Identity, Trotting at Arne's Horse Safari, Bull and the Bush, Goats and Sheep and Baboons, Oh My!

Identity (crisis?): So, this pic really pissed me off; the "masculine" advertisement showed the picture of a male being "masculine", apparently. The "feminine" advertisement showed a female being stereotypically "feminine". this came from a store called "identity", so i just wanted to relate this to myself and some personal reflecting that i have been doing while here. I have been politically, racially, and socially aware of most things around me and most disparities apparent in the U.S., but never have i been more aware of disparities than when coming here and witnessing the extremes of the classist societies in which we live, which in turn will continue to influence people's lives abroad. I will talk more about that in the following post. Right now, i wanted to speak briefly to my identity and how people relate to the world around them. Before i came here, i hated children, i did not want to conform to society's monogamous "i have to marry and settle down with kids" mold, and i wanted nothing to do with maternal care (yeah yeah, hate me all you want). This picture relates very well to my thoughts here, and how progressive evolution from one thing to another can change through feelings of personal inflection and through the changing societies that surround us. I am "finding" myself more and more here, enjoying my experiences with children here, finding myself being ok with certain lifestyles to which i am unaccustomed, and being ok with the more "masculine" side of derek. Yes, i think we can all agree i have definitely found and am OK with my feminine side, and, while i am still OK being "myself" here and being nelly and queeny whenever i want to with my roommates, it's also nice to find a new and different derek that hasn't yet been given the proper chance to emerge and blossom. I am focused on my time here, the children whose hearts i am touching (and who are, in turn touching mine!), the people i am befriending, and the experiences i am living. I am reading books (which i don't do), i am learning more and more about life and the world around me, and i am absolutely, 110% content with my life here in Botswana......

Trotting!: So, while 4 students (Michelle, yana, jenny, and caitlin) went to camp at the Khalahari Desert this weekend, Jody, Komal, Ginna, Andrea and I went to (and got lost on our way driving) Arne's Horse Ranch out in BFE (email me if you don't know that acronym). We took jody's little rental car (her land rover is kaput for a while), on some dirt road and finally found it. We were instantly welcomed by two native Zimbabweans, one of whom used to be a Jockey in South Africa and was our tour guide, named Ron. His face was covered with fresh, sun-induced freckles, and had the smile of a cheshire cat. His accent was mesmerizing, and, me being the beginner horse-rider, gave me Classic, the painted horse who is good with all the novices. Classic and I took an instant liking to each other, after i learned to gently squeeze my calves to get him going, and gently pull the reins left or right for direction of forward travel. We jaunted on our horses through the desert of Kopong, running in to random wild goats, mules, cattle, and saw some "authentic" african hut villages (not to be understood as the white man going in to an african village to see africans in their "natural" setting. i just didn't know how else to put it....lol). Ron wanted us to trot after a long time of walking, so we got the horses going fast, and Komal's camera flew out of her pants and she was HELLA scared (i believe the quote was, Oh My God, can we stop! I'm not comfortable with this!"). I LOVED trotting, but it HELLA hurt my hip adductor muscles holding on to my horse's side. I was bouncing up and down on the horse, and today my leg muscles (mostly groin area) hurt hella bad, but it was SO worth it. After we were done with 1.5 hours of riding, Ron took us back and we departed after bonding with the horses (we were told to wipe a smear of our sweat on the horse's nose, so next time we come to Arne's horse ranch, Classic will recognize my smell and bond with my instantly!)....

Bull and the Bush: So, there is this English pub, down some DIRT road we had to taxi to, in the middle of nowhere, and it's huge and it turns into a club after 10pm or so. the four of us go there to eat a late dinner. this was a nice epilogue to our long day on horses and some naptime back home. i got some hella good pizza, fed some HELLA cute stray cats, met up with our german friend Nicola (with whom i speak HELLA german!), and had a blast. Meine Familie soll wissen, dass Nicola ist viel spass, und spreche ich viel von meine Omi wen kommt aus Bremen! Ich Liebe die Deutschen! After kicking it there, we went back home and crashed....

Baboons!: OMG....so on our way running errands today, Jody was driving our car and just as we turned down a road, she was like "Look! A monkey! Do you want me to turn around (following by a prompt U-turn)...ok, here we go!". It was amazing. i got video a tons of pics of these random baboons, about 5 of them, roaming the highway of gaborone near Game City, scouring for any trace of food or water. we drove around in circles, following them for a while and loved it. Wow, the clash between urban sprawl and desert wilderness is more-than-apparent here on the paved Gaborone roadways.....

I am the lucky one.

Tonight at dinner, our new friend, Bogolo, gave some of us Setswana names (Setswana is the language spoken here.) The name she gave me was "Kesego," which means "she is lucky."

I loved it. Lucky is what I've felt all along my journey to Botswana. I was lucky to have been chosen by Penn to come to Botswana. Yes, we've had some problems this first week - getting housing settled at the University of Botswana, getting in to our selected clinical sites - but all eight of us agree that we are incredibly lucky to have Jodi as our instructor here. She's been working tirelessly to make sure that we all get the best clinical experiences possible; there'd be some pretty desperate-feeling nursing students here if Jodi wasn't here to help us get settled.

I'm also feeling lucky to have these amazing group of students with me. Everyone has brought unique perspectives and experiences with them to Africa; so far we've been able to share those experiences with each other in a pretty constructive way. If someone has a frustrating day, or sees some things that are difficult to stomach or even comprehend - so far the group has been able to pull together, to listen to each other, and to support each other. Tonight we sat around talking about HIV treatment and ARV regimens, and why some patients have a difficult time adhering to those treatments. We've gotten angry together over the way standards of patient care vary here from the standard of care that patients might receive in the States. We've stayed up late talking with each other about life, love, and other matters of nursing.

So it's true - I do feel like I am the lucky one, with these opportunities, these mentors, and these friends. Let's hope the luck continues.

Healthcare Work and Reproductive Rights

They separate males and females in the wards cuz of privacy issues, cuz they don't have the funds or resources for private rooms for procedures.



So, read the bottom middle part about HIV+ HCWs (healthcare workers) ...i though the guidelines were really interesting.

Loved this sticker... screw the male species suppressing the females and their reproductive rights!

For all of you Peds and Gyn Lovers:

Antioxidant Peanut Butter and Identity

So, check out this video: It's ALL about PB made here...



So, this store, called Identity, had some HEINOUS, heterosexist advertisements in the window, so I HAD to take pics (btw, "heterosexist" isn't registering as a word in my spellcheck on this computer. Someone call Webster please)



Here it is! BOOOO to gender stereotypes in this country! Makes me SAD :(



















At least the Mannequins were HOT and multi-racial! YAY!

Perceptions of poverty

So the UB nursing department suggested we attend international student orientation. One of our cultural events was a traditional Setswana meal at a local woman’s house. As we drove to the site of our traditional dinner, I anticipated the sights and sounds of village culture that are so vividly displayed in many media-produced images of Africa. The almost heart-wrenching outward compassion one feels for the people of Africa, the suffering, the dying, the forgotten, and the oppressed upon viewing the grotesque images of starvation and poverty is unfortunately characteristic of many parts of Africa. However, what we’ve found in Botswana, much to my surprise is that widespread poverty and its effects on the population cannot really be seen much in proper Gaborone. Much of it is hidden in small, surrounding communities and villages. I perceive Gaborone to be a wealthy capitol city; however, when I venture beyond the conventional and globalized developments of this city, another world is found. This world houses some of the most impoverished families of Botswana. I have been exposed to similar environments around the world, namely India, where the rich and poor are clearly separated; however, I came to Botswana expecting to have less of a middle class and more people on the same playing field, so to speak. After learning more about economic policy in Botswana, I realized that the wealth distribution here is characteristic of many developed countries. This distribution is one that upholds the rich and upper-middle-class and proverbially oppresses the poor simply due to the nature of its market economy and capitalistic values. And while it is obvious that the typical rich-poor gap exists here in Botswana, as it does around the world, the poor in areas around Gaborone are not visible unless one immerses him- or herself into village communities.

Planning and Executing!

Sixth night in this new and exciting country and I feel almost at home. This is definitely because of the people here. Everywhere I go I am greeted with friendliness and curiosity and kindness. In the streets, in stores, and around campus, once I say Dumela-mma or Dumela-rra (Setswana greeting for female and male), I get smiles and questions and generosity in return. Also, this country seems to be very slow-paced, slower than California. This is really refreshing for day-to-day interactions, but of course this could be frustrating sometimes like when we examine some glitches in the healthcare system.

Today was an exciting day for me. The past few days Jodi, our instructor, has been working hard to set up our clinical sites and get us started but, like I said earlier, things move slowly here. Today however, some of us went back to the Kamogelo Day Care Centre, which Derek described in the previous blogs (with the awesome pictures and video of kids dancing), and talked to Father Tony about how we can be most helpful to the community. He told us about a sewing project they have set up for the community where they provide sewing machines (with donated money) and teach the locals how to sew; this way they can then sell the clothes they make and feel ownership over a newfound talent… I wish I could sew! Some other projects include finding a way to get water to some remote villages (digging underground for wells), buying chickens for a few families to use for eggs and eventually to sell, and building rooms or roofs onto homes so that their aren’t 8 people in a small room – one can imagine how that cannot be healthy. It was an incredible experience just to witness how this type of work can be set up for students and volunteers. Conversations like the one we had today is vital around the world; as cheesy as it sounds, helping one another is the best thing we can do. Next week, we will teach the teachers at the Day Care about CPR, the Heimlich Maneuver, and basic first aide, like what to do when a child gets a cut or has ringworm. We will also do physical assessments on the children, and record their health info so that in the future, they have a baseline to compare to. In my experience, organization in many countries with needs secondary to poverty and inadequate healthcare is hard to come by, so we were all incredibly excited when Father Tony was so accommodating for us to come and help in any way we could. I can’t wait to get involved in these projects!

Bean Leaves and Duck-Duck-Goose, Of Hippie Beliefs and African HIV Politics, MDR and XDR

Bean Leaves/DDG: So, you'll have to check out some of the videos i posted on here, but this night was incredible. The University of Botswana had some international student orientation business (which none of us Penn nurses attended cuz we slept in too late still adjusting from jet-lag! :-)), but we were still invited to the "traditional botswanan dinner" out in some village on tuesday night. First of all, this "village" they spoke of was deceiving: i was thinking it was going to be out in some hut and all, but this woman's house was POSH. it was like a mansion out on some farm, with an outdoors area for all the students to sit and eat and talk. After introductions of about 30+ international students, we formed a long line buffet style for dinner. It was not that good, but i was really happy to experience a traditional dinner. And there was this alcoholic drunk mexican who kept interrupting introductions...so short story: The introductions included name and favorite drink, so when it got to the mexican PH student in the circle, and he said "tequila", the drunken mexican guy was like "Ehhhh!!!! TEQUILA!!! Corona!? Mi amigo!" and it was hilarious. the shy germans were very put off but it was a good time, and it wasn't til later that the host (big african woman in red in the first pic) announced that he was her husband! We had a LONG laugh about that and continued to enjoy our meals...(my favorite part being the bean leaves which were hella salty, mixed with the white BLAND-ASS sorghum which is what the states uses to feed livestock!)


Pic 1: The meal (clockwise from the bread): Bread biscuits, bean leaves and veggies (REALLY salty), some small portion of meat i accidentally grabbed, white corn/sorghum stuff that is apparently fed to livestock in the states (it was incredibly bland and tasted a bit like plastic), semp or kemp or something high in fiber that they feed to malnourished kids here, and some sweet sauce thing that i dipped the bread in.








Pic 2: Ginna and Andrea's response to the meal provided above, lol








Pic 3: Komal and I havin' a grand time singing.









Video 1: The host is on the right, dancing and singing, and two other students, from UBotswana but who studied in the states for one year are on the left, singing at dancing as well. we are all clapping along to the beat:)



After dinner, we sat around and got taught traditional setswana dance and song, and it was KICK ASS. there were probably 5 botswanan students who just got back from studying in the states for one year, mainly at Kalamazoo College in Michigan (WTF!?), and they took trips to CA and their favorite place was (drumroll please....) San Francisco, DUH! she said she loved it, and they all clung to be instantly. obviously, me, the californian who loves SF and we hit it off. it was fun....then we played games. and we played this version of Duck-Duck-Goose and it was SO FUN! kinda random, but after they (the hosts) were all done showing us games and songs, they asked us if we had anything to teach them. One of the germans (random) taught everyone "if you're happy and you know it..." so we had a grand ol time shakin our booties to that. after like 5 hours of playing, we finally left on the trip back home in the Combi van seating 15 or so of us. crazy...everytime we go somewhere, i think we're gonna get taken off to some slaughterhouse like in hostel, lol.......thanks for making me worry dad! ;-)

Video #2: Follow-the-Leader Type dance, i am at the end in my red sweatshirt, peacing out at the end of the line...



Hippie Beliefs/HIV Politics: So, i don't have any pics of my instructor, Jodi, yet, but i wanted to talk about her for a bit. Jodi, Jenny, and I visited Mallach house yesterday, which is a house that Penn owns that houses all the visiting MDs when they come to work here every couple months. In the car ride back from Mallach House, i was asking Jodi about HIV and the politics and she is EXACTLY like me: she was basically saying how here, adults don't get put on ART (Anti-Retroviral Therapy to control their HIV) until they are "really sick", as in stage 4 HIV, which is classified as progression from HIV to AIDS, and their CD4 counts are as low as 0-4. I got enraged, and so did Jodi. She prefaced this conversation with "I am extremely biased in my opinion, so i am not sure i should go blabbing about it", but it's all corrupt bureaucracies and politics associated with paying for the meds. New patients will come in and get counseled on HIV preventions, but will be turned away from drugs because they "aren't sick enough". We all talked about how Penn and other associations paid with PEPFAR money (PEPFAR: President's Emergency Plan for AIDS Relief. go here for more info: http://www.pepfar.gov/about/) spend their money on brand-new beautiful buildings, and pill counters for the MDs and pharmacists, and how they are salaried in the high triple-digits and how none of the money gets trickled down to the people dying of AIDS who actually need it. It makes me sick. and one of the residents at Penn in ID work has talked with me extensively about PEPFAR and how Bush's signing of this bill to aide African nations in the fight against AIDS is the biggest in history, however it focuses 60% or so of the relief money to Christian Organizations which PREACH abstinence, which DOES NOT WORK.














(Both sides of the debate: FOR abstinence: http://www.youtube.com/watch?v=SmRrJFffkSA

Against Abstinence (this video kills me): http://www.youtube.com/watch?v=ZtL-NRBmHug

Make your own decision!)

So, Jodi and I went back and forth agreeing with each other for a while, and how POOR the policies the Bush Administration has administered are regarding abstinence-only education, and the Global Gag Order..

(Against: http://www.commondreams.org/news2001/0606-04.htm
http://www.bayswan.org/gagorder/mainpage_gag.html

For it: I couldn't find any official sites FOR it...how funny....google is pretty good at finding stuff too!)

...which mandates anti-abortion policies for clinics in Africa receiving US Aide, which leads to abortions being performed illegally and incorrectly, leading to poor women's health. Ugh, anyways, it was amazing to know that this awesome instructor of our's shares nearly the same opinions on all subjects related to our trip here! Jodi ROCKS!

MDR/XDR: So, Jenny and I met with a nurse and an MD from the HIV/TB clinic where we'll be working for the next 4 weeks, yesterday. They said we'll be in contact with MDR/XDR (Multi-Drug Resistant and Extensively Drug Resistant) Tuberculosis. Ugh.....i was so intrigued and kinda scared, but this is the kinda work i wanna do. Once i told them i used to counsel people in STIs and sexual health, the nurse piped up and was like "we could use you at the clinic to counsel new patients who have seroconverted (HIV- to HIV+, new status), because the first step is counseling the patients about safe sex and HIV prevention (Um, HI. My name is derek, and that is my specialty!). At first, they were both apprehensive to have students at this busy clinic of their's, but after seeing how excited we were when we met with them at Mallach House, they were fine. I will be working there M, Tu, Th from 7:30-4ish, racking up clinical hours, but moreso racking up experience. Every other week Jenny and I will be switching off between the HIV portion/management of the clinic and the TB portion. Then, the last week we're here, we'll be doing outpatient visits to/from people's houses, who have TB, which is awesome. There is also the option of flying up to the NE border of Botswana/Zimbabwe and working with Zimbabwean refugees from the civil war there from the election, cuz there is apparently NO food and killings and lots of IDPs (Internally Displaced Persons), but some of the other girls wanna do that. While i would LOVE to do that and help with aide, house-building/shelter/food and healthcare, but i'll stick to my HIV/TB clinics, as that most pertains to my future as an HIV/ID NP.


Pic to the right: Yana, Andrea, and I making dinner in the dorm and getting ready to see the Dark Knight at the local cinemas!