Independent Study Abroad: Exploring Zimbabwe

Ankur Shah


The Island Hospice & Bereavement Service  

Mabvuku

My childhood activities after school consisted of playing on the swing set in my backyard with the neighbors and riding bikes through my neighborhood with my cousins during the summer.  My old neighborhood was considered safe.  I highly doubt my parents worried if I was going to get kidnapped in my backyard or that they were not going to be able to afford my tuition payments at Holy Rosary.

 

The parents and children of Mabvuku are not afforded any of the luxuries I had growing up.

 

I met a woman, a patient of Island receiving psychosocial support, whose child had been kidnapped by child traffickers.  Of all the vile things child traffickers do to children ranging from sexual abuse to slave labor, their activities in Zimbabwe made me sick to my stomach.  I discovered that these traffickers kidnap poor children from high-density areas to use them in sacrificial rituals.  That’s right, they murder young children in ritualistic ceremonies.  Imagine being a helpless parent constantly thinking of the suffering your child is going to undergo alone, without you to comfort them.  Imagine having no FBI or police force searching for your ten-year-old son or daughter because they have no money and because they simply do not care about your situation, as it essentially hopeless.

 

It is also extremely common for parents to be unable to afford government schooling for their children.  Fees are $35 per trimester in Zimbabwe for public schools.  The fees pay teacher salaries and other expenses, as the government does not have the money to fully support every child’s education.  The children I ran into on a road outside a settlement in Mabvuku told me that they went to school but were kicked out since they did not pay their term fees.  Eleven-year-old children wanted to go to school and were forced out.  In America, kids make up any excuse to skip school.  Even worse, those of us given the privilege of attending higher-education institutions such as Union sometimes skip class for no reason.

 

I also had the opportunity to meet ‘D.’  ‘D’ is about eight-years-old.  He lost both of his parents to HIV within an extremely short period of time.  He was living with his aunt, who cannot afford to keep him but is doing so out of her good nature.  He came inside to sit with the social worker and I for a few minutes.  ‘D’ barely spoke, but he looked up at me to say hi and shook my hand.  Then, he went back to sitting silently and looking at the table in front of him.  He was a shy kid who had suffered two horrible tragedies.  I cannot even begin to comprehend how he felt at the moment.

 

Despite their horrid situations, the people of Mabvuku were extremely welcoming to me.  I went to patients’ homes with one of the social workers at Island.  People who could not afford school fees for their kids still offered to cook me meals because I was their visitor from the United States.  They continually thanked me for coming, even though I did absolutely nothing, simply because I was there witnessing their situation.  They were hopeful that I would go home and tell people in America about the circumstances in Zimbabwe.  The kindness I experienced in Mabvuku, where the vast majority of people live on $1 or less per day, speaks wonders about the Zimbabwean people as an entity and hopefully provides some insight into the welcoming and warm atmosphere I have worked in everyday at Island Hospice.

 

On a more amusing note, when I drove through the roads of Mabvuku, probably fifteen school children ran next to the car yelling “murungu.”  Funnily enough, murungu means “white man” in Shona.  The children, as well as the rest of the people, were surprised to see a light-skinned person in their town.  And believe me, they did not try to hide their fascination with me.  When I walked from the car to the local store (basically a covered hut) to buy a Fanta, I felt every single pair of eyes staring at me, wondering what the hell I was doing in Mabvuku.  The social worker from Island that I was accompanying told me that I would be the talk of the town for the next few days.

 

It is sad to say that I only have just over a week left to be a Zimbabwean celebrity, but my time here has been a tremendous learning experience.  In addition, I am going to Inyanga this weekend with the Maasdorps.  It is a stunning getaway in the mountains where you go to hike and just relax.  I am really looking forward to seeing more of the beautiful countryside of Zimbabwe and to get away from Harare once more before I leave.

Jump!

My heart was pounding, and I could hear every beat as it thudded inside my chest.  “It’ll be fine,” I told myself.  “No big deal.”  I opened my eyes after taking a deep breath to witness one of the most stunning views in my life.  The skies were blue and clear and warm rays of sunshine heated the back of my neck.  The Zambezi River swiftly passed through the gorge that stretched out below me.  A cool breeze rippled my clothing.  And then all of a sudden, I was brought back to my frightening reality by the Zimbabwean man fastening the two ropes that would determine, what seemed to me, my survival.  “Put your toes on the edge of the platform,” he instructed.  I hesitantly shuffled forward without looking down.  Keeping my head up and my chest out, I felt ready to tackle this challenge.

 

“Are you ready?

 

“Let’s do this,” I responded.

 

“Good.  Remember, if you’re not living life on the edge [literally], you’re taking up too much space.”

 

I took another deep breath.  He rapidly counted down: “5-4-3-2-1-JUMP!”

 

I took a courageous leap forward as a breeze caught my backside.  My eyes were wide open as I immediately took in my surroundings.  Blue sky, reddish brown clay sides of the gorge speckled with the greenery of trees and bushes slightly below me on either side, dark blue water ahead of me stretching as far as I could see.  Then, I plunged downwards and released a fearful bellow.

 

Imagine free falling 350 feet for four complete seconds.  It may not seem like much, but when you are falling, it is eternity.  You have no control over your actions, and it feels as though nothing is supporting you.  The only force acting on you is the unrelenting power of Earth’s gravitational pull.

 

As I descended for two seconds, I let out a yell that could probably be heard for kilometers.  As the fear overcame me, my body shut down.  Then, all of a sudden, I felt a tightening around my chest and inner thighs.  Thank goodness, the rope had not broken.  I opened my eyes and realized that I was swinging only a few meters over the Zambezi River.  I stretched my arms out and enjoyed the cool breeze and beautiful view.  It was over.  I was covered in sweat and my heart was pounding, but I had done it.  I had survived the jump and overcome my inhibitions regarding the daunting task.

 

While my anxiety about surviving the jump may seem unfounded, I had just discovered, prior to my jump, that only last year the rope had broken.  A girl had plunged head first into the Zambezi with her feet tied together by the bungee cord.  This, in part, had influenced my decision to complete the same jump feet first.  Thankfully, the girl was a tremendous athlete and managed to undo the ropes around her feet and swim to shore.  The bridge jump was closed for nearly two months after that incident, and it had only recently re-opened.

 

Victoria Falls may possibly be one of the most magnificent places I have ever visited; Niagra Falls pale in comparison.  Victoria Falls stretch one mile in length, and when we visited, they were falling in full force as it was, and still is, the rainy season.  I had such a profound moment on the last viewing point of the falls.  At the viewing point, it was pouring rain, which is actually spray from the falls crashing against the rocks below.  I had on a poncho, but I was still getting soaked.  The wind was very fierce, and the falls were not visible because of the mist.  However, you could hear the thundering cascade of waters hitting the rocks below.  I stood there for maybe fifteen minutes and then, for a brief three seconds, the mist cleared.  I had the chance to glimpse the most powerful and tremendous portion of the falls.  The beauty of the water gushing hundreds of feet to the gorge was indescribable.  Witnessing the power of nature in such a pure form was one of the highlights of my trip.

 

In addition to Victoria Falls, I had the opportunity to visit Chobe National Park in Botswana for two days.  We went on five safaris during that time and saw everything from rare birds to lions.  The lions were, at most, thirty feet away from us.  There are also hundreds of elephants at Chobe, and the animals were close enough to our jeep that I could have reached out and touched them.  In addition, I saw giraffes, zebras, hyenas, warthogs, and many more intriguing creatures in their natural habitats.  I had the unique chance to witness two giraffes fighting in the wild, during which they viciously swung their necks at one another’s torsos.  I saw a sunset over the Chobe River and sunrise at 6am in the park.  Describing all of my adventures on safari is nearly impossible with words, and while pictures do them some justice, first-handedly observing animals roam freely in their natural environment was the opportunity of a lifetime.  But do not worry, I have many fantastic pictures and videos capturing my adventures in both Vic Falls and Chobe - even one of me bungeeing off the bridge, thanks to my mom.  As soon as I get home, I promise to post them.  I cannot believe I only have a little over two weeks left here! Time sure does fly.

A few pictures from vacation! I can’t upload the rest until I get home. We went to Victoria Falls and Chobe National Park in Botswana. One of the pictures shows me doing a feet-first bungee jump off the Vic Falls bridge - it was insane!

A few pictures from my home-based visits in high-density areas!

A Home Away From Home

T-3 days until vacation! I cannot wait. My mom is flying in with Rahul’s mom, sister, and brother on Thursday night, and on Friday, we are all finally going on our long-awaited trip to Victoria Falls and Chobe National Park in Botswana.

In other news, Zimbabwe has really begun to feel like home to me.  I have become accustomed to all the aspects of daily life here and things are going well.  We have developed many relationships with our co-workers and others we have met along our journey.  At work, people stop by our office to tell us about their weekend or share a little office gossip.  I truly feel like part of the team at Island, and it is a wonderful feeling to be so welcomed.  Instead of feeling like a naïve tourist, as I did in the first few weeks, I feel like Zimbabwe is my second home in a way.  I have visited some of my colleagues’ homes and met their wife and kids.  We have had dinner together and shared stories comparing the U.S. and Zim.  We crack silly jokes at work and make plans to get together on the weekends.  It is, in fact, sad that I only have a few short weeks left in Harare because there are so many people, places, and random things that I am going to miss about this country.  I am very motivated to make the most of my time here!

Despite last week being frustrating regarding our project, things are back on track.  Dr. Chifamba returned from the training he was overseeing in Namibia and specified the exact details of what he expects.  It turns out that our previous objectives were simply too broad and that is why they overlapped with HOSPAZ’s project.  Nevertheless, Rahul and I started the refined proposal from scratch, and we have made significant progress on it.  The project is going very smoothly thus far.

Again, I am so excited to see my mom and tour the country, as we are traveling to Vic Falls by car, and it is approximately 1000km’s away (~10 hours).  Elgar, our friend and a social worker at hospice, is driving us as he has family in Vic Falls.  I know that the countryside is going to be beautiful and the falls even more magnificent.  Hopefully, I can upload pictures while I am there!

The Hindu temple in Ridgeview. I visited it last night and had the chance to be there for Aarti. It really reminded me of my temple in Pittsburgh in terms of architecture, and that made me miss home. In addition, there is a Sunday school across of the temple that takes place in the community hall there. There is a primarily Indian high school across of the temple as well.

Ridgeview is the home of the Indian community in Harare. Before independence, Zim was also segregated much like Apartheid. Thus, even today, certain suburbs are predominantly occupied by a certain race based upon the segregation required over thirty years ago.

My collection over the past week and a half. You can clearly see the downsides to not being able to print your own currency. The condition of the bill all the way to the right is fairly common for a large portion of the money here. Cashiers wouldn’t even accept this stuff in the U.S.

My collection over the past week and a half. You can clearly see the downsides to not being able to print your own currency. The condition of the bill all the way to the right is fairly common for a large portion of the money here. Cashiers wouldn’t even accept this stuff in the U.S.

Everything

I can’t believe it’s been two weeks since I last posted. So much has happened since then, I couldn’t begin to put it all in writing, but I’ll definitely try my best to summarize.

Last Wednesday, I went to Mekka (local bar) for dinner for a friend of Nix’s birthday. I had the chance to meet about fifteen people our age, and it was a fun time. The unique thing about kids our age in Zimbabwe are that they are way beyond their years in terms of maturity in comparison to American college students. For example, every single guy that was there came with his girlfriend. Even more, typical relationships in Zim start in high school or early college and last until kids get married at a very young age. The couple sitting across from me was 23 years old and engaged to-be-married this spring. I could not fathom getting married in college or one year out. This is definitely a cultural difference that I am still getting accustomed to seeing.

Last Friday, we went to Waterfalls, a borderline rural town on the outskirts of Harare. Our co-worker and good friend Bhodeni took us there with his friend Lloyd. We went to a local bar, which only men typically frequent (the only women who come to this place are commercial sex workers), and enjoyed delicious Sudza (mashed up cornmeal, a staple of the Zimbabwean diet, which is so good) and other Zimbabwean food. It was quite the experience and definitely one of the best nights I’ve had in the country. It was fun seeing other part of Zimbabwe, instead of the Westernized places that surround our house. A cricket game was on, and while this may not seem like a big deal, watching a cricket game at a bar in Africa is like going to Primanti Bro’s on a night the Steelers are playing the Ravens for a wild-card playoff berth. It was an enjoyable game to watch both for the sport and for the animated reactions of everyone around us. The bars here are almost entirely outdoors, which is awesome because the weather is perfect. It actually hasn’t rained in over a week, which is very odd for this time of year.

We also had the chance to see President Mugabe’s cavalcade last week. It is very unlike President Obama’s or any other U.S. Presidential cavalcade. In Zim, a few motorcyclists fly through traffic with sirens blaring at over 100mph to clear the way about a mile ahead of the rest of the vehicles. In fact, about six of them die every year because of the road conditions and for the simple fact that they are driving at extremely dangerous speeds. Then, a long cavalcade consisting of Mercedes Benz SUVs – one of them containing Mugabe – speed through the road. People driving stop immediately and pull over. People walking stop right in their tracks. It doesn’t matter if you are on a side street or not. Everyone in their cars and on the streets freeze. They do not move an inch and they do not look up at the cavalcade for too long in fear of getting shot or in serious trouble. It is crazy to experience but quite the thrill. Even when driving past the statehouse, no cameras are allowed and you have to look straight ahead. There are military hiding in the trees and all over the place looking for any small signs of trouble. The house is blocked off with high fences and lots of trees and shrubbery, so it is not visible to the main road. In addition, all the roads Mugabe normally travels are the only ones with minimal potholes because they are the only roads ever maintained by the government.

On Tuesday, I got to visit Chitungwiza again, but this time for a caregivers’ meeting. This was another eye-opening experience. The caregivers’ were being given their monthly incentives for making continuous home-based visits to patients in their rural communities. These caregivers provide grief counseling, psychosocial support, and clinical advice based on traditional home remedies (i.e. boiling lemon water to soothe a cough or using cucumbers on the skin to deal with a rash). These caregivers must take notes on each case and then also make appropriate referrals to rural clinics, hospitals, or Island Hospice. The caregivers’ stipend for food for one month is $8. Yes, eight United States dollars for providing round-the-clock medical advice to fellow villagers when they are in need. This meager amount is supposed to last them one month. Despite the difference in the cost-of-living between the United States and Zimbabwe, eight dollars is nothing. It is absolutely nothing. Yet, probably forty or so women were gathered in what seemed like an abandoned building in Chitungwiza to collect their payments. According to Sister Mary, at least 75% of the women were HIV-positive and many had also lost their husbands, which prompted them to take the position. The women exemplify courage and strength, and it is unfortunate that situations like this are present all over the country, not just in this one area.

What else was interesting about the trip was the fact that when Charity, a veteran Island nurse, walked into the room, all the women jumped up and started singing and dancing in Shona. The translation was a song of welcome for Charity. They were absolutely elated to see her, and per custom, she joined in the singing and dancing. It was a unique experience to witness.

This past week has been incredibly frustrating. We discovered, after meeting with a two prominent researchers, that the project we were working on has already been completed by HOSPAZ (Hospice Association of Zimbabwe) and that it is awaiting publication. Four weeks of hard work felt like they went down the drain, but I am glad that the moment of despair is behind me. The Chitungwiza visit also really helped put things in perspectives; my ‘problems’ do not compare whatsoever. So, we set up a meeting with HOSPAZ, yet they refused to release any of their findings to us since they were about to publish their findings. However, they did share information on what details they have covered regarding our overlapping studies. This helped in some way, so hopefully now we are probably going to be interviewing the twelve palliative care organizations in the region to discover how they are integrating palliative care into primary health care settings. When reading this, it may seem as though our problem was not a big deal and that things are taken care of, but they are far from over and it was an incredibly challenging week for both Rahul and I. Words cannot accurately capture our frustrations from this week.

For Island, we are also working on creating a form of electronic medical records for the nurses and updating their information sheets so that capturing statistics for the monthly board meetings and project publications will be much easier.

On Friday night, our co-worker Elias took us to visit his home. He had just built his house in a newly developing community, and it was a very nice area. His home was beautiful, and his young kids were adorable. We hung out at his house for a bit and then went to another “Hideout” as they call it, where we had brye (BBQ). We sat outside, played pool, talked, and ate. It was another awesome night out in Zimbabwe, and I am so grateful to all the Island staff for being so welcoming and friendly to us. We really feel like a part of them, and they treat us so well.

Last night, Rahul and I stayed up in the middle of the night to watch the Superbowl at Val’s place of course. She bought enough snacks and chips to feed half of Union, so it was a great time despite the fact that I couldn’t see any of the American commercials. I am so glad she’s back from visiting her dad in Ireland. Last week without her may have been one of the longest weeks here.

Sorry for the long post, but I hope this somewhat accurately captures a few of my adventures over the past two weeks. It’s hard to believe I’ve been here for half of my stay already, and I hope everyone back home is doing well!

The Past Week

Over the course of the past week, Rahul and I entered close to 2000 names, demographic information, and other patient information into an Excel spreadsheet as busy work for the M&E lady, who is extremely busy and could always use the help. Needless to say, my head was pounding by the end of the assignment, but I was glad to help.

In our spare time, we reformatted the literature review we completed over break to meet the project outline, but that didn’t take too long. We also looked up the documents that Dr. Chirenda asked us find. Thus, the past week was busy but slow at the same time – that is until Friday.

On Friday, we had our meeting with Dr. Chirenda at the University of Zimbabwe, and we are going to be very busy over the next few weeks. On the bright side, our moms are coming to visit for a week, and we are going on vacation with them to Victoria Falls (one of the seven wonders – it’s gorgeous) and Chobe National Park in Botswana. But before we leave for vacation, we have to have a draft of our final paper done. So, by the end of this week, we have to have a research proposal completed with questionnaires for key informants that we will be interviewing, such as a member of the Ministry of Health & Child Welfare, a member of the National AIDS Council, staff members of Island Hospice, and patients in the hospital and in the community undergoing palliative care treatments. Our initial proposal is going to be submitted to the Zimbabwe Medical Research Council for expedited review at the end of this week to ensure our questionnaires, informed consent forms, and other project details uphold ethical standards.

When we get back from vacation, the plan is to brainstorm with the team in order to come up with a plan to implement care mechanisms that address the gaps in policies and treatment practices regarding chronic diseases in Zimbabwe. I am truly looking forward to witnessing the full effects of our research. It would be indescribably rewarding to have a legitimate impact on people’s lives.

In other news, on Wednesday, we went to Val’s house for a TED talk with some of her husband’s friends and colleagues. Then, we had a very interesting discussion. The talk was on community development and entrepreneurship. It was applicable to business and medicine, and I took away some important ideas from the talk. One quote that stood out to me was, “If people do not ask for your help, don’t give it to them.” Maybe our government could benefit from this advice when contemplating foreign policy…

Anyways, the other important point the man made was that the first principle with aid is respect. He said, “Do not come into a country thinking that you have all the answers or that you are better than the people residing there. The people know what is best for them, and your job is to listen and help them achieve their goals, not to promote your own agenda.” This advice is useful for any situation, and it is definitely applicable to what we are doing here in Zimbabwe.

From such a random discussion/opportunity, I learned a lot and I had fun listening to others’ perspectives on the TED talk. That night, we stayed over at Val’s…again. She’s the best. I’m already getting depressed that she is leaving for a week this Thursday, and that her daughter is leaving on Friday. On top of that, one of our closest friends at Island, Thulani, left on Friday for three weeks to take a financial intelligence course at a graduate program 100km away. Thank goodness we are going to be extremely busy over the next few weeks with our project.

On Friday night, Rahul and I went to an Italian restaurant called Da Eros with Nix and Tim. We enjoyed a delicious three-course meal surrounded by beautiful scenery. All of the seating was outside, and the weather was perfect for the majority of the meal, although it did start raining towards the end. The next morning, we went to Val’s to play tennis with Nix and Tim and to just hang out. And yesterday, we submitted our assignments for our Union independent study classes, went to the gym, and went grocery shopping (the worse part of the week). All in all, it was a good week and relaxing weekend, but I am ready to really get started working on our project, which is one of the main reasons Rahul & I came to Zimbabwe. I am especially looking forward to interviewing key officials within the government and the community as well as patients residing in hospitals and rural villages.

If you were wondering, a typical day for us is something like this:

Wake up around 6:45am.

Make breakfast and lunch.

Get ready for work.

Thulani used to pick us up, but now we walk (unless it’s raining too hard).

Work 8am-12pm. Lunch for about half an hour in the courtyard in the middle of our building (hospice is rectangular shaped with a seating area enclosed in the middle).

Work until 4pm.

Straight to the gym where we work out and then use the Internet till about 6:30pm (We get free, unlimited WiFi with the membership. I have never appreciated the unlimited data usage back home until now. They charge homeowners and others, such as Island Hospice, with Internet $30 per gigabyte here.)

Come home, shower, and make dinner.

Watch a movie (Rahul has a terabyte hard drive full of movies and I brought along a fair amount as well. Plus, the guy at the flea market gives us great deals on pirated movies just released in the states.)

Go to bed around 10pm (I feel like a senior citizen; at Union, I don’t start my work until at least 9pm.)