally, one of my roommates emerged and told me the community event was at 2 PM. But two o’clock came and went and no one in my house seemed to be going anywhere. When I finally asked if we were going, my roommate told me she did not like going to any memorial sites because it was too difficult. I later found out both her parents and two siblings were killed in the genocide. She was barely ten years old.

Although I missed the opening event, I attended most of the afternoon discussion sessions the rest of the week. I understood next to nothing, no one offered to translate and I didn’t think it appropriate to ask. Throughout the week I observed friends who I thought were incredibly outgoing and cheerful really shut down. I am hoping my presence was seen as a sign of respect and solidarity as well as a step in the right direction.

Mac & Cheese

I think I’ve already mentioned how lucky I am in Rwanda because it is a country with cheese. Not just the Laughing-Cow stuff: real cheese. On my last trip into Butare I bought a half heel of gouda cheese and brought it home to make my own version of mac & cheese! 

I have decided to call the experiment a moderate success. Considering I cooked on a wood fire held up by rocks and had three Rwandan roommates rolling on the floor with laughter as I tried to strain pasta without a strainer, I’m giving myself a pat on the back.

In order to make this a nutritiously balanced diet I complimented my oily starches with green beans! I cooked them with carrots and onions and added what I feared might be too much salt and various other spices. I thought it was delicious. My roommate Grace looked like she was going to vomit when she tried them. Umunyu!!! She screamed as she grabbed the saltshaker. Rwandans love salt. 

In America...

I have a very friendly coworker who has some pretty hilarious ideas about the United States (and Coca-Cola). Here’s what he told me last Monday:

·   In America, your family is very rich.

·   You are very rich.

·   In America, money is no problem.

·   In America, no one is poor.

·   In America, everyone has at least $100 or $200 per day.

·   In America, only refugees are poor. No REAL, ORIGINAL Americans are poor. (This concession was made only after I insisted that poor people existed in the United States).

·   In America, everyone has food and shelter.

·   In America, it is normal for twenty-year-old women to marry fifty-year-old men.

·   In America, once you are fifteen your family kicks you out of your house.

·   Peace Corps will pay for you to visit your family in America at Christmas time.

·   Peace Corps pays your family while you are here.

·   Peace Corps pays you lots of money.

·   There is no sugar in Coca-Cola or Coca-Cola products.

·   Even if there is sugar in Fanta Citron, your teeth are strong because you are strong.

·   If you are big and strong sugar cannot hurt your teeth.

At first I was really furious about some of these assumptions, particularly ones having to do with money. It’s a constant struggle for me to smile and keep going when I get “I am poor, give me money” and “White person, I am hungry!” comments. (By the way, last person who said this was actually eating while she yelled at me).

But then I thought about the questions and concerns my friends in the United States had about Rwanda. It’s been a little better than Niger because people actually know Rwanda is a country, unfortunately most people only know about the genocide.

So it appears we have some global misunderstandings. Na cibazo. No problem. This is why Peace Corps has three goals! I’m working on it. For now, I’m setting up a little middle school science experiment to show my coworker how bad Coca-Cola actually is for your teeth.

Mid-Service & PEPFAR Conference

Seven days after arriving at my site, I left for a Mid-Service Volunteer Conference. At this point I think it’s fair to say my Peace Corps timeline is not traditional.

Things that were awesome about MSC:

• SOULEYMAN! My APCD from Niger is in Rwanda! He’s helping the Peace Corps Rwanda team with their health program and also with the training program. It was so absolutely wonderful to see him, and even practice Hausa kadan, kadan.

View of Lake Kivu from the Guest House

• Lake Kivu. The guesthouse where I stayed had incredible views of Lake Kivu and D.R. Congo. Incredible sunsets!

• Nyungwe Rainforest. The bus I took to get to Cyangugu, where the conference was held, drove through the Nyangue Rainforest. In three months I’ve seen the Sahel, the Sahara, and now a rainforest. Wow.

awesome bird watching in Rwanda!

• Meeting Rwanda PCVs. This was the main reason I went to the conference. Up until the conference I had very little opportunity to interact with other PCVs, so it was great to make new friends.

• Haircut. One of the other PCVs trimmed my hair, which was desperately needed and very much appreciated.   

The conference was divided into two segments. The first two days were strictly for the health volunteers who have now been in Rwanda for over a year: to discuss challenges and triumphs, and to brainstorm. The later part of the week was focused on HIV/AIDS and the President’s Emergency Plan for AIDS Relief (PEPFAR), and how PCVs might use PEPFAR funds in their communities to fight the devastating effects of HIV/AIDS.

Overall the week was an interesting learning experience for me. Turns out Peace Corps culture in Rwanda and Niger vary as much as the local culture (which, in case you’re wondering is a lot). BUT, na cibazo, babu lahi, no problem! I’m excited to bring a little bit of Niger to Rwanda, and soak in all the amazing opportunities Rwanda has to offer. 

I’ve been told the mid-service mark tends to be a difficult one for most volunteers. People realize they’re halfway through and often get frustrated or discouraged about how little they feel they have accomplished. I could definitely sense frustration in many of the volunteers, although from my point of view they were being way too hard on themselves. A lot of the things they said they were doing in their communities sounded incredible and have given me some inspiration and a lot to look forward to as well.

Jehova’s Whiteness

Rwanda is a predominantly Christian country. Catholic, Pentecostal, Methodist, Baptist… all here. Last week, I ran into a Jehova’s Witness.

I don’t think words can really describe how absurdly hilarious the situation was.

It’s Sunday, and I’m walking up the dirt road to try and find a carpenter to make me a chair (which, by the way, I failed at). I have three kids holding onto each one of my arms and four more behind them fighting for a touch of my ghost skin.

I see a very well dressed man with a child’s tie and a small brief case walking towards me. He greets my roommate Grace, but not me until I say “Mwiriwe!”

“Good afternoon” he responds to me in English. “Where are you from?”

“Ndi umunyamerika kazi,” I respond in Kinyarwanda.

“Oooooh! America! Your country has many WHITENESS!!” he says enthusiastically, emphasis on the whiteness.

At this point in my Peace Corps career I’m pretty used to being reminded constantly of my whiteness, America’s whiteness, France’s whiteness, and Obama’s blackness. In this situation, like most others, I just laughed and responded affirmatively, “yego!”

To my surprise and confusion, the man continues, “I am a WHITENESS! JEHOVA’S WHITENESS” and hands me a pamphlet that sort of looks like it could have been the cover of a sci-fi book and says in Kinyarwanda Mbese iyi si izarokoka?, will this world survive?. The back of the pamphlet had an even weirder image of a smiling farmer who looked straight out of Sound of Music.

Incase you were wondering, the pamphlet was printed in Pennsylvania.

Motorcycle Rides in Africa

Blog post disclaimer intended for Mama, Papa, other adults who care about my safety, and Peace Corps Administration who might read this blog—please note that during each motorcycle ride I have made sure my Peace Corps issued helmet has been securely fastened, and that I have seriously examined the motorcycle, driver, and road to the best of my abilities before beginning my ride.

In my limited experience, riding a motorcycle on a non-paved road in Africa is amazing. And terrifying. It is terrifyingly amazing and amazingly terrifying.  I highly recommend it. 

A couple days after arriving at site I was given the opportunity to go “into the field” and talk with some of the Community Health Workers (CHWs) in the area. Since the CHWs lived in what was not considered walking distance from the health center, I got to ride on the back of a motorcycle!

Silly me, I thought I had conquered this business of riding motorcycles in Africa. False. Completely false.

Now if you’re trying to get a mental image of me on the back of a motorcycle in rural Rwanda, please keep in mind that this country is known as the land of a thousand hills, and it’s not an exaggeration.

Down we went. And up we went. And down again. Side to side. These directions describe both the “road” I was on, and my ass. Amazingly terrifying, terrifyingly amazing. The term adrenaline junkie suddenly makes so much more sense.

First Day at Work

Since I started Peace Corps I’ve had five “first day”‘s of work.

My first first day of work was in Philadelphia at staging, where the Peace Corps Washington facilitator sternly reminded everyone present that this was our “first day on the job” and we should be dressed accordingly. This made a lot of people wearing Birkenstocks, cargo pants, and t-shirts shift uncomfortably in their seats.

Next, I had my first day of work in Niger, where the customs agent at the airport asked me if I had come to Niger to find a husband. I laughed nervously: what had I gotten myself into?!

Three months later, I had my first day of work at site, where, much to my confusion and everyone else’s delight, two Nigerien men welcomed me with song and dance.

Barely a month after that, I had my first day of work in Rwanda. After over thirty hours of travel, I was introduced to all the Peace Corps Rwanda staff… none of which I remember.  

And so, in March, five months after my first, first day of work, I had what I hope will be my last first day of work as a Peace Corps Volunteer.

The 7AM Health Clinic Staff Meeting started promptly at 7:10AM. For most of the meeting I had no idea what was going on. The Vice-Titulaire sat at a desk in the front of the room while the rest of us congregated on wooden benches. At one point, my supervisor wrote “Autopsie: verbale” on the blackboard board. I tried to turn my head discretely to see if anyone else in the room looked confused or alarmed, but apparently not.

Throughout the meeting a renewed sense of excitement came back to me.

My first few weeks in Niger I wrote in my journal time and time again: “I can’t believe I’m actually doing this!”. On tough days when I was sure another grain of sand in my eyes or teeth would drive me into insanity, I would look around and remind myself where I was, and what I was doing.

It’s been really difficult for me to get that feeling back since the evacuation. Between all the language lessons and the rush to get through training a second time, I’ve been generally exhausted and weary of getting too excited about being here… who’s to say I won’t be evacuated from Rwanda in three months?

But during that first hour of my first day at work in the health clinic the familiar feeling of enthusiasm, of energy pouring out of my body, came rushing back to me. I felt like I had come out of a slump. New ideas for activities and projects started pouring into my head faster than I could write them down. I watched my supervisor direct the staff and I think my jaw dropped as I observed my female co-workers loudly and authoritatively respond.

I spent the rest of the day shadowing various clinic employees, nodding and smiling at people who said lots of things I did not understand, and holding babies who didn’t cry when they saw me. This, my dear readers, is what I call living the dream.

My Site

On March 5^th I moved into my new home in the Southern Province of Rwanda! The brand new Peace Corps Rwanda Program Manager for Health accompanied me to my new site.

Driving to my site was incredible! The roads in Rwanda are beautiful, winding, sloping, routes, and we trekked quite a few. I find the roads here always make me feel one of two things: 1) I’m on the top of a hill about to dive into an endless sea of green, or 2) I’m at the bottom of a valley, surrounded by tall hills that confine me. I have yet to experience anything but awe when I get in a car and go anywhere in this country.

Now back to my installation. I was really nervous. Not so much nervous in an excited way (that too), but more in an “I have no idea what I’m doing” way. Now I understand why training is generally between nine and twelve weeks long. In a new country where you don’t speak the language or understand the culture, it takes more than a month to just be able to decompress. I never felt so eager to settle in, but I also never felt so unprepared.

Once I arrived at my site, I headed to the clinic where the old PCV was conducting the last of her three-day volunteer training. Twelve women from the surrounding villages were being trained on how to conduct nutrition lessons in their own villages. It was an incredibly inspiring and exciting thing to walk into, but also incredibly intimidating.

For security reasons Peace Corps does not allow volunteers to post their precise locations on public websites but I as I mentioned earlier, I am in the Southern Province of Rwanda, very close to the border with Burundi, and a relatively easy trip to Butare—a larger city with one of Rwanda’s best Universities and best of all: an ice cream store!

The house I’m moving into is a four-bedroom home owned by the health center, connected to my supervisor’s house, and to the center’s generator. I have electricity! I also have a couple roommates, including a precious 7-month-old baby named Martin. Once the other PCV leaves, I will have two rooms in the house. The other two rooms belong to one of my colleagues, her seven month old, her sister, and her cousin/babysitter. There is also a live in maid that lives in a room off of the kitchen.

Hanging out with my roommate, Martin!

Moving in, I felt very uneasy about the roommate situation. My dreams of personal space were once again being let down. I had a million and a half concerns (some logical, most irrational) about living with people I barely knew. At the same time, I’m definitely not in a position to reject potential friendships, and having Rwandan roommates is probably just what my Kinyarwanda needs. New home, here I come!  

My Assignment

I’ve been given a post in Rwanda! I will be working as a Community Health Volunteer at a Health Center in the Southern Province of Rwanda.

My first month at site will also be the last month at site for another PCV. The culminating project of her two-year service (which I am technically taking over) has focused on maternal and child nutrition.

View from my front door

Have I mentioned how important nutrition is? It’s important. Arguably the most important factor in keeping children healthy in developing countries. Stay tuned for an Alma-rant on nutrition/malnutrition to be posted soon…

This PCV and her counterpart coordinated a nutrition program based on the Positive Deviance/Hearth model, a program that has been implemented in various countries around the world with great success rates. Here, the nutrition program has already been realized in twelve imidugudu (villages).

As part of the project, mothers with malnourished children attended NERS (Nutrition Education and Rehabilitation Sessions) everyday for two weeks in their villages. A local village volunteer taught the sessions, which focused on nutrition, hygiene, family planning, etc. At the end of each class, mothers prepared nutritious foods with local ingredients (some donated, some brought from homes), and fed them to their children.

I’m leaving out a lot of details about the project and definitely not giving this PCV the credit she deserves, but overall what you should know is that this is an incredible project that I’m really excited about working on.

At the same time, I am pretty nervous about walking into the middle of someone else’s brainchild. Right now I have neither the language nor the technical skills necessary to pick up exactly where it’s been dropped off. I’m also a little anxious about starting off with such a narrow focus. The Health Center I’ll be working at has a staff of 40 and serves over 12,000 people with all sorts of strengths, weaknesses, needs, and ideas that I know absolutely nothing about.

Luckily, I’m a Peace Corps Volunteer.

Many frustrated individuals call the Peace Corps disorganized… I like to think of it as a flexible. (A note for anyone considering becoming a volunteer—there’s a reason the recruiter asks you “how do you deal with unstructured and/or unsupervised work environments?”).

After speaking with some PC Rwanda staff members and the PCV I’m replacing, I’ve clarified my concerns and my expectations. My first priority is learning the language and the community. Once I feel comfortable, and my supervisors and co-workers feel confident in my abilities, I’ll begin/continue work on the HEARTH project and hopefully help start projects new projects in the community as well.