May 28, 2008

New Book

The end is in sight for “Charlie and the Chocolate Factory” and as I know there are teachers, authors, and avid readers among the audience for this blog, I thought I’d solicit some advice for its sequel.

I am looking for a new book to read with my high-school English class for the second half of the school year that begins after a winter break in late June and early July. Ideally, it would be something about the same level as “Charlie” and something that speaks to a group of young women, some mothers, living in poverty in South Africa. I think as a group we are collectively done with Roald Dahl, as his made-up words and word play just make things more complicated and generally unintelligible. Plus, there’s a wonderful diversity of books to read and I don’t want to limit us to just one author. And don’t suggest “Charlie and the Great Glass Elevator,” a natural sequel: it’s just too weird and I don’t like it.

I’m also tossing around the idea of beginning a similar reading group for a slightly younger group of students, say grades 8 and 9, and welcome ideas for books for that group. Something a little less challenging than “Charlie” would probably be best.

Send me your thoughts and suggestions by e-mail or leave them in the comments. If you’re interested in buying several copies of the books and sending them to me, be sure to let me know that as well!

What do they know?

During our mission training, we talked a lot about “isomorphic attribution.” Basically, the idea is that when you are working in another culture and you’re trying to figure out why somebody is doing something, you assess their motives in terms of their own cultural background instead of yours.

In some instances, this is easy. Why do Xhosa men head off into the bush for a month before getting circumcised in a public ceremony instead of just ducking into the hospital for a quick surgery (done with the benefit of anesthesia)? It’s likely because they understand circumcision as part of their journey to manhood and their culture dictates that they prepare for it in a certain way.

But there’s a crucial part of isomorphic attribution that is actually quite difficult. And that is figuring out just what beliefs and traditions the other person is carrying inside of them that dictate their behaviour. It is impossible for me to separate my decision-making process from my years of education, specifically what those years taught me about logic, probability, science, and on and on and on. But when you work with a community of people who are very poor and relatively uneducated, I’ve realized I can’t assume my decision-making processes apply to them as well.

When I was a baby my parents made sure I went to a doctor and got all my required immunizations. No doubt they did this because they had been raised with the belief that they should do what doctors told them and they cared deeply about my health. But some mothers here are downright casual and cavalier about making sure their babies get their immunizations on time. (Many, however, have the same devotion and seriousness of purpose about immunizations that I am sure my parents had.) To a western-educated mind, this is completely irrational. These mothers are turning down a free immunization that will go a long way towards guaranteeing the health of their baby and this in a place where lots of the diseases these immunizations guard against, like polio or measles, are still a credible risk. Why would anyone do this?

There are many answers to this particular question, I think, and it’s figuring out all those answers that makes cross-cultural work so difficult (and fascinating). Some caregivers actually aren’t mothers at all but grandmothers, aunts, cousins, etc. on whom the child has been dumped by the mother. In that case, the child might just be one more problem to be managed and taking preventative steps might just be too much of a demand on a woman already overstretched by other commitments. Or the mother may just not have the same belief that we westerners do in science and medicine. (I saw an article in a magazine not long ago that claimed to link the polio vaccine to HIV. The scary thing is not the claim itself but that people will believe it.) They might believe some of their medical problems can be solved by traditional healers.

I think this question of “just what do they know?” is particularly important when it comes to HIV. I hear about people with multiple sexual partners, who don’t use condoms, who let STDs go untreated, who refuse to get tested for HIV, who, if they are positive, don’t bother to try to get ARVs and don’t do all the little things that will strengthen their health. And I ask myself, “Why on earth would someone ever act like that in a place where HIV is so widely prevalent?” It is, by my standards, completely irrational and inexplicable.

And yet I believe all people make rational decisions within the confines of what they know to be true. Perhaps some men see condoms as an insult to their manhood or a sign that women don’t truly love them. Perhaps people don’t see the connection between STDs and the ease with which HIV can spread. Perhaps people are just too scared too find out if they have a life-altering virus and would rather not know than know. Perhaps they don’t realize that HIV can, in many instances, be managed and is not an immediate death knell.

The challenge, then, is sussing out all these different beliefs and attitudes that are deeply enmeshed in a person’s brain and that lead them to rationally make irrational decisions. It is a difficult task and a difficult adjustment, not helped by a gargantuan language barrier. But I’ve learned that asking someone, “Have you been tested for HIV?” really doesn’t get you very far. No one wants to talk about this and everyone would prefer to just change the subject. A better way, if you can get on to the topic of HIV in the first place, is to ask why they don’t use condoms or talk about all the treatments available for HIV now and how people can live quite long with the virus if only they find out early.

The dominant approach to HIV prevention used by aid agencies around the globe is the ABC method: abstain, be faithful to one partner if you don’t abstain, use condoms if you’re not faithful. It is completely rational and easily understood…in the Western context in which it was created. But in another culture? Maybe not. How can I abstain when I’m being raped? How can I be faithful when my partner isn’t? Why would I only want one partner when more would be a sign of my status? How can I use condoms when he refuses to? Why would I use condoms when I believe HIV has been put in them to kill Africans? I have heard it said - and I think I mostly agree - that combatting HIV in sub-Saharan Africa is as much or more a cultural battle as an educational one.

So, anyway, isomorphic attribution… easier said than done. What else is new about mission?

“Uzihambela wedwa!”

One thing I didn’t know a lot about before my arrival in Mthatha was child development and all those milestones infants and toddlers pass as they grow. But in Itipini, I am constantly surrounded by young children, ranging from newborns to almost ready for first grade and it’s been neat to watch these children grow up.

At first, I wasn’t even aware that I was watching them change. I was just sort of vaguely aware that a child who used to be easy to pick up now strained my back when I lifted her onto my shoulders or a child who used to sit on the floor in the clinic now spent his visits crawling wildly all over the place. Now that I am consciously aware of what’s going on, I’ve been watching for it. It’s fun to watch a child take some of its first tottering steps or see a young girl come to pre-school for the first time or marvel at how tall some children seem now.

And it goes without saying that if I share a moment like this with the child’s mother, it binds the relationship between me and the mother that much tighter. It is amazing how touched a mother will be when I notice that their baby is now walking all on his own. (That’s where the title for this post comes from - it’s Xhosa for “he’s walking by himself!”) About two months ago, I took a young woman (age 15) to the hospital after her water broke. Maybe by the time I ever get around to leaving Mthatha, that child will be walking.

(There’s the converse, too, namely that children who should be passing milestones are not and I’m trying to stay aware of those unchanging children too.)

On the list of things I hoped to learn when I came to South Africa, more about child development was not one of them. But now that I’m here, I’m grateful for it and it’s only because I’ve made a long-term commitment to this place.

Sad/Said

I’m fortunate that at Itipini a few of our staff members speak English. Not only does this help me do my job, it’s helped me form deeper relationships with them. (Though I’m at the point now where language is less of a barrier for the Xhosa-only staff.)

Still, there are problems, epitomized by one conversation I had not long ago with Mkuseli, our after-school director. We were doing our best to speak in Xhosa and I had to ask in English about a vocabulary word.

Me: “Coach, how do you say ‘sad’ in Xhosa?”
Him: “‘Sad’? It’s ‘watsho’.”
(I already knew “watsho” and it means “he said.”)
Me: “No, not “said” but “sad.”
Him: “Yes, ‘watsho.’”
Me (a slight note of aggravation creeping into my voice): “No ‘sad’!”
Him: “Spell the word.”
Me (thinking I’ll get somewhere now): “S-A-D.”
Him: “Yes, ‘said.’ ‘Watsho.’”
Me (very aggravated): “No, not S-A-I-D, S-A-D!”
Him: “‘Watsho’!”
Me (resigned to defeat): “Forget it, how do you say ‘cry’?”

I have conversations like this every single day. A lot of people in Mthatha speak some English but not a lot (at least of the ones I interact with) are fluent or are used to an American accent. So I am always thinking of ways to simplify my speech, find a common vocabulary, say something I can translate into Xhosa, and so on and so forth. I think it is one of many reasons I come home at the end of the day so exhausted. Working here just takes new energy in parts of the day when I’m not used to expending any.

“With a capital T and that rhymes with P and that stands for...”

Earlier this year, we had an old pool table donated to the gym we have for the after-school children. It was immediately seized upon by some young men not much younger than me, who passed long hours in the morning there for several weeks. (And they had the audacity, while playing pool, to ask me for money for food.)

Jenny eventually had the bright idea of asking them to re-paint some of the walls and buildings in our area. That cleared everyone out except one lonely fellow, who’s been working hard these past several weeks.


And now the pool table is being used by the children we had hoped.

May 24, 2008

Nobathembu, Victoria, and Ayabulela

Here’s a story about three people I know and a difficult decision confronting them.

Nobathembu is a woman in her mid-40s or -50s. She has HIV and on a recent blood test returned a CD4 count of 22. This is in I-can’t-believe-you’re-still-alive territory. Under 200 is clinical AIDS according to the government and qualifies you for free anti-retroviral drugs. Not only is she still alive, however, she appears to be thriving and showing no outward signs that her immune system is under sustained attack from HIV. I frequently see her walking the long road from Itipini to town, pushing a wheelbarrow full of groceries or balancing something on her head.Nobathembu’s daughter is named Victoria and she is one of the students in my after-school English class. Victoria is 18, in grade 10, and wants to be a doctor. She’s a good student and her dream is at least plausible.

She also has a young son named Ayabulela. Ayabulela is a bundle of joy who used to come running over to me whenever he saw me. But one day he saw me playing my guitar for the pre-school children and since then has been petrified. He only comes near if I woo him with stickers.Nobathembu looks after her grandson during the day so her daughter can go to school.

Since Nobathembu’s CD4 count is so low, she should be in the midst of the long process to begin anti-retroviral treatment. But she hasn’t even begun. She’s not allowed to begin until she can find a treatment support partner who will go with her to all the appointments and ensure, for the rest of Nobathembu’s life, that she takes her pills as required. The problem is that Nobathembu can’t find a support partner. There are some men in the family but none appear interested in helping and none, certainly, are convicted of the gravity of the situation. (I’m not sure Nobathembu is either.) There aren’t any other women who could go with her, except a sister who lives in a village outside town who can’t really afford to make it to all the appointments. So that leaves Victoria as pretty much the only option.

But that is problematic. If Victoria becomes her mother’s treatment support partner, then she’ll miss lots of school going to all the appointments (the clinic isn’t open after school). But if Nobathembu doesn’t get on ARVs, her health is going to deteriorate dramatically and ultimately she will die. (Every other person I’ve ever met with a CD4 count below 50 is now dead.) If she dies, who’s going to take care of Ayabulela? Victoria will likely have to drop out of school to tend to him.

It’s awfully hard to provide advice in this situation when every option seems to lead a worse conclusion.

Catching Up

Some favourite pictures from the last month





KNOM Abroad

I'm sure my friends in Alaska will appreciate these pictures.




Swings!

I’m not quite sure how it happened but some weeks back the cross bar on our swing set went missing. Mkuseli saw this as a problem of dire proportions and immediately resolved to make it right by constructing an almost entirely new set. This was a project that ended up stretching over weeks. My contribution was the purchase and primarily the transport of the new five-meter cross piece across town, perched precariously on top of the truck.

But the results have more than justified the effort.

May 17, 2008

I've Been Sitting, Watching, Waiting...

So my new computer is en route to Mthatha. Unfortunately, it's been en route for the last two weeks and doesn't show any signs of getting here soon. The delay appears to be South African customs in Jo-burg. I guess there's nothing to do but sit and be patient - not someting I'm good at.

In the meantime, the swirl of events at Itipini continues its increasingly frenetic pace and there have been so many blog-worthy moments in the last several weeks, I'm going to have to write a short dissertation just to include them all when I actually get a computer to type on. But the themes will all be familiar - HIV kills people, children are neglected, no one speaks any English, and somehow we all endure.

I've been fortunate to have a steady stream of visitors to my rondavel these past few weeks, friends old and new who're in South Africa and were itching for a trip to Itipini. (A friendly reminder that the offer is still open to all of you, should any of you ever want to seize on it.) In my free time, I've finally picked up the Harry Potter series and have read through the first six books but have now stalled for want of the seventh. (And what a cliff-hanging place to stop!) It's been nice to escape this world and be engrossed in another for a while.

My thanks for those of you who have been sending me those lengthy, newsy e-mails (no better way to support me than writing one of those!). I haven't responded not because I don't want to but because I just can't afford the Internet time it would take to say all I want to. I will, though, someday.

Maybe that computer will show up someday soon and I'll be able to post something that wasn't dashed off in five rushed minutes in the Internet cafe. Until then, well... this will have to do.

P.S. If you're looking for a thoughtful and beautifully-written reflection on mission, check out this one from my friend Kate in the Dominican Republic. It gave me a lot to think about.

May 7, 2008

A Slice of News

Check out this article about living statistics in my adopted province, the Eastern Cape:

THE Eastern Cape is no place to live, get sick or go to school. And ranked against the other eight provinces, a South African Institute of Race Relations survey has given this province the thumbs down....

According to the survey, barely half the people live in formal houses, no other province has such a large proportion of the population without water, electricity or cellphone access and only North West has more homes still relying on bucket toilets....

On the education scorecard, the province fails dismally. Fewer than one in five people have passed matric, 15% of the people cannot read or write and fewer than one in 10 pupils gets a university entrance matric....

As has been highlighted during the past year, healthcare is the province’s worst feature with the highest incidence of diarrhoea among children, high and rapidly growing levels of HIV and TB infection, an average life expectancy of only 48 years and only one state doctor for every 6273 people.

And if those statistics are averages, just imagine what it is like in Itipini, a distinctly below-average part of the province.

May 3, 2008

Update

I realize I haven't shared with this audience an important piece of news I recently shared with the growing audience of my monthly e-mail newsletter: I've opted to extend my time in Mthatha beyond the expiry of the initial commitment in August. After a break in August and September, I'll be back here and back to work in Itipini. I'll have more to say about this decision once I sort out my computer situation and can compose posts off-line.

Speaking of that situation, life has been different these last two weeks without my laptop around but it seems like I've been so busy at times I've barely noticed its absence, except when I want to sit down in the evening to compose long e-mail replies to all those wonderful e-mails people send me. For now, that will have to wait.

Thanks to the generosity of a number of people scattered all over, I've ordered a new laptop. God willing, it will be here within a week or two and I'll be back in the saddle again, blogging wise.

In the meantime, you'll just have to imagine what I've been up to as the weather turns wintry here, food (and gas) prices continue to rise dramatically, and I imagine what I can do here now that my departure date has been pushed back.