TIMMY BOY!

It's Tim's birthday today, so I'm doing a top ten reasons why my roommate Tim Grose is awesome:

10. We fought long and hard together to get the CD player in the purple beast to work.  It was a combination of faith, determination, and commitment.  And the first CD he played?  Wait for it...  One of the only CDs worth the struggle.  Led Zeppelin.  Fuck yeah.
        10a. When the CD player spits the CD out yet one more time, he belts out "Time after time" from the radio with the best of them, without a hint of disappointment or frustration about the loss of the Zeppelin.  Holler.
9. We both have accepted that we are obviously cast members in some ridiculous candid camera reality TV show, perhaps titled "TIA, This is Africa".
8. He eats everything I put in front of him and says he likes it.  Good man.
7. "Oh man, that one's nice...  floral prints... they just get me everytime..."
6. He calls himself Timmy when he is talking to himself.  Example:  During tennis match with local minister - "Damn it Timmy!  Get it together!",  "What the fuck Timmy?!  Jesus..."  Priceless.
5.  He loves to dance
        5a. He is not afraid to dance in his underwear.  With other men.  Also in their underwear.
        5b. He loves Phil Collins.
4. He's an awesome mother fucking lifeguard.  Dedicated to the cause.
3. He loves it when I burp :)
2. AWA = Africa Wins Again v. AFY = America, Fuck Yeah
1. "You have never lived..."

Happy birthday Timmy boy (aka Timbo Slice)!

It should also be noted that we have a new roommate, who is also awesome, but Tim will always be OG.  Don't worry, she will be introduced in the blog soon enough.

Next week I will continue with the holiday chronicles...

Maputo

Sorry the posts have been so infrequent.  Writing a big grant last week.  But, I'm back in action.  So on with the story!

Part deux: Maputo

After obtaining sustenance, on a mission for a SIM card, which ended up being a lot more of an adventure than expected.  Apparently, Mozambicans are tough bargainers.  They are actually willing to watch you walk away unless they can kind of sort of rip you off.  We were able to complete our mission in the sense that we obtained a SIM card, getting it working was another story.  When we got back to the hostel, the other Peace Corps people we were traveling with had arrived.  After swapping travel stories, we proceeded to watch multiple hours of Trace TV, aka all music videos, all the time.  Awesome.

Eventually we picked ourselves up, cleaned off, and headed out to dinner to meet more Peace Corps people, Claire's friend from college who does Peace Corps in Mozambique and some of her colleagues.  Very fun, very Peace Corps.  We made plans to meet up with them the next day and then proceeded to return to the hostel to pass the fuck out.

The next day we got up and set out on an adventure to figure out how to get the cell phone working.  But, first things first, food.  The beautiful thing about Mozambique is that they were colonized by the Portuguese, which means they can make mean baked goods, bread, croissant, you name it.  So obvi we had to stop in and nourish ourselves before setting out on our mission.  A couple cinnamon rolls later, we were off.  We didn't make it very far before we felt it necessary to stop again for pastry stop part deux, with an added bonus of European influence, awesome coffee.

After this we did manage to get the cell phone working, with the help of a little haggling and some kind strangers, including a large security guard with a large gun.  Abrigado!  (Thank you in Portuguese)  So multiple pastries and a working cell phone later, we set off sight seeing in Maputo.

Maputo is a cool place, lots of old school European architecture from the Portuguese influence, including lots of squares with greenery and such that are very nice to walk around and relax, but it almost looks like a giant fire swept the city with the scars of the revolution still very present.

 
Not to mention all the streets are Avenida Vladimir Lenine, Avenida Mao Tse Tung, etc, etc.  Oh yeah, did I mention it was a Communist revolution?

We walked the city to arrive at the main market.  Mozambique's speciality: cashews.  And I have to say they are the best cashews I've ever had.  How can cashews be THAT good you ask?  I don't know, but they roast them in these charcoal fires and they are just unreal.

After the market, we headed across the street to this amazing fabric store.  Everywhere you look in Mozambique you see the most beautiful, bright, and vibrant fabrics.  They use them for everything: skirts, aprons, to carry their babies, carry their food, bedspreads, tableclothes, pillows, you name it.  You get the best show because most women tie them up to wear as skirts, often protecting their clothing underneath.  They call them capalanas and are sold everywhere you go as pre-cut bolts of cloth that are the perfect size for a wrap around long skirt or dress.  They are just gorgeous and are pretty freaking cheap.  And this store we walked into had the most amazing selection I have ever seen, probably at least 500 different patterns.  We definitely had to practice some self control being as we had limited space in our backpacks.  But, I definitely made a return visit on my way out of the country.

After shopping, it was obvi lunchtime.

So good!  Moz has some badass seafood.

We then went to meet up with Claire's friend and posse.  We actually met them at a Chinese restaurant, which was kind of a trip.  Too bad we were too full to eat.  We then headed off to this amazing photo exhibition:
http://www.worldpressphoto.org/index.php?option=com_photogallery&task=blogsection&id=20&Itemid=257&bandwidth=high
Check it out if you get a chance.  It's a little intense at parts, but really moving.

After the show, we took advantage of our unofficial tour guides who took us on some sightseeing and souvenir shopping.  While getting caught in a rain storm, we picked up some stuff for dinner to cook at the hostel.  After an.... "interesting" dinner, we headed out to a jazz show.  It was awesome music, but very African, not just in the sense of the musical influence, but as in play one song, take a 30 minute break aka drink a beer, play another song, another break.  Seriously?  They were lucky their music was good.  We headed home decently early because we had to go catch a bus at 4 AM.  Yes, you read correctly, four in the morning.  And thus, the adventure continues...

Holiday!

Check with the OneSight, now on to the good stuff, HOLIDAY!  Woot woot!  So, this holiday extravaganza will probably be spread out through a few posts, because it's just too good.

Part 1: To the border and beyond

Day 1:
Met Claire in town.  About two minutes after Tim dropped me off I realize I have forgotten malaria prophylaxis, an essential for any trip to Mozambique.  Way to go team.  Decided to worry about that later.  Ran a few errands, and then off to catch a taxi.  It was weird walking around town with our backpacks and stuff, being treated as a tourist.  We were lucky and got a couple seats on a taxi right away and didn't have to wait too long for the taxi to fill up.  Okay, probably should define taxi in African terms.

Taxi- a kombi, aka like a VW bus, that they stuff full of people and/or cargo with a pre-determined location and usually a pre-determined route (often this is pretty straight forward as there is only one route from point A to point B).  So you get on a taxi whose end point is your destination or your destination is somewhere on their route or their end point is another taxi depot along the route to your destination where you can catch your next taxi to continue your journey.  Prices are based on how far you are traveling, obviously you pay more for the farther you go on the route.  Prices are pretty set, especially if you are a local, but bartering can be done, especially if you are a tourist and getting ripped off. :) Ok, I think that is good enough for now, more taxi stories to come...

Had an uneventful taxi ride to Manguzi, a few hours.  We were staying with another Peace Corps volunteer, a lovely girl named Carly, that neither of us had ever met, but she was more than gracious to welcome us into her home.  While we were waiting for Carly, I decided I was supes hungry and had to have something to eat.  Of course.  So we go to KFC.  Obvi.  Because there are KFCs everywhere in South Africa.  And within the first three bites I lapse into an awful esophageal spasm.  Oh and their bathroom is out of order.  Awesome.  If you don't know what is involved in an esophageal spasm, no need to get into the details, all you need to know is that it's awful.  And involves me hacking up a lot of loogies.  So, now I have to meet my lovely host hacking loogies.  Oh and then we spend the rest of the day in town running errands and meeting other very pleasant Peace Corps volunteers, all while I'm hacking loogies.  Awesome.  And somewhere in all of this that I managed to obtain some malaria prophylaxis.  Mefloquine.  Gnarly dreams.  Woot woot.

When we finally got to Carly's house, I was able to do some meditation and relax enough for my esophagus to chill the fuck out.  Thank god.  I was starting to get concerned about my hydration in the summer heat cause I literally couldn't even swallow a sip of water.  We then prepared a nice pasta meal that I was able to partake in.  Sweet!  Sustenance!

Soon enough it was bedtime (in the village- when it gets dark).  Carly had never had guests before, but she suggested we try sleeping on the floor on top of a giant, fluffy leopard blanket. 

Sounds pretty good to me.  Oh wait, until you turn the lights out, and all the crazy mother fucking bugs come out!  First it was the noises.  We heard this bug buzzing around and bumping against all the walls.  And you know how you can tell the size of the bug by the noise it makes?  Well, yeah, this was a big mother fucker.  So, we finally decided to turn the lights back on to find this bugger after a few too close encounters where we heard it buzz right by our face slash felt it tickle our legs.  Eeek!  With the lights on, we failed to find our culprit, but instead found a gnarly ass spider just chilling on the wall.  Awesome.  Thank god for big bad Claire who had the guts to kill it with a flip-flop slash was refusing to sleep knowing that thing was alive and crawling in this place. 

After that extravaganza, we opted to create a circle of Doom! and fold the blanket in half and burrito ourselves for protection on this ridiculously hot summer night.  I mean, obviously.  As Claire is securing the perimeter with Doom!, I'm trying not to suffocate as I fold the blanket in two to create our caccoon slash sauna of safety.  Oh but wait!  Holy shit!  There is a giant mother fucking millipede just chilling, scurrying around the middle of our blanket.  No fucking way!  Claire proceeds to fling it off the blanket with her handy dandy flip-flop.  And Doom the thing to death.   What a way to die. 

Ok, so fan-fucking-tastic.  That's it!  We are absolutely, definitely not sleeping on this floor.  My suggestion: gear up- aka put on jacket/sweatshirt with hood up, zipped to top, put chairs up against wall, wrap blanket around legs, shoes on.  Sounds totally, completely reasonable.  Who cares that it's sweltering hot in the little hut?  Done.  And so we rested/slept like this for a couple hours.  Then Claire suggests that we shimmy our way over to the desk across the room where we could lay our heads down.  Um, yes.  I was totally just thinking that! 

Another couple hours of rest/sleep, pouring sweat as we are still totally wrapped up.  Let's just say it was a cleanse.  Now this seemed totally practical to us at the time.  No laughs.  Okay, maybe a couple laughs as we imagined our hostess coming out to find us sleeping in such a predicament.  Needless to say, we were up before her and didn't have to live out this scenario.  Though our answer to "So, how'd you sleep last night?" was entertaining.
"Ummm.... interesting...."
"Interesting?"
"Yeah, we slept on your desk."
Carly looks at her one foot by two foot desk, back at us, back at her desk.
"I mean, we used your desk for our heads... we were sitting in the chairs..."
Break into laughter.
"Loooong story."

Running pretty much on pure adrenaline due to exhaustion, we caught a taxi into town and soon enough were in a taxi on our way to the border.  We actually arrived at the border before it was open, second in line to cross.  Way to be on the ball team.  Benefits of waking up at the butt crack of dawn because of shitty sleeping arrangements.  The sweetest gogo helped navigate us through the border and onto a taxi and onto our way to Maputo, the capital of Mozambique.

The taxi ride was an adventure, basically sand "roads".  But, we had a badass driver that managed to work our kombi, weighted down with people and cargo, down the path, passing many stuck vehicles along the way.  The scenery was... pretty desolate.  Just open plains, a few hills, maybe one village, no crops... oh, and then a giant metropolis pops up across some water. 

Ummmm... WTF?!  Is it Maputo?  It has to be Maputo... I mean, maybe...  It has to be Maputo?
Now we are stopping.  Across from this metropolis.  Is this our stop?  Are we here?  Maputo?  Sooo confused...
Yes, we're here, get off.
But, Maputo?  This is Maputo?
Take boat.
Oooooooh.  Boat.  Boat?
No one said anything about a boat.
Hmmmm... Well let's get on a boat.
Two.  For the boat.  To Maputo.
Big boat or small boat?
Ummm... what?
Crap.  There are two boats.  Big boat or small boat?
What's the difference?
Small boat maybe quicker?
Maybe quicker?
Big boat or small boat?
Big boat or small boat?
Ummm... Big boat!  Let's do it!
Woooo!  Big boat!

And big boat it was.  Aka giant car ferry.  But, hey it was 10 meticals, so we're talking maybe 25 cents.  Hells to the yeah.  Soon enough we were in Maputo and our way to the hostel.  After we dropped off our stuff,  we got some awesome pizza and Appletiser, aka the best drink in the whole world, 100% juice + bubbles.  Africa definitely does a few things right.

And I'm back!

Where to begin?  How about where we left off?  One Sight.  Oh One Sight...  What is there to say?  Let's start with what it was and then I will explain how it was.

One Sight is an international NGO that is based in the United States that provides eye screening and glasses on site.  It is a pretty cool service and definitely much needed.  They provide these services around the world through makeshift clinics made up of an international team that come in for about two weeks.  Their team they brought with them was made up of 40 people, including probably six optometrists.  This is the second year we have partnered with them, doing all the ground work, utilizing our established relationship with the community and constant presence in country.  We also provided our services of health education, health screening, and VCT (voluntary counselling and testing) with nurses on site to provide basic care.  Last year when they came, we spent the entire two weeks servicing our local community in Mtubatuba.  This year we opted to service the other four municipalities in the area, spending two days in each over two weeks, particularly targeting rural, underserved areas.  This meant that the first week we got to stay at a swanky hotel to more easily reach the sites, which was very exciting for our staff, many of whom have never stayed in a hotel before, much less a swanky one.  They thoroughly enjoyed their swankster selves.

The nitty gritty of how it went down:
Refer to the awesome flowchart that I featured in one of my earlier posts.
The line,












patients attend health education,
register,

                                                                                                  Snellen chart,

eyes dilated (by me!),

auto refraction,













opthalmoscope exam, and then receive glasses, medication and/or referral if needed, got donated sunglasses to protect their poor dilated eyes (and also to look really freaking cool- hence how we drew the kids in).

The OneSight team brought some basic meds, like antibiotics, steroids, etc.  And then they would refer out for follow up of bad infections, anything surgical- cataracts, glaucoma, scarring- or anything beyond their supplies/resources of our makeshift clinic- children with strabismus (cross-eyed). 
Finding the right pair of glasses was pretty cool.  They had thousands and thousands of glasses that had been donated, new and old, and they had organized in boxes.  They would then enter in the perscription from the auto refractor into a computer system that would search through all the glasses remaining and find the best match.  This was correlated with a code that they could then use to find that pair among the thousands they had brought, which were then fitted to the person's face, and ta da!  They could see!  Pretty freaking awesome if you ask me.  I heard some awesome stories of little old people doing jigs when they got their glasses so excited about seeing.
Sadly I didn't really get to witness this because I was stuck in the dungeon of pain and torture.  Bwahaha.  Aka I dilated eyes.  In Zulu world, dilating their eyes means causing them pain and blinding them, so needless to say I was not their favorite person.  But, damn, did I dilate the heck out of those eyes!  Lots of them.  Thousands of them.  And I did start to notice one thing after pulling down all those eyelids.  The young people, especially adolescent females, had incredibly pale conjunctiva, suggesting anemia.  I guess I shouldn't of been surprised considering my awareness about their nutrition, but a couple were so sever that I insisted they get a referral to the clinic to get supplements because our nurses had run out.  I told the OneSight team that they should start taking advantage of looking at so many conjunctiva being as they are usually working in populations at risk for nutritional deficiencies.  The optometrists were less than excited about it, being optometrists and all.  But, I think it could be a really cool public health partnership, so if anyone can think of a way to make it efficient and sustainable, like perhaps a partner program/organization to provide the supplements, and what happens when a patient runs out being as OneSight is not a permanently placed service?  Could be cool, just something to think about... (says my nerdy public health self)
Despite being involved in a less than riveting or moving part of the process, I worked with an awesome team made up of South African public health nurses and a Peace Corps volunteer, Gayle, a 60+ American public health nurse.  We were the dream team.  We were like a machine by the end.  Even the OneSight people were impressed.  And I have to say I was partly grateful for not having to work that closely with their team...

So now, how was it?  Well, it was a learning experience, that's for sure.  Some of their team were awesome.  And some of them...   not NOT awesome, but, very American.  Even some that had done a lot of these trips, traveling the world.  As much as it was a cultural learning experience for them to be working side by side with our Zulu staff, it was a cultural learning experience for our staff about Americans.  They have experienced Americans in small doses, but it was definitely new to experience them en masse.  I will spare you the details of how exactly they came off as American, but it definitely showed in their expectations and leadership style.  I do have to say this experience also helped me learn a lot about myself.  I thought I would be comfortable working with these people, having worked with many like them before, but I actually found it very challenging as I found myself coming to the defense of Africa and her people.  I also had the opportunity to watch from the outside, looking in.  Watching these people interact with my African counterparts, as well as hearing what my colleagues had to say afterwards, made me cringe.  It was quite embarrassing.  This self righteousness, that the Africans just smiled and nodded at, because they are used to complying with authority, all the while rolling their eyes, like these people must be crazy.  I understood how ugly we could come off, even when trying to provide aid.  You know, you hear tale that there are people like this, but seeing is believing.  And I realized how much work I had in front of me, not only all there was to be done, all the disparities, everything that needs "fixing", but in earning these people's trust and respect.

And easier said than done.  As much as I want to believe and say that I am nothing like "those people", I think the best I can do is say at least I am self aware that I harbor these qualities and they sometimes make an appearance.  For example, throughout the OneSight process I kept thinking to myself, what would PL say?  If you don't know who that is, no worries.  The point is, that in our culture, especially in the medical field, we are taught to always think ahead.  Ten steps ahead.  I always think back to rounds with the "big" man and him asking "So what do you want to do?... And then what?  And then what?  And then what?  And what if this happens?  And this?".  And "Why?  Why?  Why?".  Pushing us to think our decisions out past the basic algorithm, justifying our every move.  This is not how their education system teaches.  A lot more rote memorization, a lot less critical thinking.  And so they don't have the habit of always looking ten steps ahead.  This often leads to Tim and I seeing a train wreck coming from a mile away.  And this is where the challenge is.  My instinct is to say "Look out!".  But, often, this is less than appreciated, perhaps found threatening, because in a sense, I am telling them they are wrong, that their idea is not necessarily the best way or the right way.  Tim is much better than I at sitting back and watching the train wreck happen and picking up the pieces afterwards, with faith that people learn from their mistakes.  I find this more challenging.  It seems to go against every grain in my body.  I can't help but be frustrated as I watch things happen that I know could be done in a more effective and efficient manner, especially when you always have an underlying anxiety about how much there is to be done here.  Sometimes I sadistically wish PL would show up to regulate.  But, the point is, I try to be aware of this quality of mine so that I can keep it in check when it makes an appearance, and therefore hopefully not become an ugly American.

So, all in all, a challenge, but definitely a learning experience, about my own culture, this culture I am working within, and myself.  And at the end of the day we provided services to over 6,000 people in very underserved rural areas, and it doesn't get much better than that.

Eish!  And this is all before holiday!  Just wait.  That's when the good stuff starts... :)