Showing posts with label disease. Show all posts
Showing posts with label disease. Show all posts

Monday, April 5, 2010

Numb?

A few days in Ngungu, and I’m starting to wonder if I’m becoming numb, if I’ve reached the point in the humanitarian and development field where little, if anything, surprises me any longer. Maybe this sounds melodramatic, but walking the short distance between our office and guesthouse, I see things that would shock people unfamiliar with life in the developing world. Has something changed in me to the point where I barely notice some of these things any longer?

I walk with the team to go and visit one of the local authorities this morning- it poured last night and mud is everywhere, punctuated by the occasional stone jutting out of the alleged ‘road’ through town. We pass between two houses and make our way towards a central square of sorts, the office for the government representative. We pass one of the front courtyards of a house, and I see a toddler, a little boy who looks to be maybe around a year old. He’s wearing the ragged remains of a white sweater, of which a few shards dangle from each corner. He has nothing else on and sits plopped down in a pit of mud, making noises to himself. His nose is dripping a grayish-green mixture, and his face is streaked with dirt. His stomach, distended, protrudes from underneath the bits of sweater that remain. This kid is a toddling, lurching, pediatric nightmare- undoubtedly undernourished and presumably filled with amoebas, parasites, and disease from the contaminated water he drinks and the mud he plays in. Drop him down in front of your average parent in the States, Japan, or Europe as-is, and Child Protective Services (or whatever the local equivalent) would seize him from his abusers without a second thought- in Ngungu however, the mud puddle is day care. I walk by, and although I see the toddler, I barely react- I keep walking- another day in Africa.

As we continue back to the house, I pass a soldier. This isn’t anything unusual; DRC is a heavily militarized place, and soldiers are a constant presence. What strikes me though, is that rather than a soldier, this is a kid of about 13, wearing fatigues and cradling an automatic rifle. To identify him as exactly what he is, a child soldier, is to understand that his existence here, in these fatigues and with his gun, violates dozens of UN and national policies about the use of kids in combat, and would expose his leaders to charges of child abuse of the worst sort if this were a different place. I glance at him as I walk along, and although I have some peripheral awareness at how bizarre and wrong this is, I keep going.

On the way back to the house, I see three women, walking barefoot in the mud; this may actually be the best strategy to keep from slipping. This isn’t what catches my attention though. The women each have a 25kg sack of cement on their backs, attached by a strap tied onto their foreheads. They’re clearly struggling under the weight of the bags, and have a blank glassy-eyed expression on their faces that can only be described as cow-like. I’m well-aware of how bad that sounds, but it’s the truth- it’s as if everything making these women people is gone, and all that remains is a beast of burden. The vacancy behind their eyes is something that would shock most people, I know, but I’ve seen it countless times over the past few years, to the point where it doesn’t faze me, I simply accept it as part of life here.

When I was a kid, and through my early teenage years, my dad was a funeral director. To answer the inevitable question, we never did live in the funeral home. Having him in this line of work meant that I was exposed to death far more regularly than most people, certainly most kids, to the point where walking in on my dad in the middle of embalming someone or scraping ashes out of the crematory seemed almost normal. I remember asking him about it once, how he handled being around bodies, some whom were people who had undoubtedly suffered violent, untimely, and painful deaths. He explained that the only way he could do this sort of job was to compartmentalize himself, the same way firefighters of police officers would at the scene of a horrific accident or crime. It’s not that this is a unique skill, but I hadn’t thought of it in that way before. I’m starting to think that humanitarian worker is another one of those professions where this is necessary- seeing so much human suffering, degradation, appalling conditions and misery can tear you apart if you don’t have some way to cope with it. Many people in this field turn to alcohol or drugs, and burnout/mental breakdown is a constant threat. Although I’ve been able (fortunately) to avoid substance abuse, I suppose this work has caused me to form a sort of mental callus, to the point that things that would shock me in another life barely seem to elicit a shrug.

In spite of the numbness that can (and does, at times) exist, there are little moments from time to time that make doing this sort of thing feel worth it, and make me realize I’m not completely crazy to go 15,000km from home and work in some of the most impoverished, conflict-ridden and otherwise fucked up spots on the planet. Looking out the doorway as I write this, I see a little girl in a clean neon-green dress, maybe four years old, running along a muddy path. She’s towing a homemade kite made of a few scraps of wood, a length of thin vine, and a plastic bag stretched across the frame. She clearly doesn’t have a care in the world, and seems concerned only with keeping the kite in the air- I can’t help but smile as I watch her.

Driving to a nearby village the other day, we get briefly stuck in a large mud pit. Forced to stop while the driver coaxes the Land Cruiser free of the thick brown/black goo, I find a scene of almost impossible beauty spread out in front of me. The sky is sapphire blue with a few wispy clouds sailing on the breeze, and a series of dazzlingly green mountains and fields planted with corn and potatoes surrounds our car. In the distance, I can see herds of black and white cows gorging themselves on the hillside. It’s a scene so perfectly idyllic as to be cliché, and a place that my family and friends back home are likely never to see.

The natural beauty and unadulterated joy I get to see and experience as part of what I do doesn’t erase the other side, the poverty, dirt, abuses of basic human rights and dignity, but it helps make it bearable, at least to the point where I’m not ready to abandon this field, not yet. The good manages to balance out the bad, to an extent, and form some sort of reasonable mental equilibrium. As I write this last paragraph, a song comes up on my iPod, and I can’t help but laugh at how well it encapsulates this state exactly. “I,” sings Roger Waters and Pink Floyd on “The Wall,” “have become/Comfortably Numb.”

Sunday, March 21, 2010

Up to Ngungu

I’ve never been to Ireland, but visiting Ngungu, I think I have a sense of what it might be like… if I was visiting 1,500 years ago. The hills are emerald green and grassy, there are plump cows everywhere, potatoes and cabbage are the staple foods, and the weather seems to constantly cycle between fog and rain, chilly all the while. Ngungu is 80 kilometers from Goma, easily another 1,000 meters up, and many, many centuries behind the times in terms of development, minus the tin roofs and the occasional nasal beep of a motorcycle horn.

Beautiful as it is, I’m not here for the scenery. Like virtually every human settlement in DRC, from the urban chaos that is Kinshasa to the tiniest village, access to water is an enormous problem. There might be plenty of it around, but drinking a bit is likely to give you stomach cramps, diarrhea, and maybe even a bacterial infection or amoebas if you really hit the jackpot. This is where we come in; I’m leading a team in collaboration with Ibrahim, our water engineer, and we’re conducting a study about people’s perceptions about the quality of the water they drink, and seeing how knowledgeable they are about basic sanitation, things like washing hands before cooking or after using the latrine. We have a team of agents on the ground already, trying to spread messages about simple things anyone can do to have better hygiene. A truckload of PVC pipes, valves, clamps and cement arrived this morning, the first step in construction of new water points, latrines and showers for the people of Ngungu.

The ‘road’ up here from Goma, if you actually can label it as such, is something to behold in more ways than one. It’s spectacularly bad in sections, with enormous patches of thick, blackish mud, seemingly wide enough to swallow a 4x4 whole. Equally, if not more spectacular though, is the beauty of the drive- North Kivu is undoubtedly the scenic jewel of DRC, and the way to Ngungu might be the single most beautiful point in the province. Climbing the mountains out of Goma, the views of steep green mountainsides and the enormous bluish-gray expanse of Lake Kivu form a vista that would rival any Swiss postcard. Once you actually arrive, however, the scenery is still beautiful, but the town is behind the times, even by the standards of the developing world. Electricity is a distant dream, naturally, everything is muddy, the market has very little available aside from the ubiquitous (and weak) Tiger Head brand batteries, tubes of super glue, and barely edible ‘Glucose Biscuits.’ There’s a strong odor of cow manure that seems to come and go on the wind, and soldiers in mismatched fatigues who look like they couldn’t possibly be more than 15 wander around aimlessly cradling large machine guns and rocket-propelled grenades.

On the first full day in town I accompany Ibrahim and our team of technicians to a series of water points, where we’re collecting samples for testing. Each water point, usually no more than a pipe sticking out of the ground is surrounded by women and young kids carrying large plastic Jerry Cans- water collection is definitely not a man’s business in this or any other part of Congo. The pipes were put in place by a German NGO many years earlier, and although they still deliver water, they’re badly contaminated in many cases. The water points are surrounded by a sea of mud, and people wade across it barefoot to fill their containers, often several times daily. The technicians take turns filling small sample containers, checking the pH, taking the water temperature, and measuring the turbidity (the cloudiness) of the water at the source. Each result is carefully recorded in a notebook to be included alongside bacteriological tests later on.

In addition to the water testing, we also administer our questionnaire to a random sample of households throughout Ngungu and a few of the surrounding villages. We’re asking very simple questions, things like, “Do you think it is important to wash your hands?” and “Does the container you store water in have a cover or not?” It’s fairly basic information, but the sort of data that’s essential in allowing us to get an idea of how much, if anything, your average family of residents or internally-displaced people knows about elementary hygiene practices. The interviewers go to a randomly-chosen house and ask to see the adult woman, as she’s almost always the one responsible for collecting water, feeding and bathing children, and cleaning up garbage inside and out. Many of the women seem shy or reluctant to respond at first, although a little by a coaxing by the interviewer seems to cause them to open up. Listening to their answers, even though a translator, can be revealing, and it’s surprising just how low the level of knowledge about this sort of thing seems to be. Multiple people said that they rarely, if ever, wash their hands following a trip to the latrine, and the idea of having a covered storage vessel for water seems foreign to many. The interviews are (for the most part) conducted entirely in Swahili , the local language in this area. This was actually a big surprise to me; I’d never thought of Swahili being spoken outside of Anglophone east African countries like Kenya, Uganda, and Tanzania, and finding out it was the main language in eastern DRC wasn’t something I’d expected. It makes sense though- this part of the country borders Uganda, and Tanzania farther to the south, so it’s only natural that the language would have made it here, although it does have a strong French flavor to it in these parts.

Since Swahili is the common language here, there’s one word I recognize immediately from my (brief) time in Uganda, ‘mzungu,’ the universal word for ‘foreigner,’ or ‘white.’ I hear it constantly here, from the hordes of kids who follow me whenever I leave the house, fascinated by every move I make. I’ve often wondered what could be so endlessly fascinating about me simply because my skin is a different color- as I write this, I’m sitting outside, and more than a dozen children are watching me as I put pen to paper silently. Walking around collecting water samples with the team yesterday, I (no joke) must have heard mzungu 2,000 times in two hours of testing. Something I’ve noticed over the years that holds true here as well is that the sight of a white foreigner seems to inspire people to do the most bizarre things. Kids mug and stare at me as I walk by, make faces, give exaggerated thumbs-up or karate poses, while young teenagers shout bits of fractured English (“HowareyouIamfineandyou!”), while others simple stare, hiss, or give what feels like a mocking laugh- it’s enough to drive you into blinding rage, if you let it get to you. Instead, I try to let it bounce off, stay as impassive as possible for the most part, although someone being particularly persistent or ridiculous can make me show a flash of annoyance or smile a bit. It’s not that I enjoy being stone-faced while being shouted at, bur I find it’s the best defense mechanism to prevent me from going insane over being stared at like a zoo animal. In this, I have to say that I envy Ibrahim, who’s Sierra Leonean, and blends in with everyone else.

One word I’ve been called is a surprise though, and I hear it for the first time as I’m walking around; after the first time, I hear it several hundred more times.

“MONUC! MONUC!”

For the uninitiated, MONUC is the acronym for the United Nations Mission in Congo, MONUC in French, and the largest UN peacekeeping operation in history, at more than $1.4 billion a year. Apparently I singlehandedly represent the United Nations. I think for an instant about responding, ‘that’s Mr. MONUC to you,” I don’t think the joke would really make it across the language barrier.

“MONUC, biscuit!”, the kids yell, demanding cookies. I find out from one of the agents that the MONUC troops often pass out cookie s to the kids as they patrol. Joseph, my colleague (and fellow mzungu) jokes with me that if you were to come back to this part of Congo in 30 years and ask the adults at that time what the mandate of MONUC was, they’d probably say it was to distribute cookies. Since many of the MONUC soldiers are non-African, from places like Uruguay and India, it stands to reason to the kids of Ngungu that any foreigner must be MONUC, and must therefore, be carrying an endless supply of cookies to be surrendered upon shouted demand.

Being in a place like this, it can be easy to feel disappointed or dispirited at the incredible amount of squandered and ignored potential. I suppose you could make that statement about DRC in general, which has an alleged $24 trillion of mineral resources under its soil, but this goes beyond simple wealth from something extracted out of the ground. If some authority or backer, whether the Congolese government or someone else, were to invest in an actual road, electricity, and a functional water system, it would have a dramatic impact on the fortunes of Ngungu and other communities in the area in several ways. For one, it would notably improve life for everyone concerned, the most important thing. Secondly, it would be possible to bring tourists here- this place could be paradise. If people other than the locals and humanitarian workers were to see the scenery I saw yesterday, the money would pour in, and this region could get on the road to stability and development. Uganda and Rwanda, both less than 200 kilometers from here, have figured this out, and have infrastructure for people to see the mountains, the gorillas, and the lakes- there’s no reason DRC couldn’t do exactly the same thing. I don’t see it happening though, at least not anytime soon- the fatalism, corruption, and willful slowing of progress for political gain seem too entrenched.

Ngungu isn’t likely to change much, aside from (hopefully) an improved water system and fewer cases of diarrhea. It’ll still look like Ireland, complete with hills, mist, potatoes and fresh cheese, but it’ll be the Ireland of the early Middle Ages, for the most part. One reason for this, I think, is the functionality of the government, and the systems that underpin it. In Ireland there’s a legal system which has played at least a part in enabling it to develop in the way it has- the only legal framework I see applying to Ngungu has an Irish name at least- Murphy’s Law.