blessed to be a witness

I think people make it here if they can find hilarity in really-not-so-funny situations. It's too intense if you can't. Eventually, your head will melt out your earlobes and chickens, who can sense when you're in overload, will have squawked their way over and scratched dust over your puddled remains faster than is respectable for someone experiencing moral anguish. You can imagine, I walk on the edge of a knife in this regard, being such a lover of depressing human suffering, always on the lookout for poetic analogies to make sense of things. (I don't mean poetic in a Shel Silverstein kind of way either, unfortunately.)

It's still the dry season here. Each day the wizened heat wends around us, nudging the thermometer a fragment higher than the previous, but cholera has already returned. "How can it be?," I wonder, a little green in these matters, for I can clearly remember the day just back in June when they finally dismantled a little tented community I had irreverently christened "Camp Cholera".

I used to walk by it daily, its recycled UNHCR and USAID tents flapping in the wind, a canvas island in the center of a grassy field, all of it contained within a sturdy ocher concrete wall. It was where the provincial hospital quarantined its cholera patients, people deemed too dangerous in their infectious state for regular care, and therefore compelled to pass the course of their illness in an empty, scrubby field a couple of blocks from our house. I heard the Beira Camp Cholera was huge and sprawling, full of men in containment suits and people dramatically jerking between dead and alive; but our satellite location here in Chimoio always seemed pretty low-key, though there was a lot of cholera going around last season, especially in nearby Gondola.

"Must be arts and crafts time now, haha," I'd intone, making the same joke every time we'd stroll past it, necks craned for any glimpse of movement. Of course that was pointless, because at Camp Cholera there isn't Capture the Flag, just puking and diarrhea for three days, dehydrating out both ends until you're dead, unless you've sought help in time and then you're fine. "The summer camp you never want to go to," I'd murmur and jump on a crowded sardine-tin chapa headed for downtown.

So its back already, this waterborne assassin, and the reason of course is because we ARE still in the dry season, the tail end of it, the hard time. Only 43% of Mozambique has access to clean, safe drinking water, which means a lot of people, rural people, are running dangerously low on what they do have, and - here it is - now are accessing water which isn't clean, isn't safe. Cholera-infected water, dirty water that kills.

We received word last week that upwards of 39 people and counting have already died in an intense, localized cholera epidemic at a small village where we work (constructing sand dams for clean water, actually), in the north of Manica Province, a poor, isolated region called Mandie. I'm not directly involved, so my details are fuzzy, but someone told me that many, many people are sick and the whole area has been quarantined, all roads closed, no one in, no one out.

We host groups here occasionally called Work & Learn Tours, which are made up of supporters from the US and Canada who come for a couple of weeks to see our projects in person. There's one that's been planned for months now, a group of Canadians meant to arrive in two weeks, who are flying across the world to see our sand dams in this exact community where these people have just lost their lives, so quickly, entire families! Mother, father, all the children, just like that. I'm not sure what the group is going to do now, instead.

It's hard to wrap your head around some of this stuff. Hard to Shel Silverstein stuff like this.

I've been sick too for the last week, for exactly seven days laying in bed with a mixture of (possibly) strep throat and (possibly) malaria. After 4 days, when the terrible cold and sore throat wasn't going away, Heide insisted I begin malaria treatment, and it has seemed to help. But the point is, it signals the restart of malaria season as well. Johnny Raincloud though I be, yes, this is terrible news. It comes every year, but it's terrible news, every year. More people die of malaria than anything else here - the end.

Maybe its all perspective, but do you see what I'm saying about high potential for head meltdown?

Buckle up.

The last day before my body broke down and requested sleep for a week, Elizabeth, Heide and I were wrapping things up at the clinic together one afternoon. We were down to our very last baby of the day. The last child is always a gentler time, slower, welcomed with relief, when the sweeping and tidying in the clinic has already begun, when it is finally quiet enough outside to hear the thud of blue-gonaded monkeys throwing papayas to the ground, bolder than ever (for these are hunger months for them too).


The last baby happened to be a new patient, and it was with uniform dismay that we realized this 2.3 kilogram baby (5 pounds) was already four months old. She was in a state of severe malnutrition, sprawling naked before us.

The sweating mother holding her had a crazed sort of look in her eye, one which said in a silent heartbeat: I love this baby. I have five other children, I am HIV+, but this baby, I love this baby. As Heide said afterward, it was clear that was the reason the little girl was even still alive.

It wasn't just a matter of getting food into her. Heide is a genius nurse, honestly, and right off she noticed that the child had a cleft palate - or something like that, the opening in the back of her mouth was not formed right, it was too big, too high, and the net result was that nothing went down. She couldn't suck. Her stomach was full of air, a lymph node near her vagina was enflamed, absurdly swollen, and there was simply nothing to her, her little chest heaving, fluttering like a hummingbird, suffering to stay alive. Her mother patiently tried to pour milk down into her with a spoon... - look, I'm going to stop here. It was painful.

You don't do good to anyone if chickens are kicking dirt over your puddled head. You don't. I'm serious.

One of the things I love most about helping out at Jacqui's clinic was the discovery that every day is filled with riddles, or is like a high-stakes game of Clue. I help out with everything, I even see patients by myself sometimes on the days when we're really bombarded - (I'm talking up to our eyeballs in babies and caregivers,  I refer them to a real nurse if they complain of anything wrong, otherwise its just checking their weight, taking notes and handing them their powdered milk) - but the main thing I do is translate Portuguese between patients and Katie, a wonderful British nurse who doesn't speak it yet. I've also picked up just enough Shona that a few odd words and phrases are usually thrown in the mix too.

You know how one of the funniest realizations you have the first time you travel overseas is that animal noises are not universal? For example, in America cows go "moo", but in India they may go "rawl-ruup!" Or our frogs go "ribbet" but in Honduras maybe they go "yooo". Those are all made-up examples because I can't remember the actual noises people have demonstrated to me; but the point is, sick bodies also make much different sounds in other countries. We have rumbly tummies when we have diarrhea, but here they have burbly ones, with occasional fips! fips!, like popcorn popping.

Don't worry, I don't get it either.

This can make medical translating, particularly for unschooled patients, extremely challenging. (That doesn't even go into all the euphemisms people use too, either because they're embarrassed or just because it's how people say things here. For example, hemorrhoids: "a thing that comes out like meat". AIDS: "this thing which it is said we have".)

While sound effects can make translating very confusing, they can also make it uproariously funny. You have to see it that way. The toddler's grandmother is looking me in the eye, balling up her fists, shaking them like wet noodles, and uttering high-pitched trills like a... I don't know, a vacuum cleaner sucking up Saran Wrap?

"So what's she saying?" Katie will ask me innocently, as the grandma with a face like crinkly fudge pauses and peers at us expectantly.

"Okaaay," I'll reply, shifting in my plastic lawn chair and taking a few warm-up laps in my head. "So she's saying that little Franque here" - at which the toddler on her lap yanks my eyeglasses off the table and chucks them a few feet away - "after he's done eating, about once a month, he stands up and goes like this" - here I ball up my fists and imitate the vacuum Saran Wrap sound - "and then all the other kids run away, and then I think she's saying that he then" - [attempt at sound of semi-truck smashing gravel] - "and then... well, it sounds to me like maybe he's..." - wracking brain for correct English words - "falling over? Convulsing? Oh! Wait, what's that called? Um, that thing... epilepsy!! Maybe epilepsy? What she's describing sounds like he's having convulsions that kind of remind me of epilepsy. Could that be it?"

Then Katie, expert pediatric nurse, asks all the appropriate follow-up questions, which do, indeed, seem to point to epilepsy in little Franque, who by now has wandered over to the other baby being looked at by Heide, has squatted down politely, and peed on the floor.

Okay. So. Nothing funny about epilepsy for Franque. Nothing funny about kids coming in with terrible, painful burns because they convulsed next to a cooking fire and seared half their arm. But on the other hand: Yes! Hilarious! Grandma making a sound like a vacuum sucking Saran Wrap? I mean, by the end of the whole conversation, all three of us, Katie, me, and Granny, have tears running down our faces laughing, all of us balling up our fists, all of us flailing our arms like wet noodles, and Franque there, grinning up at us as a fragrant puddle of wet, Franque-pee enlarges and spreads across the floor of the clinic. Then he plops down on his bottom and begins splashing in it.

It's either Franque's puddle or my head in a puddle. And my head in a puddle doesn't help Franque one bit. Or that 2.3 kg malnourished HIV+ daughter of God. Or the people hunkering down in Camp Cholera for yet another season. Do you get what I'm saying?

What a thing. What. A. Thing.

I swear that's why God gave those otherwise normal looking monkeys bright teal-colored balls. What other reason could there be? Maybe He looked down, foresaw where things were headed, and sighed:

Yeah. Things are gonna heat up down there. That one there, yeah, the monkey - make his balls blue. Just his balls. Perfect. That's hilarious!!

And it is.

What a thing.

Katie with one our grannies