Roughing It

Hi everyone – sorry I have been out of touch for a little while. I have been working in Nyabiheke camp for the past week or so, and there is no internet connection there, nor is there any cell phone service. The only landline phone is solar powered, so at night we are pretty much stranded. The power in the house runs via generator, and this week, wouldn’t you know it, the generator was not really working. We spent a few dinners and evenings using our headlamps and torches (flashlights). It turns out that a headlamp is a muzungu thing.

When I spoke with Barry Wheeler, the Country Director for ARC Rwanda, about coming to Rwanda and volunteering back in May, he asked me if I minded roughing it. I don’t really mind at all, and sometimes think it is sort of nice to live without everything at my fingertips. He mentioned that I would be living without electricity or running water, and I thought, no big deal, I can deal with that.

Well, as I said, the electricity is intermittent. As for water, every morning, I take a shower by pouring cups of water on my head from a bucket (full of water that has been heated up on the gas stove). And because there is really no running water, the toilets don’t flush. We have to flush them manually, which means after you are done, you have to pour water into the toilet from a bucket, and gravity pushes everything out. It’s not bad, unless of course you go to the bathroom and then realize that there is no water in the bucket. Even at that point, I guess it is worse for the next person than it is for you.

Then when I go to bed, it often seems like there is a whole ecosystem of creatures waiting for me in my room. The first is a gecko type lizard that crawls up the wall. I have been telling myself that it eats bugs and that it is helping me, so that one is fine. The second is what I call a “man-eating spider.” Yes, this is an unusually thick and quick spider that is sometimes on the walls. In fact, there is one directly above my head where I sleep that I think is dead, but I am not sure. If it falls down, it will seriously fall right onto my face. I saw a national geographic commercial last week when I was in Kigali that said every person eats about 10 spiders in their lifetime; I thought well I guess it is not that impossible if you are sleeping in Nyabiheke, on your back, with your mouth open. The third creature is what Hillary calls a “sausage fly”; I think of it more as a flying worm. These intelligent insects fly directly into lights at full speed, and hit them so hard that they fall to the ground and move in circles on the ground as they try to lift themselves up. A few nights ago, one flew into the light right above the dinner table (genius idea), and plopped down right into the small space between my cup and my plate of food. It squirmed and wriggled until finally it got away. The fourth creature is either a rat or a mouse I have named Harold. I thought that if I named it something that it might think we are friends and consequently not eat me in the middle of the night. I would name the spiders too but I have already killed one, and now I am sure they all know about it and are hatching a plan to get back at me. Also, we all know that spiders are inherently evil and don’t believe in making friends anyway. And of course, how could any of this be complete without this final creature; the malaria carrying mosquito. Thankfully I have a mosquito net, so these guys can’t really get me. And, I have that lizard on my side to eat them (I think).

Last night as I was lying in my bed waiting to fall asleep, I heard Harold rustling and squeaking somewhere in the room or in the walls. I thought to myself that I could live with these animals in peace (or rather, I really have no choice so I might as well). As Barry told me when I interviewed on the phone, I would be roughing it. He wasn’t kidding. But, I hope this doesn’t sound like complaining or anything; it is sort of nice to be living in such proximity to nature. This will be my attitude until of course one of these creatures crawls into my face or takes a bite out of my finger.

Anyway, I want to give you all an update on how work is going down here, especially since I haven’t had the chance to explain to a lot of you what I am actually doing. Hillary and I are the HIV Program Interns, and we are generally responsible for getting the HIV Program off the ground, and making sure everything goes smoothly in the process. The four program areas in which ARC is working right now within the HIV Program are Abstinence/Be Faithful Messages (AB), Prevention of Mother to Child Transmission (PMTCT), Voluntary Counseling and Testing (VCT), and Palliative Care for those people living with HIV.

This is all funded by the President’s Emergency Plan For AIDS Relief (PEPFAR), which is an initiative started by President Bush in 2004 to give $15 billion to AIDS relief in the world. They usually only give to villages or communities; ARC is the first organization to receive money for AIDS relief in a refugee camp. Quite an honor, but also a lot of pressure for ARC. ARC believes that refugees have the same rights as the millions of other people living with HIV in the world. Their political status should not restrict them from receiving US dollars for AIDS relief. In fact, you might see that many refugee populations are at a greater risk for HIV infection than populations in more stable environments. Fortunately, PEPFAR sees this and has given ARC some money to see what they can do. It is not a lot, but it is a start.

The controversy with PEPFAR is that it will not give money for condoms or condom promotion in most cases. I think this is a tricky way of sort of doing the right thing by giving so much money to AIDS relief, but also a sly way of pushing the agenda of evangelicals and making them happy. A smart political move by the Bush administration. It is unrealistic to expect that an HIV program that preaches only Abstinence and Be Faithful messages would be successful. We have to work around that.

Aside from the program areas, we are really trying to increase the number of people tested for HIV by positive messaging and other forms of encouragement. In hand with this is reducing the stigma of HIV in the camps, as well as providing the necessary assistance to those people living with HIV (nutritional support, as well as emotional and economic). The end goal is to empower the staff to do all of these things on their own when we are gone; Ann Kao told me one of the most valuable things she learned from Barry while here was that she was supposed to “work herself out of a job,” and that is what I am trying to do.

So, where are we then? At Nyabiheke, we are trying to finish the construction of the VCT center so that people will come to be tested for HIV. However, Rwanda deals with all of its HIV/AIDS issues through a central governing body called the Treatment and Research Center for AIDS (TRAC). TRAC mandates that all health staff in the camps go through a three week training regarding issues in PMTCT and VCT. They do need to go, but it is a logistical nightmare. We have to take 90% of the health staff out of the health center for three weeks. Nyabiheke will not be a certified PMTCT/VCT site until TRAC has seen that all these instructions have been followed. This is our main priority right now, but it has been a slow process so far.

In other news, I talked to Barry the other day and he told me that he hopes I can use this time in Rwanda to figure out what sort of issues I am interested in regarding public health (i.e. water, sanitation, appropriate technology, children’s rights, etc). So, he wants me to get involved in other projects, and I am glad to be invited. As I have already mentioned, I am working now on starting the soccer league for the kids. But I am also starting to work on another project regarding cook stoves. Every month, people are issued a certain amount of firewood to use to cook by a separate NGO. Still, they scramble to make it last the whole month, and you often see kids and women carrying big bundles of wood back to camp. The refugees use this wood to make open fires, and small children often stumble upon them or get too close and burn themselves.

So, about 20 years ago, Barry worked on this new type of cook stove that is made of clay, I think it is called Efficiency Cook Stove (if you want to google it). It is round and holds a metal pot on top. Wood burns slowly underneath the stove, and is consumed much more slowly than an open fire. It saves a lot of firewood, and kids don’t burn themselves on it. They use these stoves in the nutrition center, but most of the people in the camp do not use them. So, my job will be to find out why people are not using them, if they even know about them, and how I can teach people about them and help people build them. I think it is a cool appropriate technology project.

So, everything is going well down here. I was sick last week a little, but I am better now; I think I caught strep throat from one of the kids coughing all over my hands. But, as is the case whenever you get sick here, I had to be tested for malaria and other stomach bugs. Thanks to everyone for keeping in touch, I really appreciate it.

I’ll be back later this week. I'm trying to put some pictures up now - I hope it works.