Handing Over the Stick

I have played a round of golf through a military exercise and a wedding ceremony. I have been surrounded by a cloud of bats each the size of a Cessna. I have said goodbye to a close friend. I have said hello to a new Country Director. I have coasted down a mountain with no breaks. I have been thrown out of a boat on the Nile. I have met many a village leader, drunk, Reverend, cattle herder, government official, prostitute, and rap star. I have eaten things that came from holes in the ground, only to see it again a few hours and many bathroom trips later. I have seen the effect of genocide first hand. I have seen corruption, I have seen development. I have stared at the countless indentations of mattresses hours after dead bodies were taken from them. I have seen things I rather forget, and some I hope I never do. I have been challenged more than I could have ever imagined. I have met people with nothing willing to give everything. I have felt my life change. A lot has happened since my last writing, and sadly there is just no way I can cover it all. What I can tell you now is that I am somewhere very different than I was last time I wrote.

I came here for a challenge, and damn it looks like I got one. A few months ago I was on the verge of throwing in the towel. The most productive thing I felt I did was wiping my ass. I’d go to work and stare at walls for hours at a time. I felt utterly paralyzed by inaction and the inability to help those in need. I spoke with a deaf girl who was raped and impregnated at the age of 15, I locked eyes with a man hunched over in excruciating pain that would die of dysentery hours later, I tried to comfort a boy having a severe asthma attack. Suffering was all around me. What did I want to do? Everything. What was I doing? Nothing. I was pulling out my hair, grinding my teeth, and afraid of my community. With no exaggeration whatsoever, for a good 6 months after arriving at site I felt I had done absolutely nothing. Yet I surprised myself by continuing to show up. In my journal I wrote, “I feel lost and found all at the same time, like a sailor who calls his ship home but sails without a compass.” Man, do I have a flair for the melodramatic. So what kept me going? The community. It sounds a tad bit self-righteous and cheesy, but I stayed for the people I had made a promise to the day I moved in. It wasn’t any sense of morality that kept me going, or any feeling of burden. To me staying was just some ordinary duty I had to fill. I came to the realization that to challenge others I had to first challenge myself.

Before arriving at site, I was told that the experience and guidance I had was the only way I could help my community. I was trained to plan. I was shown the right way and the wrong way. I knew how to make log frames, SMART objectives, and sound proposals. I was comfortably nestled into a comfy pillow of theoretical academia. Then it hit me. I knew jack shit. I couldn’t do anything. I had no idea what to do. I sat in my office alone trying to plan my way out of it. The harder I tried, the worse I felt stuck. I blamed my community, and my co-workers. I told myself that I needed to book a one way ticket out of there to a place that could utilize all the valuable skills I had. Then something unexpected happened. It’s too early to speculate on exactly just what it was but broke down and beat to pieces, I began to embrace the error. I began to unlearn everything I thought I knew. I relaxed. I had fun. I talked to people not like they were objects for development but rather allies in a struggle. I laughed more and appreciated more. I was true to myself, and true to my community. I jumped off the pedestal that was separating me from my community. And then it started. Tiny victories, small successes, and a vision of the previously unimaginable. As Robert Chambers would say, “I was handing over the stick” and letting communities direct my work. It was incredibly empowering. I stayed in the village and will never forget why. I cannot thank Jenna, Peace Corps staff, friends and family for standing by my side through all the ups and downs.

As a result, work has been exciting and fantastic. I’ve got my hands full and love it. Yes, there are still the hurdles and some of the same problems, but they don’t look insurmountable anymore. My work revolves around 6 core areas: Malaria, Hygiene and Sanitation, HIV/AIDS Education, Health System Strengthening, and work with two local community based organizations: a HIV support group and a People with Disabilities Group. Here is a quick summary of some of the things we are doing…

Malaria

-The catchment area of the health center surrounds an area of marshland and swamp. With the rains come epidemics of malaria. Mosquito net use is very low, especially among the most at-risk groups: children under 5, pregnant women, and the elderly. There are many in the field of public health that feel that mosquito nets should be distributed for free (Jeffrey Sachs-Bono for example) However, ownership and proper net usage remains low (around 40%). Everywhere there are stories of nets being made into curtains, fishing nets, wedding gowns, or sold back to the black market. Even more disturbing is how the nets are being distributed. Sub-contracts are rapidly taking hold in the development world. USAID may contract an NGO to distribute nets. This NGO will then sub-contract a regional NGO to do distribution that will then sub-sub-contract people (usually not an NGO) to do the actual distribution. By the time it reaches the village level the distribution is no better than throwing nets out the back of a truck. At every level in the chain money is taken out and accountability is lessened. Who knows how much the money that brought 1,000 nets to a community could have really purchased if the distribution channel cut out all the middle men. It also seems that the 40% ownership estimation is too high. When nets reach the village level, the sub-sub-contractors use local leaders to identify households to distribute to. These local leaders, I have been told, take payment for these nets even though they should be free. Because people are actually paying for these free nets, ownership rates will be skewed; they’d be much lower if everyone played according to the Sachs/UN master plan.

-To solve this problem the Health Center is pursuing a sustainable net distribution plan that will have nets available for sale to the community. Drawing on the pioneering work of PSI, nets will be distributed to community health workers and village health teams. For every net sold these distributors will make a small commission. The principle amount invested in a lot of nets (we will start with 2,000) will then be reinvested to buy another stock. We will be planning this distribution at the same time as the bean harvest so people will have extra pocket money to buy the nets. The nets each will be sold for about $1, with distributors making about $.30 on every net. Poor people can easily afford to buy nets and coupled with education it can eradicate the dependency that continues to make no progress in the fight against Malaria.

Hygiene and Sanitation

-The Health Center has been conducting demonstrations on the construction of hand washing stations to be built outside of latrines. Hand washing facility coverage in the sub-county currently stands around 2.4% of households. We have set up demonstrations at many local primary schools. So far the demonstrations are working quite well, and the students have been washing their hands after the latrine and before eating.

-Because of the volcanic rock in the area pit latrines cannot be built very deep in my community. Eco-San latrines present an alternative; they are built above ground with collection chambers that store human waste. The user alternates using different chambers every 3 months. After 3 months the human waste is turned into safe fertilizer that can be used for farming. Urine is also separated and can be collected in a container and used for fertilizer. Eco-San latrines also present an income generating opportunity as this fertilizer can be sold to neighboring farmers. We are debating whether to build demonstrations at local village centers. 1 latrine with 2 chambers costs about $90 to construct.

HIV/AIDS Education

-On the surface HIV is not a problem in my community; however, the health center has begun to analyze data and found that women test more than men at a ratio of 5 to 1. This is because women are basically required to test during their antenatal care visits. Their husbands then use the wife’s test result as a proxy indicator for their own status. Couples can live together for years and not transmit HIV to their partners. In order to get a better picture of HIV in the community we need to raise HIV testing amongst males.

-We have begun a weekly education program on Fridays about HIV that equips women attending antenatal care with knowledge and power to prevent HIV.

-We have conducted outreaches in village meetings about HIV, including condom demonstrations (one of which was in a church…the one thing that I was sure would get me booted out of my community)

-We have initiated a Sports for Life course at the local secondary school that involves juniors and seniors in games and activities that turn their extensive knowledge about HIV into practical action. Gender communication, dealing with peer pressure, and self-esteem are all topics included in the program. The course will happen every Friday afternoon, be co-taught with school teachers, and will be eventually taken over by seniors who will teach juniors next year.

Health System Strengthening

-Thanks to a grant from Peace Corps, the health center was able to buy some fantastic education materials and visual aides that have been translated into the local language by a team of staff and have been used quite successfully in outreach settings. We are now in the process of training the extensive network of community health workers on the use of these materials. The materials will be put in a library of sorts in which the community health workers can check out to use in local meetings, functions, and events. This builds capacity in the health system with no extra burden on health center employees.

- Recently the health center got the good fortune to receive a donated laptop from a very generous group of people from Norway and Canada. I have been conducting computer trainings for all interested staff and have been working closely with my supervisor on using excel to make reports and analyze the extensive collection of data that is collected every day. He is a really quick learner and figured out the formula function in no time (keep in mind he didn’t know how to turn the computer on a few weeks ago). He loves analyzing the data and making graphs where he can see the performance of the health centers work first hand. Many times his eyes light up and you can just see this expression of
“a-ha!” on his face.

- I continue on working on improving the data collection methods and surveillance techniques that the health center uses. We have changed our targets in line with the financial year, so we can adjust our budget in certain areas according to how we are performing. We have begun to map our community, something that has never been done before so that we know where disease and outbreaks come from and direct outreaches accordingly. I have also worked with my supervisor on forming concrete goals, objectives, and activity plans. We will form a strategic vision  the financial year at the end of this month.

- I have stumbled across something amazing. Health workers in developing countries are ruled by regulations, targets, and orders by centralized branches of the district and Ministry of Health. Inside the health center their work is redundant, boring, and unchangeable. However, the health center is free to do whatever wants outside the gates and in the community. I have found this extremely refreshing and motivating to many staff. I have used this as an empowerment tool to form leaders in health extension among the staff. The other day I went up to one of the nurses and said, “I think the women who come for antenatal care on Fridays want to hear information about HIV so that they can protect their families. Every Friday you should run the show. Do it any way you want, you are in charge.” Her eyes lit up, the very next week she held a fantastic session and ever since the women have been getting knowledge and skills to prevent HIV. My counterpart has been fantastic. He takes preparing for outreaches even more serious than I do, and we go over everything many times before going out into the field. He also works on these things when I’m not around, and not looking.

HIV Support Group

-The group is about to collect contributions to buy sheep co-funded by a Peace Corps grant. Every member will pay 20% of the cost of two sheep. The sheep will be female and old enough to begin producing offspring. Members will share the male sheep they have among them to fertilize the females. So why sheep? Because they wanted them! Who the hell am I to tell them what animal they should have. They know how to take care of them, how to treat them for disease, and know the local market for sheep. I could do all the research on the world on animals and force the group to buy something, but it would most likely fall flat on its face. Sheep produce 1-2 babies every 4 months and can be sold for a nice profit 4 months after that. Their manure is also fantastic for farming, something really exciting since they want to start their own kitchen gardens to promote nutrition. The contributions collected will also pay for two female pigs to be kept at a member’s house that has quite a bit of knowledge about their care. Pigs produce 6-8 offspring twice a year. The offspring will be given out to group members, and will be used to start their own pig projects. This represents a significant sustainable contribution to their income. When I first got to the group the thing they wanted most were donations and sponsorships from America. In one of the most incredible things I have heard since being here the group now says that the pigs and sheep will produce enough money to send their kids to school and for them to buy seeds to start gardens. They are taking charge of their own destiny, not waiting around, and coming up with solutions to their problems.

-We are also trying to market the group to the community. There are many HIV positive people that live in the community but are not in the group. The group now has 10 people but by years end we hope to have 20. One way we came up with to publicize our efforts is to buy custom T-shirts. The shirts will be purchased in time so that the members can all wear them as they go to the livestock market to buy the sheep and pigs. As the members walk back to their houses wearing t-shirts, sheep in hand, word will spread like wildfire and people will want to join. Or at least that’s what we are hoping.

-ARVs are about to arrive at the health center. I am hoping that once they do, and the support group starts some good projects going testing rates will increase. I have been told that many people did not want to test because nothing would change if they knew their status. They’d get no treatment and no help and have to suffer the stigma that goes along with a HIV+ test.

People with Disabilities Group

-The group consists of 220 members spread over the entire sub-county. Disabilities range from amputations caused by landmines, to polio, to blindness, to mental retardation. We are working together to identify and prioritize needs and come up with a project that could address these issues. So far the group says they would like to start a piggery, and a sewing and carpentry workshop. We have conducted a needs assessment for the number of wheelchairs, crutches, and canes needed and I will be looking for assistance to have these items donated. The most valuable thing to a rural poor person is their human bodies. Their strength and labor in the field is the only thing that can bring them an income. People with disabilities are more at risk for extreme poverty because they can not rely on their bodies.

In a few weeks I will be making myself a demonstration farmer for rabbits. I will construct my own hutch and start breeding rabbits in my backyard. Rabbits have sex like, uh, rabbits and are a very cheap source of protein. They take very little upkeep and a project can be started at very little cost. You feed them grass clippings and leftover food. My hope, besides some delicious rabbit stew, is to show how easy it is to run a rabbit project so that the groups I work with will build their own hutches. I will provide interested people with an initial breeding stock of 1 male and 2 females and training on hutch construction. Their contribution will be building materials and peer education to neighbors and friends. 1 lucky male, and 2 busy female rabbits can produce 75 rabbits in one year.  This will dramatically increase protein consumption and gives a steady and significant income to families with little effort. Rabbits are in high demand, and the local market cannot supply enough. I had no idea that one year ago I’d be working with rabbits, sheep, and pigs so much.

As you can see my hands are quite full and I’ve been pretty damn busy. But I’ve still managed to have quite a bit of fun since being here. A VSO volunteer in town, Craig, and I have become good friends. Even though his organization is a low-grade knock off of Peace Corps with silly ideas, I don’t hold it against him. He’s a pretty cool guy and has influenced the way I think about my time and work here. I stay with him from time to time on weekends and we always seem to find ourselves in interesting situations. Here are just two:

1) One night Craig and I met up with a British tourist that he had met the day before. Both Craig and I felt motivated to show this guy the real Kisoro, get him outside the artificial tourist stuff. This guy was fresh, much like I was when I first arrived here. It was really interesting to see all the familiar mannerisms of a person that has just found himself in the middle of Africa. He took pictures of black kids with bloated bellies, ate goat meat with a fork and knife, and seemed extraordinarily uncomfortable anytime a Ugandan talked to him. After dinner we walked to a section of town notorious for small little holes in the wall where boos and hookers are the order of the day. We were in search of gwar-gwar, otherwise known as banana moonshine. We walked past the road and went into the most ramshackle shelter (it was not a building) that Craig and I found earlier that day. When we entered two small boys no bigger than a yardstick were sharing a bowl of potatoes. “Ufite ubusherra cyangwa gwar gwar?” They did not, but led us to a bar a few doors down. I walked in first and greeted the small group of men that had assembled inside around a small dilapidated table. It was night and 1 candle on the top of a shelf dancing in front of a tattered election poster for President Museveni was the only light provided. We began speaking with the other customers. We were served a liter of the brew and damn did it taste nasty. Mix 1 and a half parts rotting banana, 2 parts backwash, a splash of pond water, and garnishes of dirt and dead spiders for good measure and you’ll have yourself a pretty good approximation of what gwar-gwar tastes like. We spent the first thirty minutes explaining that although we were all white, we were all from different countries. The more we talked, the more the gwar gwar came. We talked about a lot of things, and the more we talked the more we departed from the usual “your culture is so beautiful, the landscape is gorgeous” that although true, is bullshit filler. We had genuine exchanges talking about the poor and underserved in our countries, and how they are similar to the problems here. Every now and then a very large, and vocal woman would pop in and declare her love for our British visitor and fresh fish. She then demanded a cup of gwar-gwar saying she had no money. Instinctually, I responded, “Ndikumenya ngo ufite isenti”- “I know that you have money” and shook the pocked of her second hand Patagonia fleece. It rattled with enough coins to make a Coinstar machine blush. The bar erupted in laughter, and so did she. We had passed some sort of tourist/outsider test. She ended up buying us drinks. We knew Kisoro, and were were talking like we were one of them. The cups continued, Craig then went out for a “short call” (local term for taking a piss). Within a few seconds half of the men ran out, and the street erupted in yelling and shouting. The men of our bar were standing between Craig and some very angry and drunk soldiers. They pulled Craig back into the bar, 2 soldiers were fighting over a prostitute, which led to them beating her in the middle of the street. Craig and his Scottish balls decided to break up the fight until our bar pulled him back. It was a bittersweet moment; the fact that a woman was getting beat and that our new friends protected us. When I had to make a short call, Christmas (the name of the bartender) escorted me to the side of the shack and stood inches behind me. Although awkward, it was nice. When we left, our bodies overflowing with fermented banana juice, everyone wished us a very fond farewell. It wasn’t said explicitly, but we got the feeling that it meant a lot to them that 3 muzungus would sit around a table of drinks not lecturing them about their problems, telling them what to do, but just talking about life, laughing, and sharing stories. I have really discovered the value of keeping it real. People are not stupid and see right through the song and dance bullshit and are just as happy to give it back to you. When artificial talking points are thrown out and people truly to talk to another real things can get done. They didn’t let us pay one shilling for all the drinks. We have gone back many times.

2) One lazy Saturday afternoon Craig and I were sitting around his place waiting for hours for a YouTube video to load. We got a call from a friend who said that Chameleon was playing in the next town. Chameleon is probably East Africa’s biggest rap star. His songs and videos are absolutely everywhere. It was getting late, and the town is about 2 and half hours away. We told him we’d think about it. Craig, being an over-analytical nerd, descended on his laptop and began to formulate a pro and cons list. He will tell you a different story, but don’t listen to him. After much deliberation we thought it’d make for a good story if we went. We ran outside to try to catch our friend’s vehicle but couldn’t find him. The only option was to hitch a ride on one of the buses headed for Kampala. The last one was about to leave. We ran about half a mile to catch it. We got on board until Craig said he was very weak and needed something to drink. Being the nice guy I am I kindly decided to help him out and get off the bus and search for provisions. He will tell you a different story, but don’t listen to him. I ran around from store to store but couldn’t find anything. Finally I got what we needed. When I returned to the station the bus was gone. I saw the dim red taillights of the bus half way down the road on its way. Craig decided to stay on the bus despite my compassionate efforts to help him. I ran after the bus. Someone running in town makes a pretty big site, a muzungu running is right up there with the second coming. As I ran, people on the sides of streets yelling and cheering, I hoped my “friend” had not forgotten me. I finally caught up to the bus and sat down. Two hours later I was in the middle of an outdoor concert dancing to music. 30 minutes later I would find myself pulled on stage. 5 minutes later I’d catch someone pick pocketing me. 1 hour later I’d be backstage acting as a bouncer as I talked to Chameleon about Ugandan politics. Never mind that he called me Peter, I spent the whole night  clubbing with Chameleon and his entourage drinking Johnny Walker and playing pool. It was pretty surreal. Good thing we- I mean – Craig made that pro and cons list.

During trips to Kampala for training, my friends and I get together, talk about site, and do some fun things. There is a small little informal initiation within Peace Corps Uganda that has been passed down from group to group over many years. Outside of Kampala at the end of a crowded maze of alleys lined with chickens and used shoe sales man lie a culinary miracle. We had heard of “The Pork Joint” that served better sausages than any Oktoberfest could. They said they brought platters the size of trash can lids full of mountains of ribs, meat, sausages, avocado, etc. We were also told that the only way to find it was with assistance from a volunteer that had been there before. The restaurant, what I eventually learned was just a collection of benches around a communal table had no name. It was loud, hot, smoky, and chaotic. It was the type of place that would make Anthony Bourdain aroused. We sat down and immediately ordered what sounded like two and half pigs. A gentleman next to us who called himself “Animal” bought 18 beers for our table. This was my kind of place. The food was absolutely amazing. It was the type of food that has been known to cause some tongues to abandon ship and dance on the floors in search of scraps long after you’ve left. Some of us, faces gleaming with grease stood up and danced with the staff while others provided a steady beat on the wooden table. If any of you come to Uganda come with an empty stomach and maybe a blood pressure cuff and we’ll go to this place as often as possible. Thanks to my new found belly caused by this dinner I was able to stay afloat through the massive rapids of the Nile River when our group went rafting later that week.

This past week I had the good fortune of welcoming my dad out the village to stay for one week. I picked him up from Kigali, Rwanda which is much closer to me than Kampala. Before picking him up I went to the genocide museum with my counterpart and friend Kwizera. I had known about the genocide and the politics around it. What I realized after leaving was that there was not just simply a genocide in Rwanda, but 1 million of individual acts of murder. Too often we lose site of the sheer disaster of tragedies when their tolls exact an epic number of deaths, but what the museum made me realize was just how every one of those murders are still affecting people to this day. The thing that effected me most was leaving the museum and seeing all the people around that are still there. Everyone over a certain age lived through it, and it wasn’t long ago that dead bodies paved the streets. At the museum I ran in to two US Senators, Bob Corker (TN) and Johnny Isakson (GA).You would have never guessed that there was genocide 15 years ago. The city is immaculate. The roads are amazingly smooth. The infrastructure is on par with South Africa. It’s amazing what the country has accomplished in such a short time. Many buildings and signs read, “Shira hamwe,” “Stick together.” Being from Kisoro a town mostly populated with people of Rwandan heritage I thought there wouldn’t be much difference. But walking around Kigali was very different. People do not greet each other, I saw people pointing at me with angry looks on their faces. Many Rwandans understandably are angry with the West for not intervening, and in the case of France for partly the cause of the genocide. When I spoke the language to a person from Rwanda on a street (Kisoro and Rwanda share the same language) she said, “Habyarimana trained them well,” in reference to one of the architects of the genocide and France’s training of the Interhamwe militia that carried out the genocide. Rwanda has accomplished a lot but it still needs time to heal.

It was great having my dad around. I showed him my work, and the local area. He met with the health center staff, the HIV Support Group, the Disability Group, and came to the secondary school where my counterpart and I tried to do an activity about delaying sex with a group of 300 kids (when we played a game that involved running I thought it was the start Armageddon, so much chaos). The first day he was here my septic tank clogged, and sparing you the details, he and I spent the next 30 minutes “manually” clearing the clog. Welcome to Africa pops. I cooked him the local food, and tried to give him a real look at what life is like here outside the cities, in the villages, and away from song and dance routines of development. My hope was to show him the good and the bad, the hurdles, and the promise that “handing over the stick” can bring.

Things around the house are good. I’ve been slowly changing my diet to more local food. I’ve been staying in the village for longer periods of time. My beard is getting long, maybe too long. I’ve been making a giant collage on one of my walls with pictures from magazines sent from America. All of your emails, text messages, packages, and calls mean the world to me. I can’t believe I’ve been away for 10 months. I’m already getting scared to leave. In a few weeks Jana will be arriving in Uganda to work with me on projects (thanks Jana for agreeing to do all the dishes and laundry, that’s really sweet of you). A few months later I’ll take a vacation with Jenna for two weeks around East Africa (I can’t wait to see her!), and after that Declan will be around (how do you feel about making methane generators powered from pig manure Declan?). Please let me know how all of you are doing back home!

Talk to you soon (much sooner than I said last time).