Jesus loves MARPs

Right now, I'm sitting in my hotel room just across from the OR Tambo airport. I wasn't planning to spend the evening in a hotel room, but it turns out that sometimes flying standby has just as many drawbacks as perks. There's only one flight a day from Jo'burg to Atlanta. I'll try again tonight -- wish me luck.

There's something about the empty neutral space of a hotel room that I secretly like. They always feel like a transitional space to me. Liminal (I like that word). I like the way a faceless conglomerate tries to anticipate what an individual person would want. I like owning a flat screen TV and a whole fake-fancy studio apartment of my own for a night. I like the liminal ownership of the situation.

I could have made it on the first try had I left Saturday, but instead we had an amazing going away party that night. There was this moment, at the end of the evening, when one of our guests looked at another, and declared that they were going to stand together and advocate for themselves. That they would refuse to be ignored and would work together to make sure they were seen and heard. I have never witnessed history before, and I think Saturday night I did. Just there, in my living room. Over cupcakes I had spent the morning baking. I had goosebumps. That moment alone was worth 10,000 missed flights and 10,000 neutral hotel rooms. It was powerful.

Of course, I would also like getting on an airplane back to America tonight. My favorite part of travelling, every single time, is when the customs person in Atlanta flips through my passport, looks up, and says "welcome home." I like being welcomed home.

Margaret Mead

Last week, I took some time from my crucial schedule of life saving meetings and interminable office time spent under life sucking florescent lights to get an up close look at the HIV health systems in the country.  Not on purpose, entirely, I didn't plan it, but a friend asked for a favor and I wanted to do something that felt tangible.

My friend had told me about a separate friend of hers who is very ill.  This friend needed to get a refill on her ARVs, but the refill had to be done at a clinic that was far away, and the woman was too sick to get them herself.  My friend had already filled the prescription once on her behalf, but had been told by the clinic staff that next time the actual patient would need to fill her own prescription.  I offered to give the woman a lift to the clinic.  For some reason I thought this would be no big deal.  The friend stays in the town where I work, and the clinic is in the town where I live.  I'd just give everybody a ride on my way out of town, right?

I don't know why I still think things work this way.  I should know better by now.

Thursday afternoon my friend came and met me at my office.  We went to the woman's home.  She was extremely weak, it took three family members helped her get into my car.  I would have been able to pull up closer, but somebody had parked their truck in the driveway leading up to the woman's house and was busy washing it one 2 liter soda bottle at a time, so I just had to stop my car in traffic, throw my hazards on, and really regret that I couldn't park any closer.  

When we arrived at the clinic my friend and I helped the lady out of the car and into the waiting room.  The clinic was well lit, well ventilated, and not too busy.  There probably are some hellish visions of overcrowded, over stressed HIV hospital facilities out there, but this wasn't it.  There were only a few people in line ahead of us.  One woman was dropped off at the door, escorted in by a husband, and cut the whole line, but that was the most egregious part of the process.  After about 20-30 minutes, our friend was taken in to see the nurse.  My friend had asked me to stay and ask the nurse if her friend could be transferred to a clinic in Mbabane, much closer to where they stay.  She felt that the nurses would be more likely to listen to me than to her or her friend.  I agreed, because as distasteful as the fact is -- she was probably right.  

We went inside, and the nurses looked at the woman's refill book and refilled her ARVs.  When I asked if she could be transferred to the clinic that was much closer to the woman's house, the nurses explained that only doctors could transfer patients, and the doctor would not be in until the next day, so the woman should come back again then.  I strongly considered pointing out all of the USAID signs all over the place and dropping a good old, "my tax dollars pay your bla bla bla" but while there's a time and place for vaguely jerk like American assertiveness, there's never a time for stupid.  The nurse and I went back and forth for a few minutes.  I was taking huge, grievous, gargantuan advantage of my accent and my skin color and my wealth, and we both knew it.  But on the other hand...if all that privilege can be useful to somebody, shouldn't it?  Or does taking advantage of those things somehow reinforce some...thing that is a big part of the problem with the system in the first place?  I don't know.  But my friend had asked me to do it, so I did.

 It was very clear that the woman needed to see a doctor immediately, but getting to the clinic had already been a huge effort for her, going back there again on the next day just wasn't an option.  I come from this perspective, and this place, where I think that if you just walk into a health care facility everything will be fine.  Because thats how it was when I was a kid.  When you're sick, you find somebody to make you better.  Walk through the right door and somebody will fix you up.  I'm not stupid, I know how untrue that is in Africa, and America, and pretty much everywhere else too, but some part of me in the back of my head just kept mumbling that now that she was here, and in front of not one but two nurses...shouldn't everything be ok?  Couldn't they fix this somehow?  And the rest of me thought, no...of course not.  And what did I expect them to do about it anyways?

Finally, after a prolonged telephone conversation with the government doctor in the right clinic (during which the phrase "You get here at nine ish??!!  I'm not waiting around for whenever nine-ish happens," might have occurred, and forever cemented the public health nurse's love for me) it was agreed that we would take the woman to the VCT clinic near her house immediately to see a doctor, that the visiting doctor (who was planning to show up the next day at nineish) would sign her over to the closer clinic in absentia the next day, and I would bring the file up there myself once he (presumably he) had done that.  Complicated.

After we agreed on this, we brought the friend back to my car, and drove her back to the city.  The VCT clinic where we were going is actually two separate buildings on the government hospital compound.  One is for testing, and one is for ART patients.  Imagine what this means if you are going to get your medication.  Just by walking towards that door, the door where only HIV+ patients go in, you have to announce to everybody one of the most private, intimate facts about yourself.  When you walk through that door, you tell everyone around you that there is a virus living inside you that the King just called a terrorist.  And you have to do it to pick up the medication that helps you survive.  Some people -- a lot of people -- aren't completely sure that that bargain is worthwhile to them.

We took the woman inside, and the first person we saw took one look at her and at the three of us it took to get her the 15 feet from the parking lot to the clinic, and directed her to the emergency room.  This is literally a room for emergency patients with the word "sick" written on red construction paper and taped to the door with medical tape.  Its just that, the room for emergency patients.  I find something about this darkly funny.  We were met by a very nice British (I think) doctor, and didn't have to wait terribly long before being seen by one doctor, and another one.  While we sat and waited for the doctors to examine her, my friend told me about how she would go from house to house in their community, visiting people who were sick with HIV, encouraging others to test, and generally trying to offer all of the support she can.  Not because anybody asks her to, certainly not because anybody pays her to, but just because she feels she needs to.  I told her that I think God will bless her for that, and that if anybody deserves to go straight to heaven, it is her.  I said it partially because I think it was something she needed to hear, and partially because that I meant it.  I meant it in translation, if that makes sense, but I really meant it.  She is one of those astounding, quiet people who will never win an award, never meet the president, never be celebrated by international news media or maybe even told thank you by more than the few people who think of it, but who keeps doing something phenomenal and selfless and important anyways.  Because its right, and because...she wants to.  What do you say in the face of that, besides, "God will bless you."  

Finally, after around 45 minutes from the time we got there, our friend was wheeled out of the emergency room and admitted to the hospital.  

We followed the attendant to the hospital, and were told to meet her in a particular ward, while my friend checked her in.  The most visible item on window to the reception office is a sign in English and siSwati.  The sign explains that corpses will only be released to family members who have fully payed their hospital and mortuary fees, and have the receipt to prove it.

 We found our friend in a bed next to a window and spent some time talking with her until the ward nurse came over.  The nurse was wearing a face mask and was extremely warm and cheerful.  As we left, I smiled and told the nurse that this woman was my friend and extremely important to me, so could she please make sure to take extra good care of her?  The nurse laughed and told me that she couldn't because that would be unfair -- she had to take extremely good care of everybody.  Finally we agreed that she should take extra good care of everyone there so that our friend could get extra good care too.   I knew exactly what I was doing, I was taking advantage of a crap system again.  I was making a point of showing that I was behind this woman and that I cared, even if we only knew one another for the space of an afternoon.  It kind of makes me feel a little bit...sick to know that this is a thing I would even try.  At least in Swaziland I was taking advantage of wealth, and not race.  Like exploiting class divisions is somehow better than exploiting race divisions.  I don't know.

We left, and the the friend said goodbye.  I keep meaning to go back and visit her, and I keep...not.  Mostly, I think I don't want to go and be told that she's gone.

Nothing in the process was particularly egregious in terms of health care accessibility or services.  Supplies were never too short, we never had to wait an inordinately long time, nobody was particularly rude.  But I think at least some of the last two points had to do with the fact that I was there with these two women at every step of the process as a sort of silent (only once not so silent) advocate.  All in all it was about 4.5 hours from the time we left the offices to the time we left the friend at the hospital.  Getting all of those things done in just one day -- or any of them at all -- without access to private transportation would have been impossible.  

Maria and I had a long conversation afterwards, about health and human rights, and social justice, and whats fair and whats right and why we're in this field in the first place.  She pointed out that at no point was there a failure of human rights, and thats true.  But justice?  Is that story just?  Is it right?  We were not playing on a level field there.  The deck was stacked.  Insert other game metaphor here.  

I know, I'm a slacker

I think I was much better at making blog posts when I was a PCV than now when I'm actually working.  (Sorry mom)  Why is this?  I think in Peace Corps I just inherently had better/funnier stories.  I think also, now that I'm working-working, its a little bit less appropriate for me to (gently) poke fun at what I do every day, since most of that takes place in fairly legitimate offices.  Plus, while my job is FANTASTIC, and I love just about every second of it, its really not a good one to discuss in a public forum.  Feel free to email me in private if you're really that curious about what I do.

Oh, also, the blog stuffexpataidworkerslike.com does a WAY better job of summarizing my daily life than I ever could.  So I leave a lot of it to them.

As of today, I have 29 days left in my favorite tiny mountain kingdom.  I have mixed feelings about this.  On the one hand, it will be nice to be back in the states.  I miss my family and friends.  At Erin and Roy's wedding I realized just how much I miss a lot of really wonderful people who I went to school with and how much I want to do a better job of staying in touch with them.  I miss the variety of America, and some days I miss being invisible.  But... (sorry again mom, there's a "but")  I've been emailing back and forth with a friend of mine who did her own stint away from the US for a while.  She said, "aren't you excited to move back to America for good?!"  And I thought..."Wait?  For good?  Who said anything about for good?  I'm moving back to America for now."  I felt the reverberations of a distant, mini panic attack.  I've lived in southern Africa on and off for over three years now.  I've been a college graduate (an "adult" if you will) for six years.  I'm just as good at being a grown-up here as I am at being a grown-up in America.  Maybe better.  I love what I do here.  I love the variety and the absurdity and the slight-to-major challenge that comes with getting just about anything done here.  I like it here.

Three vivid memories, or memories of phrases, stick with me from my very first week in Peace Corps, my first week in South Africa.  I remember sitting on the bus leaving the Jo'burg airport, trying not to start crying hysterically, and thinking over and over, "I'm 10,000 miles from everyone I love and everyone who loves me."  Over and over again.  I couldn't get that sentence to leave my head.  And then, we got to our first training site, and we spent a week listening to bull roarers and singing coming from an Ndebele initiation school in the hills behind us, and I wrote my parents a letter.  I told them, "I'm falling in love with this place, and I never expected that to happen."  Which is corny and kind of cliché, but was also true.  And I remember sitting in my freezing rondavale, with the other PCVs who would really soon become the people whom I loved and the people who loved me.  I re-read Stardust, the illustrated version, and I hit the part where Tristran Thorn gets ready to walk across the wall and into Faerie, and "he knew if he turned back now, nobody would think any less of him" and he went anyways.  It was the perfect sentence in the perfect paragraph in the perfect time.  About walking into the unknown but knowing it was right.

And here I am now, four years later.  I'm still 10,000 miles away from so many people whom I love, but now I love being in this place too.  I have people who I care about here, too.  I love walking into the unknown every day.

I'm looking forward to new challenges in America, and being with so close to so many people who matter to me.  But I also am already planning how to come back here again just as quick as I can.  So in 29 short days, I'm coming back to America.

For now.