Another week

6.8.07

I want an apple.

This sounds strange, I know, but I’ve been sick off and on all week and today’s been the worst of it. I’ve been laying in bed in my hot room all day and called PC Rabat because I had a fever (38 degrees C) and wanted advice. So, now I’ve been put on the BRATT diet for the next two days: Banana, Rice, Apple, Tea, Toast; and since all of that we have in the house is rice and toast, I’m really wanting a crisp, juicy, sweet, delicious apple. I don’t even really like apples. I just hope my hostmom gets me one or two or five.

It’s been a miserable day because it’s so hot and I’ve just drifted in and out of sleep, having weird dreams about my site, and pouring water over myself to try to keep cool. What I wouldn’t give for saltine crackers and ginger ale and air conditioning. Don’t ever take air conditioning for granted. Ever. When you have to go without and you’re in a mud-walled room that’s about ten degrees hotter than outside but don’t want to lay down outside because you don’t want to get bitten by ants, you’ll realize that air conditioning was a damned fine invention.

That all being said, I have to say, despite being sick, all in all, this week has been a lot easier and more rewarding and sort of better than last week. I’m hoping it’ll only get easier.

The people at my site are really incredible. People keep wishing me to feel better, and the old man who wants me to live in his house saw me when I was waiting for the tobis to get back to Tamazitinu from my souk town on Monday. He invited me for tea at a restaurant while we waited and since I had nothing better to do, I accepted and I had tea with him and a woman who I assumed was a member of his family. Halfway through the conversation, I found out she was a beggar woman he had met and invited for tea because she had nothing and wanted to have her sit and have good conversation and a drink. He also mentioned the Koran was very specific about giving to those who have less. Very moving. The people here are just so warm, it’s mindboggling.

Tuesday, I went to the sbitar all morning to sort of observe and find out what goes on. Our sbitar is a Centre de Sante (CS), which means it has a doctor and a nurse (my counterpart) and serves a pretty large area. Tuesday is a big vaccination day, and I saw countless babies vaccinated, weighed, etc., a few prenatal visits, and even a diabetic man come in. They had a blood glucose tester donated from France, since they don’t come as standard equipment in a CS, and the last few years have been able to do more with diabetics than before. My nurse was very helpful at explaining everything that was going on and encouraged me to ask questions, look at medical records to get a sense of what the problems are, and just generally show me around. I also learned about their protocol for birth control pills (very different than the states- they tell you to start on the 5th day of your period, and you have to be married to get on them), that they count pregnancy from estimated date of conception, opposed to last menstrual period date, and that HIPPA or anything like HIPPA doesn’t really exist. I also found it interesting that the women sit and wait in the waiting room, but the men shout through the window to get medicine and not wait or go in.
I was invited to an important lunch and tried to decline but was told essentially that I shouldn’t, but at least I was just told to sit with the women. It was a lot more relaxing than dealing with men who came in from as far as Marrakech and the provincial capital. I don’t know quite what the lunch was about- something political, I believe, but it was good food and they had lots of soda and three courses. I’m shocked, still, really shocked at how much money some people have at my site. It’s all from family members working as laborers in France and Spain, but it’s still just incredible to see the amount of wealth some have, and how little others’ have, but how they still seem to do things together and relate to each other.

The next day, Wednesday, was another very sort of overwhelming but amazing day. I got to go on the Equippe-Mobile, a 4x4 with medications and vaccines. It felt very Peace Corps/development work to go and some things really bothered me and others really were incredible.

Some douars (towns/neighborhoods/villages) that my sbitar covers are far out there. Wednesday was the equippe-mobile trip that goes the farthest- 60+ kilometers from the town center. There’s no cell phone coverage, two or three of the four that we went to had no electricity, and no running water. It’s really the types of places I thought I’d go when I joined PC and the thought that even if I don’t live out there, I can at least do some projects there is really empowering.

I got up at 3:45 am because we were supposed to leave at 4:30, but I don’t think we left until closer to 5:30. Could have slept in. In any case, it was really peaceful walking in the dark across town to get to the sbitar to meet my nurse. I realized on the way that it was probably the only place in Morocco where I felt entirely safe walking alone at night. People look out for me here and I’ve only been here two weeks. The stars were peaceful, and though the mountains block a beautiful sunrise, I got to see the sky change from black to blue.

My nurse and I waited for 3 men from the conscription hospital (the hospital at my souk town that oversees the CS at Tamazitinu as well as a few others) to come. They didn’t introduce themselves to me but they did say hi and told me to put on a white lab coat with the Ministry of Health logo, “so the women will know you work at the clinic.” I felt rather official bumping along the dirt roads in the truck, sometimes at breakneck speeds.

It took about two hours on mainly dirt roads to get to the farthest site, but we passed through a rather mid-sized city that’s in another province to get there. It surprised me that the mountains are so crazy that we’d have to go through another province and pass a larger hospital to get to the areas that my small sbitar covers. One town outside the small city was just beautiful with the desert mountains and the lush fields. Seriously, I wanted to live there because it was just breathtaking.

When we got to the first site, we got out and had tea. The nurse whispered to me as we stopped out of the truck, “Do you know who he is?” about the man in the front seat. “He’s the Medcin-Chef of the hospital.” In other words, he’s the head of the hospital. Good to know. Wish I had known earlier.

After tea in a large salon that was full of blankets and rugs, we went back out to the truck and there were probably a dozen women there, most with children. My nurse pulled out his medical record book for the equippe-mobile ride, and the rest of the doctors and nurse started giving vaccines. Then, they handed out medications that help prevent or treat fever, which is a common side effect of some of the vaccines. Medical waste disposal was certainly an issue I observed and feel the need to do something about.

Two women had teeth problems and all that was given was aspirin. Sad, but true. I think I must do some preventative dental hygiene lessons on one of the equippe-mobile runs, but toothbrushes and toothpaste probably aren’t easily available. We’ll see what can be done. Aspirin and some other medications (eye cream, fever-preventing suppositories, and antibacterial skin cream) were given out like candy, but nothing beats a good dose of prevention.

Apparently, the people at this one douar are mainly nomads. Now, I don’t know the sense that “nomads” are used; I think they are mainly shepards that sleep out with their herds, but one of the doctors kept joking about how since this is part of my site, that I could go live with them for six months and then come back to the main part of Tamazitinu. Honestly, the thought is appealing. My site is a lot more Posh Corps than I ever expected or wanted, and although I’m really coming to feel more and more comfortable here and like the people, the thought of living with shepards would be really empowering. I also feel that I could make more of an impact with people there. Who knows. I don’t know if they were serious, or if Peace Corps would go for it, but it’d definitely be something I could be interested in. No matter what, I’ll do whatever I can with this douar.

The rest of the day mainly consisted of driving a few minutes, then stopping, sometimes just working out of the back of the truck and sometimes in a school classroom. At one point, they had me explaining what medications were to some of the people: a hard thing to do in Tamazight, but at least I was doing something. I saw a few cases of different diseases that I had heard about from my nurse before leaving. We ate a spicy tagine at the moqaddam’s house, and I had an interesting conversation with the medical staff in Tamazight/French.

In it, I learned that the head of the conscription hospital would love for me to do a qabla (traditional birth attendant/TBA) training at my site, but thinks a medical waste incinerator is unnecessary. My nurse had said that the day before, but since there isn’t one, I was confused as to why people seemed so against it. They explained, “If Peace Corps wants to give us one, we’ll take it, but it’s not our first priority.” When I asked what was, they said basic health and hygiene preventative measures and education (ie: all the flies that are all over everywhere in Tamazitinu that I hope I NEVER get used to; the fact that they crawl in babies’ eyes often and on food often and nobody seems to notice), birth control education and advocacy, and teaching women to wash their children. So simple, but so necessary, and all things I’ve observed.
Now, there’re two things that really shocked me: the first was when he said that what would be better than an incinerator and cheaper would be bringing hot water to the sbitar, “so the women can come and wash their children, even in the winter, because they don’t when it’s cold out. Then you can show them how, with soap and everything, so they know.” It’s so basic, but so important… but how sustainable is it? Who is going to keep it clean? Where is the dirty water going to go? Is it going to be like a public bath? Is it sustainable as far as after I leave, or is it just going to sit there? Is it something people will use? I don’t know. But it was an interesting idea.

The second thing that really was surprising is how hands-on they want me to get with birth control, as far as actually taking blood pressure myself to get women on the pill. Apparently, many women are completely unwilling to discuss this with men, even a doctor or nurse. Most won’t let men medical staff do a pelvic exam or deliver their children. I never realized that I might be doing something that so closely parallels part of what I did in the States before coming here, and I certainly don’t mind education (though am not comfortable with “prescribing” it, per se), but again, I have to wonder… is that sustainable? Is it empowering people to do this? Or is there a way to train women community health workers? Gives me much to ponder.

In any case, it was an interesting twelve hour day on the Equippe-mobile. It really made me feel like there is work of some sort to be done, and opens up some possibilities I hadn’t even come close to thinking of before.

The last few days have been pretty blah. Thursday I stayed in most of the day because I was starting to feel gross. Friday (when I started this blog entry) I felt REALLY gross so I stayed in all day. Today, Saturday, I felt better despite some nasty episodes this morning that I don’t need to get into (you don’t want to know), so I did laundry, went out to the fields and tried to plant tiflflt (green peppers of some sort) but was too slow so I just watched.

The irrigation system is fascinating. The part of the fields we went to was far from the main permanent irrigation ditch (tarugwa) but had dry mud ditches dug in grid fashion. There was a shed nearby. After the tiflflt was planted, they turned on a pump for a well that was hidden in the shed, and made holes in the mud ditches enough to flood that part of the field. Once it was flooded the right amount, they’d come in with shovels and rebuild the walls of the ditch, so the water was controlled every step of the way. It was really kind of cool to watch. I’m getting quite a farming education, but I don’t have the blisters or calluses to show for it the way most of my town does. And no matter how rich the family is, pretty much every woman works at least some degree in the fields; and let me tell you, it’s hard work.

One of the most beautiful parts of Tamazitinu is the kids. No matter how hard the day, it’s uplifting that even when the baby girl in your family (one year old) is on her mom’s back, she still reaches out for your hand, or gets giddy over your nalgene bottle. It’s heartwarming when the two-year old next door who doesn’t say your hostmother’s name knows your name and calls it whenever she sees you, or runs by your (low to the ground) window and bangs on it shouting “Katy! Katy! Katy!” People are warm and everyone invites you for sugary tea, and tonight, we went to eat at a friend’s house and they made two main dishes: couscous and rice, because my hostmom had told them I was on the BRATT diet.

Dinner tonight was nothing out of the ordinary, but for some reason, even though it’s all normal for me now, I was able to see it as sort of what a lot of people would think about when they think about Morocco. We sat in a courtyard with a mud wall behind us, under the stars that burn a hundred times brighter than at home. The oldest man wore cloth wrapped around his head that isn’t a turban but looks like one, and a white jellaba. The women (besides me) wore headscarves. There were three or four generations; we sat on rugs and blankets on the ground on top of agotil (plastic carpeting) and ate from the communal plate on a small, low-to-the-ground round table. Such is my life right now, and it feels right, especially when I get out of the house.

Now it’s Monday and I’m at souk town at the cyber. The last two days have been pretty eventless, but fun nonetheless. Last night, I finally got my apple. I went to a girl’s house who I like a lot: she’s 17 and going to be married in two months, but she can hold her own in a room full of older women. She’s also wonderful about teaching me words and speaking so I can understand. In any case, we walked around the fields last night and some women fed me fresh figs, baby almonds, apricots, and, yes, an apple. I’m amazed at the scope of the crops here. Figs, pomegranates, almonds, dates, apples, carrots, potatoes, turnips, corn, wheat, straw, alfalfa, beans, tomatoes, lentils, peppers, olives, apricots, pears, prickly pears (called “foreigner’s figs”), tomatoes, and I’m sure there’s more. So far, since I’ve been here, everyone goes and works with wheat and straw. “Ishqa,” they say about both imindi and alim, “ishqa.” It’s hard work harvesting them both. Sometimes I feel like such a city girl, but the fields still seem peaceful to me. Maybe they wouldn’t if I got up at 4 am to go harvest.