Mozambique

Katia and I have just finished two of three weeks as UCLA exchange medical students at the Central Hospital in Maputo, the capital of Mozambique.  So many stories to share and I wish I could do so in person, but for now:

Our first week we were on Lactentes, the infant ward.  Some of the rooms were quite crowded, with two babies to a bed.  Early in the morning, we met Naomi, a six month old malnourished baby with HIV, weighing only about 7 pounds.  She had developed severe pneumonia so we started mask breathing treatment.  Later in the morning as we rounded on other patients, the nurse rushed in.  We followed him to Naomi, whose heart had stopped, most likely because of poor oxygenation.  Dr. Emily began chest compressions, as I tried to feel for pulse return.  Naomi’s heart started beating again, but she passed away later that night.

Resuscitating babies is one of the hardest things to do, even at home.  What made it harder here was that Naomi’s heavy HIV burden, which made her very susceptible to pneumonia, could have most likely been prevented, if she and her HIV+ positive mother had access to adequate treatment around the time of her birth.  Rates of babies acquiring HIV from mom drop from 30% to less than 3% with proper treatment.  Why didn’t Naomi and her mom receive treatment?  There are only 50 pediatricians in the country, and given the civil war in the 1990s, education level of many mothers is still poor; they don’t know what treatment to seek out. 

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Last week there was a big hoopla planned because the dean of UCLA medical school was going to visit.  Though he didn’t make it, a vice dean and a pediatric surgeon that Katia and I know very well came.  Representatives from the hospital, CDC, Mozambique’s Ministry of Health, and US Ambassador descended on the pediatric hospital.  We walked around the wards together and everyone took pictures with a very cute baby that had undergone a complicated surgery performed by UCLA- Mozambican doctors in collaboration.  People from Anadarko, a Houston based company that recently discovered a lot of natural gas in northern Mozambique, also came—they are looking for philanthropic efforts to fund.  

The entire visit captured a side of medical philanthropic business that I have rarely seen, one that requires a lot of handshakes and smooth talking.  It seems that as some younger, idealistic doctors become more experienced, this is the way they see fit to make the most impact for good.  The thought of playing a part in these formalities makes me uncomfortable, and I’m glad that I can focus on something more black and white: learning good medicine. 

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Last, but I have to mention—on Friday we met Elena, a lively, petite, Spanish nun who first came to Mozambique fifteen years ago.  She was asked to start a clinic in a very poor area, Malhazine, where there were about 20,000 people without access to healthcare.  Since then, the clinic has grown to include a maternity ward, vaccination services, and nutrition support for children.  She has just begun a school for young children, a community garden that families work in exchange for tuition and vegetables, and ten cottages for old people without family right by the school!  I was floored by her energy and foresight. 

Some photos below...thanks for your interest and thoughts-- I'm keeping you in mine.  Be in touch-

Sunrise view from our apartment, overlooking Maputo bay and the Indian Ocean

Doctors on the infant ward...charting, the bane of every doctor's existence!

The treatment room where we resuscitated Naomi

Five year old class naptime at Elena's school...check out the little boy with the red sleeve up top.  I hope other days he gets more mat real estate :)

 A song about headaches, sneezing, and going to the health clinic

Miss Amelia has no family and lives in one of Elena's cottages.  She has a small garden out back by the school

From the right: Katia, Elena, Elena’s friend, Raul our driver

  Hippo skin para engordar...or to get fat! when drunk in a tea.

New friends...Alex checks out curious fish while Katia and Maria our host do yoga on the beach in Inhaca.

Nan-Ao at last

Thanks, Wunderground! According to this storm tracking feature, Super Typhoon Jangmi will be pounding the northeastern coast at 9pm tonight..which is home at the moment! I'm not used to changing plans because of weather, but when faced with trees swaying so furiously and flooding rain, I won't dispute the need to stay indoors.
I've just returned from buying candles, food, and drink from the stores-- before going out means risking being whacked by falling tree branches.
The eastern coast of Taiwan is less settled than the western portion, and there's so much to do outdoors! Faith, Adam, Ann and I hiked up a hill along the Caoling historical trail while the others headed straight for Fulong beach. This weekend, we were going to climb Guei Shan Dao, or Turtle Island, just east of Yilan, but Typhoon Jangmi is keeping boats from sailing. And Turtle Island isn't close enough to swim to...

I'm living in Nan-Ao, a little village a 30 min train ride from Yilan. Population ~1000. One 7-11 (you can tell how big a place is by how many 7-11s there are; in the big cities there's one on every block). The ocean is on one side, mountains on the other. Greg Swenson and Uli both came to visit this week before starting at NTU in Taipei. The beaches were beautiful, as was a little hotspring in the mountains. People have told me that the little Beihou village hotspring was built by a man for his wife as she was fighting cancer.

Teaching at Nan-Ao and Penglai Elementary Schools has been a huge challenge. I spend most of my time at school. In learning to plan lessons for kids from 6-12 years old, I've given a lot of thought to how we learn, and what motivates us to learn. We taught the first graders to play a simple Pass the Ball game with a song, and they had a blast. Here's Jennifer, my local English co-teacher, working her magic!

On Fridays I teach at the English Village in Yilan, which was built to give students a chance to practice English in authentic settings. There's a restaurant with tables and real menus, a real airplane cabin, a shopping mall with clothes and plastic groceries, and much more. One week, Beth and I taught the airplane lesson together. I'm also helping her teach a community class in an even smaller village, Dong-Ao, on Thursday nights.

One of the biggest things I've learned is that students need clear, concise directions. Clear, because if they are confused they won't bother or they'll goof off to avoid showing they don't understand. Concise, because their English vocabulary is very limited. Even adults appreciate unambiguous directions, sometimes. I'm confused by this sign that I've seen several times on the train by the restroom. Man and woman, No! Wait, Yes!

Finally, all the Fulbright ETAs have spent quite a bit of time with the Foundation for Scholarly Exchange. We recently went to an orientation in Taipei-- Kelly and Kristin are two wonderful ladies that have helped us so much. There, we met the AIT staff (American Institute in Taiwan)--the embassy in everything but name, and a few key Taiwanese leaders in science and education. AIT can help us apply for absentee ballots, help us get American citizenship for babies if we decide to have them on Taiwanese soil, and facilitate delivery of corpses back to the US if we die here. Despite all this, because of China's insistence that the international community not acknowledge Taiwan's sovereignty, a lot of policies and decisions dangle on careful euphemisms.

Notes on hilly bits

From Luodong, Taiwan-

Yesterday I opened my traveling notebook (a gift from Tianne last summer). It is the kind that's multifunctional-- this one is full of directions, phone numbers, notes from meetings, boarding pass scraps, and the remnants of poorly torn-out pages. In the back I found a postcard that Jeannette and I bought for Mom in Valparaiso...and clearly forgot to give her during the 23 hours I had in LA. It's hard to believe that only a month ago, Jeannette and I were at the historical port city of Chile, and looking incredulously at the hilly streets.

This is on the way to one of Pablo Neruda's homes. The inspiration we found from the windswept hills of Valpo were not as poetic as his. We were inspired to find food, and settled on a popular snack--a bun holding a pool of mayo, guacamole, and tomato sauce, with a hot dog somewhere in there.

How do older folks deal with the hills? The thought occurred to me more than once. At 80, if going home means walking up a hill and then the equivalent of seven flights of stairs, I think I'll spend the night in the park, next to the hot dog stand, thank you very much.

Gliding over El Parque de Amor, or the Park of Love. We left Santiago in the middle of the night for Lima, where we found a few paragliders in Miraflores and flew tandem.

One of the things I enjoyed most was the quietness-- you don't need an engine, just a hilly bit to run off of and a bit of wind. On a beach near here, I saw a few people paragliding, over this beach (Adam's great shot of Waiao). I'd appreciate any information on Taiwanese paragliders.

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Other larger hills, these large enough to induce altitude sickness. Hiking along the Lares Valley near Machu Picchu in Peru, we crossed two passes nearly 4500m in altitude. Moving one foot in front of the other was hard enough at the end of the day, but there were also harder things to grapple with--seeing little kids in the countryside asking for more bread, women weaving and getting ready to plant potatoes high on the steep hillsides while their husbands porter for the many trekking outfitters in Cusco, such as ours. The average Californian's life is so different, though perhaps not more satisfying.

And finally, we climbed a hill to see Machu Picchu. Walking through the old city to the foot of Waynapicchu, I imagined the specially chosen women living there, nearly six hundred years ago, tending the llamas and getting ready for the next shipment of goods coming through the Sacred Valley from the Amazon, to the rest of the Incan civilization. After the peace of the Lares Valley, the many visitors at Machu Picchu were overwhelming.

The footprint of Machu Picchu from Waynapicchu is humble, a scattering of stones carefully carved and arranged on the mountainside, at the foot of jagged peaks. From the top of the hill, I couldn't tell that many of the buildings were made to Imperial Incan standards, the stones cut to fit perfectly.

On our way home, we stopped in Panama. From the plane window, I watched dozens of ships bottlenecking at the canal, circumnavigating the island-hills nearby.

Pasa jhey ro, Pasa heh ro

...just one of the many differences between Portuguese and Spanish that I've noticed since being in Buenos Aires. Communicating has been an adventure, especially when I'm dead tired-- will it come out in broken Spanish, bad English, accented Mandarin, or the occasional Lugandan?

We stayed with the Vieiras in Jundiai, lovely! Shopping with Eryka and some cousins in a mall. McDonalds soft serve is ten times better here than in LA.

The following day, we were taking a 16 hr bus ride from Sao Paulo to Iguacu, so it seemed smart to look for a bookstore and books in English.
Salesperson: "English...hm...eh, here."
Me and Ian looking at the shelf increduously- the whole world speaks English, right? "Um, es todo?"
Salesperson looking expectantly, "Yes."
A grand total of four books in English: 2 Harry Potters (Ms. Rowling should be proud, and Kindra it seems appropriate for you to share in the glory), a 2007 guide to movies, and a book about vampires and fairies wreaking revenge (or something along those lines, Ian?)

I was overly ambitious and later, carsick and dizzy on the bus, regretted buying a collection of Edgar Allen Poe stories in Portuguese.
All in all, the Vieiras' hospitality floored me. I hope they come to LA sometime so the favor can be returned.

Foz de Iguacu: three times the volume of the Niagara Falls! When we arrived on the Argentinian side, it was an unusually warm day and thousands of butterflies flitted over the sparkling water. Yah. We rode through the subtropical forest (Bobby, I thought of you as we learned about the thousands of species of plants, among then three types of indigenous bamboo, all photosynthesizing happily), took a boat up the river, went under the falls.
Rainbows were everywhere, sometimes double, and often nearly coming full circle at your feet. I was glad for Ian's company and sweet camera. Sadly my four year old 4.0 megapixel one (so cool four years ago) was not quite up to the task of capturing it all! We walked through chilly spray to see the Devil's Throat, a huge roar where you can't even see where the waterfall ends for the mist.
Sunday in Buenos Aires Jet and I went to meeting at the Goodridges' though their numbers were small for the special meetings, and then to El Tigre Delta and spent the day with Esteban, Maria Sol, Daniel, Florentia, and Claudia, boating on the water by beautiful homes and past kayakers, and passing a mate gourd around. Claudia was stopped by a flamboyant street performer to be a part of his show, to be a 'flying woman.'

And finally, to remember that it isn't all fun and games, some graffiti I stumbled across while lost on the southwestern side of the city. Uncle Sam manically clasping...can it be...South America to his chest? And eyes crying blood for the nuclear weapons they see.

It's been a tense few months in Argentina, with the working class growing restless for the retenciones, or special taxes, the government has imposed. The excitement peaked on Tuesday, at two huge rallies in the city. I went to the farmers' rally, and squeezed my way through the tens of thousands of people who had come from 'el campo' to voice their indignation at President Kirschner's policies. I had to climb a telephone pole to see. The flag vendors had a heydey, and emotions ran high-- to my right was a little old farmer with a big voice, carrying a huge red banner. Still get shivers remembering the 'Argentina! Argentina!' chants. Everyone was swept up in the moment-- los hijos, los padres, los ancianos-- the children, the parents, the grandparents.