- Seeing the excitement on Erika's face when she learned she was getting a bike today. She is a caregiver in Matero and one of the last few caregivers without a bike at that clinic.
- Learning about the massive amount of community support and volunteers for healthcare in various neighborhoods/townships in Lusaka
- Getting my bag from the airport with everything still in it
- Running in warm weather
Driving through Lusaka to the different HBC sites was interesting. I couldn't see much last night but quickly noticed how every building was surrounded by brick fences that blocked any view of the building. The access to the buildings is through metal gates that are manned by a security guard. Even Jen has a security guard for her gate. The top of the 10-12 foot high fences is often covered in broken glass bottles purposely positioned with the jagged edges upward and/or a couple lines of electric fencing. In residential areas the division of the lots is evidenced only by a change in paint color on the brick walls. This may make it sound scary but violence and robbery are not really prevalent. It's just how it is in the big cities here. The main roads are lined in long brick walls that are painted with advertisements--everything from paint itself to Aquafresh toothpaste to some weird snack that looks like Fruitloops gone cheezdoodles. People are walking everywhere meaning there are well beaten dirt paths alongside all the roads on both sides. I found this uberconvenient when I went running later in the day. Majority of the intersections are roundabouts (instead of stoplights) with cars whizzing by and merging seamlessly. Each intersection where cars and buses queue men are walking between the cars selling random items like car chargers, belts, sunglasses, button-shirts. I think I saw a guy selling a pack of wrenches too. Namonje and Pule spoke highly of their salesmen-ship and said they charged higher prices because of the convience of purchasing "on the go" so to say. I made the mistake of making eye contact with one of them and thought I wouldn't get out of the intersection without buying a Zambian flag designed towel! The main talk around town was Angola's tie to Mali 4-4 the previous night. Mali came back from 4-0 to tie within the last two minutes of the game, which was quite an upset considering Angola is one of the favored teams. This game is part of the African Cup (football) being held in Angola this week. I heard every guy talking about their projected winner of the cup but very little talk about the attack on Togo's team Friday whereby Angolan "separatists" shot and killed several members of the Togoan team. Everyone else around the world seems concerned projecting the attack as a sign of things to come for the World Cup in South Africa this summer. Zambia qualified for the African Cup (but not for the World Cup) so there is plenty of chest beating going around as well.
All the main roads are paved. The side roads/rural roads through the neighborhoods usually wide with large ruts and random mud speed mounds all over. I thought of the scene in Ace Ventura when he pretends he's on a really bumpy road in the jungle...anyone? As we approach the HBC's the stereoptypical rundown housing appeared with makeshift huts in front offering random goods of eggs, chickens, shoes, or produce. The children were very enthusiastic about waving to me while everyone else spent plenty of time staring at me in the back of the truck cab as we jostled down the road.
Matero HBC is a clinic that serves a large population of people. The medicine and healthcare is free for all Zambians and the Matero clinic offers a wide variety of care and educational programs. I think the clinic grounds were busier than roads just outside of the walls. There was open access to the clinic even though it too was surrounded by a brick barrier. Without an orientation to the clinic, which had several different buildings within the compound, I met some of the staff. Dinesse is the head of the 20 community careworkers that travel to visit patients. There were three of those caregivers present: Tobias, who has had a globalbike for about two years, Christina and Erika. Tobias is actually already featured in the slideshow on the left sidebar! I think Christina and Erika use those names for the sake of pronunciation because their traditional names were practically impossible for me to catch. Each caregiver is a volunteer. I found it so surprising that these people could dedicate majority of every day to serving their community. So far 18 (well now 19) of the caregivers have received a bike from donations of globalbike. The more recently donated bikes have been purchased from World Bicycle Relief because of the hardiness of the tires and resilient qualities of the parts. Tobias's testimony was great to hear; he explained that the bike not only increased the speed in which he can visit families but provides him with enough time to ride back to the clinic with a patient on board or just to get more medicine to deliver that day.
(Side note: My host Jen is close friends with Dan the Zambian Director of World Bicycle Relief. Sometime during my stay here she said I could have the opportunity to speak with him. Jen has loads of connections around Lusaka and with international organizations!)
They explained the zone system the cargivers have in treating patients. Each caregiver is assigned an area to cover each week; some patients require daily visits but most families are seen once a week. The main focus of the visits are on the OVC-orphaned or vulnerable children making sure they have received their medicine or ART (antiretroviral therapy) if they are HIV +. Occassionally the patients, including the parents, are asked to come into the clinic for testing such as measles, TB, or CD4 counts. (Really low count of CD4 T helper cells indicates the patient has made the unfortunate transition from HIV to Autoimmune deficiency syndrome or AIDS). These appointments and treatments are written on a card which serves as the patients mini-medical history record. As far as I understand, the families keep the cards with them and serve as a reference for the caregivers as well as reminder for the families.
This network of caregivers had been well established before PCI came into the picture. In fact, PCI was interested in working with Matero BECAUSE the caregivers already had a solid, working relationship and reputation in the community and wanted to improve their capacities. PCI provided them with resources to improve care and educational opportunities such as teaching mothers how to cook/eat during pregancy and about vitamin/nutrients necessary for infants to grow health. PCI has helped implement a Growth Monitoring Program (GMP) for OVC patients at the clinic as a more systematic way of tracking child development. Mothers are reminded that the first five years of a child's life is crucial to their overall development and they need to bring in their child for vaccinations. The caregivers also serve as a counselors for the childern and families. They spoke of the need to address the psychosocial issues that children face with terminally ill parents. The need for Amy's program "Say and Play" was obvious.
At the end of the conversation we announced that we had brought a bike for Erika. Even through the language barrier, her excitement to receive a bike was obvious. She went from quiet and seeminly disengaged to full of hugs and handshakes for me. There was much chatter in Membe that I couldn't even begin to understand but "Thank you mzungu" was clear! If there is one word I have learned very quickly is "mzungu" which is a slang term for white person-- much like the use of gringo.
Everyone took a short turn riding it in the courtyard. Erika was determined to get as many pictures with me as possible. Tobias and I helped her adjust the seat height then we were on our way.
We arrived back at the PCI office for a late lunch. I met Kurt Henne, the Regional director of PCI, at lunch. PCI has Sami's Catering Service bring lunch for everyone at the office everyday at the cost of 12.5 pen (12500 kwacha). One option was fish--i couldn't get past looking at the scales and eyes so I opted for the chicken instead. Kurt made jokes about wanting to meet Curt; he trusts him on a name basis but everyone at PCI has their own vision of what he looks like. I was jokingly chastised for not showing up with picture flashcards of all the globalbike board members. Hopefully sometime this week I will get a chance to chat with Kurt one-on-one which he seemed eager to do.
After lunch Namonje and I visited the Community Based Tuberculosis Organization in the afternoon. The Muapai sisters were very informative on the growth of their organization from 1997 to now. They have grown from addressing TB to also HIV+ patients since there is a high co-infection. Again there was a reiteration of the need to address of psychosocial issues and how PCI has given resources to start an OVC program and cooking education program for mothers. The World Food Programme has offered meals for the children in the OVC program, which allows the children to be fed a meal during the day during their education. Often this meal is the only one the children receive a day. CBTO Caregivers and PCI staff offer cooking program as well where mothers and child get a meal as part of the instruction.
Talking with the Muapai sisters was helpful in understanding the power and willingness of volunteer caregivers. The caregivers started as women checked on fellow church members and have since been recruited to serve the CBTO patients. They have gained more training in order to continue serving their neighbors effectively. Majority of the caregivers are women.
While CBTO volunteers have not received globalbikes they did receive some from a UNICEF program several years ago. The 35 bikes or so were shared among 280 volunteers so needless to say the bikes did not last long due to that communal mentality where someone else is responsible for the bike maintenance. Margaret was specific about the qualities and qualifications for a good bike in the community: good tires to survive the harsh roads and rainy season; basket for carrying treatment plans and medicines; capacity to carry a patient on the back; and a woman-friendly seat. The She continued to explain that a bike as the best mode of transportation because no extra money is needed in daily transportation (ie no bus fare or money for petrol) and it still enables the caregivers to increase patient capacity. I think this interview will be very helpful in demonstrating the power of a bike in these communities.
I enjoyed interviewing the Muapai sisters because of their openness and humor. Margaret was concerned about her hair before I turned on the camera so there was much situating before I started filming. After all the fuss she was silent for majority of the filming then had much to say after I turned off the camera.Luckily I convinced her to repeat her opinions on bikes for the camera! They also joked that the seat needed to be comfortable for the "fat women of Zambia"; lots of women in Zambia are fat and its hard enough for them to pedal over the rough terrain. Turning to Namonje, they told her she needed to eat more because she's looking more like "you"-referring to me as the skinny white lady. I found it entertaining that they believe majority of American women are skinny and felt that was the appropriate description of me! Driving through town earlier that day I had noted how many young women I thought were skinny; I guess it's all relative!
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