I sat across the desk from the doctor who wrote notes on a prescription pad. He asked my name.
On the walk with Mama Happy to the clinic, Happy had called and said, “Tell the doctor you’re married to an African! He will charge you a lot of money if you don’t!”
I did not like this idea. This would mean I’d have to keep track of my fake identity if I ever went back to the same clinic again. It would become exhausting and if I were really sick, my story would surely fall apart with more probing questions.
But I also had a total of 15,000 Tanzanian shillings, the equivalent of $15. So I decided I would be married to an African. I would use Happy’s last name and say that my husband was a lecturer at a college in Masoka and that I taught at Kirima Primary School.
The doctor misspelled my first name as “Jane,” and I didn’t correct him. I could later explain to government investigators that it wasn’t my fault he’d gotten the name wrong. When I spelled Happy’s last name, the doctor corrected my spelling. He should’ve been suspicious, and maybe he was, but he neither blinked nor paused in his routine.
He asked if I had a fever. I said no. I waited for him to pull out a thermometer, but instead, he wrote, “No fever.” I was amazed I was that credible. I told him I had no appetite and was extremely tired. I told him what I thought was wrong: a tapeworm or malaria. Mama Happy added to the list: a glucose problem. He wrote these things down.
Then he sent me to the nurse across the hall who knew no English. She expertly took blood. Then taking a box of Lucky matches, she emptied it, saved one match and handed it with the box to me. She said “stool sample.”
I was mystified. Would I be lighting this one match to dynamite for stool? Outside the nurse’s office, Mama Happy sat on a bench and did some talking and gesturing with the box in hand. From that I understood I needed only a little sample in the box. I put the box under my bottom and said, “Like this?” She laughed. The teenage boy sitting next to her turned his head away.
I walked to the toilet still mystified. At least I knew the sample would go in the box. Even so, I was pretty sure nothing would happen, since this was the wrong time of day. And it was.
Back in the doctor’s office, the doctor informed me I had malaria. I did not have a glucose problem, I did not have typhoid. And if I really wanted to know about tape worms or any other kind of worm, I could return to try again with the stool sample.
We walked to another room just down from the doctor’s office and there was the nurse again, dispensing medicine. She did not charge me an arm and a leg for the malaria pills, perhaps because she thought I was married to an African. Or perhaps it was because Mama Happy had pushed me aside at the window and demanded to know from the nurse what each medicine was, how much it cost, and why did it cost that?
As Mama Happy and I walked away, I looked at the prescription slip. All evidence of my visit, both true and false, was there: symptoms, test results, failed test results, and fake name. I was free.
Wednesday, May 26, 2010
Wednesday, May 19, 2010
A complicated course
It is Wednesday morning, and for the fourth time, I have just distributed the course outline (syllabus) for Basic Communication Skills II to about fifty students. I have made changes to the outline given to me by the College. Under “Required Textbooks” I deleted all ten book titles listed. It did not make sense to me to require students to buy multiple books that looked very similar--Practicing Communication, Communication Skills, and Basic Communication, etc. Secondly, it made no sense to require nine of the books since they are not in the library nor in the bookstore. (The bookstore clerk spends most of her time photocopying pages rather than selling books.) The book that is available--seven copies for 250 students--did not have contents that matched the prescribed weekly lessons.
In light of the textbook scarcity, I asked students a few weeks ago how they wanted to fulfill the course objectives: prepare and deliver speeches, argue and defend points in debates, write good reports, use the internet. Did they want to debate interpretations of a novel or short stories (which we would photocopy illegally)? Or, I asked, did they want to debate about historical events? Or current issues?
The majority chose current issues. None of them wanted to practice oral skills by performing one-act plays (my preference). They physically shrank in their seats when I suggested the idea. And then when I said they could invite their friends and family for the performances, they slithered to the floor.
The next week I presented on the white board a large plan that entailed group debate teams, group topics, a written speech, a test, the actual spoken debate. I pointed out that this plan fulfilled most of the objectives but not all of them. I asked if they had questions or concerns. They were quiet.
This morning the class is looking at the same course objectives that I have now typed and photocopied 250 times. Are there any questions, I ask? One young man raises his hand. “Why aren’t we doing advertisements? I don’t see any assignments for advertisements.” I explain that I can’t teach advertisements because we don’t have a text book for advertising. Further, not all Basic Communication Skills students are business majors.
One student wants to know why they are not writing memos in this course, or minutes to a meeting, or advertisements. I repeat again: we do not have a textbook that covers memos, minutes, advertisements. I do not tell them, that I am grateful I have been saved from having to read 250 memos and meeting minutes.
A third student raises his hand. “What about advertisements? Why aren’t we learning advertisements?” I wonder to myself whether he didn’t listen to what I said the first and second time, or that he didn’t understand what I said. Understanding is slow because students are translating from English to Kiswahili as I am speaking. They have not gotten to the point of fluency where they do not need to switch back to Kiswahili.
When I give a set of instructions, I have to write them on the board. Then I read them out loud, then I ask whether students want me to repeat again. Yes. Then repeat again. Maybe this student who asked about advertisements for the third time wasn’t concentrating the first two times. Maybe he didn’t like my answer. I repeat again.
Finally, a student has noticed that the course description says the course will focus on the fax, as well as oral skills, reporting, library skills. “Why aren’t we learning how to fax?” he asks. I explain that we don’t have a fax machine to demonstrate it.
I suppose I could take 250 students to visit the secretary to the provost in her office which is barely larger than her desk. She could demonstrate the fax 200 times, but that seems an improper use of time and human resources. Short of several fax machines for teaching purposes, I don’t have a textbook that shows a picture of a fax machine. I tell them they can learn how to use a fax machine on the job in two minutes.
It is the first time I have had students ask why I was covering or not covering something in a course. Unlike my former students in the States, these students take an interest in what will happen. Nevertheless, trying to make an impossible course outline possible given the lack of textbooks, no internet on campus, a library with very few books, and students with little money to spare for photocopying and internet café use take their toll on my energy. So does repeating again.
The same student raises his hand again. “But can’t you teach us the theory of the fax?”
In light of the textbook scarcity, I asked students a few weeks ago how they wanted to fulfill the course objectives: prepare and deliver speeches, argue and defend points in debates, write good reports, use the internet. Did they want to debate interpretations of a novel or short stories (which we would photocopy illegally)? Or, I asked, did they want to debate about historical events? Or current issues?
The majority chose current issues. None of them wanted to practice oral skills by performing one-act plays (my preference). They physically shrank in their seats when I suggested the idea. And then when I said they could invite their friends and family for the performances, they slithered to the floor.
The next week I presented on the white board a large plan that entailed group debate teams, group topics, a written speech, a test, the actual spoken debate. I pointed out that this plan fulfilled most of the objectives but not all of them. I asked if they had questions or concerns. They were quiet.
This morning the class is looking at the same course objectives that I have now typed and photocopied 250 times. Are there any questions, I ask? One young man raises his hand. “Why aren’t we doing advertisements? I don’t see any assignments for advertisements.” I explain that I can’t teach advertisements because we don’t have a text book for advertising. Further, not all Basic Communication Skills students are business majors.
One student wants to know why they are not writing memos in this course, or minutes to a meeting, or advertisements. I repeat again: we do not have a textbook that covers memos, minutes, advertisements. I do not tell them, that I am grateful I have been saved from having to read 250 memos and meeting minutes.
A third student raises his hand. “What about advertisements? Why aren’t we learning advertisements?” I wonder to myself whether he didn’t listen to what I said the first and second time, or that he didn’t understand what I said. Understanding is slow because students are translating from English to Kiswahili as I am speaking. They have not gotten to the point of fluency where they do not need to switch back to Kiswahili.
When I give a set of instructions, I have to write them on the board. Then I read them out loud, then I ask whether students want me to repeat again. Yes. Then repeat again. Maybe this student who asked about advertisements for the third time wasn’t concentrating the first two times. Maybe he didn’t like my answer. I repeat again.
Finally, a student has noticed that the course description says the course will focus on the fax, as well as oral skills, reporting, library skills. “Why aren’t we learning how to fax?” he asks. I explain that we don’t have a fax machine to demonstrate it.
I suppose I could take 250 students to visit the secretary to the provost in her office which is barely larger than her desk. She could demonstrate the fax 200 times, but that seems an improper use of time and human resources. Short of several fax machines for teaching purposes, I don’t have a textbook that shows a picture of a fax machine. I tell them they can learn how to use a fax machine on the job in two minutes.
It is the first time I have had students ask why I was covering or not covering something in a course. Unlike my former students in the States, these students take an interest in what will happen. Nevertheless, trying to make an impossible course outline possible given the lack of textbooks, no internet on campus, a library with very few books, and students with little money to spare for photocopying and internet café use take their toll on my energy. So does repeating again.
The same student raises his hand again. “But can’t you teach us the theory of the fax?”
Wednesday, May 12, 2010
Day of the Pig
Normally at the household of Mama Happy, the first one to make a sound on a Sunday morning is Happy’s alarm clock at 5:30. She re-sets the alarm for another 15 minutes, after which there’s more silence until she realizes it’s Sunday morning and church starts at 7:00. On this Sunday in April, Mama Happy and her daughter Neema crashed around in the kitchen at 5:30, Mama Happy issuing orders.
By 6:00 when I went to shower, Mama Happy had a vat of water over the cooking fire outside. She poured some of it into my bucket which I then used for my own shower (my mother calls this a pour-bath, with a small plastic pitcher that one uses to pour water). By the time Happy and I were putting on clothes, one large pig was screaming in the raised wooden pen.
Usually in the evenings all of those pigs are screaming when they’re hungry. Mama Happy has to fight to lower a pan of pig slop from her tiptoes while I or someone else shines a flashlight. Sometimes they get too raucous and Mama Happy can’t lower the pan. I’ve learned to fool the pigs by shining the flashlight into a different corner where they scramble, giving just enough time for her to plop the pan down. By the time we walk away from the pen, my ears are ringing.
This morning, only one pig was screaming. The smaller pigs were huddled at the other end of the pen trembling. Two men outside the pen had poles that they were using to maneuver the pig into position to eventually slaughter it.
The pig would’ve been calm if Mama Happy had been right there. But today she watched from the hallway window. Normally she has guts of steel about these things. When it’s time to butcher a duck, she wanders casually near the flock and swoops down on one, grabbing the feathers on the back of the duck and marching with it to its final end. When the dog lingers too close to the food prepared outside, she’ll whip it or throw a rock at it. I usually wince at these things, but this morning, Mama Happy was wincing from the hallway window. The three-year old pig had given her 30 pigs.
Happy and I left conveniently for church at that moment. When we returned, walking through the metal gate two hours later, the pig had been butchered, now hanging in two lengthwise sections from a makeshift wooden scaffold. One butcher scraped off the pig’s hair with a razor blade.
From one of the bedrooms, Mama Happy had taken a wooden table and put it near the hanging pig sections. People had gathered to watch Mama Happy and the butcher take turns whacking away at the hanging parts of the pig, which meant chopping into the bones. All of us standing nearby soon learned to take cover from the showering bits of meat. When they weren’t whacking at the pig, the butcher and Mama Happy whacked at smaller sections on the table and plopped them onto the metal scale on the table.
Early on one boy had come to buy the head of the pig. The head had been placed on a gunny sack, steam rising from the neck. Later the boy returned with the head and asked to have it cut in two because the boy’s mother had arranged to buy the head with others.
At one point, the houseboy of Mama Kennedy staggered in through the gate. “Houseboy” is a job title that includes domestic outdoor chores, like digging a garden and fixing things. It has nothing to do with age Mama Kennedy’s houseboy appears to be 50. “Houseboy” also does not indicate sobriety, which he is not, frequenting Mama Happy’s garden to relieve his hangovers with a lime or two plucked from her trees. And usually he needs help with the plucking due to balance issues.
But today the houseboy of Mama Kennedy wanted meat. He was sober enough to help Mama Happy carry the pig’s stomach and intestines to the far back of the yard using a gunny sack as a litter, sliced off what he wanted and left the rest for the flies. The entrails seemed like something from a science fiction film, a gigantic worm larger than the pig, curled in upon itself. That evening, it was still there, but by morning, there was no sign that it had ever existed.
By 1:00, the pig was mostly gone. The metal gate was spotted with meat stains. So too was the notebook paper with names of customers. So too was the paper money in Mama Happy’s pouch tied at her waist. Within an hour, the Sunday returned to its usual self, with one less pig in the world.
By 6:00 when I went to shower, Mama Happy had a vat of water over the cooking fire outside. She poured some of it into my bucket which I then used for my own shower (my mother calls this a pour-bath, with a small plastic pitcher that one uses to pour water). By the time Happy and I were putting on clothes, one large pig was screaming in the raised wooden pen.
Usually in the evenings all of those pigs are screaming when they’re hungry. Mama Happy has to fight to lower a pan of pig slop from her tiptoes while I or someone else shines a flashlight. Sometimes they get too raucous and Mama Happy can’t lower the pan. I’ve learned to fool the pigs by shining the flashlight into a different corner where they scramble, giving just enough time for her to plop the pan down. By the time we walk away from the pen, my ears are ringing.
This morning, only one pig was screaming. The smaller pigs were huddled at the other end of the pen trembling. Two men outside the pen had poles that they were using to maneuver the pig into position to eventually slaughter it.
The pig would’ve been calm if Mama Happy had been right there. But today she watched from the hallway window. Normally she has guts of steel about these things. When it’s time to butcher a duck, she wanders casually near the flock and swoops down on one, grabbing the feathers on the back of the duck and marching with it to its final end. When the dog lingers too close to the food prepared outside, she’ll whip it or throw a rock at it. I usually wince at these things, but this morning, Mama Happy was wincing from the hallway window. The three-year old pig had given her 30 pigs.
Happy and I left conveniently for church at that moment. When we returned, walking through the metal gate two hours later, the pig had been butchered, now hanging in two lengthwise sections from a makeshift wooden scaffold. One butcher scraped off the pig’s hair with a razor blade.
From one of the bedrooms, Mama Happy had taken a wooden table and put it near the hanging pig sections. People had gathered to watch Mama Happy and the butcher take turns whacking away at the hanging parts of the pig, which meant chopping into the bones. All of us standing nearby soon learned to take cover from the showering bits of meat. When they weren’t whacking at the pig, the butcher and Mama Happy whacked at smaller sections on the table and plopped them onto the metal scale on the table.
Early on one boy had come to buy the head of the pig. The head had been placed on a gunny sack, steam rising from the neck. Later the boy returned with the head and asked to have it cut in two because the boy’s mother had arranged to buy the head with others.
At one point, the houseboy of Mama Kennedy staggered in through the gate. “Houseboy” is a job title that includes domestic outdoor chores, like digging a garden and fixing things. It has nothing to do with age Mama Kennedy’s houseboy appears to be 50. “Houseboy” also does not indicate sobriety, which he is not, frequenting Mama Happy’s garden to relieve his hangovers with a lime or two plucked from her trees. And usually he needs help with the plucking due to balance issues.
But today the houseboy of Mama Kennedy wanted meat. He was sober enough to help Mama Happy carry the pig’s stomach and intestines to the far back of the yard using a gunny sack as a litter, sliced off what he wanted and left the rest for the flies. The entrails seemed like something from a science fiction film, a gigantic worm larger than the pig, curled in upon itself. That evening, it was still there, but by morning, there was no sign that it had ever existed.
By 1:00, the pig was mostly gone. The metal gate was spotted with meat stains. So too was the notebook paper with names of customers. So too was the paper money in Mama Happy’s pouch tied at her waist. Within an hour, the Sunday returned to its usual self, with one less pig in the world.
Wednesday, May 5, 2010
Waiting at the depot
Being diagnosed with a terminal disease is perhaps like being at a train depot. Despite the company of friends and family who have come to see you off, you will board the train alone. And now you know the train has just left the other station to collect you.
For the 800 patients of Machame Lutheran Hospital diagnosed with HIV/AIDS, the future means waiting and wondering. When will the disease claim them? Who will take care of their children? And in the meantime, while they are still alive, how will they have the strength to care for the children?
Anti-viral drugs have worked to delay the train‘s arrival. Parents can care for their children for years, rather than weeks or months. But this life with a slow-moving train is fragile for those also afflicted with poverty. Periods of illness mean that a farmer returns home after weeks in the hospital to find all his chickens dead. Children are sent to relatives who can care for them, but who takes care of them when the relatives have died?
Palliative care and treatment at Machame Lutheran Hospital includes counseling and giving ongoing care to patients. But like the friends and family who linger at the train station, the waiting can be uncomfortable. What to tell the woman who desperately wants to know that she didn’t get the virus from sexual contact but from the blood transfusion in 1998?
What to tell the woman who asks, will I have to take this medicine if there’s a cure? How tempting it must be to tell her a cure means she can stop, praise God, dance for joy. But her thoughts have gone down an insidious trail: she’s thinking that she might consult a wizard for a cure, or someone in a white lab coat may come along and have a cure if she pays the right amount of money.
The people who offer palliative care and treatment understand that waiting at the train station does not always mean giving comfort. It means breathing in the silence of someone devastated not only by disease but by loss of a spouse, parents, and fears of an unknown future.
Palliative care and treatment at Machame Lutheran Hospital has branched into the building of homes that are simple, but warm and dry. The alternative--houses insulated with synthetic gunny sacks and thatched leaky roofs--are welcome places for tuberculosis in this damp cold climate on the edge of the rain forest.
There are other difficult questions that crop up for these patients: How can I make an income if my life’s work is physically difficult, like farming or selling banana beer?
And then there are the questions of how to be a human: Can a life extended by anti-viral drugs also mean marriage again? Can it include children? Does someone with AIDS only live partially or can one live fully?
In the month of April, during the four-month rainy season, men and women dot the mountain striking the soil with spades, planting their crops, and watching them grow. And for others, there is the waiting at the station.
Note: If you or your congregation or other group wish to donate a House for Health, please contact Rev. Martin Russell at the Nebraska Synod (mjruss@mac.com) or Bob Kasworm at Machame Lutheran Hospital (bkasworm@yahoo.com) . Currently one house can be built for $4,000. One hundred percent of the labor is provided locally and 99% of the materials used are local. Houses for Health is building its 19th house.
For the 800 patients of Machame Lutheran Hospital diagnosed with HIV/AIDS, the future means waiting and wondering. When will the disease claim them? Who will take care of their children? And in the meantime, while they are still alive, how will they have the strength to care for the children?
Anti-viral drugs have worked to delay the train‘s arrival. Parents can care for their children for years, rather than weeks or months. But this life with a slow-moving train is fragile for those also afflicted with poverty. Periods of illness mean that a farmer returns home after weeks in the hospital to find all his chickens dead. Children are sent to relatives who can care for them, but who takes care of them when the relatives have died?
Palliative care and treatment at Machame Lutheran Hospital includes counseling and giving ongoing care to patients. But like the friends and family who linger at the train station, the waiting can be uncomfortable. What to tell the woman who desperately wants to know that she didn’t get the virus from sexual contact but from the blood transfusion in 1998?
What to tell the woman who asks, will I have to take this medicine if there’s a cure? How tempting it must be to tell her a cure means she can stop, praise God, dance for joy. But her thoughts have gone down an insidious trail: she’s thinking that she might consult a wizard for a cure, or someone in a white lab coat may come along and have a cure if she pays the right amount of money.
The people who offer palliative care and treatment understand that waiting at the train station does not always mean giving comfort. It means breathing in the silence of someone devastated not only by disease but by loss of a spouse, parents, and fears of an unknown future.
Palliative care and treatment at Machame Lutheran Hospital has branched into the building of homes that are simple, but warm and dry. The alternative--houses insulated with synthetic gunny sacks and thatched leaky roofs--are welcome places for tuberculosis in this damp cold climate on the edge of the rain forest.
There are other difficult questions that crop up for these patients: How can I make an income if my life’s work is physically difficult, like farming or selling banana beer?
And then there are the questions of how to be a human: Can a life extended by anti-viral drugs also mean marriage again? Can it include children? Does someone with AIDS only live partially or can one live fully?
In the month of April, during the four-month rainy season, men and women dot the mountain striking the soil with spades, planting their crops, and watching them grow. And for others, there is the waiting at the station.
Note: If you or your congregation or other group wish to donate a House for Health, please contact Rev. Martin Russell at the Nebraska Synod (mjruss@mac.com) or Bob Kasworm at Machame Lutheran Hospital (bkasworm@yahoo.com) . Currently one house can be built for $4,000. One hundred percent of the labor is provided locally and 99% of the materials used are local. Houses for Health is building its 19th house.
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