Another Evacuation

Disclaimer for anyone reading this blog and thinking about joining the Peace Corps: my experience does not in anyway reflect that of a “typical” volunteer.

Greetings from Pretoria, South Africa.

Those who know me well might remember a small incident a few years ago in Ithaca, New York where I slipped and fell in a gorge. Seven stitches, two fake teeth, a root canal, and several painkillers later, I thought it was over. Turns out I was wrong.

A couple weeks ago I noticed an inflammation above the tooth that had been severely damaged during the accident three years ago. When the PCMO (Peace Corps Medical Officer) in Rwanda first told me I needed a root canal, I thought I had won the PCV lottery.

As I hope you’ve gathered from reading this blog, medical care in most of Africa is lacking. PCV’s who need specialized medical attention during their service are evacuated to the nearest country where such services are available. For most volunteers in Africa, this means a free trip to South Africa. I remember learning about this during training in Niger, plotting with my fellow trainees about the best possible med-evac situation. Broken bone? Appendicitis? We agreed a root canal would probably be the most ideal.

Eight months later, I boarded the plane from Kigali to Johannesburg prepared for my second evacuation in less than six months. I was confident this one would be better than the last, how could it not?

Med Evac perks: playing with lion cubs

Arriving in Johannesburg was strangely similar to arriving in Casablanca. The cleanliness of the airport’s bathrooms, the wide and well paved roads, the telephone and electricity poles everywhere -- all served as signalers that I had entered a much more developed country. Everything seemed strangely unfamiliar and disorienting.

As the Regional PCMO looked over my file his brow wrinkled, “your case is rather complicated”. I laughed and explained my accident-prone ways that lead me to his office.

A couple minutes later, I was no longer laughing. Due to the complicated nature of my dental history, the chances of me needing a tooth extraction are rather high. Due to the complicated nature of tooth extractions, I cannot remain a Peace Corps Volunteer if this procedure is necessary.

So, this evacuation is turning out to be a lot like the last one. I am in limbo. The dentist here has redone the root canal, and now we’re waiting to see what happens. There is a chance I might have to go home, there is a chance I might not. I am being asked to remain flexible and patient. Things that are rather difficult to do when, for the second time in six months, I am unsure of what continent I’ll be on next week, or whether or not I will still have a job.

Nitkwa A-L-M-A

Many of your probably know that my dad writes a blog. Not too long ago, he wrote (actually Dad, you rambled) about his frustration with people always addressing each other on a first name basis. So, friends: when you see my father, please make sure you address him as Mr. Aldrich. Professor Aldrich or Dr Aldrich will also probably make his day.

I’ve been thinking a lot about my own first name recently. The one that you gave me Dad! Alma. It means soul in Spanish. (To the many sleazy guys in bars across the U.S. who have tried to use this bit of information as a pick up line: yes, I know what my own name means. No, I am not impressed by your limited Spanish speaking abilities). I like my name. Thanks Mama and Papa.

If you are American chances are you pronounce my name incorrectly. It’s not Ulma or Olma or Elma, it’s Alma—emphasis on the first A, like when you say “Ah ha!”, A-lma.

When I got to Niger, I was pleasantly surprised to hear that Nigeriens were able to pronounce my name correctly. For some reason this small phonetic detail was very comforting. During training, we were all given Nigerien names (mine was Maimouna), but once I got to my site I introduced myself to everyone as Alma; because that’s my name. Everyone’s ability to pronounce it properly, the way my parents do, made me feel immediately more at home.

Rwanda is a different story. There is no difference between the “l” and the “r” sound in Kinyarwanda. Furthermore, it’s extremely unusual to have two consonants together. (When asked about my morning runs, neighbors want to know if I went “es-po-ro”. Yes, I went sport). Introducing myself as Alma often makes people scratch their heads. A-RI-MA? AN-I-MAR? ANA? ANNE MARIE? Umuzungu!

Dad, I think you would be happy in Rwanda. Rwandans take name formalities beyond last names (which actually don’t exist here-- you have a Christian name and a Kinyarwanda name, no such thing as family name).

In Rwanda you address people by their title or status. For example, no one calls the Hospital Director in my town Bosco. We call him Director. Older people are addressed as umucecuru (old woman) or umusozi (old man) to show respect. Parents are addressed as Mama or Papa followed by the name of their oldest son (or daughter if they have no sons). When people call me umuzungu (white person) it’s not meant as a racial slur, it’s just what I am. The same way the driver is umushoferi and the storeowner is umucuruzi.

I struggle with this. Yes, I am an umuzungu, but I am not the same as every other umuzungu in Rwanda. I am Alma. I like addressing people by their names.This could be because while growing up in the United States, my first name was rather unusual, and a source of insecurity during my early years of high school. If this is the case, Dad, I will bill you for the psychotherapy later.

It is, however, much more likely that my preferences are generational. In this case, Dad, I’m afraid you are out of luck. For me (and I think this is an opinion held by many of my generation) the ability to remember your name, to identify you as an individual, is my way of showing respect.

Now, I am a Peace Corps Volunteer as well as my-American-father-and-Spanish-mother’s-daughter. I am aware of the importance of culture and respecting it. In Rwanda I will call Bosco Director and I will call my neighbor, Donatille, umucecuru. In the United States I will refer to people of my parents’ generation as Mr. or Ms blah-blah-blah. But everyone is free (and in Rwanda, encouraged) to call me Alma, especially if you can pronounce it correctly!

The Walk Home

Hosting visitors in Rwandan culture is an honor. When you have a guest, you offer him the very best seat in your house, the very best food and/or drink available, and, when it’s time for him to leave, you walk him home. I love this tradition for many reasons. Most importantly, because when I visit people among the many hills and valleys in my community I usually have no idea where I am so I appreciate the guidance back home. 

This custom can, however, create some confusion when you reach home and suddenly visitor is playing host and host visitor… and then we’re walking again in the other direction.  Last week I was party to such a predicament, when after walking my friend home (a thirty-five minute walk uphill) I was invited in to look at photos and take some lemons from the family tree. After the usual series of greetings to family members, neighbors, and curious children, my friend walked me back to our original starting point on the other side of the valley. No wonder Rwandans are so fit!

Culture Moments

Those of you who think I spend my day saving the rainforest while teaching Rwandan baby girls how to create microfinance cooperatives are sorely mistaken. PEACE Corps is first and foremost about friendship and cultural exchange. Volunteers are “ambassadors of peace”, and that is what I work hardest at everyday. Some of my favorite cultural exchange moments so far have included:

•   Michael Jackson’s Black or White. I watched the video in the teacher’s “lounge” at the secondary school on my friend Fulahar’s laptop. Eight of us crowded around the screen and watched the late King of Pop dance on the top of the Eiffel tower and sing with a group of “African tribesmen”. I highly recommend you watch the first minute or two so you can appreciate the irony. Almost five months I’ve been pointing at my skin and the skin of whatever Rwandan is telling me I’m rich because I’m white, saying “cimye!” (same!). Thanks MJ, for the validation.

• Birth Control.  After scanning the register of abandoned birth control appointments, I ask one of the nurses why more people don’t use contraception. “PF is for married women who already have children”, she responded. PF stands for planification familiale, family planning in French. This very politically correct term is unfortunately taken too literally in Rwanda. So, being the former Planned Parenthood volunteer that I am-- I try to explain to my counterpart that women of all ages and marital status should be encouraged to use birth control if they are sexually active. Birth control has many benefits I tell her. Like what? She asks. Well, in America many young, unmarried women use it to help control acne, I respond. Suddenly Mama Eric’s eyes light up: ALMA! YOU SHOULD TAKE BIRTH CONTROL!

• Jehovah’s Witnesses, Part II. On our way to visit a cooking class, my counterpart and I ran into two very well dressed young men walking awkwardly through the hills. Mama Fils greeted them with her familiar warmth, asking about their day and work as if she had known them her whole life. When it was clear that I was confused, she explained to me that they were Jehovah’s Witnesses, and they promptly handed me newsletters in both English and Kinyarwanda. After they left, I told Mama Fils there are also Jehovah’s Witnesses in the United States but people don’t always like them because they come to your house uninvited and want you to change religions To this, she nodded and responded matter-of-factly, “no one here likes them either”.

I get a lot of emails asking me, congratulating me, about my “work”. I am doing (well, more like witnessing) a lot of really fascinating progress at the health center. Still, when I chart a child’s positive growth or correctly show a mother how to sanitize water, I rarely feel satisfied. The 100 grams a malnourished baby gains in a week can be lost in a day, and for all the worms expelled after taking Mebendazole, there are a million more swimming in the water. I am not here “saving the world”, or even my neighborhood. But I am learning a lot, I am teaching a bit, I am greeting and visiting a ton, and I am laughing, everyday with a couple new friends. This is the work I enjoy the most, and feel most satisfied with.

Donath

Donath is just under sixteen months old. He weighs 6.3 kilograms (13.9lbs) and his MUAC (middle upper arm circumference) is 110mm. This makes him a severe, chronically malnourished child. He should be in the hospital. Instead, he is part of the health center’s Outpatient Therapeutic Program I work with every Monday. He has been in and out of OTP for ten months (theoretically, children should be “cured” within six weeks), and his weight has not fluctuated more than 500 grams.

When I first noticed Donath’s lack of weight gain despite the many sachets of Plumpy Nut we gave his mother every week, I mentioned it to my counterpart, Mama Fils. “Yes, he is very sick”, she said. We brought him and his mother into our office and asked her if she would agree to take an HIV/AIDS test. Teary eyed, she agreed. The test came back negative. We counseled her on proper nutrition techniques and hygiene.

Community Health Worker measuring a healthy child's MUAC

Two weeks later, still no change. I mentioned the problem to Mama Fils and again we brought Mama Donath into our office. Between long sighs, quick sobs, and a very shaky voice Mama Donath agreed that she would bring her son to the hospital across the street for intensive care the following day, after she made the necessary preparations. The next day Mama Fils told me Donath would not be coming. “Don’t worry Alma, I talked to his mother,” she assured me after seeing my frustration.

Another three weeks have gone by and on this particular Monday I insist Donath go to the hospital or he could end up dying. So Donath and his mother are back in our office. There are more sobs and head shakings, and this is when I learn why Donath cannot go to the hospital. Donath and his mother live alone, because Donath’s father was a genocide perpetrator and is now in prison.

In Rwanda (and most other countries in Africa) most hospitals provide you a bed and the necessary medications. Patients are generally not admitted unless they come with a family member who will be around to feed, bathe, and generally care for them. If Donath’s mother takes him to the hospital, no one will farm her plots and she will have no food to feed him, so she doesn’t take him to the hospital. Instead, she continues to farm sweet potatoes, and Donath’s body remains too weak and malnourished to absorb any of the nutrients she is able to feed him.

Rwanda is a country making incredible progress on a daily basis. It has been seventeen years since the Rwandan genocide, which means that the children running around my neighborhood were not a part of the horror their parents witnessed. Still, they are far from unaffected.

Move (Again)

I moved again! Luckily this time it has not involved moving continent sub regions, countries, or even provinces. I just moved down the street.

As I mentioned in an earlier post, I moved into a very nice, four-bedroom house, on the health center compound, with four Rwandan roommates and, for a month, another Peace Corps Volunteer. There were a lot of benefits to having company when I got home from work and not having to prepare my own meals, but the truth is that the situation was far from ideal for me for many reasons. The previous volunteer invited the roommates to live in the house for free, which, bottom line, made me very uncomfortable.    

View from my backyard

I have been told the first three months at site are the most challenging. I don’t yet have the rest of my service to compare it to, but I do really hope this is true.

Since arriving in Rwanda, I have had a lot of great moments, but also a lot of unforeseen challenges and frustrations, particularly as they related to my housing situation and the community’s perception of me as a simple clone/continuation of the previous volunteer (only she had perfect Kinyarwanda, I am reminded daily). All of this combined with the evacuation from Niger has, over the last few months, seriously made me doubt my abilities to work and live in Rwanda. 

But now I have a new house, and a new outlook on life! I live a little further away from the health center, in a much more modest house, without electricity, and with lots of wonderful neighbors, including at least a dozen children who run and scream every time they see me coming and are always ready to greet me with toothless smiles and big hugs. And with daily hugs from my five year old friend Valentine, where else in the world would I want to be?!

 

Birthday Celebrations

On June 11^th I celebrated my 23^rd birthday in Rwanda. Thank you all so much for the birthday emails/calls, they really made my day! 

With my coworker, Yvonne

The day was a pretty “normal” Saturday. I taught my weekly English class to the secondary school teachers, I set up my hammock for the first time (thanks Max!!), and in the evening I invited my boss, my new landlord, my former roommate, and my counterpart for a beer.

The highlight of my day, and the best birthday present I received, happened rather casually. I was sitting with my friends at the bar waiting for order, trying to follow the conversation. At one point someone asked me if I understood what was going on, to which I responded honestly, “a little bit”. As usual, this made everyone laugh.

My boss, a man of few words, looked straight at me and quietly, but certainty, said: “by October you will know everything”. The comment was a huge vote of confidence for me. I’ve been struggling a lot with the language because 1) it’s hard, 2) I generally work well when I receive positive reinforcement, not daily reminders of how fluent the previous volunteer was, and 3) the truth is it is possible (not easy) to communicate in Rwanda with only English/French.

The small comment was just the push I needed. Assurance that someone else here believes in me was just the birthday present I was looking for.