Five & Alive: Ashley's Travel Journal

Entry 10 - Minister of Health and PUR

The alarm went off and I groaned. 10 hours of sleep, maybe a little more, and good sleep at that, and tired yet. Why? I suppose the physic impact of witnessing such gruesome poverty is incalculable. While making my bed, I admired the worn cotton sheet with which I am sleeping, so lusciously softened by years of use, and the nice weight of the duvet. I thought of the beds at my grandparents’ homes, how safe and perfect they were. How does one reconcile that with the squalor with which the Congolese endeavor to sleep? It’s unfathomable, even as it is real, as I see it with my own eyes.

During my visit, he described the problems facing Kinshasa: Malaria. Water. Diarrhea. HIV. What else, he asked me? Family planning and maternal heath, I noted. Ah, yes, he agreed. We took some pictures and said farewell until the embassy event tonight. Upon leaving we were met with a member of the press and asked, and I described the above chat, describing the minister as very interested in the problems that face the people and solutions that PSI helps provide.

I had my usual adventures with room service, which thankfully I have been able to frame in an attitude of amusement. I placed my order (omelet, yogurt, which is good for building a healthy gut accustomed to the locality, fruit, cereal, bread, butter, jam…I am a very big eater and I have learned to make jam sandwiches for the car), and although I thought we had a perfectly clear conversation, fulfilling my order involved 2 further calls and interrogations by different people in the kitchen. When the order came, even though it was a very quick delivery, the omelet was cold. I was nearly done with my meal when someone knocked on the door. They were delivering an empty bowl and 2 spoons. Ah, I thought, quel plaisir, I have a bowl and spoons, if per chance I should require them later for….something!

My first appointment of the day was a courtesy call to the provincial minister of health, as I am visiting in his province, after all. Theresa said she’s been able to release me from much of the typical protocol, which I appreciate. This one, however, was essential, and I arrived at the government building I was a surprised at how derelict it was. There were armed guards and up several flights of stairs, I was escorted past more guards into a small room without air, one closed window, and a small color t.v. Behind the minister’s desk was the Congolese flag, and other than some paper files stacked on the desk and a set of shelves, the room was bare. He was dressed in a nice western suit with French cuffs.

During a recent Typhoid outbreak, he called PSI to help respond. Working in partnership with the Minister of Health is critical to implementing our work.

I made a few phone calls to home, and miss having the privacy to talk in the car. Self care is a balancing act. It is Papa Jacks’s birthday, though, so I got into the group vibe and we sang to him. He reminisced about all the places we’ve been on he 2nd of May over the years, the movie sets (Ya Ya, Come Early Morning), and the PSI trips, Nicaragua, etc. What a man!

Mapela is slum community of about 400,000 on a small, shallow, rushing river. The houses are on higher ground, but even so, when the floods come there is loss of property and life. Natural disasters disproportionately affect the poor because their shelter is insecure, the preparedness low, conditions overcrowded, the government’s ability to respond poor, etc.

From the house that was receiving us we descended to the river‘s edge via narrow dug out steps secured by old sand bags. I stopped by the shower, an outdoor affair made semi private by ragged cloth hung from a tree. I also stopped by the toilet, a small hole dug into the earth made private by a leaning of corrugated tin and cloth. There were flies every where and it stank.

Speaking of latrines, I had a funny thing happen back at the rural health clinic in province L’Ouest in Rwanda. Theirs was more advanced, a deep hole paved with cement, and a right sized hole, which one covered with a block of wood that was perfectly sized to make a sanitary seal, which helps enormously with the smell and fly problem. There was also a proper door (made of tin) that one could firmly close and secure with a movable nail. The Minister of Health made a tour of the 4 latrines, and gave a lesson on how to properly go to the toilet, each and very step of the way. Good for him, and good for me, as I had use the latrine but forgot that when I popped the squat anything loose on my person would fall off of me….and so, good bye, sunglasses.

Oh man, what a dilemma.

My sunglasses were half way down the hole, but caught on something that prevented them from going deep.

I knew I had to fish them out, b/c sunglasses would be a thrilling discovery to someone using this latrine later, a very special item in this poor country. I could envision someone getting them out, and not sanitizing them properly, making themselves and sick with exactly what I am here to help prevent. So, I figured out a way to carefully extract them. I am squirming even thinking about it. I then had to figure out how to keep them with me until I could dispose of them properly. A garbage can was not an option; someone would retrieve them from a garbage can even more easily.

And, it was a good thing I did get them out, as wouldn’t you know, the latrine the Minister chose for his lengthy lesson was in fact the one in which I dropped said sunglasses. I would have a lot of explaining to do to a crowd of 40 and it would have been a distraction from an important moment in our day.

My other latrine story is from the Centaire clinic yesterday. It was very unhygienic.

The surface was cement or tile, something very slippery while and while I was mid squat and intently focused on having good aim and not creating more of a mess, my feet began to slide far, far apart and out from under me. I nearly fell in. I used every emergency muscle my body has to stay upright.

If you think it is perhaps in poor taste to discuss such things, I understand. But we have to stick with this topic, as the poop problem world wide is a grave one. Unsafe water, lack of knowledge about hygiene (hand and utensil washing) and unsafe sanitation (where folks poop) is one of the world’s greatest health crises.

Ashley speaking with Therese.

In fact, I went to see Therese Katrine in her home to talk about her family’s poop, basically. For 10 years, her 8 children, her husband, and she suffered from chronic diarrhea. At any given time, some or all of them had intestinal trouble. At one point their latrine collapsed and dumped into the river, water which every family uses for household purposes.

And, this is not an ignorant family. Her mother and her father were teachers. Her husband was raised by his uncle, and he, too, was a teacher. This couple managed through farming to send all 8 children to university!!! She is a very learned woman who loves to read, spoke perfect French; her favorite book in the Bible is John, which I thought was fitting of her intellect. She can even translate a little Greek.

But, this being Congo, they are poor, in spite of her fine mind and job of 30 years at the local health clinic. Her husband farms and sells the crops to local mothers who then make their little agriculture stands in the neighborhood, one could call him a wholesaler. They do eat 3 meals a day because of their garden, and I was glad to finally meet a family with enough food, a small miracle in Africa. When she hugged me, I could feel her body had some heft and substance on her frame, a rarity here.

Therese has zealously ameliorated every single bit of information that has come through the door of that clinic, especially since PSI identified it as offering a high enough standard of care that we could work with them. Our logos are painted on the front wall of clinic, including names of the products we make available, such as Pur. When arrived, her family’s life improved dramatic. She is a dedicated user and all our conversations under the “red apple” tree in her sandy back yard eventually came back to point of use water purification and the relative ease with which they now live.

When asked if she shares her PUR information with her neighbors, her second favorite subject, education, factored in. She lamented the inherent difficulty in teaching people who have never learned to learn. She tries, she says, but it’s easier at the clinic, where there are cleverly designed activities that support the process of learning in a dynamic and fun way. As one is already at the clinic for something, a woman’s capacity to receive an additional behavior change message is greater.

Therese’s 8 university children, except one, are unemployed. Imagine the hopelessness of scraping, pinching, saving, borrowing to do the undoable, then send them into a society with no economy to engage them. Their degrees vary from economics to theatre. When asked about how she feels about them having no chance to use their degrees, she said, “But if the good times ever come to the Congo, they will be prepared to take part.”

Her kids come over with their children on Sundays, as do her siblings and their children. She said they don’t have enough food with which to welcome them, but they make a cordial from the fruit tree and also a bit of jam, and the sense of belonging makes up for lack of food.

I, nor anyone else in the whole of Congo, for that matter, seemed to notice the garbage everywhere, right up to the very edge of the water.

A woman and her child speaking with Ashley about their struggles.

A PSI beneficiary and her child speaking with Ashley about their struggles.

I walked down the sandy road to a neighbor’s home, another devoted user of PUR. She was a quiet woman and very unengaged. I don’t know if perhaps she was tired, or didn’t feel well, or had turned shy. I made up she was simply beaten down by life. There is something under the skin of poor people, what I think of as the “second face,” where the trauma and hunger and disease is frozen in place. A smile is a temporary arrangement on top of a set point of permanent pain.

She is uneducated. Her husband is a guard at the local school. In her tidy, small home she had a tall stack of plastic jugs leaning in a corner, as she fills them with palm oil and sells them in the street. They have 6 children, and they eat one meal a day, at 5 p.m. Is it enough, I asked, and she said yes, at that one sitting, they get full. The home was decorated with last year’s calendar and an advertisement she liked because of a picture of a canoe in a lake. She had an old embroidered cloth on a table in between 3 matched chairs, and it was clear she is house proud and very much keeps a clean, cozy place, even as I could feel the dirt under my bare feet. Her dishes and pots were clean and stacked in orderly fashion.

Ashley in the home of the PSI beneficiary.

After going to the hospital for years with diarrheal diseases, where she was given medication and told water was the source of her illness, she one time went to the local clinic for treatment. It was there that she experienced an engaging program by our community outreach workers about unsafe water that she could understand and relate to. She was introduced to PUR, and now her sole concern is that the factory that makes it never runs out, and couldn’t I make sure the factory opens here, near her house?

Her children sat on my lap for a while, but then ran all over the place, as did the hundreds of the neighborhood. Before they took off, we walked hand in hand, and having only 2 hands to offer, one settled for holding a clump of my dress. Their small garden was littered with trash.

It is important to note this neighborhood was outfitted with spigots in 1987. It is this water that makes everyone sick, in addition to the activities in the river. PUR must be used even when water looks clean. As for the rivers themselves, my god: human waste, including decomposing corpses from time to time, agricultural waste, and on and on and on, contaminate them.

Ashley with children that have benefitted from PUR.

At a heaving market place I visited a tiny box that is PUR’s point of sale. Having set up in neighborhoods, we found folks at home have no money, but when they go to market, they obviously have a little in their pockets for the grocery list. So, we set up a kiosk, and today I was doing a public demonstration of PUR for anyone who happened to be passing by. I love this sort of thing, being on the street, hanging out, trading witticisms and having fun, getting people involved..

Ashley doing a PUR demonstration for a rural community.

In front of the kiosk I stood with a wooden stool (which would be a “primitive” collectable in the U.S.) and a big pale of nasty river water, laden with brown muck and filth. Using a fantastic, enormous wooden spoon, I sprinkled in PUR and began to stir. A great crowd was already gathered, and we hollered questions and answers back and forth about water: where do you get your water, do you get diarrhea, wait til you see PUR, sold here for .50, and how it makes even river water safe! The crowd grew.

After the 5 minutes of stirring, we let the water de-flock.

The particles, organisms (visible and not) settled at the bottom. Using the clean piece of gauze sold with the sachet of PUR, we strained the water into an empty pail (which does not have to be very clean). One waits 20 minutes, so we shot the breeze.

The crowd that gathered at the water demonstration.

One feller, already convinced, reflected back to us all he had learned, was excited to buy the 2 sachets he could afford today. Others asked questions already addressed, but this is revolutionary stuff and they may ask all they want! The excited one, I asked him if he was up for a challenge: would he be willing to share his new health empowering information with others in his community, and he said, absolutely. He is inviting all his neighbors over to show them when he uses his sachets. He made a commitment to me of 5 people per sachet.

Ashley persuades a young boy to drink the clean water after the PUR demonstration.

Ashley offers a young boy to drink the clean water after the PUR demonstration.

When the 20 minutes passed, I drank Congolese river water, made safe by PUR, holding the pail with the filth in my left hand for all to see. I raised my glass and toasted the crowd’s health to a big cheer. We began serving glasses. They drained them greedily, they were so thirsty, and it hurt to see their guard lowered that much, their deep vulnerability and thirst revealed. It reminded me of litte baby Astrid yesterday when she seized her re feeding formula and would not let go of the cup, a surprising will to live showing in her tiny fingers.

I bet partly why they drank so robustly is that on an unconscious level they were relaxing, because for once in their lives a vital human need was being met without forthcoming consequences that would make life ever more difficult. Relaxing in a life this hard doesn’t come often.

As we made our way back to the car, people begged for food and money at our car. I caught the eye of a young girl who had drunk a glass of PUR, and we shared a smile and a thumbs up. She beamed.

Another note about water and sanitation is that it factors in African schools’ inability to keep women teachers, as they lack proper toilets and water for menstruating women. Additionally, when girls who are fortunate enough to make it to secondary school start their periods, many do not come back to school for the same reasons.

I took a shower and finished cleaning my room. I called my Mennie and we talked for a bit, and she kept reinforcing that this is a trip at yet another new level of spiritual development for me, that I am being touched in ways I have never been. Dario answered the phone and when he heard my voice, I could tell he loves me, that he loves me so much.

I fell asleep for an hour and half. I ordered dinner and once again, the man on the other end of the line didn’t say good bye, they don’t do that here, and I had to laugh at the sense I always have that some one is hanging up on me.

I have been very isolated from family and friends on this trip, talking only to my husband and returning 1 or 2 calls from friends, but of course, due to the time change, I never get them. It’s just been me and my Higher Power. Mennie helped me realize this trip is obviously meant to be this way, and I know it’s true. It is ultimately all about my Higher Power, everything, and the greater my reliance on Her, the greater S/he enables me to meet calamity with Serenity.

Entry 11 -Ambassador and Mrs. Gravelink

“But as I am yet weak in love and imperfect in virtue, I have needed to be strengthened and comforted by thee. Visit me therefore often and instruct me in all thy holy discipline….Love is a great thing, a great and thorough good. By itself it makes everything that is heavy, light, and bears evenly all that I s uneven.”

I was meditating and before I knew it, I had had a vision, which I interrupted mid way because I was suffocating and I snapped myself out of it. It is the feeling of being Congolese that the vision brought me. I don’t know if I can describe it.

I was in dark water. I was pressed deeper into the water, into a chute and sent downward and under. When I came up for air, I discovered I was in a cave with a very low ceiling. The water was up to my chin. The rock above me pressed onto my head. There were only mere inches in which to breathe. I was to move forward, backward, sideways, every which way, precariously maintaining my nose just above the water in order to breath, to survive, looking for a way out. There was none, the ceiling was too low, the water too high, the margin for error too tiny.

It doesn’t take Jung to figure that out. One is born into it, the water and the cave, and actually at some point we all were, for we made our evolutionary leap here. The innumerable factors that conspire against our survival press down on us and box us in. In Congo, the opportunity (the ceiling) is low: no infrastructure, no roads, no public works, a ruined society, family and cultural systems decimated. And the ability to change it is confined to the desperate struggle to actually stay alive, to keep one’s head barely above water: Unregulated fertility. Maternal health. Pre and post natal health. Malaria. Malnutrition and Starvation. Clean water issues, diarrhea, cholera, typhoid, and the destination of all this, the glove on the hand, point number 1, the low ceiling: people so poor and ill living in such chaos that no progress can be made in their society.

The event at the American Embassy went very well. We drove over about 6 PM and I saw good paved roads for the first time. Most embassies are in this neighborhood, as is the Presidential palace, which is not ideal for our embassy’s safety. The grounds and home are big, having been part of Belgian grandiosity, once upon a time. American embassies are re decorated once every 16 years, and the Gravelinks lucked out, they moved in right after a spiffy re do. I was very comfortable there, things were so…American.

Mrs. Garvelink showed us the traveling art that Embassies display and trade with one another, and I really enjoyed the Michigan artists they collect, as well as the silver, which belongs to the home. The ambassador conferred at first with a colleague, as they had met with President Kabila for 90 minutes today. I was to benefit greatly from that later, with another fascinating installment of my African studies taking place via his wonderful intellectual generosity.

Outside were oil torches, soft, barefoot-worthy grass, and the call of frogs and insects in the lush Congolese air. The great river was mere feet away; wow. Africa. Wow. It was glorious to be somewhere safe and clean where I could sink into my Mother the Earth a little and let her hold me.

The Ambassador introduced me and I marveled that he must truly stay buried in his work, as he did not know how to pronounce Salma Hayek’s name right. I am definitely going to ask her to sign a picture, maybe a super sexy one; to him (is there such a thing as a picture of her that is not?). He and his wife were dolls and actually presented Papa Jack with a piece of cake, candle, and got the crowd of 400 to sing Happy Birthday.

During my remarks, I told the stories you have read in these pages, Lydia’s, Therese and Victor’s, Fifi’s, and sure enough, the French came out from time to time. The speech was “call and answer” style from African American churches. My hope was to vividly and emotionally portray the problem, then flip it, highlight the replacement principle, the solution.

Everyone was very kind before and after, and I spent time thanking our donors and with a variety of people doing good work. I was especially excited to meet an American who works on gender based violence with USAID, and a Belgium woman with UNICEF who is a breast feeding advocate. She was hard core in the best possible way. I brought up Nestle, a company that came to Africa to make money by disabusing women of their natural impulse to nurse in order to sell them formula.

I couldn’t even begin to transcribe everything the Ambassador taught me, it would be a tome. From the current diplomatic map to geo politics to history to resources and economics, it was a fascinating session and I was totally spellbound. In particular he described the way our 300 million a year is spent in the Congo, and how essential it is that this aid does not end. I agree whole heartedly. We talked at length about the depth of nothingness here, the utter lack of everything. We buy pens and paper for ministerial offices, supply some books and computers for them and the university. Otherwise, the students and teachers share books and only from time to time do they have access to a Xerox machine to make copies to spread around. I was very proud when he told me that child exploitation and all human trafficking are deal breakers in the U.S.’ dealing with the government of the DRC and the 200 remaining child soldiers are to be de listed, but not before UNICEF has a good plan as to how to care for them appropriately. I’ll also mention natural resources. He said all the natural wealth leaves this country, either via permeable borders into the 9 contiguous countries and beyond, and via companies, many of them American, who as recently as the early ‘90’s re-negotiated their trade agreements and still do not pay one red cent in taxes to the Congolese government where we mine their resources, take it out of the country, and have done nothing but underpay the miners by way of compensation. It is utterly grotesque. One of them many consequences of this is that the government’s annual budget for a country of 63 million, totaling in size everything east of the Mississippi is 3.5 billion, equal to the budget/foundation of the University of Wisconsin.

As for the gender based violence in south Kivu, he wasn’t speechless, but his speech was wanting as he said no words can describe it. He said he’s been in complex conflicts for 30 years around the world, including Rwanda in ’94, and he has never seen anything like this. He did not hesitate to call it worse than genocide as some women don’t have the luxury of death. Women are maimed, psychologically and physically ruined, and abandoned by all of society. Gender Apartheid, I said, and his eyes got big: emphatic: Absolutely. That is exactly what it is. We talked about pregnant women being bayoneted in their vaginas, a common form of the gender based violence.

In bed, my head was spinning from all the words rushing around in it, and I also woke up super early. I was so beat that I couldn’t stand up and I slid out of bed straight onto my knees. I laid my chest on the bed and prayed.

It was supposed to be gender apartheid day with the gender minister and members of parliament, but she missed her flight home from somewhere, so we pushed it to a time when she may attend. She is the draw. She’s a bad ass. I read the newly passed gender violence laws, the entire penal code, as she had a lot to do with them. The laws are comprehensive and inclusive, doing their best to leave nothing out: rape, abuse, elders to youth, youth to elders, men to women, women to men, men to men, women to women, body parts, objects, persons of authority, dependents, sex slaves, incitement, pornography, etc. I saw a word I haven’t read since college French, Quiconque, “Whereby.”

The national ministry of health building was in very poor condition. The guards tote automatic 5.6 ml FN’s, a frightening looking riffle. The Minister of Health’s office was modest but actually very nice. He had a lap top, a fax, a little fridge, and oh my, an air conditioner. This I know, as I sat in front of it for over an hour! I made up that they’re proud of it and therefore didn’t ask for it to be turned off.

He was so gracious and really complimented my “discours” from last night. We talked about all the problems, and the obstacles to the solutions. That’s a long talk right there.

We all know what to do, and I am sure each of us will. But will anyone join us?

He said his government’s priorities are: Energy. How can they build anything, whether its roads to get life saving services in and goods to trade to build an economy out, without energy? I forget number 2, it might have been education, and then he mentioned public health, but of course he meant that it all goes together, and the rising tide of one raises all others.

I got in bed. My body hurts. I think it’s the emergency surgery I had at the end of last year and its complications; my core stamina isn’t back yet. Or maybe it was the drive back to the hotel, and the dirty, misshapen hand of a cripple that reached up from below my backseat window, softly begging. I saw no face, no body, just an anonymous hand reaching up to me for help.

Yesterday at a clogged intersection our car abruptly stopped. A young man trying to cross was inches from us. He was bent over at the waist, head craned forward, his shoulders supporting a giant, heavy load. His face was anguished and sweat was pouring off of him. We were obstructing his path.

We are on our way to see the Bonobos, a monkey rather forgotten. It’s a hell of a drive, the one good road being lined with not only traffic but random stops by officials looking for a little hand out. There are market stalls everywhere; everybody is involved with an attempt at commerce. I hope I see the monkeys. I could use some good animal news I got to play with the Garvelink’s dog yesterday, my first pet in here, as Congolese don’t keep them. I remember from Surinam that the Belgians used dogs to control, menace, hunt, and kill the Congolese. They are still scared of dogs.

14 elephants have been killed in the past 14 days. Chinese, the Ambassador said. They number only 350 now, a number that might be too small to ensure their survival. The gorillas in the forest where Akumba’s militia is are in grave danger. Hopefully the gorillas can figure out to cross into Rwanda. Maybe they can work out their territory issues with the other gorilla families. That is intense and complex, but perhaps less dangerous than militia. An Australian filmmaker has just make a documentary about the militia’s menace to the gorillas for National Geographic. We met him at the airport, and in a classic twist, he approached me quietly and asked, “Is that Kate Roberts you are with?”

DAY 1 2 3 4 5 6 7