Tessa13: Peace Corps and Rice visits

Monday, July 2 to Wednesday, July 4

            I got up around the same time as I usually do for clinic (6:45-ish) to shower and finish packing for my long awaited visit to a Peace Corps volunteer’s site. Carrie had suggested I stay with a volunteer soon as I got here, but once WFP stuff started, I didn’t have any time to escape the clinic. We both thought it would be a good opportunity to see where the COE’s patients come from—not just physically, but culturally, emotionally, etc…Like, what kind of customs and beliefs exist in their communities? How are decisions made? What is the family environment like? How are orphans and abandoned children cared for? What is the system for governing? And also, this would give me an opportunity to talk with someone whose work and goals were similar to mine but who had been here much longer and worked on many more projects.

            Carrie gave me a volunteer’s number a couple weeks ago, and I had called her and set up a time to come. Tandi (that’s the volunteer’s Seswati name) and I met downtown by an internet café. She was very nice and happy to answer all of my questions. In what ended up being a very rushed morning (there had been some confusion with the new WFP system, and Dave called me to the clinic mid-shower) I hadn’t managed to squeeze in breakfast, so we sat down for omelets and coffee before heading out to her homestead. I was certainly glad for her company. I’d been on combies before (the vans used for public transport here), but only for short trips between the clinic and
Mbabane. Finding my way from Mbabane to Manzini, switching to another combie, riding from Manzini to Siphoneni, transferring to yet another combie, and riding out to her village (name was hard to pronounce, and now I’ve forgotten it completely) would’ve been quite an adventure (possibly an unsuccessful one).

            When we got off the last combie, we walked by a row of gogos (old women selling fruit or other items on the side of the road) and she greeted all of them with “Sanibonani” (the “hello” you use to address a group of people). A chorus of “Yebo”s echoed back, and the exchange continued for a minute. Everyone we passed, Tandi greeted and waved to. In that particular community, they used a two hand wave, which proved difficult since we were both carrying quite a bit of stuff. Discovering I had no Seswati name, Tandi enlisted the help of the gogos in naming me. I am now officially Zandile Dlamini. “Zandile” means “too many girls,” and Dlamini is the most common last name in
Swaziland. I’d say about 40% of our COE patients are Dlamini’s.

            We hiked for about 20 minutes to reach the homestead where she had been living for almost a year. The paths were dirt trails randomly winding and crisscrossing through brush and occasionally along pastures and homesteads. It reminded me quite a bit of the landscape and random layout of the community I lived in 5 years ago in
Nicaragua.

            At her home, I met her gogo (literally translate as “grandmother”) and the children who lived there. Her babe (father of the house) wasn’t home. In fact, he rarely is there, she said. Two of his three wives reside at that particular homestead, but neither was there at the time. One was shucking corn on the other side of the nearby mountain, and I’m not sure where the other one was. The one shucking was Tandi’s “mage” (mother…pronounced ma-ge with a soft g sound), and I got to meet her later. She was very well educated and easy to talk to. In fact, she had met her husband when they were both studying at a university in the
UK. At that time he already had two wives back in
Swaziland. She had hosted Peace Corps volunteers several times before and seemed like a very good host mom. She kept trying to make Tandi stop translating. (She thought I was another pc volunteer and thought I should know the language by now.)

            She said all the children there were her own, but Tandi told me later that in fact, they were all children of her husband, but none actually belonged to her. They were the children of all of his girlfriends. (Keep in mind; this is a completely normal arrangement for a family. Other than the fact that they were wealthy for a rural Swazi family, this was very representative of many of the homesteads all over
Swaziland. A homestead is basically a collection of homes that belong to one extended family—a gogo, a babe, several mages, and many children).

            Anyway, after I met the gogo (and before I met the mage) Tandi took me over to the hospital and VCT (voluntary counseling and testing facility) to see what they were like. It looked much like the Vuvulane clinic except bigger and cleaner (still nothing close to the COE standards). We talked to the VCT employees for a bit. They basically serve as a site where community members can come in and get tested for HIV. If they test positive, there are support groups and counseling available. Also, if they’ve been diagnosed and prescribed ART, they can pick up the meds there. One nice thing about this particular VCT was the fact that there was a woman who worked there whose sole responsibility was to deal with adherence. She was Swazi, and I believe she actually grew up there or nearby. She had obtained a grant for her project and was now trying to improve adherence in the community. Unfortunately, she had left for the day, so I didn’t get to speak with her.

            On the way back to the homestead, Tandi told me more about her experiences living in
Swaziland. She said adjusting to the culture wasn’t too difficult. She didn’t really get homesick, and the community welcomed her. Apparently the last volunteer was kind of angry. Whenever Tandi had events, people would always come up to her afterwards and say, “Thank you for not yelling at me, Sisi.” (Sisi means sister and is the word everyone uses to address a young woman who isn’t married). Evidently, the last volunteer had been a yeller. The one thing Tandi said was most difficult to adjust to was the number of deaths. Every week, there are about three vigils to mourn the deceased. They last all night and end at about 7 am with a funeral.

            Tandi also told me about the political structure of the community. Basically, there is one chief for each chiefdom (collection of homesteads living in an area together). Hers had about 500 homesteads but oddly, no chief. Theirs had died 2 years ago, and the king still hadn’t appointed a new one. Usually he chooses one of the late chief’s sons (whomever is most in favor of the king). No one is sure why he hadn’t chosen one yet, but some suspected that the dead chief’s advisor (who was ruling temporarily) was delaying the process. Tandi was skeptical. She said that things just take awhile in
Swaziland (which is definitely something I’ve heard from a lot of the people I’ve met here). Almost everyone in the rural communities respects their chief and the king greatly. They don’t question or discuss politics at all. Only in the cities, where there are more educated people, politics are a little more contentious.

            As we passed by the king’s corral, she told me about “tega,” another part of the traditional Swazi life. When a woman is sleeping over at her boyfriend’s house, a bunch of people will come over and “catch” her in the act. They yell out something to the effect of “Come out! We’ve tega-ed you!!” They then curse at her and chase her to the king’s corral and throw her on the ground. If she isn’t crying at that point, they will beat her until she is crying. Now, the whole point of this ceremony is to get the man and woman to marry each other. If she doesn’t want to marry the man, she has to run to a river (this part I’m not sure if I remember correctly). If she makes it there without being caught, she doesn’t have to marry him. Otherwise, she stays in the corral until she cries. How long she lasts before crying is actually a source of pride for many women. It is supposed to represents how much they love their husband. Tandi told me that one mage she met told her proudly, “I didn’t cry and didn’t cry. So they had to cut me.”

Later, I asked Sipho, one of the Swazi guys at the clinic about it. He said he didn’t really like the custom, mostly because of the implications for the women. He also said most people in the city don’t tega, but if they want to do it, they can go out to their parental homesteads and do it out there. The alternative is a civil wedding. If you are married that way, you are only allowed one wife, but then that woman relinquishes her individual rights and becomes essentially a minor under the control of her husband. For this reason, many women go to
South Africa to get married. When I asked Sipho what happened if a woman never slept over at her boyfriend’s house. He said that she had to in order to tega, and she had to tega in order to marry. He also said, the women don’t really have a choice in the matter and often don’t know when they are going to be tega-ed.

            We made it back to her house before dark (5:30) to cook dinner. It isn’t safe to walk around at night, and if you do, people assume you are up to no good. She had electricity, which was nice, but no running water (which made washing dishes a bit more challenging). Tandi told me more about the Peace Corps while we ate, and afterwards, we read for a bit and fell asleep around 8:30.

            The next day, she took me to the NCP (Neighborhood Care Point). There were several in the community, but this one in particular was also the kagogo, which is the central meeting place for the community. I met the secretary of the kagogo, and he asked me lots of questions about Baylor. No one in the community knew about the clinic, and he was curious as to who was eligible to go there, if it was free, and how they could become an outreach site. Most of the people wouldn’t be able to afford the 42 Rand (6
US $) it would take to go to and from the clinic, so ideally, he would get Baylor to come to the community.

            The NCPs are where orphans and vulnerable children can come for the day to receive meals and a bit of education. Tandi said that the community was pretty good about taking in the children but struggled to support them. Then NCPs filled this gap and provided as much support as possible, although often, it isn’t enough either. Talia (Canadian who visited with Rachel and Lindsay) worked a lot with orphans in
Botswana. One of the services her NGO provided was gift baskets for the orphans. Once families learned about this, they started taking in as many orphans as they could in order to receive the baskets, which they would then sell. The orphans remained just as abandoned and starving as before. Tandi said that this wasn’t really a problem in her community, but there were many others. For example, an orphan could go to school if they could prove (with death certificates) that they were indeed orphans. This is virtually impossible for many reasons. Many of them never knew their fathers, who left the mother when she was pregnant. Even if they knew both of their parents, no one gets a death certificate unless they go to a city far away and deal with some complicated legal procedure. So, unless there is someone who cares enough for the child to deal with the hassle and who is wealthy enough to afford it, there is no way for the orphan to prove their lack of parents. Thus, all they are left with are the NCPs.

            I listened for a bit as Tandi and the secretary discussed some of their projects—a community garden, fundraising for NCP renovations (most of them were dirty, stick-in-the-mud structures), education campaigns, and other events. During this conversation, I discovered that children become sexually active as early as twelve. I also learned that men fear the HIV stigma more than women (probably because it might limit the number of girlfriends they could have), while women were much more open and willing to address the problem. He told us that there was an article in the paper about a doctor who was telling many of his patients that they weren’t actually HIV positive even though they’d been told at a VCT (volunteer counseling and testing) clinic that they were. He thought they were lying about it because they were afraid that they would lose their jobs if the HIV rate dropped and funding for HIV/AIDS programs dropped. Tandi responded that it is much more likely that the one doctor was lying than everyone at the VCT’s, and in addition, many people try to place blame elsewhere in order to avoid taking responsibility for their actions (that caused them to get the disease).

            After that, I visited the school and nearby clinic. They were pretty much what I expected—about the same as the Vuvlane clinic, and the school was much like the school I worked at in
Nicaragua. We looked at the picture of the map Tandi was painting with her class and I took photos of some of the HIV/AIDS awareness signs. Realizing that her watch had stopped, we rush off to catch a combie and make our way back to Manzini. At that point, we split up. She heads over to her friend’s community to help with a workshop, and I head back to the COE in
Mbabane.

            When I get to the COE, I find that the rest of the Rice crew has arrived and we are to do the presentation and interviews that afternoon (originally scheduled for the next day). Other than the fact that I felt and looked pretty gross from being out on the homestead for two days, I think it went okay. Dave and I gave our presentations on WFP (from previous weeks), and then we discussed our challenges and experiences and answered questions about our projects and the internship. I felt a little awkward, since they had a camera following us around the whole time, but later that night we had dinner at Edlanlene (traditional Swazi food), which was much more informal and relaxed. We talked a bit more about our experiences here and what we thought future internships should involve or avoid. We also talked about what would be necessary to affect a behavior change here (ie: TV star verses the king) and I got to hear about what else the profs were working on back in Houston. We also met up with some of Dr. Ryan’s friends from home who were here looking at point-of-care diagnostics from a business perspective, so Dr. RRK and Yvette talked a lot with them about the overlap between their projects and possibility for collaboration. It was interesting to say the least, and the food was fantastic and authentic as always.

            The following day was a bit hectic. I discovered that the volunteers had been filling out the books incorrectly, so I had to spend some time fixing that and explaining the correct way. Also, that morning, I attended another WFP meeting, which was much more boring than the first. I think I made it through the first one because it was all new and exciting, but really the meetings are pretty irrelevant to the work at the COE. We go over the minutes from the last meeting, then talk about supply issues (ie: there have been tons of shortages, and many of the distribution NGO’s are only getting ½ of what they need. Luckily the COE hasn’t been affected yet. In Tandi’s community, they haven’t received food in 3 months!) and finally about challenges and problems (this is the part that takes forever and is irrelevant to the COE). One sight had problems with their delivery truck; another had problems with supply shortages. In fact, people have been threatening to attack the delivery trucks, if they don’t start delivering more food. Some people were actually arrested.

Anyway, there is really no need for them to have the meeting every 2 weeks. The individual problems could be dealt with through email much more effectively and efficiently, and the information about the pipeline (ie: getting food to the sites…supply, transportation, etc.) could be dispersed by email as well. Anyway, after that, I needed to finish filling out the WFP forms and go over them with Mlu and KT (work here permanently, so when I leave, they’re responsible for WFP). Overall, it was a hectic yet boring (especially after spending two days with Tandi) day, but it was nice to see the new volunteers working the WFP table. Now I’ll have the time to work on other smaller projects I’ve been attempting for awhile, so that’s exciting. Also, Carrie mentioned to Tina (another doctor) that I was interested in doing adherence stuff with outreach, and Tina said she actually had something already in mind. So, now I’m going to help out with the initial field test. I’m particularly excited about this because it means I get to go to more rural clinics and see more of Swaziland.

            That night, the Rice crew returned to the clinic after visiting various schools and clinics. They did their final interview of me and Dave and headed out. I think their next stop is Lesotho, then Botswana, and finally Malawi (locations of all the other Rice interns).

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