Wednesday, January 30, 2008

Domestic Life

Nothing about running a household here in Africa is easy. There aren't any easy meals. You can buy dry rice and beans, oil, fruits, vegetables, eggs, sugar, bread, flour, tea, and coffee. The rice and beans have to be soaked, the vegetables chopped and cooked. There's no bagged salad, frozen meals, Wendy's frosties, pre-made pie crusts, pre-made pasta sauce, sliced bread, granola bars, soup, chocolate chip cookies, lattes, string cheese, yogurt smoothies, or any of the other things I'm realizing made up the entirety of my diet in medical school. On the other hand, one of the true benefits to living here is the tropical fruit. I have never eaten such delicious mango, banana, pineapple, litchi, and papaya. They're little fruity miracles, fresh and sun-warmed right off the tree. There has been many a night Kevin and I stuffed ourselves with pineapples and mango and called it a dinner!

I tromped to the outdoor market a few days ago in search of food. Since the onset of the rainy season, the collection of thatch huts that make up the market have been swimming in a sea of mud and muck. As I waded through the stalls, my feet sank up to the ankles in sludge (Thanks to Mrs. Harvey for the cute galoshes. Boy was I grateful for them right then). I stopped to buy some onions and tomatoes. Women called to me from their stalls, “Senora, don't you want some couve? Amiga, don't you need garlic?” I lingered by the spice man's stall. He has little packets of powdered spices laid out in a rainbow of colors along with bouillon cubes and dried bay leaves. The intermixing smells of all of them is intoxicating. I always pause, but never know what to buy. I don't know their Portuguese names of the spices or how to use them. It could be curried crack for all I know. I recently bought some “chicken spice” that smelled good. I assume that it's for chickens and not somehow made from chickens, but I haven't yet tried it out. On the way out of the market, men were hawking pineapples from the small mountains of produce that lined the main entry. Other men were roasting ears of corn over tiny charcoal fires. I took particular note of this since I hadn't seen corn eaten here yet. I dragged my galoshes through the giant puddles in the streets trying to get the mud off on my way back to the office.

Back at home for lunch, I searched for the avocados and mangoes I had left on the counter that morning. Not finding them, I asked our new empregado if he had seen them. He proudly opened the door of the freezer and shown me that he had frozen all of our produce. I was at a complete loss for words. I guess that might seem like a good idea to someone without the personal acquaintance of freezers.

As Kevin and I tried to make dinner that night, I was discouraged by the sight of the melting fruit disintegrating in front of me. We were also boiling some corn we had excitedly bought from some street children earlier. “Can you eat it?” we had asked them eagerly. They looked at us with surprise, curiosity, and a touch of disdain, but replied “Yes, you eat it.” “Who are these stupid people?” their eyes seemed to say. I was so excited by the thought of some yummy corn on the cob. But as we continued to boil it, we noted something odd. It was still rock hard. “How long does it take to boil corn?” Kevin asked. I was pretty sure it didn't take more than 10 minutes. Since neither of our mothers was around for us to ask, we decided the best course of action was to keep boiling it. After half an hour, we poked it with a wooden spoon. Yep, still rock hard. We boiled it some more. After three-quarters of an hour we decided the corn was not going to get softer. But what can't be improved with butter and salt, right? We pulled it out to try. Definitely very hard and oddly chewy. I was mentally running through possibilities. Was this type of corn only good for making meal? Was it infected with some weird fungus with neurotoxic properties? So far I wasn't experiencing any ill effects, but I voiced this concern to Kevin. Kevin, by now used to my starting sentences with “I remember they told us in medical school about this weird but lethal fungus/poison/bacteria/disease...” noted that it tasted like popcorn and kept munching complacently. I caved and opened a bag of Valentine's M and M's Granny gave us before we left. I had carefully guarded them during our voyage from prying airport security officers who wanted to know “why I needed a whole backpack of candy on the airplane.” Turns out I needed them for just such emergencies.

We have a friend here who has been working for FGH since it started. She's a Nurse Practitioner from a small town in Tennessee (and therefore knows what good corn is) and has lots of African experience (ex Peace Corps). I asked her what the deal with the corn is. She told me that it is indeed, “just really hard for some reason. But you can still eat it.” She related a similar experience of boiling corn for an hour in confusion before giving up and eating it. At least it's not a neurotoxic fungus.

An aside from Kevin: One thing that will always be fabulous about domestic life in the Moz is the fruit. I could, and usually do, eat between 3 and 6 mangoes daily. Until recently this fact accounted for a considerable part of my waking hours. However, thanks to a lovely gift from Mr. and Mrs. John Egerton of Nashville, Tennessee, I now have my life back.

They gave us a mango slicer. Everybody's got one of those apple slicer thingies, right? That you push down over the core? This operates on the same principal, but only extracts the one giant seed in the middle of the world's greatest fruit. Before you'd spend no less than 10 minutes delicately slicing the Prime Meridian, peeling the skin back like the petals of a lily, and then making a mess of your entire face trying to eat a mango like an apple. That's not to even mention the fibers that get stuck in your teeth. Now I just push the all the best meat falls perfectly on my plate.

Our first experience with this device didn't go so well. We'd purchased a half dozen ripe mangoes, but had decided to dine with friends at the last minute. The mangoes had to wait. The next day, Lara tried the mango slicer on a now very ripe mango. The result could only be described as a mango smoothie. We'd abandoned this technology like Beta VHS until I was faced with a dozen fresh mangoes to slice. I decided to give it a chance myself, and now I am grateful: what would have taken me a half hour was done in 3 minutes.

I know a lot of people who are addicted to Africa, and the reason is plain and simple: mangoes. They are a coy fruit, promising so much flavor but requiring an incredible effort. Men are turned to mindless drones, forever searching for the dissection technique that will yield true. Do yourself a favor before your next trip here: pick up a mango slicer.

Sunday, January 27, 2008

Selections

Here are several "mini-blogs" I've been writing that I haven't had time to post individually. Also, all our luggage finally arrived as you may have read along with all the medical supplies, thankfully. The pediatric BP cuffs are going to be a welcome part of the pediatric HIV treatment roll-out. I delivered the masks and gloves to some very grateful lab staff here. They will make their difficult jobs safer. The cute card from the United Methodist children is in our FGH office! Thanks to everyone for their generosity; these things will go a long way here.

Adventure in Namacurra: Last Thursday I went to Namacurra to check on the lab there. It was a somewhat slow day with few requests for lab tests and still fewer TB samples. After spending a few hours in the lab I realized I had neglected to bring water. I headed out to find our driver and get some water or Coke in town. We found a little stand and I had my Coke and we got some water to take to Dr. Paulo. We stopped in the market so I could buy some white sweet potatoes for Kev's and mine dinner that night. In Mozambican markets, you buy things by the “lugare” or place. They build little piles of produce on the ground and that's the unit of sale. I asked the vendor how much each lugare of potatoes was. He replied “10 contos.” That's about 20 cents. By this time, our driver had gotten out of the car and started berating the vendor. “Ten contos! You know it's 5! You're going to charge this Doctora 10?!” The vendor sheepishly agreed to 5 contos for each place. Our driver collected the 2 places I asked for and I gave the man 10 contos. Back in the car, the driver chided me, “This is why you shouldn't go to the market alone. These guys will try to cheat you!” I didn't have the heart to say that whether my huge bag of sweet potatoes cost 40 cents or 20 cents didn't make much of an impact on my financial life. I'm well aware that I get charged more in the market than anyone else (you'd have to be entirely stupid not to catch on to that.) But, I felt kind of bad for the guy who worked hard growing those potatoes in the field. Produce costs so ridiculously little (a pineapple right now is between 10 and 20 cents) and these farmers labor so hard to scratch out an existence that I don't really mind paying extra sometimes. Still, I appreciate the driver looking out for me.

On the way back, we saw FGH's Mozambican social assistant and 2 Peace Corps volunteers that are working with us, so they hopped in for a ride back to the hospital. I was in the front passenger seat, talking to our other passengers when one of them gave a gasp. I had just time to turn my head and close my eyes when I heard a loud pop and safety glass from the windshield burst all over me. The driver slammed on the brakes and I looked out the cracked windshield to see a small man stalking away and scowling at us ferociously over his shoulder. The large chunk of rock or metal he had thrown slowly slid off the hood of the car. My heart nearly stopped as I looked at his twisted expression; thinking this was my first experience with someone truly hating foreigners. But the social assistant said, “No, I recognize him. He's maluco.” He's the local mentally ill resident. Turns out he frequently throws rocks at women, children, cars, animals, whomever momentarily offends him for whatever obscure reason. We went to the local police building to make a report. They wrote out a description of the accident by hand and stamped it. They told our driver, “Yes, we are familiar with this man. He's crazy. We tell people to stay away from him.” Apparently that's all that can be done. There is no place for him where he can be kept from harming other people. (And a rock of that size thrown at a child's head could easily be lethal.) There is no treatment for mental illness, even severe mental illness and psychosis like this man may have. For most of Mozambique, the physically ill have trouble enough getting care, but the mentally ill are truly out of luck.


Patients: A young woman came in the Inhassunge lab with her sister and a small capulana wrapped bundle and handed me a slip for an HIV test. I introduced myself and told her to please sit in the chair by the testing materials. She sat the bundle on her lab and unwrapped it. Inside was a tiny, scrawny baby. He could not have weighed 6 pounds. On every limb, bones, joints, and ligaments stood out in a most unbabylike way. I've never seen a baby's patella before. I tried to think of the Portuguese words for “Was he born today?” but could only manage, “How many days old is he?” The mother replied, “He's one month old.” It's times like these that I'm grateful for the practice my medical training gave me in controlling my facial expressions. She was anxiously watching me as she said this. I nodded and picked up a tiny foot, no longer than my thumb. I cleaned it with alcohol and stuck the poor thing with the lancet. The baby let out a tiny mew and tried to kick. I gingerly kept a grip on the foot and ankle and squeezed a drop of blood into the little capillary tube and put it on the rapid antibody test strip with reagent. Thankfully, it was negative, one of the few that day. So what was the problem? Intrauterine growth retardation? Congenital metabolic disorder? Congenital malformation of the GI track? Allergy? Continual infections? Diarrhea? Abuse? Difficult to know here.


Colors: Mozambique is a jewel toned country, especially now during the rainy season. The sky is an electric sapphire that can't be relegated to the background of the landscape. It has a presence. You feel the brightness of this sky and the sunlight that pours out of like heavy gold. You can't ignore that either, especially if you're standing in it. It will fry your brains (that's a medical term). I had to wait sitting in the sun on the boat coming back from Inhassunge one day at about 1pm. I felt I better understood tales of people losing their minds from wandering around in the sun. When I got home I realized that my legs had gotten sunburned in splotchy places through my pants. The plants on the ground are vivid green from soaking up all the tropical rain and even the dirt is rich black or blood and rust red, never pale clay. There are tons of little birds I've never seen before, bright gold, ruby, and iridescent green that swoop through the bushes. Some have long sweeping tail feathers and some hide in little twig houses that hang from yellow-green tree branches. There are flowering trees so covered in vivid red-orange blossoms that from far away you would say they are on fire. While we were home over Christmas, lots of people commented on the bright colors worn by people in our pictures. I hadn't really noticed that before, I guess because the bright colors people wear seem to fit into the landscape somehow. They belong more than pastels would. Many clothes come from second hand markets. People at the market shop with a taste for the bright and flamboyant, with no knowledge of the designer's original intent for the garment. So occasionally you see a man sporting a woman's red satin button down or one of those crinkly shirts with lace trim. It's kind of refreshing really. The pointier the shoes; the orangier and more Hammer style the pants; the more covered in butterflies the shirt the better. They walk proudly in their finery, calling to mind the bold, brightly colored birds and butterflies native to this country. It's pretty clear Puritanism would not have gone over well here. Actually, it's hard to imagine Puritanism being popular anywhere but under a gray, cloudy sky isn't it?


Rain: The heat had slowly increased throughout the day in Inhassunge until it reached a truly suffocating level. The staff told me it meant the rain was coming, even though I could see no clouds in the sky. I was in the lab when the rain began to fall softly. It was the first time I'd seen rain there. It pattered pleasantly on the tin roof of the building. I smiled in relief at the sudden coolness and went to the screen door to watch. Suddenly, the pitter of the rain on the roof turned into a startling and deafening roar. It became hard to see people across the courtyard as sheets of water fell from the sky. The drainspouts started to gush and the water exiting them sprayed 1 or 2 feet before hitting the ground. Small rivulets in the sand turned into rushing gullies. This went on for about 20 minutes. It looked to me as if the whole hospital would be washed away. I began to look around at other people to see if anyone else was concerned. Everyone had stopped working since no one could hear and was watching the rain. Some were rushing to put out containers to catch the clean rainwater. But no one looked particularly worried. Then, as suddenly as it started, it stopped. You could see the last sheet of water hit the ground and then no more. The sun came back out and clouds of steam rose from the wet sandy ground.

That afternoon, as we headed the 18km back to the dock in the truck, we crossed the flat expanse of rice fields near the shore of the river. You can see for miles in this particular spot because there aren't many tall trees. There were billowing piles of angry storm clouds that towered into the blue sky, but that weren't very wide. Across the horizon you could see three or four cloud columns and the rain falling beneath them. In between the columns, it was sunny. This is an odd thing about rain here. The rain comes down like someone overturning a giant trough in the sky, complete with thunder and lightning, for 30 mins or an hour in a very contained space. Then it stops and moves on. Rarely is the whole sky covered with clouds. The one time this happened, I noted it because it was the first time I've felt all the muscles around my eyes relax when I was outside. Once in Namacurra I saw it rain across the street but not where I was standing.

Monday, January 21, 2008

Poultrygeist

Slowly but surely, we are bringing our house to order. As of last Thursday (one week after we arrived), we have received all our bags. My bass came in on the 6 o’clock plane from Maputo after many poorly Portuguese-as-a-second-language phone calls and extra work from FGH staff in Maputo.

I’d always heard about musician’s getting a sign from God either to pursue music professionally or not. All guitarists have a story like this:

“I’d thrown out my back playing two-bit parts in kung fu B-movies for the last time. That’s when I decided to devote my life to my guitar.”

I figured this could be my sign to stop. I’d nearly resigned myself to 5 months in Mozambique without my instrument. However, in one final effort, I asked our friend Heather (a former Peace Corps volunteer whose Portuguese is much further advanced) to call the Maputo airport for me. She said they had it and she had them send it on the next plane.

I reserved my celebration until I actually saw my bass case on the tiny carousel at the Quelimane airport. Relief washed over me like Zambezia rain after a 5k up and down the marginal.

After we got it, we asked the security officer if there was a room that I could examine it in to make sure nothing had been stolen. He showed us to a room with a table and an ominously still pile of feathers on the floor. What better way to sum up Quelimane than a dead chicken on the floor of the security office at the airport?

The security guy totally ignored it. “What dead chicken?” he seemed to say. He regarded the carcass as if it were totally normal. Meanwhile we tip-toed around it like, well, like it was a dead chicken in the middle of the floor.

That poultry gave me pause: after all this effort to find my wayward bass, could God have put a dead chicken in between me and my dreams? Or maybe the customs agents had simply denied someone their patently third-world carrion carry-on. We checked my case quickly and went home. I have since dismissed it as someone else’s sign to stop whatever he was pursuing and do something else.

Taking stock of our luggage, we only found a few things missing. Lara brought a tiny sampler vile of perfume as a gift; some security person somewhere decided she needed it more than Lara did. Most oddly, of the entire 5-pack of toothbrushes we brought back for Troy, four of the compartments were opened and vacated. Only the fifth remained untouched.

With our final bag in our grubby little paws, we’re finally starting to feel settled in again. Our apartment is the best we could have expected in Mozambique. A one-bedroom flat-style furnished apartment above a delightfully tiny bar-restaurant called Pica-Pica. Since we’ve been here we’ve discovered three new places to eat, including the new Chinese restaurant. The spring rolls are exactly like they are in the U.S., and all the dishes have numbers instead of names.

The weather isn’t so bad. All but one day since we’ve been back have had a solid drenching around 1 p.m. that staves off the most intense heat. There is one drawback, however. To get to our apartment, there is only one narrow driveway to the back of the building where our gate is. After intense rains we have to walk through an ankle deep wall-to-wall puddle to come and go.

The city itself seems cleaner. The white walls of most of the buildings seem brighter, and to our eyes there is less dust in the street. Relating this last night, a friend corrected us. She’d had the same impression after returning from a long trip. She said that we’d only remembered it being filthier than anything she’d ever seen, and the city didn’t live up to the pigsty our imaginations had created. We decided she was right, but that hasn’t kept us from feeling better about Quelimane.

So we’re in and we’re safe. My days are filled with work, books, Mozamblog, and my bass. Lara is traveling to her research sites almost daily and comes home exhausted. Back to business as usual in Mozambique.

Thursday, January 17, 2008

Seven Connecting Flights Later....

I’ve got a new favorite quirk about Mozambicans: they congratulate you on getting fat. We’ve been back in Mozambique for three days now, and every time I run into one of my native friends, it’s always the same thing.

“Oi Doutor Kelvin! Fique gordo!” (You got fat!)

This is not abnormal conversation in this part of the world. First of all, most folks mispronounce my name in the same way, inserting an l. Secondly, they almost always assume I'm a doctor, as all the other people in our organization are. Thirdly, obesity is celebrated, and they are not at all afraid to talk openly about it. Usually, the Portuguese word for "fat" and "strong" (forte) are used together to describe people.

So I put on a few pounds over the holidays? So what? I hadn’t had any of my mom’s desserts for five months, so she made all of them for me over the break. It was fabulous. Combine that with Peggy Bratcher’s Thanksgiving extraordinaire to make up for our being out of the country and I’m lucky to have escaped McMinnville with only ten extra kilograms (don’t do the math).

We arrived in Quelimane around 3 p.m. last Thursday. None of our luggage did. None. In an incredibly convoluted effort to save some money, we took two round trip return flights to get back to Africa. We started out in Nashville with fours bags and a plane that was an hour and a half behind schedule. Only by the grace of God did we make it to our connecting flight in Philadelphia. Twelve hours later we’re in Paris at the luggage carousel looking at Lara’s red rolling suitcase, wondering Ought that not be on a plane? Unfortunately, we decided to leave it.

We flew to Vienna where we had to check-in again (this was the end of our first round trip return) with only two of our four bags. Lara’s red bag was still in Paris. I’d decided while I was home that four more months without a bass of some type would be unbearable, but I may have seen my Epiphone for the last time when we checked it in in Music City.

Down but not out, we headed onward. We had to fly to Frankfurt to get on a plane to Johannesburg. I’d barely had time to examine the seat back pocket in front of me when weariness finally caught up. I was on another intercontinental trip. Needless to say, the fourteen-hour trip to Johannesburg had me crossing my eyes, plus we arrived late there and had to run to catch another plane to Maputo.

With three days’ worth of dried sweat, we finally landed in Maputo, only one more flight to go to get to Quelimane. I don’t remember if we spoke Portuguese or English to the customs official. The luggage carousel in the airport was tiny, and only a few bags had come around before they announced that most of the bags were still in Johannesburg. All we had for five months in Africa were our laptops and a backpack full of books and Christmas candy.

We went to report our lost luggage. I can assure you that nothing seems more futile than dealing with a Lost & Found agent in a third world country. I told him about the bags in Johannesburg which he assured me would be sent on the next flight to Quelimane.

It was 11 a.m., and our flight to Quelimane was scheduled for 2 p.m. Eduardo, the driver for the FGH office in Maputo, met us at the airport to give Lara some lab supplies and pick up some things we needed to get to Maputo.

Eduardo fills an interesting role in our lives here. He is the yardstick for our Portuguese skill. When we first came here, he was the first person we met that didn’t speak English. Conversation was difficult but manageable, and he was a very patient teacher. Promises were made that we’d be a lot better when we came back through in December, and those promises were filled. Now, however, after a month away, we were all surprised how we struggled for words that we hadn’t used to. I try to keep telling myself that it was because I was exhausted.

Eduardo was kind enough to pass by the Lost & Found desk to ensure our requests had translated, and he left. We checked in for our flight to Quelimane and went through security into the gate area only to be greeted by what was left of Maputo’s Christmas decorations. They have the most precious and pitiful Charlie Brown Christmas tree you’ve ever seen at Gate 6, complete with precarious lean and insufficient tinsel. You can’t say they didn’t try.

On to Quelimane, where for the first time in my life we didn’t have to wait at the baggage claim. We were ecstatic to see Lourenço, one of FGH’s drivers, waiting for us in the parking lot. He drove us back to the office to pick up the key to our new apartment, and we dizzily hugged everyone. An hour later (around 5 c’clock), we were asleep in our first home as a married couple without a roommate. Pictures of the apartment to come soon.

I promised myself I would never say this after I started this blog, but here it goes: sorry I haven’t posted more recently. I’ve got a backlog of stories to tell a mile long in my journal, and I’ll be trying to get some of them up, as well as whatever else happens over the next five months. Thanks for reading!