Although Misleading, This is NOT an Article about Ebola

While Ebola hysteria has died down a bit on the international stage, I thought I’d take a minute to add to the growing amount of smug people who think they know a thing or two about tropical diseases. Ebola is scary- mainly because it conjures up a lot of Indiana-Jones-style face melting images, where people just erupt into bloody, bursting puddles. The air itself seems to spur on some unstoppable, apocalyptic plague. Hazmat suits don’t help anyone think more rationally, either- if you want to scare a suburban housewife to death, pull out a hazmat suit. Yes, all of that adds up to some intense panic. Truth be told, it is a terrible and deadly affliction for the more than 25,000 people who have been diagnosed with the disease since the start of the outbreak in West Africa (CDC, 2015), but it’s nothing quite as violent as the images we create in our minds. And, unfortunately, it takes much of the spotlight away from the diseases that kill the most people. For many countries in West Africa, the outbreak has been devastating but that damage doesn't just lie in simple disease burden. As it turns out, the deeply felt impact of the outbreaks in Sierra Leone, Liberia and Guinea can be seen in the funneling of aid from areas of greatest mortality like malaria and HIV to the more publicized Ebola. Health officials now fear increases in Malaria, Measles, and HIV rates (among many other diseases) due to the siphoning of aid money and staffing from hard fought eradication programs. For instance, in 2014, a mass malaria net distribution campaign in Liberia was suspended along with health facility closures (as a result of stigma and transferred staff) as well as the suspension of malaria diagnostic tests, due to the frenzy surrounding the deadly but far less frequent Ebola. (For a short but informative article on the subject click here.

It’s shocking, but the diseases that do the most damage are the ones that don’t catch a lot of air time on the 24 hour news cycle. Can you imagine if headlines actually reflected the more common deadly diseases around the world?

“Poop kills 2,082 children today. Our analysts call poop the everyday 9/11.” (WHO, 2013)

“Wearing condoms correctly and consistently, could have saved over 14 million people from life-threatening diseases this year, but didn't. The world shrugs and keeps having sex.”(CDC, 2015)

“Tiny pelvis: Friend or foe?”

“Washing your hands, paisley jean shorts and other great tips for the everyday fashionista”

“Cooking: Asthma’s greatest ally in the war on women”

“Corn comprised 90% of a Zambian child’s diet today. 3 white people were concerned.”

“3.2 billion people at risk of a disease everyone kind-of-thinks-maybe-might-actually-be eradicated.” (WHO, 2014)

Can you guess what that last one refers to? If you guessed the true heavy weight of tropical disease burden- malaria, then you would be correct. And, yes, that statistic is correct. 3.2 billion people- that’s billion with a “b”- are at risk of acquiring malaria each and every year. If we are just to compare raw numbers, 10,477 people have died from Ebola since the outbreak began but each year an estimated 584,000 people will die from malaria. If you want that said another way: 

malaria = Ebola x 55.

It is one of the oldest diseases in the world. It killed Genghis Khan. Think about that for a second. The Jin Dynasty couldn't kill him. Mulan couldn't kill him (and she had a dragon). It took an assassin the size of a grain of rice to take down arguably the greatest conqueror in human history.

This parasite has accompanied our species throughout history, transmitted by the tiny winged vector that has plagued every back yard dinner party since the dawn of time- the mosquito. And, not just any mosquito, the Anopheles mosquito. Why is that important, one might ask? Because that is the only type of mosquito that carries Malaria and it only feeds at night. Night, as you might realize, is a very vulnerable time for us humans. We can’t see very well in the dark and we are often sleeping during the time most of these insects are out taking their nightly meal. BUT, it also means that simple lifestyle changes such as sleeping under a mosquito net can save thousands of lives (but we’ll come back to treatment and prevention in just a bit).

The part of the world I am currently in, has the most to fear from this silent killer. 90% of malaria deaths occur, here, in Sub-Saharan Africa. Most deaths occur in children under the age of 5- to be more shocking, a child dies every 60 seconds from Malaria (that’s one baby every minute- whoa). Zambia considers it such a pervasive issue that the government has its own department devoted to handling this ancient, deadly disease. In Zambia, malaria is responsible for 45% of all hospitalizations, 40% of all under 5 deaths, and 20% of maternal mortality. If severe malaria doesn’t kill you, it can leave you in a coma or effect brain function for the rest of your life (severe cases have even been known to drop IQ points in children).

I don’t want to be responsible for another vast mischaracterization of a disease, either. While these numbers might send you screaming indoors and swearing off the Dark Continent altogether, most people, here, are not that concerned by it. It is “Africa’s common cold” as one counterpart phrased it. At every malaria talk I give, I usually start out with the question- “who here has or knows someone who has had malaria?” Without fail, nearly every hand gets raised. The problem is that most people are misdiagnosing themselves daily giving a very serious disease, a very toothless reputation. Every sneeze, every cough (both of which are not actual symptoms) are erroneously attributed to malaria, taking away much of the fear that should be associated with the disease. But, truth be told, a great many Zambians have had the disease at one time or another and lived to tell the tale. Thus, prevention becomes an afterthought in the hierarchy of things that are pressing in most people’s lives even though there is a very real chance that it will kill someone close to them.

As part of Malaria month (April) and World Malaria Day, Peace Corps Volunteers around the world take part in raising awareness about the disease. We often work in areas with the greatest burden and spread health messages to anyone who will listen. These tasks include health talks that support early diagnosis and treatment, behavioral changes like wearing long clothing, sleeping under a bug net, and eliminating standing water (Anopheles mosquitoes breed in clean, standing water). These changes often have cultural components that pose the greatest challenge to eradication such as not taking all prescribed medication, having the primary bread winner (i.e. mostly men) sleep under nets- leaving the most vulnerable (i.e. children and pregnant women) out in the open, among many others. While health talks and community campaigns are important, many volunteers also hope to raise more awareness among individuals at home who are indirectly and sometimes directly responsible for donor funding of malaria eradication campaigns around the world. The more you know… and all that. So, the next time you see an eye catching headline, take a minute to think about the ones you may not be seeing because they may actually be impacting the most people. Happy Easter and Happy Malaria Month from Zambia!

Want more facts about malaria and other underwhelming deadly diseases? Of course you do!

WHO- 10 facts about malaria

WHO- Diarrheal Diseases

HIV/AIDS in Zambia

Old Thoughts

It's hard to imagine what my Peace Corps life is really like. It's easy to think it is all "changing the world" and epic life experiences. What you don't see is the isolation, the fear, the crippling self doubt. There's a reason this job is hard but its difficult for an outsider to know the realities when every picture has smiling faces- a life airbrushed by Facebook. 

I was going through some old writings and found a journal from October 2013 (one of my first months at site). The scene is me house/dog-sitting for a neighbor while Scott was away for work (which was just starting to happen at that time). I think it encapsulates some of the roller coaster of emotions you feel when you are just beginning to start real life in a new place. Enjoy.

"10/28/13

I sit staring blankly at a white wall. The paint is cracked and chipping. I need something to help me express the stifled frustration I feel but every wave of creativity crashes impotently against a dam instead of the shore. 

Foreign crickets sing a familiar song outside the bars on the window. Each sound makes me jump. Everything is foreign. Everything is unnerving. Even the dog sighs in frustration- bored with the walls, bored with the crickets, bored with this waiting. 

I want to write a story. I want to paint a picture- to do that, however, requires an idea and paint, all of which I don’t have.

I miss my husband. The strange thing is that if he were here I would never get a word out. I’d never experience this frustration and boredom that plagues every other volunteer. I’d watch a vapid movie, make a kissy face and go to bed. Is this feeling a plus? It’s not- I know it’s not. But it does give me something besides happiness and contentment to feel which is at least a new experience and that’s something to grow from.

We got a package today. It was like Easter morning. Jean is really a fantastic gift giver. One of her surprising talents. It’s probably because she asks people for exactly what they want even when they don’t realize it.

The faint and familiar beat of Rhumba music thuds in the distance. What should be growls and bird calls are just another of the same 12 songs that always play at this point in the evening. It’s a Monday night, but I guess that’s little worry for many Zambians who have a completely unstructured workday.

I talk about Zambians too broadly. It’s racist. I keep saying “they do this” “they like that” when I’ve seen many Zambians who have never fit that mold. It’s the same thing I rail against. I stereotype to make it easy, but that’s just backward and more importantly wrong.

Mangoes keep hitting the roof. I think, “Is that someone jumping over the fence to weld off the bars on my door, slit my throat and take my laptop?” No- it’s just a mango. Go to sleep and quit being an idiot.

When Scott’s not around I’m a much more negative and critical person. When he’s around everything is better and that’s not just blowing smoke, it’s just a fact.

Someone throws trash in the pit outside. I self-consciously realize I don’t know the number for the police. I do have a dog and for about 3 minutes that will make a difference until they stab or shoot it. I should really stop thinking about it.

I took a cab from Choma today. On my own. I am strangely proud of myself anytime I am outside of the house by myself. I feel like a kid on the first day of school. I have no idea who my friends will be or who will try to take my lunch money. Most of the time I’m all too comfortable staying in and being frustrated and bored. That’s not okay. I blame the hard knock life of the "city" but if I were to be honest the village would be just as intimidating- although I’d have a host family in my corner telling the other villagers, “Nah man, she’s cool.” Here, I’m just Muzungu.

I’m surrounded by things I should be doing but don’t.

A car door slams. My heart pounds. Then I worry about my heart. Why does my chest hurt so much? Probably because you’re a ridiculous hypochondriac. I think most people who are prone to anxiety and have any medical knowledge should be. Maybe if I became a medical doctor I’d quit fearing things and just smile bemusedly at people like me who think they know something but obviously have no clue. I’d probably be an arrogant dick like that but I’d mask it because I do genuinely care about people.

Was that a rat? What could make that noise besides a rat? A stuck handle on a faucet?

I watched City of God last night. It was a gritty movie about hard people living hard lives. It made me a little more nervous that 1960/70s Brazil happened on the same planet as me.

I ate lunch with a new PCV yesterday. It was a bit awkward and kind of felt like a date. I feel like I have to somehow be prove my worthiness as a mate through conversation. Which is, in all lights, ridiculous.

I really want to write a book. They say write what you know but who wants to hear another PCV story? It’s pretty much rehashed in about a million different ways at this point- left all that you know to find something you didn’t expect. I can hear the daytime Emmy nominations now. Julia Roberts will play me in the movie and I’ll just shake my head because, really, she looks nothing like me. Her skin's too nice.

It’s almost Halloween but it doesn’t feel like it. Even if I got a costume, dressed up and ate candy, I’d still feel like I was in a play because there is absolutely no context for it. I live in a vacuous time without holidays. There aren't really seasons here, so, it just makes it feel like one long summer vacation. Even cold season is just less hot season or not quite rainy season. I want a pumpkin and people to appreciate it. I want to realize I should have brought a jacket. Or get in an automatic car and drive…anywhere. I hate driving, by the way, but I want to do it for at least a little bit until I realize how much I hate it again or realize how I never gave it a fair shake.

The dog wants me to pet her belly. When I don’t, she gets up to breathe in my face.

I’m reluctant to get up from my post near the entrances to the house to take a shower and/or sleep. This, too, is crazy since I’ve stayed here several times alone without any indication of insecurity. Mood changes without stimulation or evidence from the environment is certainly a sign of insanity.

Stream of consciousness writing is a much more effective way to journal. I’ll remember more of how I feel moment to moment rather than how I remember feeling in general years later. Maybe Faulkner was on to something. Maybe… he was fucking crazy though."

26 Reasons Zambia Wins

Zambia turned 50 not too many days ago and in honor of this occasion I thought I’d write a post about what makes this place great. All too often, I find myself adding to an endless list of problems I see in this country. While this can be the catalyst for great change, it can also be a black hole that sucks all the light from the surrounding universe into a thoughtless space of negativity. The things that go wrong and the slogging, endless expanse of improvements, rather than spur you energetically towards change, can sometimes drive you into the ground.

Well no more. Zambia I love you and here’s why.

1)      Singing: It is used to pray, to commune, and just to pass the time. No one cares if an individual can’t carry a tune- as a group they will make a joyful noise. I love that it is also taught from birth- not with sheet music and scales but intuition and communal thinking. A history in song.

2)      I love that foot/bicycle traffic outnumber motorists 50 to 1.

3)      I love that everyone is a farmer in some capacity. People here make things grow out of the ashes (often in a literal sense).

4)      People here know nothing but perseverance.

5)      There are no strangers. Everyone is a part of a larger community.

6)      I love that friends hold hands. Men with men, women with women. You tell a good joke? Well someone will physically let you know they enjoyed it and I think that is truly lovely. No one is ever timid or threatened by it.

7)      Literally anyone will cook for you, especially if you look like you might not know how.

8)      I love that it is customary to laugh with your whole body.

9)      This is a nation of true patriots. Everyone who is Zambian, loves Zambia.

10)   I love that this nation takes such pride in nonviolence. In a world that sometimes rushes to conflict, these countrymen will always shake their heads and say, “not here, not in Zambia.”

11)   I love the term, “be free.” I will use it forever after.

12)   I love that this is a country of tribes. The aforementioned culture of passivity has given us one of the few countries that has not reduced its tribal nations to nothing but have unified them into a nation with 73 languages.

13)   Kids, even if you scare the shit out of them, will always greet you. This is a blessing and a curse.

14)   NO MATTER WHAT, everyday someone will ask how you are.

15)   The old people here could not be more precious

16)   Breastfeeding is in no way a problem for anyone. Period. You will never be asked to leave. You can whip your breasts out at any time. Hell, you can present before parliament with a baby at your teat because guess what- that’s what God put them there for and literally no one cares.

17)   I love how creative kids can be with garbage. This may sound repugnant to our western audience but it is a testament to ingenuity when I can hand a child a soda bottle and suddenly it’s a train with a working steam engine. The Toys ‘R Us of the developing world are literally all around you.

18)   While burning the land is mostly a terrible process which I oppose, it is strangely beautiful to watch the fields burn in the evening.

19)   No one is afraid to hold or grab an animal. Tell someone “hey hand me that chicken” or “grab that rat before it gets away!”- no one bats an eye.

20)   When the grasses are tall, every breeze transforms you to a sea of gently lapping gold.

21)   Unlike most every other volunteer, I like the night sounds of animals- roosters, dogs, goats, whatever it may be. The sounds of the barn are my “ocean noises.”

22)   The stars. Are. Epic.

23)   I love that the second hand ski jackets come out when it hits 65 degrees

24)   Everyone is a dancer. No wallflowers here. Are you three years old? Well I’m sure you’ve perfected that twerk by now and made me totally uncomfortable with it as I pass you on the street.

25)   The dancing is uninhibited and just plain badass (for the most part).

26)   I enjoy that even adults need energizers. Does the idea of doing “Simon Says” at your age make your eyes uncontrollably roll inside your head? Well let me tell you within 3 minutes you’ll be giggling like your 6 years old. If you feel you are too adult for an energizer well you probably shouldn’t try to wake up in the morning, because you’re pretty much too old to live.

Throw Away that "Big Book of Baby Names." You Won't Ever Need it Again.

Zambia is full of great people. People who have no idea that they are walking through life with the best names ever. Scott and I have met a lot of wonderful men and women- many of them just regular Joe Schmoes, but, every now and then, a real celebrity baby name comes along. A name that defies logic and a true grasp of the English language. To honor those moments that make us smile, Scott and I have started an ever-growing list of our personal favorites- by category.

 You're Welcome.

Famous People

• Bill Crinton
• Johntravolta
• Hitler
• MacDonald's (Yes, it is possessive.)
• Obama
• Osama (Conspiracy??)
• Elvis

The Science Lovers

• Eukaryote
• Ehnus
• Prevalence
• Fetus
• Fetuz (For when your baby's cooler than other babies)
• Geologist
• Plasma

Royalty

• Queen
• Prince

The Lover's

• Loveness
• Lovelock

The... Adjectives?

• Litness
• Glandy (Possibly the most unfortunate)
• Fatness
• Moist (Oh wait, there's that)
• Moody

The Products of Many Shameful Nights

• Mistake
• Guessing
• Guilty
• Evidence
• Taboo
• Visitor
• Felonie
• Doubt
• Testkit
• Purge

The ...Dudes

• Coolman
• Luckyson
• Mr. Rinaldo Swagboy (Arguably, the greatest name since people began naming)
• Smartguy
• Bigboy

The Products of Uncreative Parents

• Orphan
• Same
• Average
• Perfect
• Perfecter (Twins? Their therapist can only hope)
• Woman
• Penis
• Stain (Also see "The Products of Many Shameful Nights")
• Effort
• Nurse

The Tech Savvy

• Ringtone
• Computer
• Cyborg
• Talktime (this is also name for the minutes you purchase on your cellphone- also see "The Products of Uncreative Parents)

 The Show Stoppers

• Theshow (Also see "The Science Lovers")
• Talent

The Random Objects

• Balloon
• Mask
• Door
• Braids
• Freezer
• Scissor
• Coupons
• Cheese

The Wildlife Enthusiasts

• Lizard
• Rooster

Noises Objects Make

• Guk
• Rwi

The Dicks

• Fodick
• Dick Puta Puta (Also see "noises objects make")

The Defy-ers of Classification

• Boni face (the space is real)
• Sustainance
• Clotrida
• Evangelister
• Ask
• Obey
• Roller
• Faides
• Florida (Why? There are literally no maps)

And Last But Not Least

• Final
• End 

Hope you enjoyed! The list grows daily. Keep an eye out for our favorite add and t-shirt slogans- coming soon!

‘Merica Came to Us!

What ya know good?

Were back and still rock’n Zambia, but I think that it is safe to say that Carrie and I are out of our honeymoon phase with this place. I can’t say that excitement and adventure has totally worn off but we’ve found our stride just moving through the daily routines of our work and life. I guess that “adventure” has just become so common place that now it’s just . . . normal. It's probably that we've just have made a lot of progress in achieving something that we came here to do which is becoming a Zambian as possible. Really more than anything the idea of just spending a weekend locked away with a marathon of TNG is more exciting than having dinner with a chief or exploring some corner of wild Zambia where white people are seen about as frequently as a lunar eclipse. I guess it’s all about perspective, right?

 We now more than ever find ourselves missing the niceties of America and ironically longing to travel on our own terms to new places to break the routine of . . . well. . .traveling on others’ terms. This is why my parents visit was such an amazing event. Firstly, it was an awesome reminder to know that someone loves you so much as to spend thousands of dollars, nearly 4 solid days of travel, countless injections, and the courage to fly into the complete unknown just to visit you. Actually typing it out makes me appreciate it even more.  

 We were able to do so many once-in-a-lifetime things that Carrie and I’s $10 per day allowance would have never given us the chance to do. We went on a three day safari in Chobe National Park in Botswana where we saw literally thousands of elephants, giraffes, kudu, hippos, crocodiles, baboons, monkeys, impala, lions actually feasting on a freshly killed baby elephant, and one giant tortoise. For about a year I have been traveling through rural Zambia and I have never seen any stereotypically African wildlife, but right across the river there are animals every direction you looked. It was truly unbelievable. Thank god we took thousands of photos to remind ourselves it actually happened. We also walked and petted lions and cheetahs, flew over Victoria Falls in a helicopter and hang glider, and cruised down the Zambezi at sunset. Honestly it’s hard to put everything into words. It was just awesome.  

Carrie and I had wished we could have shared more of our work and how we live our life while they were here, but time is always fleeting and travel in this country is just too difficult and slow so we kept it simple and confined to the nicest city in Zambia, Livingstone. One thing that we did clearly notice is how Zambian we have become. Seeing my parents’ reactions, how they managed the food, and how they interacted with people reminded me how Carrie and I were a year ago, still new to Zambia. Which is in stark contrast to how we are now. Now we have our sea legs beneath us and can navigate the seeming disorder that is just inherent in a developing country. There are many many things that we will never understand or appreciate like how lines aren’t a think and every situation where people should line up they just form a chaotic mass of humans all pushing to be  in front or how respect for time just doesn’t happen. But for the most part we’ve come to terms with it and as Carrie said a few days ago, “I’m just so damn patient now.”

Sorry for not posting sooner. Carrie and I are moving 1000KPH on our project and the blog always seems to fall by the way side. We will try to be better. I want to wish my Dad a very happy birthday! We love you! Don’t worry, your really not that old and we have 6 more wonders of the world to see so don’t get to cozy back home.

Talk to you again soon.

-Russpatricks

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.