Potpourri

If this blog entry were a Jeopardy category, Alex would refer to it as 'Potpourri' because potpourri pretty well sums up how this week has been.

First, I ran into a bit of a SNAFU with immigration upon my arrival back in Botswana after my trip to Australia, so I have spent much of my week sorting that out. Next, the Mochudi Prevention Project has been moving full-steam ahead, so I spent some of my time getting updated on the progress and plans for the future. Finally, our CFO introduced me to the Executive Secretary of the Nurses Association of Botswana and I am now working on a project for the Southern African Network of Nurses and Midwives General Assembly Meeting. So, here are the ingredients in this week's potpourri 1, 2, 3.

1) When I landed in Gaborone last week, after spending time in Sydney, the immigration officer at the airport informed me that I did NOT have the proper documentation for my extended stay in Botswana. I showed her my exemption certificate that allowed me to work in Botswana until June 2011 and explained that I thought this was all that I needed. However, it seems that I was supposed to have obtained an exemption certificate for residency in addition to the one for work. Thankfully, the immigration officer gave me an 8-day stamp in my passport which gave me time to spend this week getting the proper documentation. Any 'foreigner' who has spent any time in the immigration office in Gaborone can empathize with the experiences I have had this week- getting conflicting information, waiting in lines when there seems to be an abundance of personnel wondering around behind the counter, and the sense of relief when someone finally helps you with your 'problem'. So, at this point, I have a temporary permit to wait for my official exemption certificate to be ready in 14 business days. By mid-November, I'll either be a legitimate worker and resident, or I'll be home in time for Thanksgiving.

2) In between trips to the immigration office, I had time to get updated on the progress of the Mochudi Prevention Project. We had our weekly conference call with the Boston constituency on Tuesday, and things are really moving forward. The clinic is still pretty slow because participants don't come to the clinic until after they have been visited in their homes by the home-based counselors. Two of the major challenges we are facing right now is a lack of space for our growing team to function and inadequate transportation to allow the home-based counselors to do their work as efficiently as possible. In most of my previous work experiences, I have known in advance EXACTLY how things were supposed to roll out and had all the resources available to ensure that things went according to 'the plan.' This project has been a little different in that we are continuing to make minor (and major) adjustments as we go along.

3) The final ingredient in this week's potpourri was a fortunate connection to the Executive Secretary for the Nurses Association of Botswana. Apparently my name came up in a social conversation and she thought I might be interested in helping with a few projects that are underway. She was right! I am working on one project for the Southern African Assembly of Nurses and Midwives, and with my supervisor at BHP's permission, I am hoping to work on a few other projects she has-- including analyzing survey data... my FAVORITE!

So, this has been a bit long-winded and I don't even have a good picture to go along with it! If you need an image, just close your eyes and imagine yourself getting passport-sized photos taken by a friendly, entrepreneurial Motswana who has set up shop outside the immigration office and before he takes the picture, he reaches out and helps you adjust your bra strap.

You're Invited to Gaborone

I am feeling settled in and ready to entertain visitors. Here is one of Gaborone's older residents (you can tell a giraffe's relative age by his markings- young giraffes are light-colored and older giraffes are dark-colored. We would be happy to see you. Just shoot me an e-mail.

G'day and goodbye to Australia

I am back in Botswana after an amazing trip to Sydney, Australia. The trip was successful on all fronts: I attended the Australiasian Sexual Health and HIV/ AIDS Conferences, did some memorable sight-seeing, and took care of some 'practical matters' in-country.

My main objective for the trip was to attend two conferences: The Australasian Sexual Health and HIV/AIDS conferences. The first one completely surpassed my expectations. I was very impressed with the quality and diversity of the topics and I think Africa and North America could greatly benefit from adopting some of the forward-thinking strategies discussed related to sexual health. The HIV/ AIDS conference was also very good, but the epidemic in Australasia is quite different than it is in Africa, so some of the information was less relevant to my work here in Botswana. For example, the prevalence of HIV/ AIDS is less and it largely affects gay men rather than heterosexuals.

During my time in Sydney, I also had time to explore the city. It reminded me a lot of Seattle- but everyone spoke like Crocodile Dundee and they sold Veggiemite in the grocery store (for veggiemite sandwiches). In short, I LOVED Sydney. Above is a picture of me on a cruise of the harbor with the Australian flag behind me.

Finally, my trip to Sydney offered me an opportunity to take care of some practical matters such as getting a hair cut. I also enjoyed seeing the deep turquoise ocean again (Botswana is a land-locked country), having high-speed internet, going to the grocery store without having to be searched by a security guard and having soap and paper towels in the public restrooms.

All in all, it was a great trip and I am looking forward to continuing to digest the voluminous materials I brought home from the conferences-- just as soon as I get my luggage, which has not arrived back in Gaborone, yet.

Katie in Botswana?

Enjoying a bit of the city after a day at the Australasian Sexual Health/ HIV/ AIDS Conference in Sydney

My changing frame of reference

This week I had the privilege of taking a break from my normal work routine to attend the 3rd Botswana International HIV/ AIDS Conference in Gaborone. It was a fantastic conference with many international speakers-- coincidentaly, several of them were from my alma mater, the U of W. I met people from all over the world and even got to know some of my co-workers, who were also attending the conference, a little better. However, one of the most striking things about my experience at the conference was realizing how much my frame of reference has changed since my arrival in Botswana.

The conference was held at the conference center associated with the hotel I stayed at my first night in Botswana. This was the first time I had returned since my arrival in July. Before I came to Botswana, I decided that, in order to ease my transition, I would make reservations at an 'upscale' hotel for my first couple of nights. The hotel looked wonderful on the website and I was excited to arrive. However, when I got to the hotel, I was sadly disappointed. Having just come from 3 weeks of living in the Hyatt in Bethesda while attending Global Heath Seminars at NIH and tearing up the town with Mom and Jessie at some of Boston's finest restaurants, it is safe to say that I was tough customer. So, when I was at the conference hotel in July I found it lacking in many ways. In fact, after the first night, I canceled the remainder of my reservation in hopes of finding better accommodations.

Now, fast-forward 10 weeks to my more recent experience at that same conference center/ hotel in Gaborone. When we drove onto the conference grounds, I recognized the place, but at the same time, it was completely new. I noticed the manicured trees and the shined furniture. It was the same place I had been before, but my expectations and frame of reference had completely changed. My gut feeling is that this shift is a good thing- being easier to please. So, that's my story of my changing frame of reference- from chagrin to charmed... in 10 weeks.

Princess Marina Hospital

Botswana Harvard Partnership's (BHP) main offices and reference labs are
located on the campus of Princess Marina Hospital near the central
business district of Gaborone. Despite their close proximity, the
relationship between the two entities seems rather distant.

When I first arrived at BHP, I asked if I could tour the nursing wards at
the hospital-- I was especially interested in the maternity wards because
this is the area of the hospital that I am most familiar with. I expected
that one of the doctors from BHP would be able to show me around the
hospital or introduce me to a professional colleague who could do me this
favor.

This expectation was in-congruent with reality. Lacking an informal
opportunity for a tour, the CEO of BHP graciously wrote a letter to the
Superintendent of the hospital describing my credentials and interest in
seeing the hospital wards. (This letter was dated August 13, 2010). Making
a long story short, today, October 12, 2010, I got my tour of the
hospital.

Each of the matrons who showed me around the various wards was extremely
gracious-- and crazily busy. When I arrived in the ante-natal ward, the
head nurse was preparing for the monthly clinical conference where
clinicians discuss maternal deaths-- so I got a chance to see a bit of
their record-keeping and vital statistics systems. The ante-natal ward was
full past capacity, but rather mellow with women resting, eating and
talking on their cell phones in beds and mattresses on the floor.

The delivery ward was quiet, except for one wailing infant under a warmer
in one of the rooms- his mother was in an adjacent room and I couldn't
quite figure out why they were separated. The delivery ward matron
reported to me that the hospital does about 650 deliveries each month-
but the serenity of the delivery ward made me question this estimate. So,
she showed me the delivery book, and sure enough they deliver A LOT of
babies. However, the mothers and babies don't spend much time in the
delivery ward. Women labor in the ante-natal ward and about an hour after delivery, they are transferred with their infants to the post-partum ward.

All of my skepticism about the 650 deliveries per month vanished when I
saw the post-partum ward. There were women and babies and doctors, nurses,
orderlies, everywhere. Beds and mattresses were lined up along the walls
of the ward, on the floor, and in every little nook and cranny-- there was scarcely room to walk. It seemed like total chaos to me. The matron told me that they receive about 20-30 new couplets each day (from the delivery ward) and about 5-6 of those are status post cesarean section. I learned that women have the option of delivering at clinics, but most choose to come to the hospital-- she didn't know why.

One of the most interesting aspects of my hospital experience-- aside from
simply arranging my visit in the first place, was meeting several people
along the way who were asked to wait with me or guide me along from place
to place in the hospital. People are often curious about life in the USA and my impressions of Botswana and the HIV/ AIDS 'situation.'

Pula!

Pula refers to money and water- two very precious resources in Botswana. Here is a picture of the different denominations and examples of how much things cost.

Dinner for two at a restaurant comparable to "Outback Steak House":
P250.00 = $38.00

T-bone steak on special at the grocery store:
P55.00/ kg = $8.31/ kg = $3.78/ lb

Apples:
P16.00/ 1.5 kg = $2.42/ 1.5 kg = $1.09/ lb

Bananas:
P6.96/ kg = $1.05/kg = $0.47/ lb

Small bottle of shampoo:
P25.00 = $3.78

Butter:
P22.00/ 250g = $3.32/ 250g = $5.98/ lb

Milk:
P15.00/ 1 L = $2.27/ L = $8.60/ gal

Petrol:
P6.05/ L = $0.91/ L = $3.45/ gal

Letter to the U.S.A.:
P6.10-P8.00 = $.90 - $1.19

Biscuits!

Baking in Botswana intimidated me enough that it took me almost 2 months to try it out. However, I feared unnecessarily. Above is a tray of my most recent creations- no-bakes and peanut butter biscuits (here, no one says "cookie"). They may not be gourmet, but they have gotten rave reviews from friends, co-workers, house-mates, etc. I made the batches pictured here for the Missions Conference at my church, but when I arrived to help with the Face the Nation brunch (for 150 people), we realized we needed more baked goods, so they were served early.

So what was so intimidating about baking in Botswana? Well, the ingredients are all a bit different- white and brown sugars are coarsely ground (moist, packable brown sugar does not exist, as far as I can tell), good coconut, chocolate chips, and baking soda are hard to find, quantities and temperatures are in metric/ Celsius, and it is SO dry here that things get 'crispy' in a jiffy. Thankfully, the internet had the answers I needed to overcome some of these barriers including tricks like allowing your moist ingredients to soak with the sugars until it dissolves and using AllRecipes.com which converts any recipe to metric with the click of a button. Hooray!