When Seronga Gives You Lemons

A story of my eternal African pessimistic optimism.

I recently returned to Seronga from training and holiday and have basically been away from my little village for somewhere near a month. Coming back has never been easy for me, and it’s the end of the Botswana winter, so despite the “lake effect” temperature regulation of the world’s largest inland delta outside my door, it still damn cold. People are sick with colds and flu and the clinic is pretty busy.

Not only has the clinic staff been busy but recently it seems as though I, too have been spending more time at the clinic than I particularly care to. Many of my projects at this point take place more in the community with various villagers and other organizations in Seronga. Perhaps the clinic is trying to tell me they miss me. Or perhaps they just realize I’m basically free labor and have decided to take more advantage of my skills. Either way it seems I’ve been put in charge of the World Breast Feeding week activities at the clinic.

As always I dislike being in charge of anything here, which is of course ironic given my tendency to love to control and be in charge of things in my former life. Here it is so clear to me that if I do things for people it ends up disempowering them more than helping. Teaching is another hurdle to overcome with cultural differences making it a bit difficult for me to try to teach those who may be older than me and unwilling to learn or admit they don’t know how to do something. I usually try to find a way to help people do things for themselves in such a way that they don’t have to lose any face.

The good news in all this is that in some ways I’m improving my listening skills. Sort of. I’m getting to a point where I can listen on average about ten seconds longer than I used to be able to before butting in with commentary, opinions and my personal favorite, solutions to whatever statements the speaker has yet to even make. It seems that my headstrong idealism rears its ugly stubborn head on occasion with less alarming frequency but what is likely increased intensity. I try and tackle it and keep quiet and smile politely like I know would be the better idea, but often fail. In attempting to keep myself in line I usually lose the battle quickly and end up pounding my fist on the nearest somewhat solid structure for emphasis while making an impassioned point attacking whichever injustice I’m observing (or imagining). I don’t blame the people here for thinking I’m crazy.

The aforementioned habits make me less than optimal for leading such campaigns which must be based in teamwork in order to be successful, but there is also my small personal issue rooted in the matter of the mixed messages about breast feeding being sent by the administration in this country. It’s one of those development things wherein the research and studies being done on (and to and in) this country to determine the best ways to prevent HIV takes forever to actually get disseminated. Botswana is one of the richest and more developed countries in Africa, yet we still suffer from a slowness in both movement supplies and information that is brain rattlingly frustrating.

Right now Harvard is working in partnership with hospitals in Gaborone performing studies about on the transmission of HIV through breast milk and the preliminary findings are that it may not be as big of a risk as previously thought. As Peace Corps volunteers we’ve been hearing about these trials for a year, although the information is not yet published. As various places in the country (read: rural and including Seronga) are often suffering from distribution problems with getting the formula where it needs to go, it seems a reasonable solution might be to encourage women who have a record of good adherence to ARV’s to breast feed.

Obviously the research isn’t complete and hasn’t been published (One of the frustrating things about being a Peace Corps Volunteer is that we have trainings wherein the best and the brightest are brought in to speak to us about the latest and greatest in the research and projects being launched to determine the best practices aimed at the reduction of transmission of HIV in Botswana. While I’m grateful to have such valuable information, it’s very, very difficult to attempt to convince any of my colleagues at the clinic to consider the possibilities. I’m not asking them to change anything, but even to consider our responsibility in not perpetuating misinformation is nearly impossible. It’s a very “written-rule/by-the-book” sort of culture, which can sometimes stand in the way of innovation, which I truly believe to be essential to this country slowing the spread of this virus. But I digress.) and I’m not about to suggest anyone do anything that might potentially put babies at risk of contracting HIV, but I feel we have a certain moral responsibility to honestly education women on their options, using the most up to date research we can give them in a land of no other resources through which a woman could do her own independent research to help her make a decision.

The official government sanctioned and distributed message is that HIV positive women are counseled on the advantages and disadvantages of breast feeding and are allowed to make the choice in the end for themselves. They are then in theory provided with formula with which to safely feed their babies should they choose. The reality I’ve found is that mothers are basically forced- through clinical coercion combined with public stigma- to formula feed. Again the importance of rule following as part of the culture prevents certain levels of critical questioning and open discussion, women just do as they’re told.

Formula feeding can be a risky endeavor when the supply of formula is often interrupted, the water and sanitation are difficult to maintain, and depending on the mother’s level of health, access to nutrition, adherence to ARV’s and other measures of PMTCT during pregnancy, breast feeding could be a way to at least help the baby along through its first few months when those vitamins and immunities are so essential. Just a few more pieces of this problematic puzzle.

So despite my general refusal to be in charge, and in addition to my incredibly extensive (read: ga gona siepe- which means there is nothing.) knowledge about anything related to breast feeding, I’m the boss. A bit reluctantly.

So after a full day (which is really a half day as per the culture of Botswana---man is it going to be hard to come back to the States after this) of World Breast Feeding Week planning activities [(I’m sure I’ll write more later, but all I’m saying right now is that when I’m in charge it means the babies are gonna race, two categories-runners and crawlers- to determine which baby is healthiest. I know there is almost no correlation but the people at the clinic seemed confused and intrigued when I suggested it, and so here we go. American culture exchange day!!!!) which is incidentally the first week in August for those of you who may be interested in commemorating] I was a little tired and frustrated and struggling to decide how I would spend the rest of my day.

It was a warm day, but windy, typical July weather which is the sort of cold warm confusion that I’ve come to think of as typically African winter. The sun shines with a lessened intensity and the wind is enough to keep you on your toes. The nights are extremely cold and yet the days get just hot enough in between the nights that one almost forgets the cold which has come before and will come behind each day. The dead of the Botswana winter is very much like a Minnesota fall or spring, so it feels very familiar in a confusing way to me, which is, when I think about it, how I’ve come to feel about Seronga.

As I’ve said, being that it is winter, it’s also cold and flu season in Seronga. One of the nurses, seeing that I had that bored look on my face which usually means I’m about to come up with an excuse to leave the clinic to go work on one of my other community projects, asked me to pack ascorbic acid (vitamin c).

The clinic is both the hospital and the pharmacy for the people of Seronga. The clinic is divided into several areas according to function. There’s an injection area, and area to dress wounds, a small maternity ward, and another room that would be like urgent care. In the consulting room one nurse consults the patients to determine what is wrong with them, and then in the dispensary the other nurse reads what is written on the patient’s health cards and dispenses the drugs that the first one recommends. The drugs come in in huge bulk containers like you would get at Sam’s club, which are then divided into small seed bags in common numbers of doses and labeled accordingly. The task of pill counting and packing is undertaken by anyone who happens to be around and not doing anything, and is mind numbingly boring, and most definitely not what I had in mind when I agreed to come to Africa to work with HIV, but something I often find myself asked to do.

I quickly packed a few hundred pills to show I was doing something the clinic staff considers to be “useful” while I plotted my escape. I decided to go next door to Okavango Community Trust to see what, if anything, was happening there.

A few weeks back I had stopped by the OCT office to try to send a fax and had promised one of the women I would come back again and try to help her feel more comfortable speaking English by chatting with her. I walked through the gate to find all of the staff at the Trust sitting in a circle in the yard. How they justify getting paid for this I will never know, but I try not to spend too much time around it because it makes me a little mad, as I know they are getting paid a decent salary to do just that, when that money could be used for so much more, or they could at least be doing something tangible to benefit the community. But how do you convince someone who is getting paid to do nothing that they should increase their workload to something, which then might potentially come with responsibility and dare I say actual stress of some sort?

I greeted everyone and sat down. I tried to make a little conversation and nobody was really interested in speaking English, which was what I explained I was here to do. The woman I had met a few weeks back was “tired” which seems to be a constant ailment in Seronga. “Tired” to me can generally be roughly translated to mean “bored”, which was what I was about to become in this crowd. For my hyperactive American brain this is something to be avoided at all costs, but I’ve found within Seronga this is often an only slightly negative state of being, and preferable to suffering through its alternative, which is being “too busy”.

So I quickly racked my brain for something to occupy and amuse me while not feeling such an incredible waste of time. I vaguely remembered that there was a lemon tree back by an abandoned house on the property (which is in and of itself a sad remnant of another community project which was sort of neglected and then basically destroyed by the very community it was put there to benefit, but that again is another story). I asked if perhaps there were any lemons growing right now. A small squabble broke out amongst the six of so people sitting in the circle about who was going to take me back to the lemon tree, or if they should just tell me there were no lemons (the little Setswana I can hear just comes in very handy sometimes.) I smiled and told them that I knew there were lemons and could someone please just take me back there?

My Setswana amused one of the old men, and he jumped up to take me, dragging along with him a reluctant younger woman. We walked back through the gates and past the abandoned house and toward the lemon tree. It was down a hill a ways, just short of the delta, so the wind that came over the hill was warmer in the sun. The smell of lemons wafted through on the breeze. I was briefly confused by the smell I always associated with summer coming at me in the dead of an African winter, but have come to know this constant slight sense of confusion to be normal.

I looked at it and was amazed at how many lemons were growing there, and quickly realized that this was a great resource that the community was just wasting. Not to mention a great source of cold preventing vitamin c. All my remaining shit attitude drifted away of the lemony breeze and I became excited at the potential I had uncovered to “build capacity” in my favorite sort of way, which was to help the community take better advantage of something already plentiful in their community. My eternal militant optimist busted forth from the darkness of my mind, and I became more and more excited to a point where I had eradicated flu (and probably HIV and TB) in Seronga in my little brain. Wishful thinking ;-).

I filled my bag with lemons and explained to the people in the circle that I would go home and make some foods with these lemons and come back the next day to have them taste them and teach them how to make some things with lemon, and by the way have you all ever tried lemons on fish? My enthusiasm was slightly catching, and the woman who had wanted to speak English was excited and I bounced off in a cloud of lemony scented pleasure and eager fervor.

I walked back through the village to my hut with a big Disney Princess smile, as opposed to what can occasionally be my Icabod Crane tendency towards shoving my nose quite antisocially and culturally insensitively into a book. I will not apologize for this habit as sometimes you do what you gotta do to get through the day as Seronga’s local celebrity (read: white person). For a long time there has been no such thing as anonymity for me in this village and sometimes I need to be mentally somewhere else to attempt to ignore this fact (I feel ya, Britney;-). The book reading used to occasionally become a really interesting habit that often caused me to risk my life when I would be reading something as I walked and nearly walked into one of the randomly placed grave sized holes that had been dug for the electricity poles. It was a close call more times than I care to admit. The things would pop up out of nowhere, completely unexpected when you consider how long anything usually takes here, these holes would appear quickly each day in different locations. Needless to say I made it through that little minefield with no major incidents. Just another little love tap from Seronga.

I got to my house and busied myself with sifting the tiny bugs out of the flour (a practice which disgusts and appalls me, and which I would avoid at nearly any cost except that the last five bags of flour I purchased already had them in it, and I cannot afford to keep throwing the shit out. I’m grossed out but am told that this is what most of the locals do-I guess the others just cook with them in there. I try not to think about it and keep repeating to myself, “When in Rome, when in Rome, when in Rome.”) to the beats of some new music that I had recently pirated from a friend (no shame, I’ve got no shame). I screwed up two batches of lemon bread nearly completely (Botswana has taught me to salvage, salvage in any ways possible) but was able to get something together to bring the people at OCT the next day.

I arrived bearing lemon bread pieces which in the States would have been sampled by a whole office but here in Botswana covered three and a half people (likely three but I begged one of the women to save a piece for the old man who had taken me back and climbed the tree to get the lemons down for me, but I very much doubt that happened. Whenever there is food present it is taken as custom that as much of whatever is there is supposed to be consumed immediately, I believe I’ve gone into the policy with leftovers before ie; there are none…ever. There is never any concern as to make sure there is enough for anyone else, and the idea of being rude by grabbing half of whatever is offered to you regardless of how many other people may be present is completely and totally foreign). I heard the Setswana words for “tastes good” while hearing the critiques of the item (too sweet) kindly stated for me in English, followed immediately by the inquiries as to why didn’t I bring more and when will I be bringing it again? “Thank you” is a statement I’ve come to not even dream might be heard.

I smiled through what were very close to gritted teeth and repeated my promise to teach whoever wanted to learn once they got hold of a bread pan and measuring cups (which can be purchased in the nearest town of Shakawe, and where a majority of the residents of Seronga go at least occasionally for some sort of supplies, or could even be borrowed from neighbors). Where there had been enthusiasm about the idea yesterday, today there was again the glazed over boredom and excuses as to why this baking project would be an impossible undertaking, why can’t I just make the bread again for them, I already know how to do it. I politely took my leave and went back to the lemon tree, this time collecting lemons to attempt to make lemonade for the staff at the clinic.

I bought some sugar at the co-op and mixed up several batches of lemonade for the staff at the clinic, touting it as “an American drink that we have in the summer,” while also babbling about the different uses of lemon and local honey (available care of our resident bee-keeper through the small store in town) in tea and as health improving “muti” (Setswana word for medicine, particularly “traditional” which in my culture would be “homeopathic” except here there doesn’t seem to be any requirement of any sort of evidence of these particular remedies working for what they are reported to heal, but then I suppose that is true of some things in the States as well.) with as much charm and enthusiasm as a “seen on T.V.” host of some late night infomercial. The response towards this effort was as enthusiastic as that reception at OCT, and I was again struck at how much I appreciate good old American polite dishonesty when it comes to my cooking slash drink making skills.

The whole episode reflects something I’ve found here, which is my seemingly never ending ability to cultivate hope and excitement, at least in myself, in this village that seems to so desperately lack both. I’ve often thought of myself as a pessimist, due to the fact that I can some up with 17 reasons your idea won’t work before you completely finish explaining it without blinking an eyelash. But here in Botswana it seems I’ve found new and formerly untapped wells of optimism, I often finding myself blatantly refusing that there are aspects of this or that idea or project that can’t work, and my problem solving skills have become frightening on occasion. I can “make a plan” to get things that might seem impossible on the surface accomplished or completed. It’s a quality I’ve come to admire in myself (but am, of course still very intimately in touch with my less endearing qualities-see above), and hope I can continue to harness it more effectively (and appropriately) when coupled with my newfound habit of patience (repeat to self: “will into reality, will into reality, will into reality”) which has come a long way in my time here.

We’ll see how it all goes after Breast Feeding Week ;-)