Friday, September 25, 2009

Optimism, blood tests and rat skins.

This week and last I’ve been doing a sort of Jeopardy-style review game with my high school students to assess how well they’ve actually listened to my lessons this past year. And, unfortunately, even though we spent the last 8 months talking specifically about HIV, they still don’t understand BASIC things. For example, I asked them “Name the three ways a mother can pass the HIV virus to her baby” (something we covered in the Mother to Child Transmission lesson). They answered, “Being circumcised makes it harder to get HIV.” What? That doesn’t answer the question at all! And they didn’t know the answer to basic questions like “What does HIV stand for?” I would hope that, in a country where almost half the population is infected with HIV, they would know the most basic things about the virus. And, upon first impression, it SEEMS like they DO know the info. But they’re just repeating what all the HIV educators before me have said to them. Instead, of actually learning the material, they learn how to regurgitate things like “you must abstain from sex” and “always use a condom” and “all men should get circumcised.” But do they really know what that means or have any idea how to actually avoid HIV in their own lives? I don’t think so.

So how do you make the lessons translate into actual behavior change? How do you make memorized phrases like “always use a condom” actually influence a 15-year-old boy when he decides to have sex? Make him actually USE a condom? When it really comes down to it, the kids I’m teaching need to make the choice to change their own behavior, and nothing I can say—no matter how scary I make HIV seem—can change their minds or their behaviors.

It’s a challenge, that’s for sure, and because of that it’s sometimes difficult to see any sort of progress in this job. If the kids I’m teaching now actually listen, it means that in 30 years they will still be HIV-negative, or that the women will know how to protect their babies from getting HIV. How do I measure that? For now, it’s just a matter of having a small impact on at least one person. In training, they told us that a “teach one, reach one” attitude would keep us going…that if we have made a positive impact on at least one person that our time here isn’t wasted, that we’ve left the community better than when we came. So it’s all about reaching individuals, and hoping that those individuals go on to reach other individuals.

And I know I’ve reached individuals, particularly on my homestead. On Tuesday, my sisi (she insists on being called “Monica”) and I made the trip to Nhlangano to have baby Mpendulo tested for HIV at the clinic run by Baylor University. We arrived just before 9am, after an hour of trudging through the pouring rain, and obediently made our way through line after line at the Nhlangano Health Center. E7.50 later (that’s about $1), I found myself in a room full of babies waiting patiently for their HIV tests. Presumably because I was white and they didn’t want to keep me waiting, baby Mpendulo got to go first.

The test for babies is called a Dry Blood Spot, or DBS, and, unlike the rapid test for adults, actually checks for the presence of the HIV virus in the blood. (The adult rapid test looks only for the presence of HIV-related antibodies, which are always present in the blood of a baby born of an HIV-positive mother, at least for the first 18 months. For adults, the Western Blot test looks for the virus, but it’s super expensive.) For the DBS, the nurse draws blood from the baby’s big toe and, on a little paper card, fills 5 quarter-sized circles with the baby’s blood. Then they send it to Pretoria, South Africa, for testing because there isn’t a laboratory capable of running the test in Swaziland. And in 4-6 weeks, we’ll know.

The biggest confusion of the whole day, for me, was how the baby was registered. On his birth certificate, his name is Mpendulo Khumalo, but when Monica registered him, she wrote Mpendulo Mkhulisi. Which doesn’t make any sense, since his mother’s surname is Masuku, and Mkhulisi is Gogo’s (grandmother’s) last name. I’ve found that names here often don’t make sense. For example, my sisi Londiwe goes by Thobile at school, which isn’t even her middle name. So her school certificates will be issued in a name that is not legally hers, so if she goes to college or applies for a job that requires her high school diploma, they’ll be issued for a different name. Likewise, my bhuti Kwanele goes by Nkhosinathi, which also is not his name. I don’t understand why there’s all this unnecessary confusion. Every day in the newspaper, there are announcements of name changes that say things like “Phindile Simelane will now assume the name of Phindile Dlamini, the reason being that it is my natural surname.” For one, the grammar is incorrect, but mostly I don’t understand why mothers can’t just name their kids what they want to call them.

Speaking of other things I don’t understand, I’ve been watching “The Wire” (an HBO series that’s like a really long episode of Law & Order, but mostly about drugs), and on the WARNING screen at the beginning of the DVD it says that it is licensed for home use only. “The definition of home use excludes the use of this DVD at locations such as clubs, coaches, hospitals, hotels, oil rigs, prisons or schools.” Oil rigs? Do people commonly watch movies on oil rigs? So commonly that it needs to be stated in the warning? It also says that the soundtrack can’t be publicly broadcast in nursing homes or railway stations. Hm…

In other news, my new roommate Patrick is pretty much the most useful pet I’ve ever had. Wednesday night, after about an hour of hunting flies in the house, I got sick of kitty knocking over my stuff and coaxed him out the window to the great beyond. Not 10 minutes later, Patrick came waltzing back into the house with a mouth full of monster rat, still alive but scared out of its mind. He proceeded to play with his food for the next 20 minutes, leaving the rat playing dead in one corner of the room, then pouncing on the poor rodent every time he tried to make his escape. And nothing made me more proud then when Patrick finally made the kill, leaving a streak of rat blood across the middle of my floor. A year ago, this definitely would have bothered me. Instead, I video-taped him skinning and eating it. Swaziland has changed me.

The other highlight of my week is that KFC has FINALLY introduced the Famous Bowl in Swaziland. Since I arrived, the napkins have been advertising “The KFC Famous Bowl: The home-style meal you don’t have to go home for.” And, a year later, it has arrived. In case you don’t know, the Famous Bowl is mashed potatoes and gravy, corn, chicken strips and cheese mixed together in a bowl, served (in Swaziland at least) with a pink sparkly spoon. Judge me if you will, but, since my first Famous Bowl on Tuesday, I’d say I’ve spent about 15 minutes each day fantasizing about it. Nhlangano, my shopping town, just keeps getting better.

Anyway, that’s all I’ve got for now. I’m supposed to be in town this weekend for last Shiselweni Region Youth Support Group meeting of 2009, but because of the Swine Flu outbreak in southern Swaziland (13 volunteers, 3 staff members and our doctor are all sick), the meeting is cancelled. Instead I’ve come to town to eat another Famous Bowl, buy cat food and finalize vacation plans for November when Erin, Jess and Brittney come to visit. 44 days!!!!

Love from the Swaz!

(Oh, and I’m sparing you the disgusting photos of Patrick eating a rat only because I took them on my video camera and I haven’t figured out yet how to transfer still photos from my video camera to my computer. Unless the internet café knows how to do it, in which case I’ll post them later. I assure you it was glorious.)

1 comment:

Michael said...

Madlenya Gamedze - a PCV in Swaziland from 1979-1981 has the following comment: your comments are excellent. You seem to understand the problem. It is a problem that is unbelievably difficult to deal with and that makes it very frustrating. I believe no one person can solve this problem, and I believe the problem of AIDS in Swaziland will take years to deal with. Anything you do will not be immediately regonized, but clearly you are one who will save lives. I say this because I was a PCV to Swaziland in 1979 and I married a Swazi lady. I have returned to Swaziland many times and I know how AIDS has affected the country. What you are doing is unbelievably important. When you hear them say being circumsized makes it harder to get HIV you must have looked at them and said no that's not true. If not say it in the future. I am an American married to a Swazi, and I believe people like yourself not only can help Swazis with AIDS, you can help all people.

Thank you, Michael Greaves
and my Swazi name is Madlenya Gamedze (MG in both cultures)