Words to live by...

From A Rolling Stone

To pitch my tent with no prosy plan,

To range and to change at will;

To mock at the mastership of man,

To see Adventure's thrill.

Carefree to be, as a bird that sings;

To go my own sweet way;

To reck not at all what may befall,

But to live and to love each day.

To scorn all strife, and to view all life

With the curious eyes of a child;

From the plangent sea of the prairie,

From the slum to the heart of the Wild.

From the red-rimmed star to the speck of sand,

From the vast to the greatly small;

For I know that the whole for good is planned,

And I want to see it all.

-Robert Service

Adventures...

I am heading out to the field tomorrow morning with a small team of health workers. We are going to investigate some suspected cases of Measles, and possibly to immunize some children. I will do my best to take some pictures! Updates coming soon......

:)

Measles Update:

As of this morning, we have 362 cases of Measles reported in Opuwo District....and the number continues to rise. Our Measles Treatment Center is now fully operational, which is great for the 29 patients we currently have on admission at Opuwo Hospital. We are still struggling to acquire supplies and balance our staff, but at least the patients are now in relative isolation. Also, the health outreach teams returned from the field last week, and they were able to cover 872 children who had never been previously immunized. With any luck, we will have another round of outreach teams in the field next week so hopefully more children will be protected!

Omeva...

Water. Beautiful water.

Over the last nine months, I have become painfully aware of water. In my life before Africa, I understood water in simple terms: It comes out of the tap when you turn the handle, you can buy it in nice little bottles, the faucet has an endless supply, and you shouldn't let it run while you brush your teeth. Turns out that my understanding of water was very limited.

When I turn the handle in my bathroom, more often than not nothing comes out. Sometimes we go many days at a time without any water whatsoever; in the past seven days we have had about 6 hours of water service at the hospital. I repeat AT THE HOSPITAL. We deliver babies here and perform surgery. It boggles the mind that there is no water in a place where patients come to be treated for TB, HIV, Measles, and a variety of other illnesses. But it is a reality, and its now my reality.

The Director of the health facility has been very active of late trying to solve this ongoing water crisis at the hospital. Numerous meetings and discussions have been held with key officials in our area regarding the struggle we are facing in the absence of water. As often happens when a crisis breaks out in Namibia, a committee was assembled to address the issue. A couple months ago, representatives from various water agencies came out to the hospital and took a long look at why water is not being supplied effectively. They discovered that one of the main reasons why water is not being supplied to the hospital stems from an engineering oddity. The intake area in the reservoir from which the hospital should be pulling its water supply is quite high, and as such the reservoir must be over 60% full in order for the hospital to receive any water.

Now here is where the first problem arises. As long as NamWater is suppling all of Opuwo town and surrounding settlements with water, the reservoir level will remain too low for the hospital to receive water. Upon making this discovery, the decision was made among some officials to stop providing water altogether to two local villages, so that the water level could be raised. The water returned at the hospital, but when the Director discovered that it was at the expense of countless people in our local community, she again took up the issue.

It turns out that things are even more complicated; it just so happens that the vast majority of water contracts in my area are held by the Town Council, an organization of traditional authorities from the surrounding territories. NamWater pumps the water up from the earth, and the Town Council buys the water and in turn supplies it to the town. It seems that the Town Council has some past due contracts which are outstanding, and currently they do not have the money to square their debt. Thus, NamWater has refused to continue to supply water until some agreement is reached. So, for the time being Opuwo has water only when the Town Council can pay.

Now, unfortunately for us, the hospital is one of major contracts held by the Town Council. So we are subject to the same "water outages" as the rest of the town while Nam Water and the Town Council sort out their problems. This political problem, coupled with the engineering problems at the reservoir, have left us both literally and figuratively high and dry.

We have now begun the process of getting a direct water supply, where the hospital would have a direct line from Nam Water complete with private meter and a pressure boosting pump, thereby eliminating the Town Council as the middleman. The process is long, but if it works out Opuwo Hospital may have water once again. Of course the Town Council is not pleased to be losing such a large contract, but all of these things will have to sort themselves out in time.

So to add to my previous water understanding: water is scarce. water is political.

Otjinguenjenje

Otjinguenjenje is the Otjiherero word for Measles. The entire Northern area of Kunene Region is being heavily affected by Measles at the moment. The outbreak started about a month ago, and so far Opuwo District has had 292 cases reported. Currently we have 36 patients on admission (15 adults, 21 children) and to date we have admitted 120 patients at Opuwo Hospital. Thus far two people have died: one a woman of 42, the other a two year-old child.

Measles is a virus which is highly contagious, and also highly preventable. Symptoms include rash, coughing, fever, conjunctivitis, and spots in the mouth (Koplik spots). In the Western world, people are routinely immunized for Measles as children, and outbreaks are virtually unheard of. However the vast majority of people in my area are not protected, and as a result Measles is spreading like wildfire. In schools children often stay in "hostels," where they sleep in close quarters, and the home situation is very much the same; the traditional style of living here keeps families very close together. As such, when one person is exposed, they then spread the virus to many other people.

This crisis has stretched us to the limit. Our wards are overflowing with people, and after three patients who were here for treatment for other diseases contracted measles, along with two hospital staff members, we reached out for assistance from other organizations in Namibia. Thanks to the Namibian Defense Force, we have now had five tents donated to our health facility so that Measles patients can be kept in relative isolation. Some nurses have also joined us from other regions of Namibia, and they are helping to ease the heavy burden on our staff.

So its been a very busy time here, to say the least. As one of the coordinators for the social mobilization/targeted immunization campaign, I have been working to help ensure that we protect as many children as possible from this disease. Last week we had 8 teams in the field, and over the course of 3 days they were collectively able to immunize 581 children who had not been previously immunized. It was a great start, and hopefully this week will prove to be an even greater success. Despite the fact that we are facing a transport crisis, as well as a water crisis, progress is being made!

There is still a lot of work to be done...wish us luck!

Here comes the rain!

The clouds have officially returned, and with them the rain! In the last few weeks the temperatures have climbed rapidly and the sky, which has been a startling shade of royal blue for the last few months, is now adorned with huge storm clouds. IT'S GLORIOUS.

Hungira....

Hungira means "speak" in Otjiherero, and it is used as a both a command and a request. So I'm going to speak on it. Here goes....

1. Namibia is rad. Its true. I have been here close to 7 months and I still get a kick out of passing goats, pigs, and cows on my walk to the grocery store.

2. I love street meat. One of my favorite treats is going down to the open air market and buying a few hunks of delicious cow. Most of the ladies who cook in the market know me, and I have become such good friends with one of them that she usually gives me an extra piece of meat for free :) They cook sirloin because it is one of the cheapest and least desirable cuts of beef (its not considered a "good" piece of meat here unless there are bones and gristle attached). After grilling the beef, it is seasoned and mixed with grilled onions and sliced tomatoes. When you buy some, they wrap it in torn pieces of old newspaper and top it off with some chili sauce...its AWESOME.

3. Conditions at our grocery store vary. For instance, now that tourist season has gotten underway, we have been getting an incredible selection of fruits and veggies. Last week the store even had feta cheese! Crazy! In general, our produce selection is decent...we get cabbage, tomatoes (usually better from the street vendors), onions, apples, pears, bananas, avocados, beets, potato's, oranges, broccoli....its enough to live off of. Sometimes the quality is poor, and sometimes things from South Africa are quite expensive, but overall I consider myself very lucky to have access to fresh produce!

4. On tourists: as grateful as I am for the influx of tourist friendly food-stuffs, by and large tourists are terrible. I know its awful to generalize like that, but I'll explain why...its not the "khaki nightmare" phenomenon which I find repulsive. In a weird way I almost appreciate the people who climb off the tour buses clothed head to toe in various shades of khaki (especially when they come complete with a floppy had and a gigantic camera) because they never fail to give me a good laugh. What really gets to me is the general sense of entitlement which people seem to feel over the local people. Walking to the store the other day, a shiny vehicle stopped in the middle of the main road and the smiling white faces inside quickly grabbed their cameras and started shooting photos of the local mama's sitting under a tree selling their herbs. It made me want to scream! Not only had they stopped the cars behind them, but it was a tremendously rude thing to do. Local traditional Himba and Herero people are often happy to pose for photos...they simply request that you get their permission first, and that you pay a few cents as a sign of good faith. I KNOW most tourists read that in their handy-dandy guidebooks, and yet they still take pictures and video of the Himba while driving by in giant air-conditioned buses. Arrrgg...is it too much to ask for just a little cultural sensitivity?

5. Summer is coming! Winter is now coming to a close and not a moment too soon. I am looking forward to the increasingly longer daylight hours (we actually "spring forward" this weekend), but along with more daytime comes the incredible HEAT. It is already starting to warm up a little more every day. Even the nights are getting warmer--i haven't needed a sweatshirt for rara's nightly walk this past week :)

6. My pupster is growing up. She got fixed a couple of weeks ago and recovered just fine! Most of the dogs in Opuwo are semi-wild and it seemed responsible parenting to have her spayed. No need to add to the uncared for population of local dogs (thanks Bob Barker). Everyone wants puppies but no one really seems to care much about the scrawny, malnourished dogs they turn into. Plus she will be happier and healthier in the long run!

7. On that note Rara went on her first long hike this past weekend!

Hiking the plateau

We hiked the plateau with some volunteers who were in town visiting, and it was a lot of fun. She definitely tired out at the end, but overall she did excellent! This weekend I think I will take her on a hike in some of the nearby hills.

8. I miss my (American) family so much! Its no secret that I am head over heels in love with each and every one of them...i love getting updates on what everyone is up to and how things are going. I'm super proud of my sister Keri for starting her second year of college soon, and my sister Bayli starting fourth grade! I'm glad my brother Owen is recovering well and that my parents (all of them) are somehow finding their way through the nightmare that is the US economy. I love you guys and I cant wait for all of the future adventures we will have together....

That's all for now!

keande nawa, matu hakeanea....

(go well, we shall meet again)