Aparna in Mozambique

Sunday, May 20, 2007

On people…and culture…and social change…

May 20, 2007

Greetings all!!

Well, I believe that the last time I wrote was just on the brink of my new set of modules. I was fresh off of the travelling bug and not accepting the fact that I had to get back to work. But, wow, getting back to work has never felt so good and I am glad that I am. Every day, I feel that I am truly blessed for this opportunity to experience a new location. It really truly makes me realize that people are people and that they really are the same no matter where the time, place, or difference in experience.

I think that in so many ways, I was very naïve about what I would experience when I came to Malawi. I had prepared myself mentally to be alone, to be depressed, and to be very very introspective. I imagined that I would tune in a lot to my ipod and that my solace would be in books. I romanticized Malawi to the extent that I felt I would be as a peace corps volunteer, doing surveys in the village and in my spare time travelling on mini-buses across Africa all by my lonesome. What I found was not what I expected…and at the same time it was.

When I arrived, as most of you know, I immediately did a field survey. The field felt very real. I remember thinking to myself, this is Africa. I saw children everywhere with malnutrition, I saw people working in the fields, I worked side by side with Malawian nurses taking blood pressures, and I walked miles on end from household to household, through fields of maize, just to take a single survey. If I were a VSO or Peace Corps volunteer, this might have been my life. 85% of the population of Malawi lives in rural parts. But, because of my Rotary sponsorship, I was intended to be based at the college of medicine, doing courses and living in the grand city of Blantyre. I remember driving through Blantyre on my first day after arrival to Chileka airport.

I remember my co-surveyor asking me how I was adjusting. I had literally come straight from the airport to the field. For me it was all very exciting still and I hadn’t given much thought to the whys or whats or hows of my trip and my journey. But, after she asked me, I realized that it felt completely normal and natural to me. I looked at people objectively and not as other people. I felt no different in a village in Africa, than one in Costa Rica, or India, or Bolivia. It was a strange feeling, and one that I am not sure everyone shares. When I finally did arrive in Blantyre later, I tried explaining this feeling to a new friend. The friend had inquired if I had travelled. I responded with my list of countries that I found impressive for my less than 25 years on this planet (Canada, Mexico, Nicaragua, Costa Rica, Bolivia, Argentina, Brazil, Spain, France, Italy, Greece, England, Australia, India)…I thought that I knew enough of the world to be able to live in Malawi. He responded with yes, but this is Africa, it’s not like those other places. My first instinct was to respond, yes you are right. But, then I realized that I felt more comfortable here in Malawi than I had ever felt in any other country. And I don’t ascribe this to the fact that Malawi is distinct culturally or socio-economically than any of the other places that I have travelled. It was just that I as a person had come to Malawi with a sort of detachment from the location. That is, I didn’t feel that people were going to different and this formed my judgement on how and what I would be doing. I came in with the assumption that this was just another place to experience that it would connect to me, touch me in ways that would be new, but that the people might as well have been from Paris or New York, simply that they were situationally located in sub-Saharan Africa.

After I came back to Blantyre, I began to feel more and more like this…the people I met, the places I went were very much like the ones I would visit at home. I could still eat pizza if I wanted to…I could still go to a bar…I could still wear jeans and stiletto heels. But, at the same time, I go to class during the day and learn about the tribulations of primary health care in Malawi and read about the rates of co-infection of TB and HIV/AIDS (77% of TB cases). This dynamic, of having a life that I could lead in the U.S. while having a purpose in being away from that home, was difficult at first. What were these two people that I had to be? And the guilt associated with knowing that my classmates (district nurses, doctors, health officers, and social scientists) could not be eating a pizza on a Friday night that cost nearly as much as a weekly wage. In so many ways, my experience here has been reminiscent of that that many of use face in a city like New York.

An interesting statistic that I heard in class a few weeks ago is that Malawi is considered more equal than the United States. Yes, you heard it right, Malawi, according to an official index, is rated at 38.6 while the U.S. is ranked at 40.2. For those of us working in the social services industry, we may have experienced this firsthand. I know that feeling of two lives always pervaded my experience in New York, whether it was on the train from Morningside Heights to the Southwest Bronx or to Washington Heights to work with an after school program or to volunteer with survivors of domestic violence. Then, I would return to the comfort of my shared flat to order Chinese and watch television. And return to the classrooms at Columbia and listen to me and my relatively comfortable classmates discuss issues of inequity that we ourselves might have never faced in life. It’s a tricky situation and one that I am still grappling with. How do we reconcile these two people and do we have to? To me, it has become to feel completely normal. No matter what I do or how I pitch myself, I am wealthy, not only in Malawi but in the global scheme of things. And with this wealth, comes some responsibility. But, I also have the ability to enjoy this wealth without harming others and to pursue my passions in a way to benefit others. Is this problematic? I don’t believe so…because at the core, to come full circle, I believe that people share a common experience regardless of place or time, and that my duty to my sisters and brothers is the same whether I am in Chicago or Blantyre or Timbuktu. I would love to hear your comments on this issue family and friends. I think it would make for a great Jerry Springer episode when I come back (Only joking).

Ok, so back to what I’ve been up to….

Since we last chatted, I haven’t been up to a whole lot, to be honest. I have met a great girl named Donna, from Ireland and we have practically been living together since we came back from our travels. We like the same foods (peanut butter) and have the same hobbies (staring at the wall and going for long walks) so things are working out very well. I do have my own flat in Mandala, which is near the college, and my roommate Veronica (a nurse and classmate) have been sharing some wonderful times cooking and drinking tea and chatting about non-school subjects. The scary thing is that both Veronica and Donna enjoy my cooking so perhaps I have gained magical cooking skills while in Malawi. So, come to Malawi and you too can learn how to cook an amazing Indian meal

Donna and I are putting together health workshops for the children at her school and have planned to do two at the end of June. One is about basic personal hygiene and nutrition and the other is about common illnesses. I am buying some personal items for the children (toothpaste, toothbrushes, soap, and nutrition charts) so if any of you are interested in donating funds to this, they would be greatly appreciated and I promise lots of pictures of the children brushing their teeth and washing their hands. Also, if anyone has books that they would like to donate to the school, that would be wonderful as picture books are a bit hard to come across and the school is always in need.

So, the last time I wrote, I was just on the brink of a HIV/AIDS module. I was so excited about this course, but unfortunately all of the people that were supposed to conduct the course were in Lilongwe at a meeting for the week. It was supposed to be done by the National Aids Commission (NAC), but since there were gone, we had our usual lecturers. It was still good, don’t get me wrong, but ended up being quite clinical, mostly about anti-retroviral drug therapies and scaling up the ARV plan for the future. Another topic was HIV/TB co-infection, which is a huge issue and a major factor in planning programs for the upcoming years. I learned a bunch about MDR-TB, XDR-TB, ARV drugs, PMTCT, and lots of other abbreviations, but the fact for me to take away was that 77% of TB cases are HIV+ so clearly both programs need to identify how to have a collaborative program for TB and HIV that is sustainable for the future. In other words, in Malawi, one can’t deal with TB without dealing with HIV and vice versa. Easier said than done, I know.

Last week, I had my first exam…I know, I actually still am in school. My grandmother (or Ajji as we call her) keeps telling me to stop studying and just get married. She has had enough, but I anticipate a few more years of school so that I should be ready for marriage by the time I am 40. Sorry to break the hearts of the Indian-American community, but my grandfather always told me studies first, so I am following his advice on this account. So, back to my exam, it was on epidemiology and statistics, which was a bit gruelling, but hey I made it. We have exams for all of our core modules (there are 5). I had no idea about this before I came, and was shocked when they mentioned the four letter word for the first time. Ah well, the permanent student had to pay a price at some point. These past two weeks, I have had the following courses: Health Management, Health and Globalization, Health Policy, and Health Economics. Most of these things I have learned before, but what I love most about it is doing it all with my Malawian classmates. Management styles may be universal, but certainly hearing the Chichewa phrases used to describe lazy bosses, lazy employees, and common sayings such as, “I’ll do it tomorrow,” are things that I’ll never forget.

In Rotary news, things have been a bit hectic for the groups here. There was a Group Study Exchange (GSE) team from Scotland visiting and then another this week from New York. I did not get a chance to visit the Scotland team because of my exams, but we did have a joint dinner this week with the Blantyre and Limbe clubs for the New York team. It was so great and I was really impressed with the hospitality of our club as well as the calibre of the people who came. There was Laurie, a librarian, Sarah, a community nature educator, TC a zoo marketer, Joe, a middle school teacher, and a TV producer. The team was led by a kind woman named Jean whose love for Rotary was apparent in the care she took of the group and the amazing video presentation she had prepared for the club. She spoke about how the groups had visited Malawi Children’s Village, an organization started by Peace Corps volunteers, and how touched she had been. She was so proud of her team, the work Rotary has done here, and of her team back home (her district is the only one where all clubs support a disabled camp in upstate New York). The team was visiting 6 countries in 32 days and I was so thrilled that I had the opportunity to meet them. This dinner reminded me of why I am here. The spirit of Rotary is very strong and truly does connect people worldwide. I am going to try my best to make as much of a difference as I can while I am here in the 7 months that I have left and to engage in Rotary and help them as much as I can in obtaining funding. I met many Rotarians at the dinner who are doing work in nutrition and health and I hope to link with them to volunteer and potentially design some future projects. In June, I will be presenting at Limbe as well as Blantyre Rotary clubs. I am really looking forward to this and to experiencing the different cultures of the two clubs.

Other than my philosophical travels, school, and rotary, my biggest upcoming news is that Achie (also known as my brother or Ashwin) is arriving on Monday. I have loads of things planned for him….but mostly I am going to try to keep him locked up and away from the women of Blantyre. They keep inquiring about him but I have assured them that he is permanently unavailable. Don’t worry mom, I am still keeping my eyes peeled for a suitable wife for our Achie. So, on my next blog post, expect more pictures of travels and hopefully a few of my classmates and Rotary presentations!

Bon Voyage and I look forward to hearing any and all comments as usual (the good and the bad)!

Warmly,
Aparna