Saturday, October 31, 2009

If there is anything that is good, worth of love and of joy, focus on that.
This is the paraphrase from some letter somewhere by St Paul (I am not soo knowledgeable of the Bible), but I know this - the verse tells us that no matter what, let us focus on what is good and wonderful.

My wonderful friends in Italy, that I met at the United World College, my friends from here and those I met in New Jersey. I love them. I am blessed with the dance, with a family, with a mind.

I am blessed

Halloween

Perhaps it is Halloween and its effect,but I feel awfully unnerved. Perhaps it is the harrowing news this week in one of the local papers that the body of man was found, with the genitalia, heart, several fingers, right foot, eyes and who nows what else, missing.

In the river dumped. It was in the North East of Namibia, where it is green and lush.
Before the article came out on Thursday, with the gruessome picture of the decaying body, my colleagues spoke to me about this on Wednesday. They told me about how it is dangerous to go about in the bush now, when it is green, lest someone kill and sell your private parts. In the Northeast of Namibia, the trade of human parts is notorious. To me this story is new, but not to those who live in this region of Namibia.

I was at my youth group yesterday, my old youth group and I met up with my friend Jean-Pierre there. I told him about this piece of the news - he had not heard of it. He said it was very dodgey, which means "sketchy" for all you Americans, with his eyes widened and his face brightened.

"Why can you not write about these people cutting others?" asked Lavinia, one of my four colleagues that enters the data for the health facilities census. "Cutting like a chicken, they must be killed also, why can't they bring death penalty only for these people." She bemoaned the situation, to say the least. I told her of how my letter was published in The Namibian, the independent newspaper of Namibia (one of many, but it calls itself that). I wrote a letter in about 40 mins about how ordinary people are precluded from calling in and chipping in on "Talk of the Nation" on television. This was on Monday, after I felt quite frustrated by non-participation.

I wield great abilities now, I realized : I can write a letter and get it published, I can mobilize the youth at my Church and get them to talk about volunteerism (that was today) and I can do wonderful research for my public health thesis (still to come). Now she wanted me to act, to write about this issue. It is a sordid, petulant, stinking issue - just thinking about it makes me want to throw up. Yet it is happening. I wonder what the relationship is between this type of fetishism and witchcraft and traditonal medicine. Traditional medicines are herbal and they mostly provide palliative treatment, especially for those suffering from the side effects of antirtetroviral therapy, according to a professor at UNAM. Now, is the relationship a continuum, where traditional medicine is on the light side of a spectrum of constructed views of healing and human fetishes are on the extreme dark side? Or are they two distinct ways of healing? Why does someone even take human body parts? Could it be for something distinct from their health, such as to get rich quickly, or to become sexually active again? Are the two things I mentioned actually separable from health in a meaningful way, given that the indicators of health (such as blood pressure in the West Indies) could be a function of collective representations of reality (cultural beliefs).

Just as the government condemned traditional healers that advocate the rape of baby girls as means for someone to rid themselves of HIV, I hope our government will unequivocally crack down on people who kill and commodify other people.

I think I will work on an article pertaining to traditional medicine and I will cast my net sufficiently wide to draw in fetishes into the discoure.
However, what about my idea for an article on the prisoners and HIV.
I still have this idea about prisoners and HIV. However, I find myself being pulled in the direction of discussion pharmaceutical policy in Namibia (how will we ensure the sustainability of our ARV rollout) and the difficulties in harnessing traditional medicine. Our government is going to pass a law that categorizes and standardizes traditional medicine for the consumption of the Namibian people.

Trade in Body parts (French )

L'une des choses plus frappantes depuis mon arrive en Namibie est la découverte qu'il existe un marche des parties du corps humain. Premièrement, j’ai entendu de mes collègues qu’il est tellement dangereux de marcher tout seul dans les espaces vertes et sauvages comme près d’une rivière. D’abord j’ai pensé qu’on se met au péril en raison des animaux qui y habitent, comme des serpents. Par contre, j’ai compris que le vrai danger est celui des hommes qui tue des gens pour leur déchirer les génitales. Quelle horreur ! Ma collègue Violet nous a raconté comment sa mère échapper aux hommes qui s’approchaient d’elle dans les herbes. La mère a appelé son mari pour faire l’impression qu’il n’était pas loin d’elle et par conséquence, les hommes sont fuit.

Deuxième événement frappant été l’apparition dans un journal hebdomadaire namibien un article sur un corps qui a été récemment retrouvé à nord-est de la Namibie où ces abductions sont communes. Au corps manquait plusieurs doits, un pied, le cœur, les yeux et aussi les génitales. C’était un homme de vingt sept ans qui était une garde. Un groupe des gens est soupçonne de l’avoir tué est les suspects sont des citoyens Namibiens et Zambiens, car ce marché est évidement transnational – la ville où sa se passe est près de la frontière zambienne.

Que puis-je fais ? Je suis tellement ému, négativement, par toute cette histoire. Pourtant, pour les Namibiens qui vivent dans les régions touchées par ce marché atroce, cette une réalité ancienne de laquelle il faut se tenir compte pour survivre aux croyances en magie.

Je me disais « Ça n’a rien avoir avec ce qui m’intéresse, l’épidémiologie et l’anthropologie, mais pourquoi suis-je si fortement pértubé ? » Sono rimasto malissimo a causa di questa storia sordida.
En effet, il y a un lien avec la santé publique vue que les gens qui sont victimes de ce marche sont morts. En plus, quelle est la relation entre la magie africaine qui présume l’importance des parties humaines dans la vie quotidienne et les traitements pour un très nombre des maladies qui sont fait des herbes et légumes traditionnelles ? Autrement dit, est-ce que l’attitude vers la superstition et le fétichisme une analogue de la crédulité en la « médicine » traditionnelle ? Sont-elles deux attitudes dans un continuum des connaissances ou sont-elles complètement singulières ?

Il y a quelques jours, un professeur de l’Université de Namibie a publié un article sur son étude des traitements traditionnels pour les symptômes du SIDA, lesquels les docteurs traditionnels tentent à guérir. Tant au rôle que ces traitements pourraient jouer en Namibie, il espère de exploiter leurs potentiel comme drogues antirétrovirales, en dépit le fait qu’il y a pas encore des preuves scientifique pour attester l’efficacité des traitements. Je vais me servir des documents sur sa recherche qu’il m’a gracieusement fournis.

Monday, October 26, 2009

More titbits

What is the life a Princeton University alumn? Is it a constant frustration over what happened at the GRE, that I did not writethat amaizing essay, worth the maximum score - '6', like the Bulgarian system? I failed. The exam I passed for sure, but definatelynot with the grade I desired or expected.
Well what did I expect? I did not even do the five other essay questions I devised for myself,I just abondoned them after I found the official ETS list of topics for the essay. Per quanto riguarda la matematica, l'epreuvedes Mathematiques est bien allee, malgre que j'aie pas repondu a toutes les questions. En effet, l'examen n'est pas mal passe, c'est que j'ai pu mieux faire. Nonostante tutti questi sentimenti di regretto ai quali non riesco a rinunciare, cel'ho datta!L'esame e finita, morta, non mi pervade piu la mente. Dio mio, aiutami a compiere la tua opera, nonostante il fatto che non sono adeguato, in gradodi farla addesso. Help me Lord, to complete your work, even though I am not worthy at the moment.
Pancho Mulongeni discusses what it means to be a Princeton University alumn. He begins by posing the question "What is the life a PrincetonUniversity alumn?". His reply to the question is frustration. Pancho recounts how did not perform well on the GRE exam, an exam that is require forgraduate school admission in the United States, as well as he expected to. He cites his inability to do all his prepertory essays as one of the causes.Pancho did not write on the five essay questions he thought up for himself, because he found a list of official ETS topics for the GRE.He grapples with legitimacy of topics of his own creation as a preparation for an exam. Does this feeling of legitimacy of the self extend to other areas of Pancho's life?Does he feel that he needs to live according to the hegemonic perception of a Princeton University alumn, rather than a path of his own design. Pancho regards his failure to do all of histopics as weakness and one of the reason for not attaing the maximum 6 for his essay.
It is important to note that though Pancho claims he did not attain the maximum score, he does not know the results of his exam. Hence, this underlies a pessimism and desperation provoked by him not being satisfied with his performance.Why is he so distressed we might ask? What is at stake in him performing poorly on this exam? His identity as a scholar is probably dependent on him being accepted a top of the line research Universiy.His ability to study and do well on the GRE was likely a means to re-enter the local world of academia, where a number of his peers have gone on to study.The value placed in GRE might be connected to the popular belief that Universities recruit students with the highest scores.
Notwithstanding the overbearing pressure to perform excellently on the GRE, Pancho does not plan to do the exam. As he writes in French "L'examne n'est pa mal passe"he in French, Pancho acknoledges he did not perform poorly on the GRE. His expression, "c'e l'ho datta" is a conflation of the Italian expressions, 'c'e l'ho fatta' meaning I did it and "dare un esame", which meansto write an examination. Therefore, Pancho announces proudly that he is done with the exam, in spite of his regrets :" Nonstante tutti questi sentimenti di regretto..ce l'ho datta".His sudden change into Italian and French indicates his need to justify his reputation as a polygot, one who commands five languages.His unusual conflation of two different Italian phrases may suggest he is losing command of the language. However, it may also be a result of the free-indirect-discourse or stream of conciousness style in which he writes,in which thoughts are typed unedited. This is especially likely considering the title of his blog - Pancho's Brouillons - Pancho's random scribbles.
His ability to overcome mechanisms of regret that were probably inculcated in him during an early age will require a great deal of agency.(But something tells me Pancho is able to do it. The Lord will see him through) It is likely his Christian faith will provide a means for this agency.

Anthropological titbits

Anthropological titbits

A pharmacist inspecting the rash on the wrist of woman, across the counter, asking when the rash began and then she gives a cream, making sure the patient knows to complete the course even after the rash disappears “Keep putting it on for one more week, otherwise it will come again”. The pharmacist diagnoses and prescribes medication. She is at once a physician and a pharmacist, when confronted by patients who probably cannot afford to go and see a private “general practioner.” However, this pharmacist, a German Namibia lady, works at a private pharmacy in the centre of Windhoek, a far cry from the long queue of people waiting to receive their medication at the government health facility hospitals. Does her free time play a role in assenting to the clients request to become a patient of sorts? My friend from high school Mekonjo works at the pharmacy of the central hospital, which is a stones throw from my ‘computer cluster’ at the ministry of health. He says that “pharmacy is a dead end job”. To him there is nothing stimulating in this job. Probably his job does not require him to be both doctor and pharmacist, but would he like to do that?
What are the consequences for health care when private pharmacists play two roles, both doctor and pharmacist? Are they able to fill in the gap in between a full day’s wait to see a doctor at a state hospital and the expedient service at the physician consulting room? How different is the role they play from that of patients who go to a private physician to merely request a prescription for their auto-diagnosis? Are they just an extension of people’s desire to self-medicate? In the case I observed, the woman with the rash did not know what she needed to get, but the pharmacist did. Therefore, in a sense, the pharmacist is filling in the gap between private and public health institutions.

Time spent searching

I spent so much searching for this file called "Activism", in the white drawer, whose back wall is comming away, under this very laptop, amongst all my papers and my brothers old notebooks, half filled or 17/19ths filled, that I use.

I need some tighter organisation. So especially since I finished studying for the GRE. It's over. Now I must find a new thing to do. And I have. I want to write about prisoners in Namibia, somehow I want to tie to what I am learning in my own studies of epidemiology and medical anthropology. Plus, I want to incorporate it into applying for a fullbright.

Perhaps I can use this space to list my aims, short term and long term.
Short term
The immediacy of Catholic Aids Action Project Happening on the 21st of November. It is a "Happening". I am hoping to involve students of the Holy Confirmation and the youth from Highlands and the Older Youth of St Boniface. However, will not the age disparity be to large between the various volunteers. We need not all go on the same day. So for now, let me work on the St. Boniface students and those of SMYL. I need to contact Melissa again, who is the organizer of the students at St. Mary's Cathedral.
Alright so now there are two disparate projects within the same realm. The first is to mobilize these teenagers at the two parishes, St Boniface and St Mary's. We will go Nov 21st.
Then the other will be the older youth of St Boniface (myself, Takudzwa, Yvonne, Brona, Barbara + others who show up) and the Sol Nascente group of St Marys + older people from SMYL (St Mary's Youth Leage).

- The other aim is to purchase books for my public health courses next year + get the books on Medical Anthropology and Molecular (Biology of Epidemiology) books, that will interest me.

- Then there is the aim to save a quarter a day. Saving one quarter namibian dollars (or Namibs as some people call them, US college interns in Namibia - interesting girls I met here). Just for everytime I log into my email, I must save one quarter. Eventually, I will save enough for something.

- Get a driving liscence before the end of the year
- I need to read the articles on Medical Anthropology and Medical anthropology. Well yes I am scatter brained somewhat.

- Read about the Fulbright.

Longterm Goals (before end of 2011):
- Apply to as many postgraduate fellowships and scholarships as possible - there is the fullbright for the US, the commonwealth for the UK and the Rhodes. For France, there should be something too. For Italy, is there? I would have to look that up (will I?).
- Start an Italian table at Studio 77
-Learn Oshiwambo
-Performance of my choreography - including work I did with Hennie.


Let me see which are most important. I have underlined short term, because it is the sum of shorterm goals that give one longterm one. So they are most important.

Now I need to choose three short term goals from my list, excluding the Catholic AIDS action. Devo scegliere tre scopi di quei sopra tranne quello della Azione Catolica contro l'AIDS.

I will choose them for this week:
- Reading for my driving liscence - every Mon Wed.
- Read the TB epidemiology article and Med Anthro
- Purchase your medical anthro books + find out about course books

Loosing it

Even in my most sullied moments in a dingy place, Lord you are there.
Even whe I am struggling to struggle,
with what I have cut out for myself,
there is your prescence

Lord please giv me your ability to handle things.
Perhaps that request is too much, to make me a divine.
So what I do I want,

Ho voglia di fare quello che comandi, ma bisogna solo che mi organizzi meglio per affrontare
tutto

Saturday, October 17, 2009

Chutney

I lost the chutney! Thursday I went shopping with the money my dad gave me after he dropped me off after work at the shop (I will refrain from using Americanism such as the grocery store, why should I assume I am writing for an American audience?) I bought chutney and other foodstuffs, only to find out today that the chutney is nowhere to be found. I searched high and low and I am sure it is not in my house. The chutney is gone and I never even tasted it. I wonder where that bottle filled with chunks of boiled peaches and sugar is? The famous Indian condiment, known as Mrs Balls Chutney is not part of our household. Never have I felt so bitter about losing a food item. Perhaps it is because I bought it, as part of the groceries I was supposed to by and by losing it I have be found to be irresponsible. But this fixation on chutney is not typical of me.

When I left Princeton, I left a world of material possessions behind me. Clothes, yoga mats, sleeping bags and even books were just given away. There was a catharsis of renewal that I experienced during those hours after graduation, whereby I forbade myself to hold on and care about the material. Now why am I so concerned about this chutney?

I should detach myself from the material and dedicate myself to worthy ends. The mobilization of the youth at my parish to volunteer is about to come to fruition when we go to a home for AIDS orphans called "Baby Haven" in a poor part of Windhoek next Saturday. Weeks of negotiations between myself, the students of the Holy confirmation and the teachers have allowed us to finally take action in our community. In addition, in November, the students in the first year Holy Confirmation are planning to go to Catholic AIDS Action, which is the project I have nurtured since early in the summer ( or fall in the US). Today I went for my meeting for the planned visit to Baby Haven so as to ensure the students are organized and inspired to volunteer next week. Logistics were planned and I encouraged them by speaking about how every fifth child in Namibia is an AIDS orphan, a dubious statistic that I learnt at Princeton during the day we wore our Orphan T-shirts. I was wearing mine as I spoke to the kids and told them about our campaign to sensitize the Princeton Campus about HIV. I am supposed to be African and so I am supposed to survive on little and understand that life is a struggle. On the other hand, I spoke to the students, all of whom are teenagers, as if I was an American volunteer, refering to them as "guys" and leaving my number and email in case they had any ideas about fun games for the event. Notwithstanding my American behavior, there were certain Namibian phrases such as "zula" which means "hustle" that I used to convey to them my message. I want them to raise funds to purchase gifts to the "Baby Haven", most of which will be in food.

Food is scrumptious and I had a full lunch before leaving to the Church, though it mean I was a few minutes late. Luckily for me, they were also late in starting. Nevertheless, why am I not dedicated enough to just run up and go to the Church, no matter what, whether I have eaten or not? What is the basis of my work? Is it pure motivation or do I need to be comfortable to effect my projects. I remember that Socrates in the Phaedo by Plato spoke about the meaning of life: He said that humans must strive to rid themselves of the slavery of the body's desires and thereby liberate the soul to contemplate knowledge, life, the universe and everthing (as Douglas Adams says). Somehow, I cannot achieve this state of the ascetic and live for holy, higher ends.

The reason that I am angry at myself is not because I lost the Chutneay. The truth is that I am searching for my role after graduation and I cannot seem to situate myself. I am caught between the need to work for the greater good and the desire to life a regular life of materialistic consumption. It is possible that is this tension between these poles of my existence that keeps me going.

Sunday, October 11, 2009

Review of AATABA


AATABA was a contemporary dance performance by a Moroccan female dance trio that became a quartet with the addition of of Namibian artist Angelica Schroder. The show had no program, the name of the choreographer was not announced, we were only told of the idea. The idea of cultural exchange between francophone Morocco and francophille Namibia.

The exchange of culture did appear fruitful as the ripples travelling through the back of Schroder captivated me. She had clearly internalized Moroccan belly dance techniques .However, when one of the Moroccan dancers began to send pulses of muscular articulation from her head to her waist and back up again, I felt shock waves move through my body in amazement. The Moroccan dancers used what we would call their traditional dance in combination with the dance of their former coloniser, France. This was demonstrated by the Moroccan dancer who executed sinuous movements of her arms while taking minuscule steps on the tips of her toes with her legs tightly together, called burees. With her back to the audience and her head turned just a tad to the side and up, she was the ballerina with mystic Arabian arms.

What made AATABA distinct from ethnic dance performances, whether they be ballet or belly dance, was the form of the whole piece. The painstaiking progression of movement ideas pervaded this performance. For me, the most poignant example of this was when one of the dancers took a plastic tub, full of tomatoes, dropped it on stage and slowly stepped into it. I still feel reverberations from that moment - her feet slowly plodding in the tomato pulp, while she turns with each step to give us a 360 degree view of how she steps. Time was dilated by her slowly meditative steps, but also rushed forward each time she jerked her foot up to the shin of the opposite leg. During this plodding, a woman undresses her self as she sits at the lip of stage. Taking her time, she pulls of her top to leave us staring at her in a her black lace bra. Her look is pensive and she begins to sing along with a chorus of female voices, in arabic, which is playing. Just that look evoked feelings within me. I wondered how her half naked body would be perceived in her native Morocco. What message could this send to those who believe in covering up the woman's body according to Islamic tradition?
It was the build up the ensued which wove together a message. The one on the tomatoes gradually stepped harder, splashing bits of red along her smooth legs. Concomitantly, another woman, lying on her back on stage and he bent legs jutting like mountain tops is roused to move. She progressively comes to cover her head with a black pantie hose. To her feet, she attaches the ends of the stockings and comes to stand up, with her knees bent. Black sinews appear to run from her feet to head and her legs resemble the curved arms of a praying mantis. Indeed, like the stealthy mantis, she moves forward in spurts with quick insect-like turns of her head. The stockings from her head to toes appear to constrain her movement as her torso stays close to the ground. But then she winds her arms round those black sinews, pulls on them occasionally reaches a leg up in a high diagonal, pushing the limits of her body. I saw her as dancing the plight of the Muslim woman who cannot show her face and is finding out how many was she can manoeuvre given her constraints. As this occurs, the voices of Arab women begin to crescendo and Schroder, seated in a far corner of the stage, covers her head with a green garment, resembling a woman wearing a veil, green for the color of Islam. A pulse in her torso raises her body to upright and she takes large steps towards the audience while her upper body continues to pulse and gyrate causing her veil to flutter. From within the veil, her arms grasp towards the audience, as if she were reaching from within this symbol of Islam.

Once Schroder came to edge of the stage, she removes the veil and begins to breath easily, while her fellow dancer removes the pantie hose from her head to also find respite. The tomatoes splashing stops and an air of stillness descends on stage. Was AATABA an expression of Moroccan feminism or was their something else? In spite of my interpretation, other audience members may have found different messages. An Italian lady I spoke to afterwards said she saw the bloodiness of War within the tomatoes and the stomping. Italians, French, Congolese, Moroccans and a few Namibians, these are the people that attended AATABA. I wish more of us could have come. It was probably just bad luck for the producers of the show, because while we were watching AATABA, in a half filled hall, hordes of Namibians were watching the Rugby. Next time, come to a contemporary dance show, where anything goes, including the physicality of rugby.

Saturday, October 10, 2009

Monday this week, the 6th October

Anthropological titbits

A pharmacist inspecting the rash on the wrist of woman, across the counter, asking when the rash began and then she gives a cream, making sure the patient knows to complete the course even after the rash disappears “Keep putting it on for one more week, otherwise it will come again”. The pharmacist diagnoses and prescribes medication. She is at once a physician and a pharmacist, when confronted by patients who probably cannot afford to go and see a private “general practioner.” However, this pharmacist, a German Namibia lady, works at a private pharmacy in the centre of Windhoek, a far cry from the long queue of people waiting to receive their medication at the government health facility hospitals. Does her free time play a role in assenting to the clients request to become a patient of sorts? My friend from high school Mekonjo works at the pharmacy of the central hospital, which is a stones throw from my ‘computer cluster’ at the ministry of health. He says that “pharmacy is a dead end job”. To him there is nothing stimulating in this job. Probably his job does not require him to be both doctor and pharmacist, but would he like to do that?
What are the consequences for health care when private pharmacists play two roles, both doctor and pharmacist? Are they able to fill in the gap in between a full day’s wait to see a doctor at a state hospital and the expedient service at the physician consulting room? How different is the role they play from that of patients who go to a private physician to merely request a prescription for their auto-diagnosis? Are they just an extension of people’s desire to self-medicate? In the case I observed, the woman with the rash did not know what she needed to get, but the pharmacist did. Therefore, in a sense, the pharmacist is filling in the gap between private and public health institutions.

Post today

Alright, so for those of you reading this, I think you must understand me better, perhaps now. Remember though, I am person who is rarely at ease. Even today, I am thinking about how I will accomplish these aims I set for myself. Tomorrow I am going to Church to announce how the youth can become involved in two different volunteer projects - one called "baby haven" a place for unwanted and often "dumped", yes literally dumped in the trash babies and the other called "Catholic AIDS action". At the Catholic AIDS ACtion place, they have a literacy and numeracy program...
There I go again telling you about this idea of mine. Did I tell you I also turned down an opportunity to perform in a dance show this October because of this project, because they will clash in time and occur at different places.
Somehow, my organisational limitations anger me! I am angry! Even in my bag, I put my diary somewhere I cannot find it, untill only later I do. If I were more organized I could do so much more I say, but then again what would I loose out?
Those times with my family at home, when I just sit infront of the TV or cook wonderfull meals of my own design (or the recipes of my grandmother).

Today I bought a baking pan. I will bake at my home with it. I plan to bake bannana bread at the Church with it and share it with the candidates for the priesthood I have come to know there.
On Friday, I was there at the Church, because I met with our priest to discuss the volunteer project and I told him "You can help by announcing after mass that the youth group exists and asking all the members of the youth to stand up and get involved". Apparently, this worked in drawing the interest of the youths of Saint Mary's Parish in our city center, now will it work at our parish in the suburb of Pionnerspark?

Ahhh! Frustration at so many things. My dad not being home since Thursday and not responding to my calls, only my brother saw him yesterday. My parents are on the brink of divorce, and they have been on the brink of divorce for a long time now.
I ask for the Lord's peace but do I care to read his word?
Today , I went to practise essay writing for the GRE and I walked to the nearby library, only to find out I had forgotten my practise book!
The irony was that I took two taxis to go back home, get the book and come back to the library only to not end up using this book, because I focused exclsively on my writing, which needs alot of work...

Lord, please grant me your peace.

Sunday, October 4, 2009

Medical Anthropology

I am so glad to be writing this blog, because I must satisfy an inner desire to acknowledge my new found discovery. Inside of me an interest in medical anthropology is burgeoning and I am contemplating studying this for my doctorate in addition to epidemiology. An interdisciplinary approach to combating infectious and chronic disease is definately what I want to do.
Medical anthropology opens up a new avenue through which I can understand the human subjects afflicted by the diseases I wish to fight.

The ethnography "Will To Live" is the text which converted me to this field. I am still reeling from its explanatory power and its ability to illustrate what mere figures and statistics cannot.
The ethnography covers how Brazil became the first developing country to universalize ARV distribution to AIDS patients. It looks at how international political manoevering by Brazil allowed it to produce generic drugs and the local distribution of the drugs on the ground. It follows the lives of marginal AIDS patients, who are economically destitute and cannot afford to live a life conducive to adherence to the ARV regimen. That's where this house of care, Caasah came in by providing a place where people can find refuge from the violent distractions of street life and start anew building a "Will to Live".
The author Jao Biehl has such an intrepid way of writing as he exposes the inadequacies of the state health facilities in coping with homeless, marginilzed AIDS patients, including policies that understimated the HIV burden amongst the urban poor. He uses an epidemiological study of HIV reporting at the data reported to the Bahain HIV surveillance unit and draws astounding conclusion. He unravels the terms under which a patient is most likely to be engaged by the health facility, which appear to discriminate against men who have sex with men..
In addition, he shows that many patients from the street are admitted to the hospital only to die.

The most compelling question for me was how does an AIDS patient in Brazil balance their seropositive identity, which grants them access to a disability income from the government and material assistance from AIDS NGOs thereby giving them rights to certain good, what Biehl calls a patient citizenship with the fear of stigmatization? This played out in the prison where prisoners with HIV were separated from the other inmates and given special meals, but they were stimatized by the other prisoners.

I am still on my way to finding out what this Anthropology thing is. Biehl says "Anthropology produces different kinds of evidence", meaning different to what normally expect, especially in the sciences. The evidence from anthropology is by taking a local perspective into peoples lives and their dynamics, which I believe complement studies into the dynamics of disease within populations. Indeed, it is through the perceptive view of the ethnographer that we are able to understand how a person transforms their life to benefit from the ARV rollout and turn AIDS into a mere chronic condition, rather than a death sentence. Where else can one find that out?

Saturday, October 3, 2009

Correction

The post below says "Today I visited the Windhoek Central Hospital"
In reality, that visit happened weeks ago.
Today I visited the Windhoek Central Hospital. We passed through corridors, went up and down in an elevator and we managed to have Violet seen for the her swollen eyes. She was at first incredulous that we would be seen without having to wait for hours and hours:"Last time I waited the whole afternoon" she told me.When we first arrived, we had a problem - Violet did not have the thirty dollars necessary for the user fee. So we went to the medical superintendent's office, where we were directed to go to admissions. We walked to the reception of the OPD , where my question of "is this admissions" was met with the answer of "I don't know" from the puzzled woman behind the iron meshgrid barrier. Nonetheless, she directed us to the eye clinic, where Violet appeared to be the only patient. She was seen by a registered nurse and we came back down, in an elevator that went up and down several times before reaching the G floor.
At the medical superintendents office, Violet got her stamp of approval to receive medication, and the only question the secretary asked was "Did the Doctor already see you?" which was in Afrikaans, a language Violet does not speak, but I do. In fact, I know this secretary, since I have been in that office many times when my mother's friend was the superintendent at the hospital. Violet later boasted that because she was with me, she was able to circumvent the long waiting process and access her medicines without paying:"I went with Mulongeni's son!"Being linked in, so to speak, with the hospital staff, being known, being a member of a well known family, this is what is commonly believed to permit one efficient access to services in Namibia.Though I do not know if this is the case, because the woman at the admissions was exceedingly friendly without knowing my name. When I asked her whether it was alright for Violet to go to the eye clinic without a health passport she reassured me:"They have everything there, don't think I will just leave you to go somewhere" She did not abandon, she helped us and I believe that made all the difference.
To what extent are interpersonal networks important in determining the outcome of a patients visit to a hospital?

Hennie Breakdancer

Hennie is a break dancer. He teaches break dance by night at a tiny theatre in Windhoek. By day he works at Pupkewitz Megabuild, a company that sells equipment and materials for ‘do it yourself’ building, similar to Home Depot in the US. In partaking in his passion, dance at night and during performances with his students, Hennie forges a new and almost secret identity that one would not expect from a blue collar worker. When he teaches, he speaks of breakdance as an art and explains to us how it is innate in him: “I come from a family of dancers” he says while explaining the wave, a movement sends a ripple of movement from the tips of fingers, through the arm across shoulders and to the fingertips of the other hand.

There is complete investment of his self when he teaches, he appears to be professional. But he is not, as professional dancers cannot yet make enough money from their art in Namibia. As I was stretching after class, he spoke to me about the constant tension between his life as worker and a dancer : “You know sometimes I feel regret, regret that I have a job. Especially when someone tells me this happened or that happened, I say to myself ‘Hennie why don’t you quit your job and pursue your passion’. But then I think of my one year old son and I remember. That’s why I want to start my taxi business so at least that can sustain me and I focus more on this”. Dance and workman identities are imbricated to construct his identity, where his workman life supports him financially; his dance supports his personhood, what he considers to be of value in life.

As a break dancer, he wears a vest and tracksuit pants – an urban look. However, he knows that to survive in Namibia he must conform to the hegemonic idea of a decent man. After the class, he puts on a black shirt with a tie and an ironed pair of brown pants. This is what he wore to work today as part of “casual day” a fundraiser for the elderly which raises money by allowing workers one day of casual wear. The white collar workers from USAID where I work were dressed casually, with shirts and jeans, instead of suits and ties. Here I find Hennie with a tie and shirt and I ask him “Why did you choose formal and not casual?” “No I asked the lady if I can wear anything and she said yes, so I chose to dress like this”. To me, it appeared that he wanted to look like an office worker and just for a day, escape the identity his overalls give him.

Do I escape my identity as a person who works at the directorate of special programs, doing a health facility census by dancing? For many years in college, dance was my refuge and when I had academic difficulties I would go to it. Only later did I realize that I needed to solve my difficulties and still dance. It is not easy to analyze myself.

Remember Etanga in my work

I was at the ministry of heatlh's directorate of special programs. I was there every weekday this week and the week before that and the one before that. But over a year ago, I was not in this room filled with computers and bundled up questionnaires. I was in a place named Etanga of rolling hills. Far from the nearest town.
I danced there, spoke to the Ovahimba and recorded over 5 hours of their singing and dancing on an audio format. I am listening to it now.

Now. The reason I remember to write about this is because I have been reminded about Etanga by small things. A friend at my Christian youth group was going to the Ovahimba villages for her class on communal law and Etanga was one of them. When I found out it was the night before he departure. Would I have sent something by her if I had more time. Resents-je un desir de me remettre en contacte avec la famille Tjambiru, laquelle m' acceullie dans leur village-maison pour mon stage-etude de leur pratiques de danse? (Do I feel the need to reconnect with the Tjambiru family that hosted me in the village/house during my internship study on their dance practises?)

Even though I did not send anything to them, I received a package from Etanga. It was a set of questionnaires that evaluate the Etanga clinic. It was done by colleages of mine, people I was trained with for the health facilities census. I had been outside this clinic. It was where Vuanderua's daughter gave birth to her child while I was doing my study. Me and Hoveka walked to the clinic from the vilage, a trek of about 2 km, which for them is normal, but for me was shocking, especially when at first Hoveka planned I go with him, early, even I don't have breakfast. He is a warrior, that's what I felt and still feel. I am weak. Weakened, afaibli par la vie urbain et sa manque d'exigences physicalles (weakend by urban and its lack of physical demands). I am drifting off into the zone of remembering my visit to the clinic and how small and vulnerable that baby looked like, a neonate with wrinkly skin on its fingers.

I received the package of questionnaires for this facility, the clinic, from Etanga. I made it ready for data entry and assigned to a colleage, a data entry clerk to key it away. The information gathered by the interviewers in thise blue, green and yellow booklets, with one red cover, stacked together, will hopefully improve services at the clinic. I remember when I was at shop in Etanga, doing my glissades, showing Hoveka some of the ballet I learnt. When all of a sudden, there came a man, Iwe, with a large swollen leg. His leg was swollen, evidently from faulty draining of fluid from tissues. He asked me "Please man, when you go, tell them about this, I went to Opuwo hospital and they did nothing. Find out for me what I can do." I said I would, but I never did. I was suprised that this man's condition had not been treated at the hospital in Opuwo. I guess I did not realize I was in Namibia, Africa, where the provision of health services covers the fundamental ailments, at best. This condition, just was not part of it. Here, in Windhoek, one of the data entry clerks, Katrina, has a similar problem with her leg. She was involved in an accident. Slowly but surely her leg is reducing in swelling. What are the chances that both Iwe and Katrina suffer from a similar condition? What are the chances I would not take up dance as profession, but instead look to epidemiology and public health as my vocation.

At times, I think it was a simple as him ruining my plan to create an amaizing work of dance based on the Ovahimba tradition. There I was doing my glissades, being a dancer and he comes, Iwe to tell me about his leg. "What do I know about your leg!" I could have shouted or even said "Sorry I am here to do dance, not be a public health expert or doctor". Those words did not leave my mouth or enter my thoughts, however. I am an interesting specimen, I think for anthropological study. I am betwixed and betwined on a variety of levels, Namibia and Bulgarian, African yet somewhat foreign (people occaisionally think I am not from here, but from US) torn between the urgencies to help people using science and humanities (medical anthropology and epidemiology are my choices here) while drawn to the dance art. Having had so much exposure internationally, first in Italy then in the US, I have forged interpersonal networks that will forever guide my life trajectory and that have impacted my thinking.
I am apparently "a contradiction", because I am a gay, and I open to whoever asks, while being a Roman Catholic.

Nw what is tha path I will take, given that I am already involved in public health work while pursuing dance after hours? I strongly feel that I must not be " a dancer by night and epidemiologist by day". I remember my academic advisor and her colleage telling me about an epidemiologist they knew that played in a band by night and they said "I think he would much rather be a rock star, if he could. I want to be a harmonious person, not one that is fragmented. I want to go deep into my vocation and never ever have what is considered a "job", something that one does just to earn money. I do something because it is a calling, a vocation.
This brings me to my break dance teacher Hennie. I write about the tension in his life in the next post.
Breakdance is much like the Ondjongo of the Ovahimba. People in a circle clapping and when someone goes in the circle to dance, the cheering intensifies. That's maybe another reason for me taking up breakdance. I still miss ballet, but don't regret taking this new form.