Numbers 11 and 12

Hey, you know what this means: I scribbled enough in a word document entitled Personal_Statement.doc that I decided I deserved to doodle here as well. Let me get you up to speed.

Yesterday Emily and I completed our final two focus groups in a village called Kapondero. It's right past Luhomero, we told our taxi driver, Phillip, when we bumped into him the day prior and haggled for a ride. 

You told me it was right beyond, he told us en route, as the rain slashed down hard and Justin Bieber serenaded, but then I looked into it after you left and I realized it was much farther. Good thing I got extra fuel. 

Oh, Phillip. You know what's cool about Malawi? You actually see your taxi drivers again. Like, daily. Randomly. They become pals. Sometimes they call to check in. 

The day, in great part due to the company, was epic. The roads (which are a barrier to healthcare access, btw) were extra rundown and 45-minutes or so into our ride we came to a stop in front of a small pond/river interrupting our path. Phillip and Gladson (our interpreter supreme) got out to survey the situation, and I took photos. 

It fast became clear that we would not be crossing the water body in the car, and it was time to start footing it. In the rain, with a crate of 18 glass bottles of Soda and backpacks busting with 20 Obama Rolls, with long skirts and wet hair and 1 small striped umbrella and 1 smaller leopard-printed umbrella and with a laugh track self-supplied, we began our trek. 

The water was the only real obstacle; it involved holding onto outstretched arms and deeply rooted water shrubs and   balancing on wobbly stones. 

I'm a little concerned about your balance issues, Emily's caught telling me on one of many videos. 

Let's restart the 6-week praziquantel post-exposure prophylaxis count. 

Well needless to say, over the river and 30 or so minutes later we ultimately made it to our destination. Even taxi driver Phillip ditched his car and came along for the walk, which at the time didn't even strike me as unusual it was so typically Malawi. 

We then proceeded to conduct two focus groups in a row, me leading the first (with Emily typing) and the opposite configuration for the second. 

I don't know if it was the weather or the journey there or the people or on our last day us finally getting the hang of this focus group thing; I have a feeling it was probably a recipe of all of the above. But the focus groups were some of our best yet. 

They say you're done gathering qualitative data when responses start repeating themselves (they become saturated) but the other seemingly cool way of confirming you've conducted your fair share is immersion begins. 

While conducting, sitting in a circle with this group of selfless strangers, you're no longer distracted by the situation and the peoples faces and the tape recorder and what question you're going to ask next-- you're suddenly and beautifully totally and defiantly emersed and enjoying it and listening. That's what yesterday was about, more than any groups prior, and it was really cool. 

The walk and ride home were really memorable too. We spent the first have chatting and laughing and recounting stories and jumping out of the car once or twice to take videos and photos. And then Emily and I, I think, spent the second half of the ride just sitting quietly in the backseat. Thinking and watching the clouds and landscape creep by. 

It was the fourth time we had taken this particular off-road route, the one that snaked off the main road and to Luhomero and beyond. Four is a funny number because it's not too-many-to-count but it's not too-few-to-not take notice. We've traversed it on foot, in cars, while pushing stalled cars, and in the back of flagged down pickup trucks. It's a route I want to remember. It's a route I don't think I'll forget. 

Remind me to tell you about the rock on the mountain.

See you,

Rebecca 

Embracing disorder

Alright, all: this is the last time I sit down to write something that isn't my personal statement. I must start it, or at least create a word document for it, before I blog again. I'm already hyperventilating about this (not the lack of free writing, more the requirement of formal writing) so I think starting tomorrow I'll just force myself still for 15 minutes per day in front of the to-be-created word doc and see what happens. 

All the best plans start tomorrow; you know that, right?

Tomorrow Emily and I have our last two focus groups, which will bring the total to a chilling twelve. Then it's time to tie up loose ends, prepare for (re: start) a presentation we're giving later this week on our findings, work on our paper, and, arguably most important: continue exploring the Pandora's box that is our bicycle ambulance initiative (which I recognize I've yet to outwardly describe; bear with me). 

Today, the Fishers, Alfred, Richard, and I went to Mzuzu and met with a member of the District Heakth Office to share with them our thoughts and plans regarding bicycle ambulances (again, I'll return to this, you can count on it). 

Organization-wise, it was a day that wouldn't jive with my life in NYC, a day that had it occurred 2 months ago may have given me a headache. 

But it's a funny thing that happens when you stop expecting things to go as planned. It's a peculiar shift in mindset that takes place when you've spent the last two months in a vortex of meetings starting late, stores remaining closed, ATMs running out or money, check out lines coming to abrupt and arbitrary halts, cars breaking down, restaurants running out of food. 

What is it that happens? 

You chill. I've chilled. And though I'm still a rose with a stem of prickly flaws, the unexpected, the annoying, and the delays-- I'm trying to embrace. 

I should note here, before I fall asleep, that I don't have a personality dysmorphic disorder. I'm not as crazy as I'm making my Non-Africa self seem- I know I'm not and I know you know I'm not. Rivers go with the flow and so do I. Most of the time. But rivers are shallow and sometimes deeper down I need to remind myself to just breath. 

In Malawi, beyond the stagnant lines and the moneyless ATMs and the broken clocks and the watchless wrists is a society gritting it's teeth and stomping it's feet to the tune of what's actually important. Days and life and agendas going according to plan are not.  I hope I remember this when I'm home. 

Good night,

Rebecca 

Back up North

Good morning, team,

Emily and I had a conversation two days ago about our reluctance to over-share, but I'm now thinking that my blog writing and photo posting might defy this. Neither here nor there, really. I hope I'm not becoming annoying. 

I'm live, at the moment, from the Ekwendeni guest house. I moved in here on Friday and had a restful first two nights. Have I articulated, dear reader, how ridiculous my circadian rhythm is these days? I'm regularly asleep in the 9 o'clock hour and ready to rise in the 5 o'clock hour. I'm sure this schedule will sustain for precicely 1 day once I'm back in the States before I'm clapping down hard on my alarm clock's snooze button. 

To summarize, for the books, I had a wonderful time with my parents. We went from Majete National Park down south to Lake Malawi, then up to Lilongwe (in central Malawi, the capital). We concluded our time together in Mzuzu and Ekwendeni, where I have been stationed. A highlight: on our last full day together my parents accompanied Emily and me (and our interpreters Gladson and Elaina) to a focus group discussion. And an underline: Matt(hews) (as he goes by in Malawi), Emily's husband, was and is here as well.

It was really special to have everyone with us, particularly because this specific focus group took place at a school, where upwards of a hundred children were basking in their last full day prior to a 6-week holiday. Last days are universal. On top of that, there was also a mobile/outreach clinic being conducted at this site on this morning. Wrapped in a neat but Malawiesque bow (bright and loud and with infinite light), our guests got to see a little bit of everything.* 

I'll note: my dear father, with a valiant and successful effort, drove us to this remote site. We crossed rivers and deep, deep pot holes that made more traditional off-road driving look crisp. Naturally, upon arriving at our location our Malawian interpreters got word of an alternative, unpaved but significantly less tumultuous path which we returned on.  

After the focus group, we showed my parents the hospital (Emily gave a noteworthy tour), and then we all headed to Mzuzu to wander and read and ultimately have dinner (at A1, of pizza dough fame).

I have a lot of wonderful photos of my travels with my parents so I'll look forward to sharing those at a later time. Monkeys and sunsets and a startling vast array of out-the-window-driving-80-km-per-hour photos courtesy of my mom. Forewarn me when we're approaching an ox cart, she'd request. Finis. 

This past Friday: Matt, Emily, our Malawian friend Alfred, and I trekked on foot to Luhomero. Recall: this is the village where Emily and Matt donated an ambulance (see previous post written around July 4th). I should have looked at a watch, but I believe the walk took us approximately two hours. Time flew, because Emily was educating me on Truman (her most recent read; see previous post entitled Bookworms), but it was not lost on us that this is a distance many residents of Luhomero and other remote villages are required to travel any time they have to get to the hospital. Pregnant. With diarrhea. Febrile. Dehydrated. Often, out of necessity, on foot. 

We went to Luhomero to discuss with Alfred and Richard (the local health officer in the area of Luhomero) bicycle ambulances. More on that later, but it was productive, informative, thoughtful, and thought-provoking. I chose those four adjectives with care.

Alright. C'est tout. Now, I most definitely have to get reading done for our project. I'm skipping Sunday morning services, it's time to be productive.  

Have a good day, thanks for reading,

Rebecca

*btw: no one extra sat in on actual discussion; we were separate. This is serious. 

Counted: a conversation on Lake Malawi

He just got to me, my mom said, nodding her head gently, I don't know why. 

A lot of the people have that effect, I countered, bordering on snappily. 

But not like that, she offered, when he talked about losing his father, his strength, I don't know. 

What do you think, mom, we conduct focus groups with these people; all we do is talk about deep, personal things. I was defensive and insistent that our conversation with Black, the hotel employee who had taken us out on the speed boat to go snorkeling, wasn't as out of the ordinary as she was interpreting it to be. 

Sometimes we make remarks to try them on for size, listen to how they sound, see how they make us feel. We say things aloud to see if we can work with them; see if we can agree with them, even if we're not sure, when we let the thoughts fly, if they're even true. 

Because the truth --and I knew this as soon as the words left my mouth-- was that Black had gotten to me too. 

----

We were drinking hard cider and Black was drinking orange Fanta, the speed boat was anchored off a small island in Lake Malawi and we were sitting on its cream faux-leather built-in couches. We were eating vegetable samosas from a silver tin container. The samosas were warm, soft. Cooked and heated earlier in the day, but they tasted just right. 

Black was wearing an aqua and blue uniform shirt with a patterned Island print. We were in bathing suits and striped towels, having just reloaded the boat after a brief bout in the water. 

I don't recall how the conversation started but I'm sure it was in the usual way. We probably asked Black where he was from. Fast to the surface was that his village was nearby, on the lake. It was a fisherman's village, and he had lived there all his life.

Black had these eyes that focused on you but at the same time seemed to look farther. Especially when he steered the boat, he stared deeper into the distance than one would expect. He seemed to be seeing more. 

Black has two brothers and a sister and together they take care of their mother. Their father died when Black was ten and when his siblings were ten, give of take a few years. His father had been sick.  

(Black was one of many strong, young men who had spoken to my family and me about losing their fathers too young.)

Black has three children, 5 and 1/2 year old fraternal twins and a three year old as well. They're all healthy and were all born at the government hospital in Mangochi, a 2 hour walk from Black's village. The hospital is too far, he shared, completely unprovoked. 

(I had breathed a sigh of relief to hear about the twins- now over five and thriving. Twins are more likely than single gestations to be born before their due date, and most hospitals in Malawi frankly don't have the resources to care for premature babies. I've seen this firsthand.)

For minutes, Black spoke and we listened. I fell silent about my project here: our focus groups, our goal to understand barriers to hospital access. Black told us he used his vacation days to be at the hospital with his wife while she was in labor. He was so proud to tell us this. Even though the hospital is far it is where we must go for care. 

Black's home is a 45-minute walk from the hotel, where we stayed and where he worked. He does not have a bicycle but planned to buy one when he saves enough money, 40,000 kwacha, or 100 USD. Footing it for now is not a problem, he told us. He also had such pride in this job he had: he had started as a gardner and worked himself up in the ranks at the hotel, now he is responsible for the speed boat and a sail boat as well. Doing what he has to do to support his family. 

I'm not remembering this all verbatim (poetic license, they say). But it was a beautiful thing to listen to Black tell us about his family. The anecdotes about the hospital just go to show you (to show me) that this is a universal problem that surfaces without much prodding. We didn't feel rushed but were conscious about returning on the speed boat at a reasonable time, so that Black could begin his on-foot commute to his village, his children, his wife, and his mother. I'm probably not don't Black, his character, or this experience justice, but it was one of those days that touched my parents and me; one of those days we won't forget. 

Counting to ten

Over dinner this past spring, in my NYC apartment/shoe-box, a friend recounted for me an activity she had partook in earlier that day, as part of her Palliative care elective. It involved sitting face to face (or so I pictured it) with someone she did not know that well, and taking turns talking for sixty seconds about something meaningful. The listener had to refrain for an entire minute from verbal feedback, from providing any form of response; the listener wasn't allowed to speak. 

This lesson, second-hand but instantly, served me well. I've always thought of myself a good listener, (a little pat on the back), but overnight I implemented an abridged version of this concept, I made an amend to the well-worn way I listened. 

When lulls arose in conversation, when people paused in recounting and sharing and story telling, when the phone line went limp and static resumed.... with patients, family, and friends... I consciously made the decision to keep my mouth shut. 

I started, quite literally, counting to ten. 

And something -don't wait- kind of, instantly, amazing happened: there was a lull in the lull, a pause in the pause, an end to the static. People resumed talking. 

I'm obviously romanticizing this a little bit. Don't rewind to conversations (friends and family and foes)- this wasn't as calculated a maneuver as the retrospect makes it seem. And the test wasn't 100% sensitive (specific? Shoot.) But it was a conscious implementation, and the more I did it the more valuable it became. 

See, dear reader; see, friends and family and foes: it took me almost two months before I started to sermonize. 

The point of this post, obviously, is that in Malawi this lesson has taken on another form. Inherently, the focus groups Emily and I conduct are loyal to this philosophy. We talk minimally, embrace the silence, and quietly celebrate when a more reserved participant chimes in. 

Further though, this idea has held true with all the people I've met along the way. It's crazy, but in those ten seconds, you can hear the other person forming their next thought. Like claymation. Or maybe in the silence the previously stated sentence echoes. Either way it works. 

I have a story to share but I'm going to save it until I have the gusto to tell it well. Think of me as counting to ten, ironing out the details, unbending the kinks. 

Have a good day,

Rebecca 

Last night, with the telescope, I saw Saturn

Deja Vu: good morning from the lake. I'm at the southern tip, now, instead of up north where I wrote from 2-3 weeks ago. Have you seen a map, perchance, to appreciate this land-locked sliver of a nation?: bordered by Tanzania, Mozambique and Zambia; monopolized by Lake Malawi, which takes up around a third of the country. Third largest lake on the continent, I believe they say. 

It's a small country, but there are tinier. Remember in 9th grade when we picked out of a hat the African nation we were to do a report on, and my fate was São Tomé and Principe? Excluded from most artists renderings of the continent and the majority of history texts: it was a challenge. I remember photo-copying page after page at a local library; the internet search still hovering low under the radar. 

I've been pensive, lately, if you hadn't noticed. Relatively inside my own head and alarmingly conscious of my own thoughts. It's protective sometimes to not be like this, to let thoughts baste unbothered. And imperative other times to let them be served, even if their insides are still doughy, like the buttered croissant(sss) I had for breakfast. 

I'm talking about "thoughts", kid, in case that got lost in the mumbo-jumbo.

I've put a lot off over the last 6 weeks, which I'll very well regret in three. There's a personal statement to prepare and an exam to acknowledge and other things out of my working brain's reach at the moment. I thought I'd proven to myself how glorious it is to get things done ahead of time, to not procrastinate, but some habits die hard. 

Today (and not three weeks from now), I'm slated to go snorkeling. I know a lot of people boast discoordinate, but I'm a special case. Swimming, real swimming, has always been a challenge. When I tried to do laps yesterday in the pool I closed my eyes (chlorine, to induce better imagination) and tried to emulate Michael Phelps. You know what they say about reaching for the stars.

What else can I say? Let's see. I'm with my parents for another handful of days and then the galavanting will cease. Then, there are three more focus groups to conduct, and work to be done with regard to our bicycle ambulance initiative. In the interim: I'll enjoy my time with my family. They've been entertaining, but not in a terribly reproducible way. My mother is constantly pointing out animals to me, which is only funny/complicated because 99.9% of the time she tells me to direct my attention at twelve o'clock. Well if I see them they're obviously right in front of me. 

Aside from that, my parents have been incredible in their appreciation and pure enjoyment of Malawi. They're falling for the people, the landscape, the relaxation, and the food. I believe in that order. 

I'm happy here, as I think is clear, but'll be happy to be back home as well. I think it has something to do with the fact that I know I'll be back here, one day. There's security in knowing I'm not leaving for good. Maybe it's a little premature to reflect on this. Now I'm going to get back to Oscar Wao.

Thanks for reading,

Rebecca 

PS: I could even see its rings. 

Right of way

Third row of the land cruiser, speeding along a semi-paved road from Majete National Park to our next destination on the lake. The window is horizontal, sliding, and for a moment I opened it up wide and let the air gush in. It slapped me in the face, and it was hard to breath steadily for a moment. It doesn't feel terribly polluted around here, but the thick air holds more than the invisible elements. It holds dust. 

The conversation in the first two rows is churning around Malawian politics. For a moment, the focus is inside the vehicle and not the world that surrounds. I catch snippets: Banda. Corruption. Fines as salaries. 

It's as if we're driving through the countryside, until we stumble upon a pocket of settled earth. Like an aneurysm, small villages and neighborhoods peel off the main road and swell into the distance. There are one-room homes, brick-walled, with roofs of thicket or tin panels. Laundry lines hang low and still, weighed down half way across. 

We pass bicycles and over-stuffed minivans and clusters of people traveling the semi-paved roads as well. The people: carrying rods of sugar cane or a basket or a bundle of twigs or knapsacks. 

For sale, you name it, on the side of the road: potatoes and rice and timber and coal and bricks and tomatoes and raw meat and fried dough and on occasion, on skewers usually held out by children's outstretched hands, roasted mice. 

We pass goats and chickens and little black pigs. A fair trade, I guess, for yesterday's wildlife. 

Have I said enough about the safari? The game drives? Is there that much more to say? Sometimes it takes me a few days to put into words an experience, so maybe I'll say more this coming week. I had resolved to start writing longer posts (a challenge) but I've yet to follow through. A work in progress, on the road again. 

Rebecca