Lessons in information transfer

7.  All roads get you there sooner or later.

Whether one is running out of gas or just plain lost, it is a fair assumption that if you follow the taxis and the dirt roads to their ends you will find tarmac. With tarmac comes signage, and with signage (ideally) comes knowing where you are. This past week has involved two moments of “oh geez, where are we?” Now, I am not talking about being in a bad part of town, but just not heading toward the proper city. On our way back from Tiyani HC last week, Chris and I were in the car headed back from one of our trainings when we missed our turn (followed by 3 trailing cars). We were pretty sure we had missed it, but then decided we would be able to find the next tarmac road north and take it. Little did we know that meant 40 km’s east of where we actually wanted to be. While this likely would have only added an hour to our travel time (maybe), it would have led us back to Thohoyandou. In many ways, the story of making a u-turn to please the peanut gallery was fine, but unnecessary. Letting things happen isn’t always a bad thing. Along the road, you might just run into a gorgeous waterfall, a man selling jewelry at a gas station nowhere near ‘along the way’ or just see an ostrich walking alongside the road. Who knows?! But moral is that night always ends with a new morning, and dirt roads always lead to tarmac- U turns may be required (in the case of dead ends), but sooner or later you find gas and you keep going.
with that from a charity perspective, and people trying to just treat one another as equals and being unable to do so for lack of knowledge. This makes for a particularly frustrating shopping experience. Economic models lack these basic elements of humanity to me, and maybe it all works out in randomness, but I doubt it. 

Durban Boardwalk post shopping/baragaining

8.     Beauty is subjective, historical and cultural. Custom and tradition can limit progress.

There is such a cultural norm in Africa of good wives being at least a little overweight. It’s interesting to see the notion of being ‘fattened-up’ to make a good wife (that I heard from my Ugandan home-stay momma) playing out with girls here in Thohoyandou finishing nursing school and wanting to get married. One of the girls we worked with specifically is trying to gain weight, so that she will be able to marry. While that seems crazy as I know at least half a dozen brides-to-be trying to lose weight in the USA, this is a historical notion as much as a cultural one. It says that the girl can cook, that she will be able to provide good food for her husband and children, but also says she comes from a good family that does not starve her. In the background context of people dying of hunger, it seems fitting you would want to marry someone healthy. Just healthy seems to be relative to the rural norm, not the medical one.

Coming out of hypertension and diabetes trainings, the food-based lifestyle changes needed for South Africans seemed to receive the greatest push-back and while I initially blamed this push-back on the notion of wealth and weight being correlated, it was not the only reason. In a country that has been ransacked by the AIDS epidemic, there are also challenges in overcoming the desire to hide one’s status and prevent the shaming of the self and the family. Losing weight is a sign of AIDS and so in a context where people are regularly dying of AIDS and wasting is a sign that things are not going well. 

Fear that losing weight will announce to the world you have AIDS is something most South Africans would do anything to prevent. The stigma and the isolation that often follows being diagnosed and categorized is poignant. Whether or not losing weight is actually indicative of status, there is fear. This fear is incredibly dangerous in a community where chronic illness is becoming more and more common by the hour. Overcoming the fear of visibly losing weight and turning it into a positive thing is not going to be easy, and I am not sure outsiders will be able to turn the tables.

Coming from a place where losing weight is a sign that you are capable of keeping New Year’s resolutions (good self-control), that you value health &/or fitness and that you will make a more capable juggler of life (are not lazy). It is a strange dynamic to tell people to lose weight for their lives, to do it for their children, to prevent themselves from having a stroke... Changing the diet of local peoples to include less pap (a white starch eaten in massive quantities with a little sauce) is going to be really hard to change, diminishing salt intake will be tough as well, and increasing the intake of fresh veggies (rather than cooked to oblivion or canned ones from Shoprite) will take the dedication of these home-based carers beyond their normal call of duty. Particularly because losing weight is seen to be so negative. This irony is of course met by the double standard that foreigners and whites are expected to be thinner (and therefore beautiful), but that adds a whole additional layer of complication.

9.     Economics says humans are rational, but circumstances are such that there is no such thing as perfect information. So have we ever truly been tested?

In some ways, humans are rational in the moment. We often weigh the options that lay before us, but on any given day, the weights applied to different things can be heavily skewed. So if this is the case, then how do we actually use economic and statistical modeling? If one day something is too risky, and another it is the safest of alternatives how could we possibly ever include enough into the modeling to make anything useful come of them. People make decisions in many ways, but very few moments exist where people would not change their mind with one more piece of information.

Here in the markets, bargaining assumes perfect information and competitive processes that get us to the best price and yet many of the people I have been traveling with don’t bargain. This is not merely based on a lack of language skills. Whether they don’t feel the need to bargain or assume that the extra 50 cents will do more for the person they are working with, there is some version of  philanthropy/charity/altruism that is skewing the market. Among sales people, a sense of “milk it if they don’t know what to pay” is quite common- and a clear example of imperfect information sharing. So you not only have people trying to overcharge, people being okay

If there are reasons that public policy and public health interventions fail, it seems to be that it is because there is no way to culturally be honest with one another on the superficial levels in which most people interact during trips like these. When the superficial levels are skewed, how can you truly reach the deeper levels of understanding. In some ways, people are too guarded, hiding their cards in order to have a leg up on at least one other person.

10.     Displaying faith is more than religion; it’s faith in people not just in God.

Religion is important to people everywhere. There are so many people that are active participants in religion and one of the most striking things for me this past month has been seeing the ZCC 5 pointed star on the green felt lapels of so many people here in Thohoyandou. They wear the pins everyday dutifully, but as a Jew with the recent history of the holocaust and the Rwandan genocide as part of my understanding of what humanity can do, I wonder how strong this custom is. Persecution is common, and flares its evil glare on people when they least expect it. In some ways, wearing this pin is a curious thing to me- it seems fearless of being targeted. It states pride in self, faith that you will be able to share your religion with others to spark conversation, but in my opinion it also makes you vulnerable. In wearing something like this uniform or pin, you alienate, or at least separate yourself from others. You risk being different by conforming to a small group and open yourself to be targeted for that difference.

As one who’s never looked Jewish to the average eye, it is always a surprise when people learn this. They laugh at themselves for just assuming that my dirty blonde hair and blue eyes are those of a Christian, I don’t fit the stereotype and easily evade negative attention for my religion. Not that I think the neighborhoods and friends that I have found throughout my life would have treated me any differently for my religion, but if it had been part of my first impressions from day one, how would that have changed the way I saw the world? I believe it would change a lot. These men and women of the ZCC church open themselves to categorization before they even interact with another person through purely visual means, something that in my mind is bold.

In some ways, having these pins on is brave. It is a claim of faith in a minority sect of a religion and a god, but it also claims a faith in people. A faith that people will come together and that ideas and religion will not be targeted by disagreeing groups is something few people have come to terms with. Some survivors keep their tattoos from the camps as a reminder, others as a declaration of survival, and some have them removed- wishing to forget. Faith in humanity, rather than fear of it, separates this very small and yet consistent action from merely following tradition and makes it lived faith. 

Experiential learning continued....

4.     Words only matter sometimes, and fail often.

Communication’s challenge: Code switching is the norm. Things get lost in translation so easily and so quickly when there is not a common language. There are often miscommunications between me and my friends at home, but generally they are resolved quickly and don’t cost anyone too much time or money- maybe a few extra chai tea lattes in my life, but nothing serious. Here in Limpopo and at the University of Venda, common language skills don’t exist and there are constantly places in which language literally cannot be translated. Language is incredibly complex and you only realize it when you are forced to speak at the level of a 3 year old. Hi, How are you, I want this, I like that, My name is Kate… the list goes on but never gets too detailed.

South Africa has 11 official languages, and in the past the language that was used in schools was not English. Now it is. There are so many people that speak many languages, but for many these changes in language provide only a place for mistakes, misunderstandings, and poor usage of direct translation. While I think language is critical to expressing humanity’s intricacy, it also creates a space for these intricacies to morph into far greater levels of detail and complexity. It opens doors for misunderstanding between peoples, and alienates people by limiting who they are able to connect with.

I have been taught the importance of language since my first study abroad trip, but this time has proved particularly applicable. Since people are constantly miscommunicating, people purposefully withholding the translation of previous statements is just frustrating. While it is very much my own fault (and that of the programs which brought me to this point) that I speak zero Venda and or Tsonga, it is truly isolating to know people who are capable translating will not do so in order to let you into their conversation. I won’t say that I even slightly became knowledgeable enough in Xhosa, I did begin to learn some of it. I could pick (understand) a decent amount of words, and was dutifully attempting to broaden my vocabulary. With the experience (from Acacia), language was ignored on account of the partners wanting the training sessions in English. While our student assistants from Univen did not all speak the same language , they knew what each other meant, and how to react.

This leads directly into non-verbal communication. Exuberance, love, friendliness, apologies, etc. Most things can and have had real, physical representations. While these are often cultural, anger is clear, love is clear, and other more universal notions do exist as well. Dance is a fabulous form of expression and the women at our certificate ceremony on Wednesday were ecstatic with the possibilities this mere piece of paper had to offer them. The smiles, the laughter, the bravery, and the connections that were found through heavy skirts, necklaces, and the DJ’s music were incredible. The shy danced and the loud maintained their air for the dramatic! The costuming is traditionally reserved for celebrations or funerals- this was in a way their graduation. The certificates for the two days were well deserved in some ways- skills were learned, practice, and in their work many lessons were already being woven into their own lives. The energy around the ‘event’ was immense, and I felt very lucky to have had the opportunity to celebrate with these women. At one celebration, one woman told my team mate, “I thought I would only ever earn one certificate, but it would be my death certificate.” So much pride in one place.

Certificates seem trivial to those in the US unless they are from an accredited institution, but these mere pieces of paper were truly important. They will help people to get better jobs, to feel empowered to do their work well, and to have a deeper knowledge of the patients they already treat. In many ways, this piece of paper that represents nothing of how much information was absorbed means a lot for the progress of the individuals and the specific patients that they will go back and speak to about their diet.

5.     Humans are animals and vice versa.

Something else I have noticed beyond the language barriers are the commonalities between humans and animals – even if I cannot understand what animals say or the reasons behind their actions- something is common. Songs of birds and their fights. They fight over theft and over badgering of one another. They sing in hopes of finding friends and warn their friends of dangers even if it puts themselves at risk.

For the zebras we saw this past weekend, they prance with each other, follow the leader in their travels (we’ve been caravanning all over the country), are so curious and wary of strangers. In some ways these are just survival tactics, but in other ways perhaps it is a desire to understand that which is different. Curiosity of babies (zebras and humans alike) is slowly dissolved through the experiences of life.

Now monkeys are brilliant. While this seems to be over stated, seeing the way monkeys have learned to get the foods they want – rather than those they would eat in nature. They are clever, rather than trying to lift up a garbage can lid off of the can, they merely know shoving it over will spill the contents out or that if the lid gets shoved off (or forgotten) they can quickly dart in and grab food. Even when visiting Kruger, the picnic area was a risky spot to take out food! One of my colleagues brought out her peanut butter, apples, avocadoes and bread. Within moments of having thing set out, a monkey darted in and grabbed her entire loaf of bread! As we all hollered out and watched him carry the loaf off, the park staff came running over as my friend ran after the bread (and monkey). The monkey had already torn open the bag for a few nibbles by the time he dropped it. He ran off with both of the two people running after him, but the rest of the monkeys had begun to gather around our table, in the trees or elsewhere. In Cape Town, there was talk of baboon patrols trying to keep the monkeys out of homes. Who knew they would learn the break open windows by throwing rocks, but it is true! The rest of lunch was far more guarded. Each person’s food stayed in a bag unless it was being eaten at that very moment! While the monkeys were not stealing food, they were sitting in pairs or little families watching out for each other. Grooming or playing in the tree branches kept the little ones occupied, and the adults seemed to keep an eye out for us (just in case an opportunity to dine and dash arose).

6.     Natural wonders are not so wonderful to everyone. 

While this would apply to many of the sights we’ve been lucky enough to visit, it is interesting to take a step back and recognize the immense challenges that nature is providing people. I have mostly focused on the beautiful surroundings (the animal life, mountains, lakes, plains, peninsulas etc), but often these things are also very deadly.

Hippos may be the most dangerous to those living near water, but the dams that create gorgeous lakes also bring about the flooding of what would have been the homes of many people and sometimes entire villages who once lived by streams or riverbeds. The mountains form a natural barrier preventing easy access to other spaces, and national parks require admission fees. As a tourist, this is of course something you budget in, but in many ways, this prevents the very people who come from these regions from actually enjoying them. There is so much work to be done in conservation, but sometimes by limiting the animals’ movement, you inadvertently prevent natural migrations to watering holes or grazing pastures. While I had not particularly thought about these elements, it is because the animals are being protected in these more controlled environments.

Even in Rwanda, there were friends of mine who had never seen safari animals (zebras, impalas etc) - let alone elephants or rhinos. To me it seems incredibly strange and almost unfair for the human element to be removed from the places of their ancestors and then socio-economically barred from visiting these places. It is of course not that simple. The animals are destructive. Elephants knock over entire trees in less than 2 minutes, so imagine the devastation they could create in a nicely tilled farm!

More still to come!

10 Unexpected Findings

10 findings from this trip- may or may not be unexpected, but the manner in which I came to each realization (or affirmation) definitely were surprising. This will clearly take more than one post to get through!

1.     Food unites or divides.

When you think about specific foods, you generally think about a time of year or people that you tend to eat or drink it with. When I think ice cream, I think of a pier, the pool in summer time or just before bed sharing a spoon with Scott. When I see plantain, I think of Uganda and my home-stay family where I ate Matooke many nights and gaining my Senior 15 during undergraduate. When I think martinis, summer break with the Arizona lovelies comes to mind. Spaghetti sauce- Hannah; bagels- Charlottesville; cast iron grilled cheese sandwiches, Dad; Turkey, Thanksgiving, and for here in Vhembe, pap. Maize meal porridge- nearly tasteless and yet is unimaginably common. Mopani worms? You guessed it- Vhembe.

The past 2 weeks have flown by with some Indian food, Pakistani food, interesting takes on cheese burgers, the neighbor’s fabulous from scratch challah and of course the traditional braai foods (anything you’d grill). Here in Limpopo, braai’s are common. Charcoal grilling is one of the easiest ways to cook, so we do it often! We’ve eaten with our University of Venda counterparts only once, but it was quite an experience, an all-day roller coaster. Beginning with making the shopping list in the morning (and killing the two chickens that our guests had brought), everything was much like a negotiation of what is normal, what is expected, and what was affordable. Quite a juggling match when you don’t know how many people you are truly expecting and fabulously complicated, but by the end of the night as things wound down things had turned out alright. We’d all tried Mopani worms, pap, cooked-down spinach, potatoes, mac-n-cheese, chicken feet and goodness knows many other dishes including a peanut sauce by Meg (an American nursing student with my group) whose recipe came from the Congo. It was quite the multicultural experience, and everyone had a fabulous time! Singing, dancing and grilling were the most common of activities, but cooking fresh ginger tea in a large vat over the still fresh coals was the last step to winding down the night. 
 

  

 

Our dinner experiences here at Acacia have all been self-prepared and from Sid’s delicious and spicy dishes to Hannah’s brave ones like coal cooked pizzas, falafel and her beautiful braided challah bread, it’s been such a fun food experience! Every meal has brought people closer together, and the preparation periods have kept everyone working together. Milk and sugar goes into tea, and in the end this metaphor for life is that life and energy can be found in everyone, and in this crowd, the excitement was clearly visible.

2.     People may surprise you. 

It’s not that people do not hold surprise parties for family and friends, but here everything is a surprise (your schedule, tire pressure, wake-up call, new friends, rain, shine, and even monkey’s plotting to take over the chalet kitchens). You did not want to bother with a car wash- surprise we will wash it while your gas tank fills up! You wanted to just go to the fabric market, 30 minutes later, you will have tried eating the largest variety of insects you could see, bought a scarf and be on your way to finish vegetable shopping as the experience comes to a close, or maybe just begins.

Plans for work have been in constant flux, and so flexibility has been critical yet again in my travels. In some ways, this has been one of the most challenging of dynamics to juggle. Working with the ministry of health, the University of Venda, and my UVA counterparts has meant negotiating many different personalities. The quietness of individuals is misleading from time to time – one minute you are practically begging people to participate in a workshop or to give you feedback on a project, and the next moment you hear their voice alone above the crowd. Passion rings out, but only when and where it is culturally appropriate.

Since coming to Venda, the only days that have gone as planned are those in which the plan was understood as not an actual plan for the day, but a hypothetical one. This of course provides a plethora of challenges, but in some ways, the surprises have been good: in making friends, in hearing the frankness of new acquaintances, and in the warmest of welcomes by complete strangers (American and Africans alike). Even our first day of orientation led us from an empty meeting room to an auditorium lined with more than 150 nursing students singing us a welcome song. Hard to believe it, but in many ways, this exemplifies the surprises along the way.

Not all the surprises have been good. There is a lot of false health information being propagated, and many people who are unable to reach their potential because of knowledge gaps or bureaucracy. We have been lucky to hear some of the surprising information about causes of mental illnesses, home remedies for serious chronic diseases, and seeing the community health workers and nursing students in the field doing work. Keeps me wanting to stay as far away from a hospital as possible, but then again, this is the slowness of growing these systems- it cannot happen overnight and yet without the home-based care model, there would be little way to reach most of the people in the region.

3. Polka Dots are universal.

Patterns can be found everywhere, and not just in the fabrics used by people across the globe, but also in the way they act and they rhythms by which they function. Today, I ordered a traditional skirt (I guess slightly modified, but still lovely). I had the striped fabric and was totally ready to go have the seamstress the fabric, but then she goes, “OH! We must get the dots!” and runs off back to the counter getting pink fabric with white polka dots (totally killing the more mild vibe of the darker fabric I had purchased to make this wearable back home…). I was able to switch her mind from pink to green, but I am think she thought I was crazy haha! All I could think was…not polka dots, but we will see how it comes out! One thing I am fairly certain won’t happen is that I will need “satellites” (a necklace of plastic colored beads and white satellite looking things out the back, they represent one’s youthfulness at any age. 

This week, I saw the celebration of Mandela’s Birthday. Our team went to celebrate our 67 minutes of volunteering by driving to rural areas to give lessons in health, hygiene, substance abuse, teen pregnancy, and attempting to motivate each student toward futures outside of their current box of possibilities. The charge was that Mandela spent the first 67 years of his life fighting for others, so each year spending 67 minutes volunteering should be done. The idea of celebrating the life of a great person through community service is not unique to South Africa. While MLK day has become “a day on, not a day off” in the USA, there are other places with similar traditions globally. This pattern of encouraging service to others is one that I hope spreads like wild fire and yet, I hope that it does not also result in the destructive outcomes of false information spreading.

I’ve also come to see patterns in behaviors and conversations. Have you ever wished you could just change languages in order to make sure only one person in the room could understand you? I’d say everyone’s probably wished that at some point, but though the time here, it’s been entirely available to our Venda partners. The code-switching is incredibly common. By having such drastically different levels of language skills locally, there is an understanding that speaking in native tongue is effective at keeping the foreigner out of the conversation. This method is an old one, but still stings when I see it occurring. I always want to hear what is being said, but this trip there has been more deliberate lack of filling in than I have experienced before. A desire to be “in” on conversation versus being left without understanding of anything more than the basic idea of what the hand motions might have implicated is incredibly isolating, and makes me give even more kudos to those who have come here to do work long term.

Lastly, the commonalities in awe-filled moments have been immensely beautiful! The natural surroundings, the animals, the waterfalls, savannas, trees, pools, the calmness: all of them have just brought peace to my relatively chaotic experience. They have brought me home and comfort for a few moments, and to other places I have seen or experienced.