Africa Malaria Day

When I first started writing this blog entry, on Tuesday, it was National Mango Day in Malawi. I wouldn't be writing about it now, except for that as I was listening to the news story, I got a shock.

BBC was interviewing a mango-seller in Malawi who was selling three fresh ripe juicy mangoes......for the equivalent of 14 cents. 14 cents! Even after buying fairly cheap tropical fruit here in Rwanda, I confess I was stunned, and then angry at how unjust that is. I think about how much I pay for a mango back in the States, and while I'm sure there's some economic supply-and-demand theory that could explain why this woman who probably lives in a hut and struggles to put her children through school is only earning less than a nickel for selling a single mango, I confess I don't want to hear it. My prayer is that there are people who are much smarter than me who are working to solve this major problem of inequity. That is about the only way I can get through my day sometimes.

Thanks for listening...and for praying for the mango-sellers! Not to stray further from the topic of this post, which is supposed to be Africa Malaria Day, but writing about economic theory makes me think of my good friend Jennifer C., who (props) just got a tenure-track position at Orange Coast College as an economics professor!! Way to go, Jenn!! Very exciting news. (Maybe you can help me understand the mango-seller dilemma...!!).

Okay. Africa Malaria Day!! Last Friday (a week ago now...time flies) Rwanda celebrated Africa Malaria Day, and for the first time since the conception of Africa Malaria Day (which was a decade and a half ago, here in Africa), Friday was also Global Malaria Day (sponsored by the WHO and UNICEF). The theme of the day was "Malaria: A Disease Without Borders" to underline that malaria is not just an "African" disease, but impacts impoverished populations all over the world.

Here in Rwanda, malaria is still one of the top three killers of children under five, although with diligent effort, education, and behavior change in the population, it may yet lose such an infamous title in the coming five or ten years. In the meantime, Africa Malaria Day was celebrated at a national level out in Kirehe (east Rwanda).



With several friends here from both WR and the child survival program, we attended the festivities. Along the way, we stopped to visit a Care Group, though (one of the community volunteer groups that World Relief helps to sponsor...Care Group volunteers teach their neighbors about good health and hygiene and sometimes distribute simple medicines and other health tools):



Following the visit (which was a lot of fun...Care Group volunteers are always so friendly and fun to hang around), we proceeded to visit the home of a Community Health Worker (CHW). A CHW is an elected community member who is the point-person for simple distribution of pre-packaged medicines for basic and common health care problems in the community. CHWs are part of the government's nation-wide strategy to implement community-based primary health care (and yes, there is a lot of overlap between Care Groups and CHWs, the primary difference being that Care Groups take the initiative to go to their neighbors to present preventive health messages, whereas the community members seek out the CHW if they have a health problem):



Mom asked a good question when I was talking to her about the CHW system: is the CHW a nurse, or a doctor? I explained to her that he/she is neither a nurse or doctor, simply a community member who is trained to fight illness so that more children (and adults) can receive treatment for basic health problems. The CHW was very knowledgeable and hospitable, and this photo shows him explaining how he treats a child who is brought to him, using a government-issued kit and instructions.

Following the CHW visit, we attended an ITN (insecticide-treated net) distribution for malaria prevention, and then ended up in a big field, flanked by hundreds of schoolchildren and local community members, where there were speeches, poems, and dramas about fighting malaria. This photo below is of Ashley Judd (who, as the spokesperson for Population Services International, an NGO, attended the event) is shown greeting some of the schoolchildren after the celebration.




I have a few more photos to post in a following entry....

go bears (rwanda edition)

It's official - they've infiltrated the world.



I spotted this fellow on my way to work today, on a busy road while I was waiting to make a lefthand turn. When I leaned across the car and asked him if I could take his picture, he was startled and asked me a (reasonable) question in return: "Why?"

I of course had to make that left-hand turn, so I quickly tried to explain to him I was from California (there wasn't enough time to explain any more than that...although there was a time when I would not have even noticed a Cal shirt coming down the street).

The young man looked at me blankly, as if to say, Cal-i-what? He did let me snap his photo, but my guess is he didn't know the difference between a Cal bear and a grizzly bear. I'm sure there are some who don't mind that, though...according to some, this might be cultural imperialism at its best.

At any rate. Go Bears. :)

update: how things are going

It's been a while since I've written an update on anything work-related....but I did promise, so here we go...

Most of you probably know that I'm here doing public health research related to newborn health, in conjunction with the WR child survival program (in association with Concern Worldwide and the International Rescue Committee). I have the total privilege to do work here in Rwanda owing to my church's (Ev Free F'ton, let's hear it!) partnership with the Africa Great Lakes region. It was through Ev. Free's partnership that I first came here in 2005 on a short-term team, was able to return here the following summer for my internship, and then was blessed to be able to return again this year on a research fellowship.

The last time I gave an update, I shared how I had been able to network with several other NGOs and local organizations that are also doing work in the arena of newborn health here in Rwanda. Nearly 40% of all children under 5 who die before they turn 5 years old are under 28 days old, so addressing special needs of newborns is critical in fighting preventable child deaths.

Well....wow, so much has changed since then. :) But if it all went the way I thought it would....well, it wouldn't be a true cross-cultural experience, as I was reminded by my Philippines friend Wendy recently.

Essentially, I have been asked to change the focus of my study by the government, with whom the child survival program partners. So the project has broadened to address other child health issues (not just newborn health, but also malaria, diarrhea, pneumonia, and malnutrition, all top killers of children and all preventable, which is so sad, but that's another topic). This new project involves doing a rapid assessment / qualitative research throughout the country (rapid as in 8 weeks) and then using the research results to work with Rwandans to create health behavior change messages for national standardization, in partnership with the Ministry of Health.

It's a wonderful opportunity, for which I was thankful...and the whole project was supposed to be entirely completed last week. As things stand, the project is still going through the proper approval process in the halls of the Ministry of Health. There were some important advances last week, but there are still two more steps it has to pass through before we can begin. Thank you for praying that the project will pass through SWIFTLY...it has been a long wait!!

In the meantime, besides preparing the project and working on organizational and coordination details, I have the privilege of overseeing some sustainability work in southwest Rwanda, in the former child survival program (where I did my thesis). I am currently working with a totally brilliant Harvard public health student to try to get some more funding for the excellent community health work that WR did out there (Rach, I know you get this on RSS feed....I'm almost done with the proposal draft but I needed a break! I'll send it to you tomorrow!). I also am trying to learn the ins-and-outs of the EIP, and helping with some of the compilation of reports that they have to do (tedious, and in French, but really really helpful for me in terms of learning about what's happening out on the field, and necessary to the advancement of the project, so I hope I can do a good job for them).

So that's the update (if you made it this far!). I am loving it, even with all the attending challenges....what a blessing to be here, and I feel very sustained by your prayers. There are lots of opportunities every day to share God's love, either by a smile, or showing patience, or lending a listening ear (there is sometimes a lot of venting in high-stress situations...there is tons of work and few laborers, it seems!). Sometimes I even get to use words to share His love. You are such an important part of what's happening here, through your friendship, words of encouragement, and prayers, and I just want to thank you.

More than anything, my desire would be for this work here to be a vehicle for God somehow to reveal Himself and His character to a hurting people, and to the impoverished and poor. I am completely powerless to accomplish that. But your prayers can do that. Thank you so much for praying. :)

And maybe the best part about being here is getting to interact with amazing, dedicated, fun people (mostly Africans) who serve and sweat and laugh and cry, trying to give dying children a fighting chance to live...live up to their God-given potential. The work I described above really becomes secondary to what I learn from the heroes here who put in long grueling hours at times, just to make sure trainings get planned and carried out, or reports get submitted to people who will pay the next vital budget installment, or that medications get out into the hands of the community health workers who will administer them to needy children. Thank you for your prayers for them too.

more on Rwandese worship

A couple of weeks ago I posted photos of church in Kigali. Here are a few more photos of the other church I attend (outside the city) where Baraka's father is the pastor.

This one is a shot of the youth choir practicing at a gazebo outside of Baraka's "office." Even though they're called "youth," they're actually young adults, from teens to mid-twenties. They essentially help lead worship every Sunday, singing several songs with often-choreographed movement. There is one synthesizer and sometimes drums, but otherwise the instruments are just their beautiful voices:



Here is Baraka during the church service leading the children's choir in a song:



And I know this photo looks a little scary, but not to worry! It's a drama that the children put together...they did a great job, too! Can you guess what Bible story they're acting out?



It's the Abraham and Isaac story....in this photo, Abraham is about ready to kill Isaac! And then from outside a nearby window, we all heard the Voice of God (sounding suspiciously like a Rwandese boy) telling Abraham that He would provide a lamb to sacrifice instead of Isaac....

I enjoy my church families so much. Last week three friends from Kigali came along, and we had a blast (not to mention a very warm welcome). If you come visit me here, I'll bring you out here to meet my new friends.

pepperoni, anyone?

I had grand plans to bring pizza to Baraka's home last week, for dinner...and then discovered that (due to mourning week) all the pizza places around town were closed! So I grabbed two large-ish baguettes and a big wheel of cheese (gouda is about all that's affordable here) and headed out to her place -- the plan was to have modified baguette pizzas, along with Baraka's own yummy garden fare.

It was a treat for me to be able to hang out with Baraka! She invited me to stay overnight because her parents were out of town (most Rwandese women live with their parents until they're married....it's not common to see single women living off by themselves here). And when I showed up at her place, Louise was there too! Louise runs the Child Development program here at WR (and does a fantastic job too).

When I showed Baraka my plan, to make baguette pizzas, she was ethusiastic but explained, "We don't have an oven!" The electricity in their home in Gasabo is solar, in fact....isn't that cool? They weren't even trying to be environmentally friendly (I don't think?)...it's just more economical.

At any rate, it is admittedly difficult to make baguette pizzas with no oven. So Louise came up with this idea to cook the pizzas over coals outside. And so sure enough, it worked! Here are Louise and Baraka, pizza-chefs extraordinaire:



Here's a shot of me fanning the coals, to keep them nice and hot:



When the pizzas were done, they were added to Baraka's feast of rice, vegetables, beans, fresh papaya, and an assortment of other yummy things. It was a super fun evening...

1000 hills are alive with the sound of music

I asked a very cool guy the other day if he had ever seen The Sound of Music, and he said, "Oh, maybe once, or twice....or fifteen times." :) So my guess is most everyone out there who reads this blog has heard of the VonTrapps, and remembers Kurt ("I'm incorrigible!"). And of course you know that the musical was based on the true story of the VonTrapp family who escaped Nazi-occupied Austria during World War II.

Well....Kurt's grandchildren live in Montana now (you might be interested to know that Kurt's name wasn't actually Kurt, it was Warner. And Leisl was Agatha in real life. Or so I was told last Saturday night). Kurt, er, Warner's grandchildren have also ably carried on the family legacy and form a singing quartet that now performs all over the world.

Last Saturday night, I was hanging out with some friends here in Kigali, and who should walk in the front door, but the VonTrapps themselves! They have been in Rwanda for a few weeks, and they are good friends with a roommate of some of my friends. They were scheduled to sing the Rwandan national anthem the next morning at President Kagame's Council meeting, so they rehearsed for us a little bit....it was great! And then they broke out into a chorus of "The Hills Are Alive..." No kidding. Thank you, VonTrapps, for making our evening so memorable....

further prayer requests

There is so much emphasis here in Rwanda on healing and reconciliation, but there is continual need for prayer. At the end of last week, there were two incidents highlighting that ethnic tensions still simmer beneath the surface of government efforts to maintain peace. One incident took place just down the road from where I live, at the genocide memorial, which made it all the more real. Read more here:

http://news.bbc.co.uk/2/hi/africa/7342866.stm

Thank you for your continued prayer for peace in this country. Rwanda has come so far since 1994 -- it's amazing! And there is much reason to have hope for the future. But even in my own life, I can see that if I let myself harbor any kind of bitterness or resentment in my heart, even (especially?) if I have been wronged, it's like poison (I am actually borrowing these words from a wise and beloved friend). So if I can see this in my own heart and life, how much greater would harbored bitterness and resentment be, on a country-wide scale? What might wait beneath the surface to uncoil and strike, at the opportune time, or when it just can no longer be contained?

I think this is why prayer is so important: on the surface here in Rwanda, most days everything looks the way it should....the nation appears to be embracing development. But God looks beyond the surface and into the heart of things, and He is the One Who knows what truly needs attention. He is a big and powerful God, and able to do what benevolent and wise governments and well-meaning humanitarians cannot do!! So it is not a fruitless task to pray -- in fact, it is critical. Thank you again for praying! And I believe we will see God continue to provide answers in ways we could never imagine.