Handicapable in the Developing World

Every day I walk down a road that I often despise- the mud, the cavernous ruts, the garbage, the throngs of people, bicycles and the occasional brave automobile. You know, just a treacherous little slip of dirt that burdens me daily. One day, I, the classic, able-bodied complainer that I am, was bemoaning my plight at being forced to walk on such a road. As the 5^th group of children ran by to slap my white skin and sprint away, I noticed I was walking behind a man in a wheel chair. The sandy potholes and Himalayan-esque mounds that cover every meter of the 5k+ road were difficult even for the young and fit, so I was stunned to see him puttering along. He struggled with unbearable slowness. After all, he only had one working hand to propel him.

Now my western friends, this is a “wheel chair” in the sense that it is a chair with wheels but I don’t want you to think that it is anything like the image you have in your mind. They don’t have legitimate wheel chairs in this neck of the woods. It was a hand welded metal lawn chair which he attached 2 different size wheels to the outside. The seat looked to have collapsed long ago and had been replaced with a plastic disk- possibly the top of a bucket.

People passed him by the dozen. He moved at a speedy 3 centimeters an hour. As I got closer, you could see that he was older and had an obvious longstanding defect consistent with polio. His one working hand was even misshaped but long callused from turning that wheel. How was he not going in circles? The answer- impossibly small motions. I was faced with that awkward moment where I would pass him. At this point, talking with strangers is not my favorite pass time, but I couldn’t walk to my house knowing that if no one helped him, this man would still be here on this road long after I went to bed. So, I said hello.

He gave me a 6 tooth smile.

“Can I help you?” I motioned pushing him with my hands.

He apologized immediately in Tonga “I don’t speak any English.” So I said it in Tonga and added a quick “but I don’t speak much”. He laughed riotously and put his crooked hand to his forehead. “Okey.”

I’ve pushed my fair share of wheel chairs but this was an extraordinary challenge. The road is truly one of the worst even for land cruisers, let alone for jerry-rigged wheel chairs, so, you know, there was that. But the real challenge was that there were no handles on the chair to speak of, so, I just kind of awkwardly hugged it as I pushed. We chatted a bit but within 4 seconds my small talk was expended. Luckily we had the laughter of every single person within a 1 kilometer radius to fill the silence. He loved every second of it, as if he was the head of a prestigious parade. He waved and chatted to people passing by and they called out to him “look at you with your white driver!” and he would chuckle. Meanwhile, I was near collapse. Arms shook, the sweat dripped and my breath came more rapidly than I’d like to admit. Every time we tackled a hole/rut/sand pit/incline/decline he would hold his breath. When we eventually made it out with him still in the chair, he would say “Ah, my good driva’!”

As we came up to my turn off, I asked him how much further he needed to go and he told me to stop because his brother would come and finish the job. A crowd of ladies gathered and said, “We will take him if his brother doesn’t come. You can go.” I must have looked as worn out as I felt. But I appreciated it that now other passersby were willing to volunteer for the job. I guess it just takes one lumbering, out of place muzungu to show that anyone can help him do this.

I’d give you a cursory platitude here about the struggle it is to be handicapped especially in an area like this but I’m sure it is no more insightful that what you can surmise for yourself. The main moral I got from the experience was that he was smiling before I ever got there to help him and that makes him a much better man than I.

What Scott Does.

Scott here. I know I've been neglectful. This blog was supposed to be for both of us, but after 10 months of being here in Zambia, I find myself posting for the first time. I hope that doesn't reflect poorly on me . . . oh well.

Most of you probably only have a vague idea of what I am doing here in Zambia. But most of you know that for 6 years prior to joining the PC, I worked in recycling and solid waste management. I use to say that I wanted to get away from waste management and that I didn't want that to be my career. Well, in moving to Zambia I did get away from recycling and consumer waste and I now deal exclusively in human shit.  Step in the right direction? I think of it as being more grass-roots.

Shit here is a big deal. Like HIV/AIDs or Malaria kind of big deal. And yes, ‘shit’ is the politically correct term. I’ll get into that more in a bit, but, now, let me fill you in. Less than 40% of rural Zambians have access to adequate sanitation. Now American ‘adequate’ to Zambian ‘adequate’ is like comparing the Taj Mahal to a sand castle. Here we are only talking about a basic pit latrine made of logs with a floor made of mud with some sort of walls around it (mud bricks, plastic bags, sticks, etc.), and a place to wash your hands with ash water.  No TP, no flushing, no sitting, no roof, no soap, and no hand dryers besides the wind. Lots of smells, lots of flies, and lots of squatting. I hope you see my point. For you scouters out there, think of a more primitive Philmont. 

Now that most of you are disgusted, you might be thinking that, "if that is how the 40% that do have ‘adequate sanitation’ get by, how does the other 60% live?" Well my friends . . . let me use a Zamlish expression- "They shit anyhow." Meaning they just use the bush close to their homes, and they do not wash their hands. Remember, they do not have TP. This is also a culture that uses their hands to eat. Right for eating, left for shitting. Wonder why we shake hands with our right?

Anyways, so now you’re piecing together the problem. Open defecation + flies + not washing your hands = being sick A LOT. 47% of Zambians are stunted due to having fairly constant diarrhea between 0-5 years of age due to fecal contamination of food, soil, water- basically everything.

Now you’re thinking, “Why in the world have they not done something about this before now? I mean the Romans figured it out like 4000 years ago.”  I find myself thinking that a lot too. Two reasons: One, you don’t miss something you have never known before. Not having a latrine and the resultant consequences are just a part of life. They have never known differently. Two, in Zambian culture, it is taboo to talk and almost even think about any bodily functions: sex, pregnancy, masturbation, crying, pain, vomiting, and especially shitting. In some Zambian languages (mind you there are 73), there isn't even a word for shitting.

OK, so now we bring in what I actually do. Enter the Community Lead Total Sanitation program (CLTS). The whole idea is to have trained community volunteers go around and shame villagers into building latrines. My southern friends and family with their refined sensibilities and my other friends with MPHs in health behavior are thinking to themselves, “Shame? Behavior change doesn't work with making people feel bad.” I thought that too, before Zambia, but we are all very wrong. Shame is the only thing that does work and it works really well here. The culture is too turned off by any mention of sanitation that if it is not put into a more confrontational light it won't gain any traction. Believe me, everything else that has been thought of has been tried and failed.

By now, I imagine you have images playing out in your mind of me yelling at a poor Zambian about how bad a person they are because do not have a latrine. I do not do that. I help the people who are doing that, do it better. Actually there is no yelling. Everything is done through village activities like "The Shit Walk," "The Shit Calculation," and "The Shit Eating Display." Notice I used the word ‘shit’ exclusively because that is actually the term they use.  Ironically, I use to get in trouble at work from my boss Donny for saying shit too often, but now I actually have to say it to do my job correctly.

We are now down to the nitty-gritty of what I do. I work for an NGO called Akros Global Health as a Sanitation Surveillance Officer. Basically, I manage the progress and data collection for the CLTS program in 5 districts in Southern Province. Choma, Namwala, Monze, Kazungula, and Sinazongwe specifically, if you cared. Essentially, all of the community volunteers going around getting villages to start building latrines are using a cell phone application to capture data on how well the program is going. And yes, there is actually a fairly good cell network here. I analyze that data, report it up to the powers that be, and tailor my program implementation activities to suit. For instance, if I see through the data and get feedback showing that there is an issues with the traditional leaders not supporting the program then I’ll plan a meeting with the local senior chief to get them on board, or if I see the villages are reluctant to start hand washing, then I’ll meet with my volunteers to reinforce the programmatic elements behind hand washing adoption.  

I really like the work that I’m doing. I definitely have a positive and substantial impact, but as you can imagine, covering an area a little larger than size of South Carolina, means that I’m traveling a lot. Basically always. I thought bouncing around the bush of Africa (keep in mind there are no paved roads in rural Zambia) would be romantic and adventurous. It is adventurous, I guess, but it’s mostly really hot, dusty, and physically jarring. And no, I never see any animals except for the very rare monkey because they have killed them all off for food. You'd do it too, if starvation was a real thing in America. Only on game parks do you see any animals.

The really cool thing is that in many of the places I travel, I am the first white person that a lot of the children and even some of the adults have ever seen. Along with that there is a whole number of weird reactions that you get, but that could the the topic for a post all on its own. I can also say nearly every day that I am the only American in these places. For anyone that has traveled, you know that is basically never something that you can say. Americans are everywhere.

Well there it is. I know it was a diatribe, but that is what I’m doing. For now on, I’ll keep the posts short and sweet.

Love Y’all,

Scott

Please feel free to hit me up with any questions.