Wednesday, July 25, 2007

25 Things I Learned in Africa

Well the last few days in Africa and the ride home was tumultuous to say the least. The day before we left someone came into my room and stole my I-Pod. I was pretty lucky as my wallet and passport were both sitting out, but apparently someone liked my taste in music more than they liked my money. Fine with me, an I-Pod is replaceable, while being stuck in the hellhole of a country called Botswana without a passport would have done much more psychological damage. The flight home was long and by the end of it my legs looked like that of a cabbage patch doll they had swelled so much. Of course when it came time to collect my bags, Delta/Air Botswana had left one of them (containing all my clothes) in Southern Africa. Sweet, Botswana wanted to screw me one more time for good measure. It took me a few days before I finally received my bag and could stop worrying.

I am very happy to be home in America and now that I’m over my jet lag I figure I should wrap up this blog. Thanks to everyone who made it this far and liked my long winded writing. I enjoyed hearing from everyone who emailed me and IMed me with their thoughts. So I’ll finish it up with a few things (25 to be exact) I learned from my stay in Africa.

1. Gaborone, Botswana is right behind Compton and just in front of Hell in the race for the “Last Place on Earth Someone Would Go for Their Honeymoon.”
2. Cape Town is the best place on earth to go for your honeymoon.
3. African people love to listen to Akon. And R. Kelly. A lot.
4. Nelson Mandela is probably the most important person in the world. For his birthday while we were in Cape Town Bill Clinton, Jimmy Carter, Peter Gabriel, Pele, Kofi Annan and other world greats turned out to wish him well. George Bush wasn’t invited.
5. No matter how lame a place is (see Gaborone, Botswana), the right group of people can make it fun. The people I was with were absolutely wonderful and I will definitely be paying many a visit to OU.
6. Botswana as a country is in a lot of trouble once their diamonds run out.
7. The HIV problem in Africa is much more serious than anyone can imagine. There are so many different aspects to the disease, which attacks every facet of every culture that it was tailor-made for a place like Africa, where over 900 cultures and tribes interact. A virus finally outsmarted the human race.
8. Everyone talks about Darfur, but nobody seems to know anything about Zimbabwe. The economic crisis there is slowly escalating and there are over 100,000 refugees now, but no response from the West. I won’t tell you what’s going, but if you’re interested look it up.
9. There’s a reason America doesn’t donate more money to third world country NGOs. From what I saw, a lot of the money is wasted by inefficient businesses. Or it is stolen by assholes.
10. Banning homosexuality causes a latent gayness amongst the men in your culture. Trust me on this one.
11. Girls, if you think the guys in American culture are very forward and creepy when they hit on you, go to Africa. Then you’ll be hit on by both guys and girls. Maybe they will just kiss you without any warning or offer your friends money so they can dance with you. Yep, these things actually happened.
12. Although every one complains about our cell phone usage, Americans don’t speak on their cell phones nearly as often as Africans. Maybe it’s because cell phones are still novel to these people, but even during important business meetings, they have no problem answering them and talking for the duration of the conversation.
13. On the same note, Africans don’t understand good business. In each of the cities and countries I was in, we had issues with people who didn’t want to serve us because they were lazy or exchange our money because they had tiny creases or help us because they were chatting on their cell phone etc etc.
14. Something that would take 2 hours here takes 6 hours in Botswana.
15. Afrikaners are the most pompous, unlikable people in the world. Period. Apartheid is over, time to wake up guys!
16. The view from Table Mountain in Cape Town will have you saying “Wow” and have you appreciating your life and how blessed you are every 5 seconds.
17. The beaches in Cape Town are 1000000000x better than any beach I’ve ever been to in America. Or the Caribbean.
18. Yes, there are computers (even if they are 1992 models) and cell phones in Africa. No, Africa is not just a large desert and no, not everyone in Africa is malnourished and dying. In fact, as a whole, Africans are much larger than Americans.
19. African soccer is the beautiful game at it’s finest.
20. Canadians aren’t so bad.
21. George Bush is the most hated person in the world. It’s not even close, he's way in front of Bob Mugabe, the Devil, and Eminem.
22. Botswana is truly at a crossroads of development. It seems stuck in the middle, not knowing whether to return to its traditional values or to become fully westernized, a problem that will have to be dealt with before they can make any progress in the fight against HIV.
23. The one thing I’ll always take with me from this trip is being in the poor area of Gabs and seeing the little kids’ faces whenever they saw me (a white person). It was always the same expression, a mix of shock and glee, faces I’ll never forget. Somehow without even trying, I had made someone’s day just because of how I looked.
24. Unless you are a cute African poor child, never stare at someone for being different because if it ever happens to you, it won’t be enjoyable.
25. Count your blessings that you live in America. I think you need to leave the country to appreciate all we have here.

Thanks again to everyone for reading. It’s been a long, interesting ride and I’m glad to be back.
If you're interested in seeing pictures from the trip, they can be found here.

Friday, July 20, 2007

Cape Town=Love of My Life

Well a lot has happened since my last post so bear with me. Our trip to Kasane and Victoria Falls was a huge bust. It started out pretty solid with a boat cruise along the Chobe River. There we saw tons of elephants (one swimming!), hippos, giraffes, crocodiles, and zebras. This was much cooler than our game drive as the animals were in their natural setting. Our lodge was right on the Chobe River, which is amazing, so everything was going really well. We even decided to do a night swim in the lodge pool that was about 10 degrees below zero. Unfortunately, that swim was interrupted with the news that Zimbabwe was on the verge of anarchy and the U.S. government had added it to the "Travel Advisory" list. This meant that OU could not allow us to go to Victoria Falls, even though it is very safe and people from our lodge were on their way there that same day. They also refused to allow us to see the Zambia side because it had not been an approved trip. Our group was told that if we went on our own we would be expelled from the program and have to pay our own way back. This was completely devastating as all of us had really been looking forward to the trip and had even planned to bungee jump off the Falls. I was upset with the world as the entire trip I felt had been incredibly frustrating. OU handled the situation very poorly and looked out for their own welfare (after consulting with their lawyers) before they looked out for ours.

With the time we had left in Kasane, we took a boat cruise in Namibia. This was relaxing, but hardly the thrill of jumping off the world's largest waterfall in the world. We did get a Visa extension in Botswana upon our return. Thank god, because I had been an illegal immigrant in Botswana since the first week. Apparently the guy at immigrations in the airport thought 6 weeks meant 6 days. I was so angry with the world that I went to an internet cafe to write nasty emails to OU and George Bush. Just on a whim I looked up prices for flights to Cape Town, as well as we all had decided it was time to get out of Gabs. They were cheap, hostels were cheap, and the next day we were backpacking it across South Africa.

We woke up early the next day, tried to get a luxury bus, failed, and ended up taking a combi to Johannesburg 6 hours away, where our flight was leaving from. Let me explain how combis here work. They are the size of minivans, privately owned, and don't leave until you fit 20 people into a car that should only fit 12. Also, keep in mind that all of us had large bags with us. So now you can picture the seven of us who decided to go to Cape Town, bitter about Vic Falls, working on 4 hours of sleep, and having traveled 12 hours in a cramped van the day before killing ourselves for 6 hours. Add to that the fact that our driver, driving a combi named "Slow Jamz", played Celine Dion, Britney Spears, Elton John, and Bryan Adams on a continuous loop for the duration of the trip. You can't make these things up.

We finally made it to Cape Town and the smile has not left any of our faces. Landing at the airport was an unbelievable view and love at first sight for all of us. I'll do my best to explain but nothing will do it justice. Cape Town is blessed with stunning beaches, a quaint little city with awesome European architecture (think Bourbon Street in New Orleans), all with the backdrop of absolutely breathtaking mountains. It really is unfair how amazing the city is (especially compared to Gabs). My well traveled friends and I (combined we have been to almost every major city in Europe, Asia, and North Africa) all quickly decided it was the most beautiful city in the world. Our time there was spent taking in the views from the top of Table Mountain, where the city looks unreal (it has been voted "Most Beautiful View in the World" several times), hanging out on the world class beaches, and shark diving. Yeah, that's right I swam with Great White Sharks. 9 to be exact. Our group needed some kind of thrill to replace bungee jumping off Vic Falls, so we came to Cape Town on a mission. Instead of a 4 second bungee, we got to spend the day on a boat, whale and seal watching and shark cage diving. Although Cape Town is the Great White capital of the world (70% of shark documentaries are filmed there, including the Planet Earth episode where the shark jumps from the water), no sharks were guaranteed. The group had been there all of 10 minutes before we got our first one and then for the rest of the day we had a steady diet of 8 more, including a 13 foot long one (our guide apparently measured him). It was a surreal experience as they would ram into the cage, jump out of the water for the bait (Cape Town is the only place where Great Whites can breach the surface), and just circle the boat for hours. The guide said it was one of his most successful trips. Apparently, all of the frustrations endured on this trip led us to have unbelievable luck in Cape Town as everything went perfectly. My new vacation home, my medical school, and my next trip (2010 World Cup, anyone?) are all located in Cape Town. Trust me when I say, no vacation in Europe will be better than this place. I miss it already.

I'm writing my 10 page final paper now after pulling an all nighter, due in a few hours, and then we leave for America on Saturday! I'm definitely not looking forward to the 24 hours of plane rides, but being home will be awesome. I'll post one more time when I get back to the States. See you guys soon!

Tuesday, July 10, 2007

Winding Down

I ended my work at the hospice today and the patients seemed kind of betrayed that I was leaving. All of them wanted me to stay longer and thought things would return to the way they were before I had arrived. I assured them that they were in good hands and that eventually I'd be back as a doctor to see them all alive and well in a few years. They thanked me for my work and the T-shirts I had given them (I gave them the rest of my Pitt T-shirts before I left) and two even cried when I left. Reflecting on my work at the hospice, I feel like I really did some good and accomplished a lot while I was there. Just through chance events, I was able to basically take over the nursing department and change things to make them more patient-oriented. I also was able to get Peter the Prick fired. Yeah, that's right...he got whacked. I'd love to sit here and tell you that it was all my doing, but I really think my complaints were just the tipping point. I went out to dinner with some friends from the hospice last week and they informed me that he was being "borrowed" from a company that basically lent their workers to NGOs who needed help at certain positions. I was able to obtain his bosses email address and sent her out a quick email explaining the problems I was having and the resignation letters accusing him of embezzlement. At the same time, he was being investigated by the company that oversees the hospice for claiming workshops had been held (which cost thousands of dollars), when in fact they had never actually been run. My email coupled with this accusation led to his demise…OK well the accusation alone would have led to his demise but let’s pretend I played a large role. So, while I wish I could say I was completely responsible for him being shipped back to the Philippines, I really only slammed the door on him on his way out. Either way, I have no remorse.

Everything is really slowing down around here as we leave for America in 11 days. We have basically seen all of Gaborone and have very few events left for us, although this weekend we go to Victoria Falls and Kasane which I've been looking forward to the entire trip. A big surprise will be reported on this trip when I get back, granted everything goes as planned. We did get to attend a U.S. Embassy party for the 4th of July that was a pretty good time. Hot dogs and Hamburgers never tasted so good. Being here for so long, I definitely appreciate American food and the American way of life much more than I have before. More on this at the end of the trip.

Thursday, July 5, 2007

On Hiking, Hardships, and Helping Out

This weekend was a long one due to a public holiday Monday, so my group and I took the opportunity to do some hiking. We climbed up Kgale Hill, which probably stands around 2,500 feet. Only four of us, myself included, made it to the top because the terrain was extremely rocky. I really enjoyed the hike as it gave me some reprieve from the stressful life that befalls someone trying to save the world.

We also got a chance to attend the Charity Cup, an all day soccer and music festival held at the Botswana National Stadium. It was a lot of fun until the end, when all the drunkards around us started hitting on the girls I was with and talking in Setswana about Lekgowa (white people). We decided to leave before the end of the final match, so as to avoid the inevitable confrontation. Unfortunately, this wasn't possible, as we saw one of the girls from the "Old Naledi Street Kids project" getting egged on by some trashy girls. My friends and I decided to try and help this girl avert danger, but apparently the people around us wanted to see a catfight and prevented us from getting involved. We left the stadium unharmed, but it was tough to see a girl who was so kind to us getting involved in such a mess in an extremely hostile environment.

And now we come to the hospice. When I last left y'all the hospices only nurse had decided to take leave, so on Tuesday the nursing student and I decided to make some large-scale changes. The hospice had never been about putting the patients first, even though they were the reason for its existence, and Loni (nursing student) and I wanted to change that. All day Tuesday we made the nurses office into a "nursing clinic", by hanging up posters, sitting out old brochures, and digging out condoms that had been sitting in a drawer collecting dust. We also moved a copy machine out of the nursing office so as to give the patients privacy when it was time for them to open up in the counseling area I had fittingly dubbed the "Circle of Hope" in the center of the clinic. We got proper permission for it and everything, so no big deal right? Wrong. Apparently, there is a Filipino Financial Officer who thinks he runs the hospice. I had been handed three letters of resignation the day I got there, all stating they were leaving due to the FFO, whom I will just randomly call Peter the Prick, and accusing him of embezzling the small amount of money the hospice receives. Peter the Prick burst into our office at the end of the day Tuesday, after everyone had told us how incredible our clinic looked, and demanded to know why we had put the copy machine in his office. Well, we explained, because patients are going to start coming first around here and they needed some privacy. Peter the Prick, whose patient care techniques rival that of Dr. Jack Kevorkian, thought that the patients were fine sitting outside by themselves (perhaps furthering the stigma that comes with HIV infection) and that a copy machine was much more important. Well obviously I lost it, destroying him with an argument in which I uttered the phrase "patients are dying and you are worrying about a copy machine" somewhere between 20 and 2000 times. The director decided to walk in just as Loni and I were blasting this "guy", giving Peter the Prick an opportunity to ask why we were yelling since he just came in to ask us a simple question (oh the chutzpah!). The day ended with the director kicking him out of our office and apologizing to me for the incident.

The next day no patients came to the clinic because the hospice needs a whole day for office work even though people do that kind of thing while the patients are at the center anyway. Everything was going well until the administrator, who secretly (along with everyone else) wants Peter the Prick gone, told us that he was holding some medicines and foodstuffs in his closet (which conspicuously says "DO NOT OPEN UNLESS GIVEN PERMISSION"...yep, not even kidding, where are the auditors when you need them). Loni and I decide to go have a look, as PTP begins to yell "why are you looking through those, we need to buy them, they are samples...all while stammering and turning red. I take this opportunity to inquire as to why the patients are not seeing any of these medications, considering the fact that every sample I've ever seen has been able to be used. He tells me that in Botswana samples are different, to which I pull out a Merck and Pfizer pill bottle, containing ARVs (priced at about $500 a bottle) and tell him that these medications happen to come from America, where samples are usable. We go back and forth, people stare, I tell him financial officers at hospices should be seen and not heard, he tells me I'm an idiot, and the day ends with me yelling at everyone I can get my hands on and hating my life.

Today it all became worth it. We opened our clinic, and the patients absolutely loved it! I had come up with an HIV "Fact or Myth" game, with the questions being used as transitions into deeper conversations on topics like condoms, fidelity, and nutrition. It was unbelievable to hear what these people thought about HIV (a few samples: condoms have worms, drinking on ARVs is OK, HIV can be spread through shaking hands). I really could not fathom how these patients had been infected for so long, yet all the people who cared for them neglected to teach them anything about the virus. Anyway, the day went incredibly well, was PTP free and the patients told us that our clinic was what they had always wanted, a place where they could have open discussion about their feelings. They said they were worried that when Loni and I left that everything would go back to normal and they didn't want that to happen. I was thrilled with their reactions and felt like finally I had made a difference. The patients and the last few days have really helped me to see that yes, it's impossible to change the world, but changing a few people's lives, maybe even their days, is worth it, no matter how much trouble it takes.

Sunday, July 1, 2007

Quick Photos

Here are some quick photos courtesy of my group members who brought camera cords with them.

Playing with an SOS Child

Village Child

My group in the SOS Village

My "wife" and I at our traditional wedding


Halfway Home

Well we've reached the halfway point of our trip, and I think everyone in our program is about ready to leave. Walking home from eating one night we all just decided that Botswana is no longer welcoming. The people who were once seemingly friendly and interested in our culture now just piss us off. Everywhere we go, people stare and no doubt judge us as Americans. I've even had one of our dying HIV patients ask me when President Bush is leaving. Oh, OK well I guess that should be your main concern right now! I’m thinking we’ve all just reached the point where the honeymoon is over and hopefully will get over it soon.

The work at the hospice has slowed down as of late. I've done very little but take vital signs and try to talk to patients who don't understand a word of English. The hospice as an organization is unbelievably inefficient. There is never any rush to do things, patients always have to wait to be seen because of lack of transport, and as of now there is no nurse on staff. Yep, that's right no nurse and no doctor. My medical education has just been expedited. Apparently, on Friday our nurse decided the staff was doing such a good job he needed to take a one-month leave starting Monday. Are you kidding me?! First, no manager in his or her right mind accepts a request a day before the leave is to start, when you have no one else to fill that position. Secondly, are you kidding me? Not only that, but the nurse just up and left without telling any of the other nursing staff members. Starting tomorrow, I will be one of two other people (a nurse's aide and a nursing student) who will have to take care of 20 critically ill patients. I'm sorry, but I was planning on coming to Africa to play God after I get my medical degree.

Finally, during one of the down periods at work, one of the social workers took me to the dumping grounds of the poor area in town. It is basically a huge landfill, but it’s packed with literally hundreds of people, hanging out, cooking, or scouring the grounds for leftover food. I seriously felt like I was at a refugee camp, as people approached us constantly asking for help. Our purpose there was to find kids who were skipping school and tell them to go get an education and also to find children for the local orphanage. At one point, we were offered dump food from a child who couldn't have been more than 10. Of course the picky eater I am I took it and ate it (later to spit it out) because the social worker wanted to build a trust with the child so that later he could register the kid in the orphanage. It was probably the most eye opening experience I've had here to date.

Wednesday, June 27, 2007

Hospice Work and T-Shirts!

The beginning of this week saw my start with the Botswana Council of Churches. For the most part we were briefed on what the BCC did and taken around to some of their various projects. The one that was the most interesting was "The Place of Hope", a school set up for street children in a rough area of Gaborone. Some of the children were orphaned and forced to the street, but some were there because it was profitable for them (it was explained to us that these kids were similar to our gangs…just not violent). There were about 40 of these kids, varying in age, and many were affected by or infected with HIV. Fortunately, this program was doing really nice work and had turned around many of their lives, getting some of them jobs and even sending a few to Universities. I decided this was the perfect place to distribute some of the T-shirts I had collected from Pitt. I handed them out to the one class that was in session while we were there, and from the looks of it they were really thrilled. The kids were hugging me and rocking their Pitt wear proudly, even joining me in a “Let’s Go Pitt” chant. I got a good amount of pictures for those who donated T-shirts (thanks again!) and also so that Chancellor Nordy can use them to plug Pitt (I can see it now…”Carl Krauser wasn’t the only street child we saved”). The kids enjoyed me so much they asked me to join their futbol team, which I accepted, as I will any chance I get to dominate small children (actually the soccer team competes in a city league and has kids as old as 25 on the team...the head of the school says he’s won championships with interns before and expects nothing less from me). All in all, that was the most fulfilling day I've had thus far.

The first few days with BCC were to show us their programs, but today was the first day that we got involved with a specific program within the Council. I chose to work with a Hospice which deals with HIV and cancer patients. They only employ one nurse and one nurse’s aide so they were very happy to have me and within an hour we were on our way to an extremely poor area to see some home-based clients (usually the patients who were too ill to come in to the hospice). The truck we were driving in was very small so I rode in the back (its legal here). While driving, a number of small children in the area started screaming Lekgowa (white person) and running after us (smiling, thank god). For just a minute, I felt like Paris Hilton or Lindsey Lohan when they are being chased by the paparazzi...unlike them however, these kids didn't drive me to cocaine, rehab, or even alcohol). Most of the patients we saw were just check-ins, but I did see some thing I’ll probably never see in the States. One patient's disease had progressed significantly and she was clearly in her last few weeks. When we arrived at her house, she was so bed-ridden that she had developed intense open bed sores all over her body, which at first I thought was gangrene, something the people I was with had never heard of. The nurse was ill-equipped to treat such a condition and only used a saline wash to cleanse the wounds. Additionally, she was suffering from a uvular cancer that was extremely gruesome and had completely taken over her pelvic area. When asked why a doctor was not being consulted, the nurse said no one would operate because of her HIV positive status and that she wanted to die in peace. Unfortunately from what I saw, there was no way this woman would get what she wanted.