Ready...Set...Update!!

Ok, so I know that I have been SUPER bad at updating over the last couple of weeks so here is an attempted synopsis of some of the exciting, routine, and amazing things that happened in that time.

Trip to Kayanza to assess a community outreach project aimed at increasing prenatal care and deliveries supervised by skilled birth attendants:

This part of the project is just getting underway, and it would appear (to my admittedly immature skill set) that there is a lot more work that could be and should be done with this project.  Here is a picture of me, and a community health worker, interviewing one of the women with whom we spoke that day.  We ended up talking to about 8 women, all of whom had had more than 6 pregnancies each.  Some were 45, and on their 10th pregnancy, and with very little information or access to family planning services. 

In a way, it is great that I have had the opportunity to experience several different activities underway here, each with its own intricacies, strengths and weaknesses.  I was supposed to write an article on this project, like I had done for the positive deviance/mamans lumieres project of muyinga province.  Unfortunately, I had to tell my boss when we got back, that I really felt a lot more follow-up had to be done before we would truly be able to sing the praises of this intervention.  This is certainly true if a 'cause and effect' relationship is to be demonstrated between this outreach and the increasing use of services at the health center.  Tanou (the boss, and luckily for me an M&E guy himself) understood entirely what I meant, and set me upon a new assignment: writing the quarterly report!!  

Here is a picture of the Community Health Worker of Matungo Health Center, charged with educating the community about the importance of pre/post natal care and hospital delivery.  Not sure if this picture does it justice, but I call your attention to his t-shirt.  It reads "FBI: Female Body Inspector".  I wonder if he recognizes the irony of his attire.  Kept me laughing on the hike, I can tell you that much!!  

The hike was pretty good though I will tell you and we got to see some great scenery while we were clambering about.  

Miles and miles of tea farms, interspersed with banana plantations and coffee fields.  

As usual, we gained quite a following out and about, trekking around the hillside.  Not much weirder that watching a white woman hike around in a skirt, particularly in backwoods Burundi.  

Day at the Beach:

Getting back from this trip, I had the weekend to relax before heading back to work.  After a long night on Saturday, I slept away much of Sunday morning, but managed a nice trip to the beach during the afternoon.  Beautiful place, and a lovely place to spend a day with a couple of different clubs and restaurants to go to.  Here are a few pics, worth many thousand words, I'd say :)

Writing the Quarterly Report:

The next big assignment when I got back from up country was to begin work with the M&E specialist writing the quarterly report.  At that point I had indeed only worked for the project for three weeks, so you can imagine the difficulties and frustrations that arose with trying to capture the last three months' worth of activities. Two days, countless phone calls, myriad frustrations, translations, and computations later, a final version emerged with which I was relatively content.  It only took a couple of edits and revisions before Tanou was happy with it too.  Unfortunately, having completed that, I appear to have left myself open for another demanding assigment: the complete rewrite of our family planning/gender based violence work plan...fun fun fun.  But before that: Annik and Ramillo's wedding!!

Annik and Ramillo's wedding:

This is the couple, friends of Diane's, who I had met during my first week here.  Their wedding had finally arrived and I, along with the dress and shoes I had had to buy here, was ready to go!!

The mass was sooooooo long! 

Even for Burundian standards, it was long apparently.  Like, almost 2 hours long.  Then there was the reception, with its 500 guests.  Receptions here are a bit different than in the US, consisting mostly of speeches and gift giving, by all kinds of different people, while family and friends watch on.  There are also the inevitable dancers and/or drummers to celebrate the new couple.  I have to say though, this was a pretty impressive wedding!

That's you caught up until about a week ago.  Will see if I can find some time tomorrow at the office to catch up the rest.  Spending the day at the beach today, enjoying my last weekend here!

A la prochaine,

Amy

xoxo

Bon Appetit

Alrighty, so here it is, the skinny on the food here.  I am finding myself getting tired of traditional fare and my preoccupation with finding alternative food sources and types is largely responsible for this post.  I have been finding more restaurants to go to however, and, with the help of new friends, have been able to deviate slightly from my routine.  Yes I will update you further on what I have been up do for the past week, but this is a little 'taste' (haha, get it?) of my every day life.  

Throughout Burundi, Brochettes, are a local delicacy and seem to have garnered as much community adoration as the Tambouriers (what I thought was Burundi's only claim to fame).  These meats on a stick come in the goat, beef, chicken, fish and sausage variety, although true nature of the meat is sometimes questionable.  In all honesty, these are pretty yummy, although eating what is basically a kebab every night can get a bit tiring.  Other than this, people eat a lot of eggs and peanuts, available for very little from street vendors throughout the city.  Coming soon to a car window near you.....

Here are a few ideas to give you an idea of our typical lunch:  

I usually go to a nearby restaurant with Raissa, or alternatively, we sometimes have Violette, our office assistant go for take-out. Regardless of where we eat, the food remains relatively the same.  Rice (also sometimes called pilau if it has yummy spices in it, peas, and bananas (the savory kind, which are super delicious) are often on the menu. 

Also, variation on the same theme: 

pilau with a leafy vegetable/manioc mix known as linga linga.  The manioc is pretty much for texture and to give the linga linga a bit more substance.  In all, it looks like sloppy canned spinach, but I really like it!!!

Beignets:  A food that is probably not too far fetched if you have been to New Orleans, or other former French colonies.  These are amazing as a snack and are pretty much African donuts.   We have these with tea, as a frequent afternoon treat.  

Lastly, a Burundian classic: Bugali.  Not to be confused with Ugali, found in other regions of East Africa, Bugali is made from Manioc rather than from wheat flour.  I don't particularly like this difference, as the manioc gives a bit of a weird aftertaste to the whole experience.  If you have never had Ugali/Bugali before, just eating it is a process.  The actual Bugali, the beige colored mound in the middle, is really elastic and you have to separate a lump of if, roll it into a ball and then use it as a sort of spoon (think Tosito's Scoop Chips) to eat the sauce (aptly named, sauce) and linga linga.  The other stuff...fine...bugali...not so much...

Other than these few things, I buy a lot of fresh fruit: papayas, pineapples, bananas, marachuja (no idea how to describe this), passion fruit, and, of course, avocados as big as my head. 

 On a final note, the French word avocat means both avocado and lawyer...food for thought?

Laissez les bons temps rouler...

Things are picking up here and getting quite busy!  I am learning a lot about both the administration of public health in resource poor settings, but also much about office politics; both are experiences that will no doubt serve me well wherever I end up working in the future!!

  Last week I week I was given my first actual assignment, something that I am working on finalizing today.  I went up to Muyinga, the province that is closest to the Tanzania border, and also at the highest elevation in Burundi.  There, I was charged with assessing and reporting on the process of a MCH nutrition project that has been in place for 4 months now.  The Mama Lumière project identifies indigenous helpers within the community - women who have demonstrated a capacity to raise well-nourished children.  These women are trained and are then charged with training other mothers within their community.  Over an initial 12-day training, they learn basics of nutrition, i.e. the 3 (yes, 3 here) food groups, basic food safety and general hygiene.  After that, they meet about once a month to review and cement the things they have previously learned.

  Of course, none of these meetings take the shape of what we might consider educational meetings in the US.  In fact, I have to say, the Burundians really know how to run a meeting! They internalize their lessons through a combination of song and dance that are a pleasure to both watch and participate in.  You can truly see the joy on the women’s faces as they recall what they have been taught; pride that comes not only from having learned and remembered information that will help their children, but also because of the growing bellies and happy faces of those children themselves.  How they mnage to dance with their children on their backs, I have no idea.  

So now, I am charged with writing a compelling article to demonstrate both of these things, to show the success of the project in pounds, confidence, and healthy years gained.  

Overall the trip was great: 

I got to carry a baby on my back, a nerve-wracking but surprisingly secure means of carrying one’s young ... 

... I danced (a lot) with the mothers, a move that gained me some street cred with the group...

... and also got to go to the Tanzanian border:

 Although I will be back there in just over three weeks, it was still pretty cool to be at the border between Anglophone Tanzania and Francophone Burundi.  Perhaps the most interesting, and laughable part of that experience was the transition that takes place at the border, from driving on the left in Tanzania, as per English tradition, to driving on the right in Burundi, as is done in France.  

This is not, however, facilitated in any organized manner, and the signs are in the language of the country you are going to, which doesn’t really help if you don’t (as many don’t) speak English or French.  Let’s just be thankful it isn’t a very heavily traveled road…and remember that sometimes we just need to shake our heads and laugh.

This weekend was the busiest one yet, and hard to believe sometimes that I had so much time on my hands at the beginning of my time here.  On Thursday night, I went with my boss, Tanou, to an Independence Day party at the US embassy, albeit a little early.  Pretty low-key event and not much to report, except that, of course, I was asked to rub elbows with some of the higher-ups in the US government and USAID staff here.  Then, on Friday and Saturday I went out in the evening with some people from work and had a great time, except for the mosquitoes and really late nights!!  

Raissa and I at a really cute outdoor bar with a stage, band, and billiards to boot!

Below find a picture of a sign posted at the club we went to afterwards, right in the entry way no less.  I have no idea, really what this means, but apparently this is the kind of place where whatever he says, goes, ladies!   HILARIOUS....

Also, a highlight of this weekend, was the manicure/pedicure date that my new friend, Claudine, and I had this weekend.  I know I am supposed to be roughing it, but come on, a 2-hour manicure/pedicure for less than $10?  Yes please!!  Also got to go over to Tanou’s house to watch both Wimbledon finals, a welcome break from my usual fare of CNN, CNN, and more CNN.  The William’s sisters rather lack-luster match was more than made up for today by the nail-biting, albeit heart-wrenching men’s final between Federer and Roddick.  All in all a rather patriotic weekend, as I celebrated Independence Day and watched the Williams sisters and Roddick at Wimbeldon. 

This week is shaping up to be a relatively busy one.  I have been pegged as the local translation service, so no doubt there will be more of that, as well as finishing this article for the USAID website.  On Wednesday, I am going up-country again to begin work on my next article, on a project looking at advanced strategies for antenatal care.  

If you are confused by what that means exactly, you are not alone, and I will be sure to fill you in as soon as I understand what exactly I am doing there.  My neighbors, Lillian and Josh (whose wedding I went to last weekend, and are pictured here) are moving out on the 8^th as he returns to the US and she awaits her visa and can join him there.  Looks like things might quite down around the apartment, but they are picking up elsewhere, with more people to hang out with and places to go.  

All in all, having a great time here so far.  Have found a couple of places to go and eat that are close to my house, so I don't have to walk around much alone at night.  Safety was the first thing I was concerned about when I found out I was going to be coming to Burundi, but I have to say, it is like any other place in the world that you travel too: you just have to be careful and mind what you do and where you go.  There are very few reminders of the civil war, and most people are very friendly, even to the strange mzungu, for there aren't a whole lot of us here!

Lots of love, until next time....

xoxo

Gone Country

Hey all!!

Sorry it has been so long since my last post, but work has been picking up and the project has been sending me all kinds of places and giving me lots to do.  Last week, I went on a trip up-country, and am set to go on another this week, leaving tomorrow.  Here is a picture of me in the office, to prove that I am actually working here:

When the staff is not in the office, which is quite a lot of the time, they are out on field visits. Most of the real work takes place in the rural areas, as opposed to in the capital city of Bujumbura. This makes sense as, the project is called ESD: Extended Service Delivery. The idea is to extend services to people and regions in need.  This means ensuring quality training of staff, adequate provision of equipment, and access to necessary resources such as water and electricity. As you can imagine, this is much easier said than done. 

Last week I was in Kayanza province, which is located about an hour and a half away from Bujumbura, along a curvy mountain road.  There are no paved exits from the road, and it goes from Bujumbura all the way to Rwanda.  

It is amazing how well kept the road is, but I suppose if it is the major transportation route for commercial and government use, it has to be.  I was also shocked by just how green and mountainous the countryside is.  The capital sits in a valley, on the border of the lake, but the rest of the countryside slopes up and away from the capital, thus the term ‘going up-country’.  

 

 

 

Something we saw quite a bit which was funny, but also ridiculously dangerous, is the way many people manage to travel up-country and back.  These men will grab hold of the back of a semi truck, sitting on their bikes, and cruise up hill.  All fine and dandy (I suppose) at a leisurely pace, but the speed of some of these trucks as they go up the hill, it is a wonder that more people aren't flung into oncoming traffic.  We had a couple of close calls on our way up; pretty sure that this picture is my submission for next year's photo contest at the public health school:  What not to do!

Kayanza is an extremely poor (to be fair, more rural areas are in dire straits here) region of the country, where Maternal and Child Health services are far from adequate.  We visited the Kayanza provincial hospital, which serves as a major center for the province.  People are referred here for all conditions that cannot be treated at local health centers, and there is a surgical center, AIDS treatment clinic, and Urgent Care unit.  However, these facilities are far from what we would deem acceptable in the US, and the hospital must operate daily under quite extreme conditions.  There is only one doctor for the entire hospital, who must therefore serve as Medical Director, as well as performing all necessary surgeries and procedures that call for her expertise.  Yes, I said her.  Amazing to see, in this type of patriarchal society, a woman who has managed to achieve so much educational and professional success.  She and I talked at length about differences and similarities in the attitudes of our respective nations regarding women in the workplace.  (Incidentally she also invited me to her wedding, which will be in Bujumbura this July, making it 2 invitations for me thus far!!)  Most of the work is done by ‘nurses’ whose training may be anywhere from that of an NP to a CNA in the US.  Beyond staffing difficulties, there are frequent power outages and the back up generator is in disrepair, there is no running water and standing water is far from guaranteed on a daily basis, the demand for resources like disinfectant and cotton swabs frequently exceeds the supply, there are frequently 2 or 3 patients to a bed, and more still sleeping in the hallways for lack of space, and the one vehicle the hospital can use is in need of new tires and a supply of petrol that is neither easy to procure, nor cheap.  It is amazing that any quality medical care can be delivered given the circumstances.   But they manage it.  And they do the best with what they have. 

We were there to administer a training of a quality improvement strategy known as COPE, which focuses on improving the quality of services through client satisfaction and fulfilling providers’ needs.  Here is a shot of Charlotte (the Head of Pediatrics and Internal Medicine) leading the workshop:

The staff had a lot to say and it was great to see them come up with ways in which they could each take responsibility for ameliorating some of these dire conditions without assuming that responsibility lies in the office of the director.  It was an enlightening experience for me, although I found that I, as the strange white woman, was sometimes an inadvertent distraction to the process.  

Pictured from left to right:

Charlotte (Head of Pediatrics and Internal Medicine)

You know who

Lea (Head of Maternity)

Dr. Pascal (employee of MSH who is instrumental here)

On returning to Buja (as the locals call it) I went back to work in the office and had a meeting to discover more of what I would be doing over the course of the next week or two.  The meeting was a little intimidating, but it was great to see the boss hold everyone to account and ascertain what the will be doing this week.  

Also (!!!!!) got to move into my new apartment! Wooo hoooo.

Pros of new apartment:

·      TV (and satellite to boot!)

• Little living room and larger bedroom.  Can relax a bit, even put my clothes away in the closet!
• Really nice neighbors!  The man is from the US, and the woman is Burundian.  I went to their wedding this weekend! (that makes it 3 that I will attend so far!!)
• Little refrigerator and hot plate; I can have tea and keep some food for breakfast etc…
• Safe and secure neighborhood, closer to town, with more people around.
• Someone comes to clean and change the sheets…nice to not have to do it myself.
• I have a pet!! Lizzie the Lizard, a tiny little gecko, who likes to hang out on the table in the living room.

Cons of new apartment:

• Satellite can only access one channel (CNN) – I suppose this is better than some French melodrama (yes, I watched even that at times)
• Shower gets only cold water brrrrrrrr
• Electricity turns off between midnight and 6 am, rendering little fridge somewhat useless for keeping perishables. 
• Lizzie died….the life of a gecko is short but sweet I suppose...

Phewwwww....what an update.  Hopefully I will be able to be on here a little more regularly this week to update as I go.  This week is bound to be a busy one: I have a meeting today with project-funder USAID and the US embassy to discuss my stay and work here; I leave tomorrow to Muyinga (another province) to complete an assignment on the MCH nutrition project being conducted there; Thursday is the US embassy’s 4^th of July celebration (why Thursday, I have no idea) which my boss has requested I attend with him; finally, I have to have the write up for the Muyinga project done by the end of the week.  This week is very much an instance of them wanting things done yesterday, a nice change of pace from the laid-back attitude of last week, but a little stressful nonetheless.  

Thanks for your interest in what I am doing here, I love hearing from all of you and will try to post more when I can.  

A la prochaine fois,

Amy

xoxo

I found them...the other foreigners that is...

To the left is the view from my apartment.  The hills you see are part of the countryside. Everything outside of Bujumbura appears to slope upwards and away into the countryside.

Good news of the day: I discovered where all of the other foreigners have been hiding!! Last night, after hours of trying to quell my boredom, Raissa (the woman who is coordinating the details of my visit here) and her son Jason (who is super cute) retrieved me from my hotel and took me out and about for a little bit.  I got to change some more money, buy more credits for my phone (amazing how quickly it eats those things up) and went with her to the beach.  Now, remember that Burundi is landlocked, so I am talking here about the beach on Lake Tanganiyka, although by its size, it might as well be the sea.  Burundi shares its Eastern

 border with the Lake, and capital Bujumbura, where I will mostly be working sits right on it.  Really happy to have gotten up and out of the house a bit and get to see the water, and also to discover where Burundi has been hiding all of its foreign visitors.  

At at work today for my first day and ready to get stuck in.  It looks like I will be working quite a bit with a new project that is being developed, on Family Planning.  There isn't much of a program here and so they are trying to institute something that will work in both the city and up-country, in more remote, rural areas.  The details are as yet unclear, but it looks like I will be involved in evaluating the potential for this type of program as well as planning what the program would look like (hello formative evaluation!).  The final report will have to be written in both English and in French, so they would like for me to be the primary author of the English report, and to work closely with a colleague who will be writing the one in French.  I am excited to see how things unfold and to learn more about what the project entails. 

First weekend here...

First things first: my bag has arrived!! So for all of you who were worrying about me, losing sleep over whether or not I had my shampoo, favorite t-shirt, and economics book, worry not. I am now bathed, clothed and, yes, forcing myself to learn introductory economics. Well, the last part, not so much, but definitely the rest! And just to appease your fears, Momma, yes I did pack extra underwear in my pack, so I was not completely without yesterday.

Last night I went out with one of the women I met at work, named Diane. I was sitting in my room, having woken up from a 2 hour jet-lag induced nap, when the front-desk dude (more on him later) came upstairs to let me know that there was someone there to visit me. Clearly, I wasn't expecting anyone, but there she was, a visitor!! She invited me to come out with some friends of hers so that I could see the town at night and get out of my room a bit. Of course I jumped on the invitation; as all of you can probably guess, I don't do particularly well alone without other humans for very long. First we went to the future home of two friends who are going to be married in July, and then on to the bar! Only coca-cola for me, but I did eat the local special - beef on a stick served on a bed of bananas. Was pretty good to tell you the truth and I am not paying for it today (knock on wood). I had a great time and discovered half way through that about half of them spoke English to some degree, however don't think that they let up, because they were definitely still making me speak French with them. On that note, speaking French all of the time is tiring! You forget how easy it is to think and speak in your native language and it really takes effort to speak (and think) in French all of the time. I have started a vocab list in my journal to try and remember the words that I would like to have used and their translations (thank you Webster's pocket dictionary!) We hung out there for a while and then came home relatively early (around 11 or so). An extra special moment: I was invited to the wedding of two of the people there! It will be in July and will be AMAZING to get to go to a real Burundian wedding - whatever will I wear? :)

I promised you more on front desk dude: I have been talking to him quite a bit, mostly because there do not appear to be any other guests at my hotel. I am told that they are there and that all of the rooms are occupied, but you rarely see anyone coming and going. Also, the 'hotel' appears to be more of a missionary hostel, so I am getting a lot of questions and invitations to church (hence the reason that I have been holed up in my room and at the internet cafe all day). On that note, the connection here is really cheap! It is 10F (10 Burundian Francs) per minute. So...to translate...if I spent an hour on here, and wracked up a bill of 600F, I would pay about 55 cents for the time. Not half bad! Anyway, this front desk dude seemed nice at first, then as he appeared to get more comfortable with me, the barrage of questions began. He wanted to know about my religion, my marital status, my relationship status, and that is when I had to put a stop to things. Sure, it is nice to have someone to talk to, but this guy is just weird! Unfortunately, I feel that I may have opened pandora's box and found myself a buddy whe all I want to do is read my book.

Before I go, I would like to mention that I have never been more aware of the color of my skin. In Tanzania, I was travelling with other wazungu (the Swahili word for foreigners or white people) and so perhaps didn't notice being looked at like I didn't belong. However, I am very aware of the looks I am getting here. Most can be appeased with a smile or a simple 'Bonjour', the people here are so friendly and helpful, but I am still aware of being very different. Since I have been here, I have seen 5 other white people (seen mind you, not met) and all have been men. Are the other wazungu hiding out somewhere? Maybe there just aren't that many here at all...I dunno.

All in all, the experience is shaping up to be amazing. I am supposed to be moving hotels soon (the one I am at is for short stays only) and there are supposed to be more people around at the next. Also, tomorrow I begin work and will be making trips à l'intérieure, or up-country, to see the project in action, which I am really excited for....

Last thing: I have a phone!! My number is: + 257 797 88 463. Please give me a call if you'd like (skype is relatively cheap I think), just remember that I am 9 hours ahead for you Californians, and 6 hours ahead for those of you on the East Coast.

A la prochaine fois (until next time)
Amy xoxo

Je me suis arrivee!

Got in last night, safe and sound, and am excited to say that I am finally in Burundi. At the office right now as our boss, Tanou, is going 'up-country' (meaning anywhere but capital city Bujumbura) on Monday, so wanted to meet me today. I am getting right into the swing of things and feel like I am actually going to be helpful with a lot of the projects that they have in mind. Also, French is kicking in and coming back to me, and I can already tell that most of the communitcation will be in French, which is precisely what I was hoping for.

Unfortunately, the one downer so far is that my suitcase hasn't made it. I am not thoroughly surprised as the woman who checked me in in Boston told me that there was a slight issue with my ticketting whereby it appeared that I wasn't booked all the way through to Bujumbura. She seemed to have been able to remedy things, and clearly I got here ok, but apprently my bag didn't quite follow the same instructions. Heading to the airport in a bit to see what can be done. Filled out a declaration last night, so they should be trying to wrangle it in from Nairobi. As my boss said (albeit in French) "sometimes you just have to find someone and put a pistol to his head". I'll keep that in mind.....