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Editor's note: In mid-2007, Isthmus published an essay from Madison resident Madeline Uraneck about her work as a Peace Corps volunteer training teachers in Lesotho, in southern Africa ("Letter From Lesotho," 8/3/07). That essay was honored by the Milwaukee Press Club as the best long-form feature story published in Wisconsin in 2007, winning out over dozens of other entries.
Recently, we asked Uraneck, who has voluntarily extended her stay in Lesotho until next August, to update readers here on her experiences. This is her report.
Not long ago, a visiting former Peace Corps volunteer told me that people in the States often ask him, about his time in Lesotho, "What do people eat? Where do they get food?" And he'd reply, "In modern, well-stocked grocery stores."
He realized he'd sent home photos of people dancing in strange-looking skirts and talked about traditional healers and herd boys in colorful blankets. Yet somehow he failed to mention the many things here in Lesotho that are fairly modern and completely ordinary - grocery stores, cars, office buildings.
I'm guilty of this too. So let me correct the images I've created about Lesotho, a nation of about two million people surrounded on all sides by South Africa. The town of Mount Moorosi, where I've lived as a Peace Corps volunteer since November 2006, has three grocery stores, two large schools (primary and secondary), and traffic going through town on a tar road from morning to night. There are giant lorries from South Africa, government-owned four-wheel-drive Toyota Land Cruisers and every sort of pickup truck.
But it's what's different that intrigues. As I look out over the fields, I see what we call in English "herd boys" (balisana in the Sesotho language); really, they are herd men. In the years before free primary education started in 2000, poor boys stayed with the family's small flocks of sheep, goats and cows. Today most little boys are in school. It's grown men, who never got schooling as boys, left to look after the animals.
The land is unfenced, and men wander with their small flocks looking for places to graze. This is Lesotho's landscape - old lifestyles amid modern, changing ones. The men are wrapped in colorful blankets, and often wear ski masks to protect their faces from the searing sun, blowing wind and grainy dust.
Almost every boy or man older than 12 has experience as a herd boy, and their stories are rich: staying in the mountains for months at a time; getting beaten for losing a sheep to wolves; trapping rabbits and birds; roasting stolen corn over fires in ant hills; being bullied by other herd boys; waking up to find snow on their blankets.
The defining experience of my first year here were two deaths that happened almost simultaneously. My brother David in Portland, Oregon, died of a brain tumor. And my 14-year-old "adopted" orphan Dintle, who lived alone in a house just up the hill, died of an HIV-related illness.
How does a girl still in elementary school become HIV-positive? I asked many, but didn't learn the answer until after she died. It was buried in shame, written in the medical booklet she carried: "Raped at age 9."
My brother's two operations together cost $550,000, and were performed by one of Portland's finest surgeons. He was caught without health insurance, so funds he'd intended for his retirement were paid out to give him what turned out to be a mere last year of life.
Meanwhile, the money for Dintle's health care came out of my pocket. As Peace Corps Volunteers, we're not supposed to pay for ill people's transport to the hospital, for family bus fares to visit, or for food for the patient, but I did it. Three dollars here and $15 there.
I'm not sure I want to put into print how bad I found the hospital services, but for me, a non-health professional who recoils from illness, the experience was horrifying. When I, a white woman, first walked into the female ward to visit Dintle, gaunt, naked women rose from beneath their sheets, beckoning me, "Nurse! Nurse!"
The hospital is severely understaffed. A doctor (actually the equivalent of a medical intern on contract from India) would do rounds each morning, along with a qualified nurse. He'd give lots of instructions, hurrying from patient to patient, and the nurse would write them down. But few of these orders were carried out. There were just too many patients, too few resources.
I blew my welcome immediately, not understanding the reality of Lesotho hospitals. I expected American-style dedication and care. I walked through three buildings before I found a group of nurses chatting, and demanded - politely, I thought, beneath my quiet rage - some care for Dintle, who I suspected was having a stroke. They seemed angry that I'd found their place, and angrier still that I was asking for something now. Walking back, alone, with no knowledge of how to handle the situation, I experienced true despair.
Over the three months that I visited, Dintle became thinner. She never lost her ability to speak English or her laughter or sweet nature. Her bed was often soaked with urine. She had horrible bedsores from not being turned often enough. Patient care, I learned, was up to family and friends. I made schedules of visit rotations - her lame grandmother, unreliable sister, devoted cousin and me - and paid their bus transport from our village. If we didn't feed her, she often didn't eat. Too late we learned she was vomiting up her large anti-retroviral pills. No nurse had time to crush them up and put them in her food, much less patiently spoon-feed her.
One day a girl Dintle's age, even thinner, even sicker, was put in the four-person room. The next day, before I'd even learned her name, the girl disappeared. "Where did she go?" Dintle asked a nurse. "To another ward," the nurse replied. But when I was rummaging in the linen room for clean sheets, I saw the girl's name scrawled on a scrap of paper pinned to the blanket she'd arrived in. Fear seized me, thinking this was how I'd learn of Dintle's death - handed a blanket, labeled with her name.
So one day, against the doctor's orders, I bundled up Dintle's 80 pounds of skin and bones into a blanket and put her in a taxi. Her head was so weak I had to hold it up. Neighbors in my village had urged me to take her to her grandmother's hut in the neighboring village. "We die at home," they said. Dintle lived for three more weeks, surrounded by her grandmother, sister, cousins, babies and cat, cared for with love and fed nutritious food.
To this day I don't know if I killed her - taking her away from medical care. The anger of the doctor makes me think I did. But the thought of a 14-year-old dying alone in the night, in a horrible hospital, compelled my choice.
Perhaps fighting for Dintle's life was a metaphor for wanting to be at my brother's bedside, doing this for him. The experience taught me to be less fearful of illness. Having few other medical skills, I emptied bedpans for the women on the ward. I bathed private body parts. I sang hymns with the black-clad church ladies who visited on Sundays. The patience and tenderness of caring for the ill and dying is a skill most Americans have lost. Though I often had tears in my eyes as I did it, I touched the essence of being alive.
With the best care in the U.S., and less adequate care in Lesotho, David and Dintle died within days of each other. Dintle was buried without a funeral, since her family had no money. The chief assigned men to dig a hole in the parched earth. She was laid in a coffin and placed in the cemetery across from her grandmother's hut, a nameless stone atop the grave. David was cremated. I missed Dintle's burial, but flew across oceans for David's memorial service, comforted by friends and family, shedding tears for two.
After David and Dintle left my life, Lesotho's sunsets for weeks turned spectacular, crimson reds. Now I remember them with each sunset I see. Death brings strange lessons and precious gifts. I walk my mountain paths with these gifts and poignant memories.
Having experienced Lesotho's HIV close up, I began teaching "Life Skills" - a new subject in Lesotho's school curriculum - with renewed vigor, and encouraging the 2,000 primary school teachers I work with to "Know their status" - that is, get tested for HIV.
Probably 70% of the teachers I work with have not been tested. And these are people, primarily women, with an education. They've attended HIV workshops and are supposed to be teaching Lesotho's children about HIV. Also, most are in the age group (25-40) most likely to contract AIDS.
Why don't they get tested? These are the reasons they give me:
"If I have only a few years to live, I'd rather live it with the joy of ignorance, rather than the stress of knowing I will soon die."
"There is no medical privacy here. If I test, the clinic nurses will tell everyone the results."
"My husband will leave me if he knows I'm HIV-positive. Then, how will I live? How will I feed my children?"
"My students will lose respect for me if it's known I'm HIV-positive. Parents and neighbors will shun me and my children."
"Even if I test, my husband still won't use a condom. He has sex with other women. I'll get it sooner or later, regardless."
In fact, HIV care is changing rapidly in Lesotho due to groups like Clinton Foundation, Germany's GTZ, Doctors Without Borders, PSI and Baylor College of Medicine, all on the frontlines. But the above reasons persist, and make my job more difficult.
Workshops I schedule get canceled. Final exams are slated on HIV-testing days. Life Skills, the new subject, doesn't get taught because the Ministry of Education doesn't require it. There are as yet no textbooks.
But obstacles are no reason for not trying. I struggle to network with others trying to accomplish the same ends. Phones are scarce and email scarcer; weeks may pass without a trip to the capital city; grant deadlines are missed.
One of my successes has been finding ways to talk about HIV - not talking "at" people but letting teachers put it into their own language. Three hundred fifty people came to a "Music Is Life" concert at Lesotho College of Education - teachers danced in the aisles and laughed as their colleagues put new words - about combating HIV - to old hymns, traditional dances and Afro-pop.
People say I'm brave and selfless for joining the Peace Corps. Actually, it fits my perpetual restlessness - the music of faraway places calling my name - and my selfish desire for a late-in-life career change.
Living among poor people is humbling, spiritual. I am not poor. I have enough food to eat, water to drink, and a safety net of Peace Corps-provided health care. On any day, I can walk away, returning to Madison's vibrant community, communication, commerce.
But my village is filled with people who can say none of these things.
Even in the Peace Corps, I cannot escape the guilt of the wealthy. Indeed, I'm much closer to it. Every day I see children going to school, half of them orphans. Their toes stick out of shoes whose fronts have been cut off. They carry their books in torn plastic bags. A parent lies in bed at home unable to afford transportation to the clinic. With a tiny donation of money or effort, I could help any one of them. But they do not ask.
I'm probably asked for help less often here than I was in Madison, where my daily mail brought a deluge of letters requesting contributions. At work there were funds for this and that. One grows hard - learns to say no. Justifies saying no. Pretends not to see.
To have wealth and hoard it produces a heavy heart. As soon as one tries to address a global problem, the weight shifts. One loses the guilt, and gains frustration. Frustration is better, because it can lead in satisfying directions.
Scrawled on the walls of the outhouse on the hill used by volunteers are many quotes, among them:
"And right action is freedom from past and future also. For most of us this is the aim, never here to be realized; who are only undefeated because we have gone on trying."
- T.S. Eliot
One of the surprises about living among the poor is how generous they are. When hitchhiking, as we sometimes do, volunteers quickly learn that the fancy cars driven by white people from South Africa seldom stop. But when we see a rickety truck, dragging its bottom, driven by an old black man who can barely see over the steering wheel, we learn to expect he'll sputter to a stop, offering not just a ride but a place to stay for the night.
Little wealth seems to trickle down into my neighborhood, but kindness trickles up. Most of the people living on this planet are poor. It's a relief to lose fear of them. Rich people should know that few poor people want their wallet, car, home or even citizenship in some wealthy country. They want a job in their town, a good school for their children and less trash on their roads.
So I continue to gaze in ironic amusement as I see cars with white people rolling up their windows, staring out in disgust as they pass through rubbish-infested Mount Moorosi, my windy, squalid town. My temporary home sweet home.
News about the U.S. presidential election and stories about financial collapse passed me by. I caught snatches on BBC Radio, which reaches me by short wave. But it remains to be seen how much Obama's policies can alleviate poverty in Africa, a huge task. For once, Lesotho is ahead of the U.S. - it's already in a state of financial despair.
And so, from this small mountain kingdom, I send you my year's lessons in the form of wishes for your new year:
That you might cross into rooms of the ill and dying and offer tenderness.
That you may be enriched by the profound stories of ordinary people around you.
That you might trade the guilt of doing trivial work for the frustration that comes when tackling important things.
That you may dare to give more, in order to know the bounty of your heart.
Khotso, pula, nala (peace, rain, prosperity),
Mount Moorosi village, Quthing District, Lesotho (southern Africa) firstname.lastname@example.org
To learn more or help
Friends of Lesotho
c/o 4110 Denfeld Ave., Kensington, MD 20895
Here you can contribute to projects run by Peace Corps Volunteers in countries all over the world, from schools to wells to tree planting. Individuals and groups may wish to "adopt" a project and watch it succeed.