I had grand plans for the writing I was going to do here in Africa. I was going to record it all, every day, and just post entries whenever we happened upon an internet café or made our way back to Lusaka.
But that was before I witnessed the peculiar paradox of starving women refusing to claim an errant 1,000 kwacha note that could buy them food for days; before the water quit working and then came back spluttering out of the faucets in muddy, tubercular bursts; before I learned just how glorious a meal is when you make it entirely with your own hands, from scratch (even the tortillas!); before the rains, the violent African rains, battered the swollen red earth and made a river of the road in front of our house; before I heard a funeral dirge, sung with vacant detachment by the village women, still manage to haunt and ring like the holiest of hallelujah choruses. Before the chickens and the dogs. Before Dorica. Before the stinging, bitter-smoke smell of sweat and sickness.There’s just… it’s too much. Not to perseverate (by the way, totally my new favorite word) about the enormity of it all, but it really is overwhelming. There is too much to say and, so, nothing at all. Because, if you know me – as some of you do quite well – you know that if I can’t write it exactly, if I can’t write it perfectly, I usually don’t write it at all. So I sit, day after day, fingers hovering optimistically over my keyboard, and stare at a blank screen. There are stories to tell and observations to make – too many, in fact – but they seem silly without a context. And, well, I don’t mean to disappoint but, so far, the work (my work anyway) has not been particularly exciting. I’m not exactly saving lives or building schools or planting sustainable farms or anything like that. Don’t get me wrong – the work I am doing is rewarding (there are broader, if less tangible, programmatic implications for it), and I am, frankly, over the moon that I have a skill that can actually be utilized here (although the coronation to demigod and the attendant expectations that result when I am introduced as a – this is a good one - “computer expert” are a trifle unsettling). But it’s just, well, it’s just not very sexy.
Incidentally, the “work I am doing” has turned out to be a wee more complex than what we’d initially thought I’d be doing. In fact, it is essentially the same sort of work I was doing in Denver before I was a (ahem) “full-time actor”: poking around in large, relational databases and trying to extract data in meaningful ways so that it can be measured and analyzed. The short version of what that means at Chilonga is that I have had to figure out what questions to ask of their HIV patient tracking system (called CareWare) so that the reports I develop will answer them. Then, in order to actually build those reports, I’ve had to teach myself how to use the system, how to understand its basic architecture, and how to identify the relevant data
variables. Finally, I have had to figure out how to train the data entry clerk – a delightful Zambian woman who, although she has an astonishing native intellect (particularly given her limited schooling) and a memory like a steel trap, is still trying to conceptualize “File, Save As…” – to run those reports herself. This all, of course, with no guidance from the folks who are purportedly requesting the data, no training on the CareWare software, and no access to the database developer or even a typically-useless-but-I’d-give-my-left-booby-for-one-right-now User Guide. And all in less than two weeks.Suffice it to say I did not get much sleep the latter half of the Chilonga trip. I was up most nights until midnight, 1am, even 3am, writing and testing over 30 different reports (I’d have sacrificed my right booby for a SQL for Dummies book). I did catch a break when Herbie (remember Herbie? the current Chief of I-Forget-What-His-Title-Is-But-He’s-the-Big-Boss-In-Charge-of-Everyone-at-CRS? well, he’s also one of the former members of the FUTURES group, the company that originally built the database) passed by Chilonga on his way to another site early the second week and spent about 30-40 minutes giving me a crash course on CareWare’s basic reporting principles. Herbie, by the way, is a gigantically imposing, thickly-French-accented Haitian man and he kept saying things like: “Ok, so, dee CareWare ees not een-too-ah-teeve, so let me show you dees one ting how you can do dees”; and “Yes, ahk-choo-uh-lee, you haff to put dee dates in dee Ah-merry-can date format but nowhere ees dat written so you would not have known dat” (everything here is in the European dd/mm/yyyy format, including – confusingly enough – all of the date fields in the rest of the database); and “Ahk-choo-uh-lee, dee CareWare ees an Ah-merry-can program, and dey haff not fee-neeshed to making dee euh… dee euhm - ”
“The customizations?” I pipe in.
“Yes! Ouì!” he brightens. “Dee cost-om-eye-zay-shons! Dey haff not fee-neeshed to making dee cost-om-eye-zay-shons for dee African version.”
“Awesome,” I say, my task looming ever larger before me. My sarcasm is not lost on Herbie. He smiles apologetically, knowingly.
But Herbie, it turns out, is a godsend, and in our half hour together he shares a couple of tricks that were not, as he rightly maintained, even on the same planet as intuitive. But they are enough to get me started and so I am off. Er, well, sorta… Because this is Zambia and things never quite go the way you plan. In fact, if I had to name the biggest challenge I have faced thus far, it would not be the bugs or the water outages or the humidity or the physical hardship or the ripe, rank smells – these were the things I expected. In fact, I kind of counted on them. And they were, of course, everything and nothing like I imagined at the same time. No, if I had to name the biggest challenge we face (and all of us, by the way: Chris, Amy, me… IHV and the entire AIDSRelief team…), I think it would be learning to let go – to surrender whatever plans or expectations we have for the way things should or will go; and to be patient. Because even when you know (according to your plan) you can do something faster, or better, or more efficiently, or more effectively…you can’t. And not because you don’t want to. In fact, you are desperate to, because you know it would not only make your life easier but it would make theirs easier, too. You know how much more you could accomplish.
“But,” as my brother pointed out after one particularly maddening meeting during which a room full of medical professionals sat for more than an hour and a half (the first forty-five minutes
were spent – I sh*t you not – in total silence simply waiting for everyone to show up) to discuss whether to increase next year’s target goal for number of HIV treatment enrollees over this year’s, or leave it the same, only to then turn around and decide to actually decrease (!) it for some to-this-day-unknown-to-me reason, “this is the way things go here. And, truth be told, it is their program. Amy and I are technical advisors only. We can make suggestions, which we did, and ask leading questions, which we did, in an attempt to get them to think about things – like setting goals and creating new programs – in different ways, but we cannot think for them. We cannot decide for them.”He’s right, I know. But this offends my very American sense of efficiency, of accomplishment. I mean, if I can get something done faster and better, why can’t I just go do it? Zambians, though, value consensus over efficiency, and relationships over accomplishments – even if that means making decisions that will set their program back a step. And for Zambia to triumph over HIV, Zambians have to lead the charge, however ineffectively. So you sit there, in helpless, tortured silence, and watch them do it, because allowing them this freedom is how you earn their respect. And you sit with the data entry clerk, for hour after constantly-interrupted hour, on a data validation task you know you could have completed in 15 minutes by yourself, because sitting with the data entry clerk for hour after constantly-interrupted hour is how you earn her trust.
This sitting-with-the-data-entry-clerk meant, of course, that most of my report developing was done at night, on my laptop, in to the wee hours of the morning. It was impossible to do it at the clinic, what with Dorica (the data entry clerk) constantly being pulled away to attend to one of the myriad tasks outside her job description but which, by necessity, she was required to perform. I’d stalk home at the end of the day (ok, so not visibly, but in my mind - I stalked) and mutter to Chris and Amy about “what a waste of time” the day was, “how much more I could have done” if I’d just worked at home and how “annoying” Dorica’s lack of focus was. “I know she wants me at the clinic with her,” I whined, “but it doesn’t really make sense for me to be there if she’s going to be hopping up and down the whole time. Not only can I not teach her anything, but I can’t get any of my work done either. All this stuff I’m trying to do is going to be a waste. I’m not going to end up being able to help her at all.” In other words: Wah. Wah, wah, wah, wah, wah.
And maybe that’s all true. Maybe if I’d had more hours to myself I could have built sleeker, more efficient reports instead of the clunky, this-is-what-we-have-to-do-to-work-around-CareWare’s-limits reports. But, truth be told, nobody expected that there’d be any reports finished before I left, least of all reports that Dorica could be trained to run on her own. But like everything else here, I’m learning, things have a way of working themselves out when you’re willing to let go.
So, on the Thursday night before we left – with reports still to complete and a full clinic day ahead of us on Friday, during which I knew Dorica would be unavailable for the three-hour training I’d developed for her – I let it go. We invited Ireen over for a lesson in making the traditional Zambian meal of nshima (it’s dreadful, but more on that some other time), fetched
Dorica from the clinic, and spent our penultimate night in the company of our Zambian friends. And wouldn’t you know? I somehow managed to complete the final reports on Friday morning, load them on to Dorica’s machine and – miracle of miracles – spend the unexpectedly slow afternoon training her, with no interruptions, in her office at the clinic. And I got to see her not only get what I was teaching her (remember, Dorica was the one still grappling with the concept of “File, Save As…”), but reason through the complexities and light up when she discovered – on her own! – how the reports would make her work both easier and more accurate.“Aiy!” she squealed, and clumsily high-fived me. Then her face clouded over. “You cannot go on Saturday,” she said. “You must remain behind when Chris and Amy proceed.”
“Ah, but I must go to Mukinge,” I tell her.
“Then you must leave your brain with me,” she says.
“Told ya,” Chris smart-alecked at dinner that night. “Things always work out. I have no idea how it happens or how to explain it. All I know is: you can plan, and plan, andplanandplan. You can do aaaall the planning you want, but you might as well not bother because nothing will ever go according to that plan. But I’m tellin’ ya - things always always works out.”
And that, my friends, is that.
Picture 1: Approaching rain cloud seen from the top of hill at Chilonga Mission
Picture 2: Dorica
Picture 3: Mrs. Banda (l) and Mrs. Phiri (r), midwives at the hospital
Picture 4: Dorica laughing at me making nshima
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