Wednesday, August 18, 2010

SUVs in Africa = international health and humility

I arrived in the town of Choma, Zambia Sunday night to observe and provide feedback for the facilitators of the HIV prevention program I am working on as they practice in preparation for implementation. Located on the main road between Livingstone and Lusaka in the southern province of Zambia, Choma has roughly 40,000 people and a bustling main street. It also, apparently, has as many NGOs as it does people.

Everywhere I look, I see Land cruisers, big Toyota off-road trucks and other Japanese-made off-road vehicles that proudly display their various NGO affiliations, including World Vision, Hope International, CDC, USAID, AFRICARE, DFID and many, many others. They are easy to distinguish not only by the fact that they dwarf the other vehicles, but that despite the roads being incredibly dusty they manage to stay sparkling in the sun (thanks to daily car washes), as if to underscore that they were funded by perfect, sparkling, developed countries.

Seeing how I myself am traveling in one of the giant, gorgeous white Toyota trucks complete with a nifty CDC logo on either side, I certainly can’t claim to be any different. But I can’t help recalling when I was a thrifty backpacker traveling through Laos and Cambodia, and the scorn with which the locals viewed the innumerable NGO vehicles that clogged their streets, and the air of self-importance that comes with the neo-colonial ritual of international organizations sending people to “save” the unhealthy and dying locals. Back then, I both wanted to be an international health care worker, and understood the frustration of the people who I spoke with who felt that money was being squandered or not going to the right people, or was being extorted and siphoned off bit by bit.

But now I am that international health care worker, and I can’t help but look around at all of the vehicles and offices in this small town, and wonder how much of a difference they are making. Of course, many of them are making a huge difference – but I wonder whether the citizens of Choma are getting tired of the endless parade of organizations and information/sensitization programs. Even more importantly, are any of the programs making a lasting, sustainable difference for when the money dries up and the organizations leave to begin a new program in a new country? Will the program I am helping to implement be successful not only in my eyes but in the behavior and health outcomes of the community?

It is not that I am jaded (I haven’t been at it long enough) – although I certainly do know that many programs never see the results they set out to achieve. If anything, it has to do with my amazement at the sheer numbers of international public health workers that are living and working here in Africa and elsewhere in the world, and how so many can all be working in one small town (reminds me of how every time I read an article about research conducted in Kenya, it has been conducted in the same province/town [Nyanza province/Kisumu]). And it is also a healthy dose of humility as I am driven around in a fancy white truck by a driver for the local NGO I am working with (how embarrassing), knowing I am just another international health worker here for a brief period.

Monday, August 9, 2010

A typical Saturday in Livingstone

My work here in Zambia this time around has been far more difficult and busy, leaving me with only Saturday free and a full day of work on Sunday (boo). Being exhausted, my boss and I decided we'd rather relax and see the Falls than do an expensive touristy activity (I'll have time for that in the next weeks).


The dry season has hit here in full force, and the elephants have begun closing in on Livingstone trying to find food in the bushes and trees along the road leading from the Zambia-Zimbabwe border (the bridge over the Victoria Falls through Livingstone and up towards the airport. A herd of elephants has been hanging out along the road not far from the border bridge, and i have had the opportunity to see them a number of times on my way to and from the Falls and the bank. Now, with the border right there, you constantly see men on bicycles weighted down with hundreds of pounds of goods they bought in Zimbabwe (for cheap) and are bringing to Livingstone to sell for a profit. But when these elephants are on the road, they don't dare bike past them. and so you can always tell when the elephants are out because you will first see a line of men standing next to their bikes, warily watching the herd tear up trees and cross the road.







Once past the elephants we arrived at our favorite hotel hang-out - the Zambezi Sun hotel on the banks of the Victoria Falls. This is the same hotel that in a previous blog from my last trip here, I described the cheeky monkeys who terrorized the tourists at breakfast. And so I found it too funny when we arrived to see a man relaxing as he read a newspaper, unaware of the monkey hiding behind him that was about to steel his pair of Crocs.



After sunbathing and enjoying a well-earned mango daiquiri, we headed down to see the Falls, running into the herd of zebras that live on the hotel property (the baby zebra that was one-week old when I was last here is so big now!).







On we went to the Falls, which is so different now in the dry season than it was when I was last here in March. Mainly, I could actually see it! Before, the water was so high the rain mist hit before you could see much. Not so this time.













All-in-all it was a lovely day off, hopefully things will slow down and I'll actually have two days off for a weekend...though I can't complain when I can get in elephants, zebras, monkeys, water falls, and sun-bathing in a single day.

Tuesday, August 3, 2010

On the way to the bank...

You would think that as a world-traveler, savvy in every way when traversing the continents, I would have cemented in my mind one of the most important truisms ever offered by a commercial: “VISA – it’s everywhere you want to be.” Unfortunately, my reliance on my MasterCard meant that I found myself unable to use my debit card here in Livingstone, Zambia.


When I think about it, I’ve had a number of blog posts over the years relegated to the search for ATM’s, frozen credit cards that always occur when it’s a national holiday back in the States so I have to wait two days to get it cleared, traveling six hours to a town to find there are no banks or ATMs, bringing my credit card instead of my check card (last time here in Zambia), finding ATMs only to learn they are broken/out of cash/for Nationals only/have a personal grudge against Drewallyn Riley for some reason.


Thus I found myself today on a journey of discovery – tracking down the elusive, endangered ATM that accepts something other than Visa. Of which the last one was apparently hunted down by a Texan last week. Fortunately, I am so used to something going wrong with my bank cards that I wasn’t too worried, plus being here for work means I have a driver to take me to banks, rather than catching local public buses with 25 people in 6 seats or walking 10 miles (love it!) – not that it made it that much easier…

We picked up a woman who worked at the organization I’m working with.

We picked up her children from school.

The first bank ATM was being refilled with cash.

The second bank ATM wouldn’t take my card; inside there were so many people (it was lunch hour) that I couldn’t get in the door.

We dropped off the children at their home.

The third ATM didn’t take my card.

We dropped the woman off to run an errand.

Then we drove down to the touristy Zambezi Sun hotel located on the edge of Victoria Falls (see previous posts on Zambezi sun), about 5 miles from downtown Livingstone, as the driver knew that this hotel was so fancy it had its own branch of Barclays bank with clerks who could run my debit card. I went in, they said “no problem, let me have your passport.” And being the responsible, world traveler I am, I had left in my hotel room safe.

Back in the car to my hotel. And on the way, on the side of the road...a large herd of elephants, leaving a tell-tale trail of massive dung across the road. Of course, being the responsible world traveler, I had also left my camera in the safe. Well done Drew!








Went to the hotel, got my passport and camera.

Took pictures of the elephants on the way back to the hotel bank.





Arrived at the bank with proper documents (yeay me!). asked them for $600 USD worth of Kwatcha (Zambian currency). They gave me $600 USD. Tried again – finally made it out of there with a massive wad of kwatcha ($1 = 5,000 kwatcha, with the largest kwatcha bill being 50,000 or $10, making for a very big wad of cash). Let’s just say if I tried to act like a local Zambian woman and stash my cash in my bra, I’d of suddenly jumped to a D-cup.

Took more pics of the elephants and some baboons scampering across the road.




Picked up the woman from her errand.

Dropped the woman back off at the office.

Came back to the training I’m observing in time for everyone to have finished their lunches.

Couldn’t find my wallet, nearly had a heart attack.

It was on the floor of the car.

I win!